Evaluation of pain, swelling and trismus after extraction of impacted third molars relative to the use of betamethasone in submucusal infiltration.

The aim of this study was to evaluate the anti-inflammatory effect of a single 4 mg injection of submucosal betamethasone after extraction of impacted third molars. Single-centre, single-blinded, parallel group study; Forty-three patients were submitted to impacted third molar extraction. In this study, 4 mg single-dose submucosal betamethasone was injected in the interventional group, while in the control group nothing was injected. Postoperative measurement included pain via the VAS scale, swelling and trismus with facial measurements and maximum mouth openings, and finally nerve sensitivity. There was a significant difference between the two groups regarding trismic pain and edema. The use of a single 4 mg submucosal betamethasone injection leads to a reduction of oedema, trismus and pain in patients undergoing impacted third molar extraction. .

Tooth agenesis: part 2. Orthodontic treatment and prosthetic possibilities.

Dental agenesis has a great clinical significance due to its frequency during daily practice and the therapeutic problems that can arise from it. This paper will explore all the aspects to consider in order creating a proper multidisciplinary treatment plan: in particular, orthodontic, prosthetic and implantologic therapeutic alternatives are described for the rehabilitation of the different areas of the dental arches. In fact, dental agenesis is a problem that often requires the intervention of specialists from the different fields of dentistry and its treatment must meet aesthetics needs, stomatognathic function and patient satisfaction.

Bi-layered collagen nano-structured membrane prototype collagen matrix CM-10826 for oral soft tissue regeneration: an in vivo ultrastructural study on 13 patients.

A new developed collagen matrix CM-10826 (CM) of porcine origin designed to be used as oral soft tissue substitute was investigated before and after implantation by light microscopy (LM), scanning electron microscopy (SEM), and transmission electron microscopy (TEM). In a case series biopsy specimens were harvested from thirteen patients at 10, 20, 30, 43 days after abutment surgery for uncovering dental implants. The in vivo histological evaluations of each patient were performed via micro-coring of newly formed oral mucosa in the area covered by CM (test side) or left uncovered (control). Results showed that CM can be integrated in connective and epithelial tissues within 10 days, can be completely resorbed within 20 days and it is able to reduce inflammatory infiltrates and to stimulate both fibroblast/epithelial cell proliferation and neo-angiogenesis. Generally it seems to be superior in promoting soft tissue healing compared to that induced by secondary intention healing. Furthermore, it is able to act as a scaffold for soft-tissue regeneration, allowing the proliferation of keratinocytes from the wound edges and favoring neovascularization and growth of connective tissue in the mesh of porous layer. It appears that a CM might function in oral surgery as a substitute for autologous grafts and to avoid secondary intention healing in soft tissue defects.

Guidelines for achieving the best implants survival rates in the rehabilitation of the atrophic posterior maxilla.

The first option in the rehabilitation of the posterior atrophic maxilla is the sinus lift. The aim of this study is to highlight the characteristics that a sinus lift should have to maximize the subsequent implant survival rate. 33 systematic reviews regarding sinus lift procedures, implants success and survival rates were identified through scientific archives and analysed. The obtained results indicated that a heterogeneity of sinus lift procedures are described in the literature. The sinus lift should be performed through the apposition of particulate xenograft materials, in at least 4mm residual bone. Implants should have a rough surface and the patient should be non-smoker.

Agenesis: pilot case report by 2.9 mm implant.

The agenesis of the upper lateral incisor is one of the most frequent aesthetic-functional problems in dentistry. The reported case concerns a 49 years old male patient with bilateral agenesis of teeth 1.2-2.2 and a root stump of tooth 5.2 temporarily rehabilitated through a Maryland bridge. Without orthodontic treatment, the only solution for implant-prosthetic rehabilitation of tooth 1.2 results therefore in the use of a 2.9 mm diameter implant. The clinical and radiographic control of the implant and the gingival stability at a distance of 1 year gives a positive result both clinically and radiographically. The use of the implant with a 2.9 mm diameter is therefore indicated in extreme cases of limited bone availability.

Piezoelectric surgery inserts vs conventional burst: a clinical investigation.

Piezosurgery is a new technique that can be used to cut mineralized structures without damaging adjacent soft tissues. This device has a lot of advantages: reduced surgical time, blood loss, and inferior alveolar nerve injury in bimaxillary osteotomy. Fifty patients underwent different surgical operations (orthognathic surgery, traumatic surgery, reconstructive surgery, aesthetic procedures) with 7 different kind of piezosurgery inserts in a period of 8 months. The same two surgeons performed all the procedures. All the procedures were carried out in order to improve the precision of the osteotomy and the comfort of the surgeon. Piezoelectric devices provide an innovative ultrasonic technique for safe and effective osteotomy compared with methods that use rotating instruments. Different inserts have been developed in order to achieve the utmost advantages.

Effect of dental care on the oral health of Sjögren’s syndrome patients.

Sjögren’s syndrome (SS) is a chronic, systemic autoimmune disease affecting the exocrine glands, particularly the salivary and lacrimal glands. Xerostomia is a major feature of this syndrome and greatly affects patient quality of life. The most typical clinical signs associated with hyposalivation are dysgeusia and dysosmia, dental caries, candidiasis, periodontal disease, gland inflammation, mucositis and oral ulcers. The aims are to investigate on Plaque Index (PI) and Gingival Index (GI) before and after dental care of SS patients. Fifty-two consecutive patients (mean age 48.9±2 years) were analysed. At T0, (baseline) T1 (3 months after T0) and T2 (6 months after T0), a Plaque Index and a Gingival Index were calculated. The statistical analysis was performed using one-way ANOVA test. If distribution was not normal, Friedman test was chosen instead of ANOVA. Dunn’s multiple comparison procedure was performed as post-hoc (IBM SPSS Statistics 21 software). A statistically significant decrease was observed both in PI and in GI between T0 and T1, T1 and T2, T0 and T2 (P less than 0.05).

Iatrogenic traumatic optic neuropathy: report of an injury occurring during a choanal atresia correction surgery treatment.

We report the case of a 36-year-old adult male patient who came to our attention for the evaluation of a possible iatrogenic injury suffered during the surgical correction of congenital choanal atresia. This case report retraces the patient's medical history and the events lapsed in the peri-operative time analyzing if any malpractice has occurred in causing the amaurosis.