Guided sinus lift: virtual planning of surgical templates for lateral access.

The sinus lift with lateral approach is a regenerative technique nowadays considered predictable to increase the height of bone in the atrophic posterior maxilla. Knowledge of sinus anatomy and evaluation of risk factors are the basis of regenerative and rehabilitative surgical success. The positioning and size of the lateral antrostomy represent critical factors in the execution of regenerative surgery, due to the difficulty in transferring radiological information to the lateral wall of the maxillary sinus even for skilled surgeons. The knowhow of guided implant surgery in recent years is also finding use in planning and precisely delineating the lateral access to the maxillary sinus using CBCT imaging and dimensional reconstruction software, through the realization of surgical guides with 3D printing, as shown in the presented case.

Critical investigation of the pre-surgical anatomic factors that influence the aesthetic result in post-extractive implantology and immediate prosthetic.

The aesthetic goals of implant dentistry should be similar to those of conventional prostheses. In implant-prosthetic rehabilitations of the anterior sectors, the quantity and quality of hard and soft tissue play a fundamental role in achieving the desired aesthetics and in integrating the restoration in a complete and harmonious way into the existing anterior dentition. Post-extraction implantology is a treatment option for implant therapy after the extraction of a single tooth in the anterior jaw. This article presents some key factors to analyze and follow in order to achieve a predictable and acceptable aesthetic result. The creation of a predictable peri-implant aesthetics requires adequate preservation of the bone and soft tissues around the teeth that will be extracted and a correct positioning of the 3D implant. Furthermore, aesthetic success requires the creation of a correct transmucosal path, during the provisional prosthetic phases, which must be replicated and maintained with the definitive crowns.

Endodontic retreatment and bioceramics: A case report.

The success rate in endodontic retreatment can be significantly boosted by using materials that guarantee both intimate adhesion to the canal walls and long-term stability. Bioceramic cements used in root filling show interesting properties including extraordinary sealing capacities, antimicrobial activity that stimulates periapical healing and the continuous production of hydroxyopathitis for a long time. This case report deals with the application of bioceramic cement in endodontic retreatment. The Bioroot RCS (Septodont), thanks to its ability to firmly adhere both to the gutta-percha and to the walls of the canal and to definitively seal the apical third, can allow to obtain extraordinary healing in a relatively short time by exploiting its antimicrobial abilities. However, further studies are needed to assess the effectiveness of this technique over the long term.

Oral rehabilitation of edentulous jaws with one-piece implants: a case series.

The popularity of one piece implants has increased considerably between patients and dentists. The advantages of one-piece immediate loading for rehabilitation of edentulous mandibles is to reduce the number of interventions and timing of prosthetic. These parameters can be better controlled with a one-piece implant. Twenty-one patients with one-piece implants inserted in totally edentulous mandibles were considered for this retrospective study. Inclusion criteria were: Good oral hygiene, absence of lesions of the oral mucosa, no smoking or smoking less than 20 cigarettes a day, drinking less than 2 glasses of wine a day, good general health no pregnancy. Twenty-one (12 females 9 males) patients were enrolled in this retrospective study. The mean follow-up was 1 years. A total 84 one-piece implants (Biohorizon, Italy) were inserted in edentulous mandible. Implants diameter was 3.0 mm in all fixtures. Implants length was equal and longer than 12 mm in 44 and 40 fixtures respectively. 48 were inserted in females 36 in males (range 33-67; mean age 58.3). One-piece immediate loading implants has no difference in survival rate respect to two-piece implant and delayed loading for rehabilitation of totally edentulous mandibles. In conclusion one-piece immediate loading implant is a reliable device for mandible rehabilitation.

Complications in sinus lift.

Prosthetic rehabilitation of atrophic maxillary implants often requires grafting owing to vertical and transversal bone deficiency. The use of this procedure in order to insert implants was introduced by Tatum and published as a clinical study by Boyne and James. It can be performed via a lateral or crestal approach. This surgery is now widespread, with good results in terms of bone augmentation and implant osseointegration. Nevertheless, there is a small proportion of patients who have infectious complications with an incidence ranging from 3.5% to 10.5%. We observe that maxillary sinus augmentation is a successful preprosthetic technique for augmentation of the edentulous posterior maxilla. Preoperative assessment of the anatomy of the sinus reduces the rate of complications considerably.

Computer-guided implant surgery: analysis of dynamic navigation systems and digital accuracy.

