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OBJECTIVES: Primary focused question for this systematic review (SR) was "Which is the evidence about surfaces decontamination and protection masks for SARS-Cov-2 in dental practice?" Secondary question was "Which is the evidence about surfaces decontamination and protection masks against airborne pathogens and directly transmitted viral pathogens causing respiratory infections?" MATERIALS AND METHODS: PRISMA guidelines were used. Studies on surface decontamination and protective masks for SARS-CoV-2 in dental practice were considered. Studies on other respiratory viruses were considered for the secondary question. RESULTS: No studies are available for SARS-CoV-2. Four studies on surface disinfection against respiratory viruses were included. Ethanol 70% and sodium hypochlorite 0,5% seem to be effective in reducing infectivity by > 3log TCID. Four RCTs compared different types of masks on HCW. The single studies reported no difference for laboratory-diagnosed influenza, laboratory-diagnosed respiratory infection, and influenza-like illness. A meta-analysis was not considered appropriate. CONCLUSIONS: There is lack of evidence on the efficacy of surface disinfection and protective masks to reduce the spread of SARS-CoV-2 or other respiratory viruses in dentistry. However, the consistent use of respirator and routine surface disinfection is strongly suggested. There is urgent need of data on the efficacy of specific protection protocols for dental HCW against viral infections.
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COVID-19 , Influenza Humana , Dispositivos de Proteção Respiratória , Infecções Respiratórias , Viroses , Humanos , SARS-CoV-2 , Máscaras , COVID-19/prevenção & controle , Desinfecção/métodosRESUMO
Current evidence suggests that SARS-CoV-2, the virus that causes COVID-19, is predominantly spread from person to person. Aim of this narrative review is to explore transmission modality of SARS-CoV-2 to provide appropriate advice to stakeholders, in order to support the implementation of effective public health measures and protect healthcare workers that primary face the disease. "In vivo" and "in vitro" studies from laboratories and hospitals confirmed the presence of surface contamination and provided insight of SARS-CoV-2 detection in the air, particularly in indoor settings with poor ventilation where aerosol-generating procedures were performed. Measures for aerosol reduction, in conjunction with other effective infection control strategies, are needed to prevent the spread of SARS-CoV-2 in dental setting.
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COVID-19 , Aerossóis , Pessoal de Saúde , Humanos , Saúde Pública , SARS-CoV-2RESUMO
The present study aims to investigate clinical and patient-centered outcomes after the implant-supported rehabilitation of narrow ridges using a novel wedge-shaped implant. Forty-four patients were treated with the insertion of 59 tissue-level wedge implants (1.8 mm bucco-lingual width) in horizontally atrophic ridges (mean bone width 3.8 ± 0.4 mm). The main outcome measures were: implant stability quotient (ISQ), marginal bone loss (MBL) and patient morbidity. Fifty-eight implants were functioning satisfactorily after one year of loading (98.3% survival rate). ISQ values measured in the mesio-distal direction resulted significantly higher than those in the bucco-lingual direction at all time points (p < 0.001). Both mesio-distal and bucco-lingual ISQ values at 6-month follow-up resulted significantly higher than at 4-month follow-up (p < 0.001 for both). Mean MBL was 0.38 ± 0.48 mm at prosthesis delivery (6 months after implant insertion) and 0.60 ± 0.52 mm after one year of functional loading. The majority of patients reported slight discomfort related to the surgical procedure. Postoperative pain score was classified as mild pain on the day of surgery and the first postoperative day and no pain over the following five days. Within the limitations of the present study, the device investigated showed low morbidity and positive short-term clinical results in narrow ridges treatment.