After the static computer-guided implant surgery, borns the concept of "navigated implantology" (NI) that offers significant advantages in the treatment planning and help clinicians to perform successful implant rehabilitation. NI allows an optimal final location, to avoid the risk of damaging the noble anatomical structures near the site and allows the achievement of satisfactory aesthetics. The aim of this study is analyze three different systems: the RoboDent® system (Berlin, Germany, 2001), today not for sale, was the first implant navigation system introduced on the market and made the history of dynamic surgery; X-Guide (Nobel Biocare, 2017), a dynamic computer assisted system that uses the principles of stereoscopic triangulation by optical video cameras. And last, the Navident® dynamic navigation system (Toronto, Canada, 2015), produced by the Canadian company ClaroNav, evolved from the Navient brand used in orthopaedic surgery, neurosurgery and otolaryngology, sharing the motion tracking technology. Dynamic computer assisted surgery systems allow more accurate implant placement when based on an accurate 3D CT-based image data and an implant planning software which minimizes errors and simplify the surgical technique.

MRI findings of working and non-working TMJ during unilateral molar clenching on hard bolus.

The aim of this study is to evaluate with MRI the TMJs behavior during one-side clenching on a hard bolus. The sample consisted of 13 patients. an MRI of TMJ using a 1.5 Tesla superconducting magnet and a dedicated surface coil was performed in all patients. Parasagittal scans of the TMJ (perpendicular to the long axis of the condyles) were made with the mouth closed, open and with a plastic thickness 10 mm high, 15 mm wide and 20 mm long always interposed between the molars of the left side; TSE T2W and DPW sequences were used. The working condyle is always positioned behind the non-working contralateral condyle and the morphology of the retrodiscal tissue upper lamina was curvilinear in all TMJs examined. This work confirmed that, during clenching on a unilateral hard bolus, the working condyle translates less than the balancing one and that the condyle-disc ratios are substantially the same in both sides. The study of the retrodiscal tissue imaging in the different functional phases, suggest that it does not exert any pulling force towards the disc.

Appearance of normal MRI anatomy of the lingual nerve using steady-state free precession sequences at 3-T.

The aim of this study is to assess the value of SSFP MRI sequence in depicting the normal anatomy of the lingual nerve (LN), particularly in the molar region, in order to help the periodontists, dentists and oral surgeons in their daily practice. The study group included 24 patients who were to undergo MR study for a reason unrelated to our purpose. All imaging was performed by using a 3.0T system with a head and neck multiarray coil. The evaluation criteria included image quality factors such as the identification of the LN, its demarcation and its contrast to surrounding tissues on a five-point scale. The LN is clearly visible throughout its course from its origin from the mandibular nerve (MN) to the mylohyoid muscle. In edentulous patients, the LN could be damaged during surgical procedures especially it during the dissection and retraction of a lingual flap and, above all, during the suture due to a direct trauma caused by the needle or indirectly during tying the knot.

The effectiveness of endodontic sealers and endodontic medicaments on the elimination of enterococcus faecalis: an in vitro study.

The aim of this study was to investigate the efficacy of endodontic sealers and endodontic medicaments: Aureoseal (OGNA), MTA (DENTSPLY), calcium hydroxide (CH) (Endoidrox OGNA) and iodoformic paste (OGNA) against Enterococcus faecalis. Thirty-six Biomeraux plates (18 MH and 18 DCO) were inoculated with the experimental suspensions. The E. faecalis broth culture suspensions were prepared and adjusted to no. 0.5-0.7 McFarland standard. In each agar plate, three cavities were created, each measuring 4mm in depth and 7mm in diameter, and then completely filled with the product to be tested. To investigate the root canal sealers' antimicrobial activity, the agar diffusion method is used. The diameters of the zones of microbial inhibition were measured in millimeters around the plate. The results showed that the antimicrobial activity of Aureoseal was superior to those of MTA, iodoformic paste and calcium hydroxide for the microorganisms tested. The study confirmed the resistance of Enterococcus faecalis to endodontic sealers. Aureoseal and Calcium hydroxide showed the best results in inhibition test suggesting to employ them in clinical cases.

Application of the radiosurgery assisted gingival displacement technique in the aesthetic area: a case report.

The use of digital tools offers a new perspective to daily clinical activities even though sometimes different clinical approaches are necessary. This case report of a maxillary anterior rehabilitation demonstrates the application of a gingival displacement technique to enhance the recording of subgingival finish line by means of an intraoral optical scanner (IOS). The temporary restoration was used as a guide for the radiosurgery tip in order to displace the gingiva in a guided and mini-invasive approach. It was then possible to create the space between the tooth structure and the soft tissues for the light beam of the IOS to properly detect the finish lines of the dental preparation. Six single porcelain fused to zirconia crowns were delivered. This technique could be considered as a solution of complex cases with subgingival dental preparation to be detected by means of an IOS.