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BACKGROUND: The thickness of the soft tissues around dental implants is crucial for both the preservation of the marginal bone and esthetic profile. Many authors have showed the thickened soft tissues favor a better peri-implant bone stability; however, different thickening techniques can be used for this aim. METHODS: Forty-seven patients were enrolled in this study, each one had one implant included in this analysis. According to the thickening procedure, patients were assigned into group A (porcine dermal matrix, n = 24) or B (healing abutment used as tenting screw to sustain the soft tissues, n = 23), soft tissue thickness was measured after flap elevation in a standardized way. Six months after implant placement, implants were uncovered and soft tissue thickness measured again. RESULTS: At second stage, 6 months after implant placement, the mean vertical thickness was 3.01 ± 0.58 mm in group A and 2.25 ± 0.53 mm in group B. The difference between the two groups at 6 months was significant (P < 0.001). The mean vertical gain in group A was 1.33 ± 0.71 mm, whereas it was 0.43 ± 0.55 mm in group B. This difference was also statistically significant (P < 0.001). CONCLUSION: The use of a healing abutment for "tenting effect" has limited efficacy to obtain a significant increase in soft tissue thickness. The use of a porcine dermal matrix at time of implant placement is effective to thicken peri-implant tissues.
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PURPOSE: No information is available on the perception of the quality of care in patients treated for periodontitis. The purpose of this article was to assess how periodontitis-affected patients perceive the quality of periodontal treatment (PT) and to measure the factors which may influence it. MATERIALS AND METHODS: 306 subjects who completed PT were invited to participate. Questionnaires and visual analogic scales (VAS) evaluating perception of quality of care, symptoms, and oral health related quality of life (OHRQoL) were handed out. Oral and periodontal indicators were collected before and after treatment. The impact of different factors on perception of quality was assessed with a regression model. RESULTS: Quality evaluation was high yet unrelated for both patients and clinicians (p = 0.983). Quality was negatively influenced by the number of residual oral infections (p < 0.001), patient's age (p = 0.07) and presence of residual pain at completion of PT (p = 0.02). Professionalism, kindness of the staff and communication skills were the characteristics mostly appreciated. The OHRQoL was influenced by the number of residual teeth (p < 0.001), increasing age of patients (p = 0.08), number of residual infections (p < 0.01) and pain (p = 0.04). CONCLUSIONS: Patients' quality perception appeared to be influenced by clinical and emotional aspects. Oral care providers should be aware of the impact of non-clinical factors in patients' appreciation of quality of treatment.
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Saúde Bucal , Periodontite , Assistência Odontológica , Humanos , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
The presence of vital bone after maxillary sinus augmentation is crucial to enhance the quality of bone-implant interface, ensuring predictable long-term results. The aims of this RCT with split-mouth design were the histologic and histomorphometric comparison of two different biomaterials in sinus elevation after 6 months of healing and the evaluation of the clinical outcomes of implants inserted in the augmented areas after 12 months of prosthetic loading. Twenty-eight patients (10 females, 18 males) were treated with bilateral sinus floor elevation with lateral approach. Pure sintered nanohydroxyapatite (NHA) and anorganic bovine bone (ABB) were used as test and active control, respectively. After six months, 52 bone biopsies were harvested from 26 patients, and 107 implants were inserted in the augmented areas. Histomorphometry showed that, in the two groups, vital bone percentages were 34.9 ± 15% (NHA) and 38.5 ± 17% (ABB) (p = 0.428), marrow spaces percentages were 44.5 ± 18% (NHA) and 43.5 ± 23% (ABB) (p = 0.866), and residual graft percentages were 20.6 ± 13% (NHA) and 22.3 ± 12% (ABB) (p = 0.638). After 6 months of healing, no statistically significant difference was present in histomorphometric outcomes between NHA and ABB groups. Implant survival rate in NHA group after 12 months of loading was 96.4%, showing no statistically significant differences with ABB group.
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Substitutos Ósseos/uso terapêutico , Durapatita/uso terapêutico , Xenoenxertos/transplante , Maxila/cirurgia , Nanopartículas/uso terapêutico , Levantamento do Assoalho do Seio Maxilar , Adulto , Idoso , Animais , Bovinos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Levantamento do Assoalho do Seio Maxilar/efeitos adversos , Levantamento do Assoalho do Seio Maxilar/métodos , Levantamento do Assoalho do Seio Maxilar/estatística & dados numéricos , Resultado do TratamentoRESUMO
PURPOSE: To evaluate the influence of cigarette smoking on the survival of dental implants with a retrospective observational study of 5 years. MATERIALS AND METHODS: A total of 1727 consecutively treated patients at four private practices were divided into non-smokers (NS group, 1178 patients) and smokers (S group; 549 patients) according to what they declared prior to implant placement. Non-smokers received 4460 implants and 2583 implant-supported prostheses, whereas smokers received 2260 implants and 1292 implant supported prostheses. Various implant systems and procedures were used. Outcome measures were prosthesis and implant survival. RESULTS: Over the 5 years after loading, 159 (17%) non-smokers and 91 (13%) smokers were lost to follow-up; 20 (0.9%) prostheses could not be placed or failed in 15 non-smokers and 12 prostheses (1.2%) could not be placed or failed in 12 smokers. One hundred and twelve (2.9%) implants failed in 105 non-smokers and 107 (5.5%) implants failed in 75 smokers. Most of the implant failures (90%) occurred before implant loading. Fitting a logistic regression for early implant failures and total implant failures, taking into account the clustering of implants in patients, there were no statistically significant differences for prosthesis failures (P value not calculated as too few failures) and early implant failures between the two groups (P = 0.13). However, when considering all implant failures up to 5 years after loading, significantly more failures (5.5%) occurred in smokers compared with non-smokers (2.9%) (OR 1.72; 95% CI 1.20 to 2.50; P = 0.003). CONCLUSIONS: Due to the retrospective nature of this study, conclusions have to be interpreted with caution. Five years after loading, smokers experienced almost twice as many implant failures compared with non-smokers. Non-statistically significant trends in favour of non-smokers were observed for early implant failures and prosthesis failures.
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Implantes Dentários , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Fumar/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibioticoprofilaxia , Estudos de Coortes , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Feminino , Seguimentos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Observação , Índice Periodontal , Periodontite/terapia , Prognóstico , Estudos Retrospectivos , Adulto JovemRESUMO
AIM: To evaluate the outcome of dental implants placed in patients with a history of periodontitis. Patients with no or mild history of periodontitis served as controls. MATERIALS AND METHODS: A total of 1727 patients were consecutively treated in four private practices. Patients were divided into three groups according to their initial periodontal conditions assessed with a modified periodontal screening and recording (PSR) index: 630 patients were in the severe periodontitis (SP) group, 839 in the moderate periodontitis (MP) group, and 258 had no periodontitis (NP). Patients requiring periodontal treatment were treated prior to implantation. Various implant systems and procedures were used. In total, 3260 implants and 1707 implant-supported prostheses were placed in the SP group, 2813 implants and 1744 implant-supported prostheses in the MP group, and 647 implants and 424 implant-supported prostheses in the NP group. Mixed implanttooth supported prostheses (98 prostheses in 89 patients) were not considered. Outcome measures were prosthesis and implant survival. RESULTS: Two-hundred and fifty patients were lost to follow-up 5 years after loading. Regarding prosthesis failures, 13 prostheses could not be placed or failed in 13 patients of the SP group (0.8%), 11 prostheses could not be placed or failed in 9 patients of the MP group (0.7%), and 3 prostheses failed in 3 patients of the NP group (0.9%). For implant failures, 130 (4.5%) implants failed in the SP group, 74 (3.1%) implants failed in the MP group, and 15 (3.0%) implants failed in the NP group. Most of the implant failures (90%) occurred before implant loading. Fitting a logistic regression for early implant failures and total implant failures, taking into account the clustering of implants in patients, there were no statistically significant differences between the three PSR groups (P > 0.05). CONCLUSIONS: Owing to the retrospective nature of this study, conclusions need to be interpreted with caution. A previous history of periodontal disease may not have a significant impact on implant failures up to 5 years after loading.