Compound Odontoma Associated with Dentigerous Cyst Incidentally Detected in an Adult Patient: Tomography and Histological Features.

Odontoma is the most common benign odontogenic tumor of epithelial and mesenchymal origin. The standard treatment involves a conservative approach. While this procedure is generally well accepted and tolerated, some difficulties may arise in case of odontomas associated with cystic lesions. In general, the expansive nature of cystic lesions requires their surgical excision, different from isolated nonsymptomatic odontomas that can be monitored radiographically. However, to the best of our knowledge, there is scarce evidence currently available reporting on the presence of odontoma-associated cystic lesions in the oral cavity. Therefore, the present case report is aimed at describing the diagnostic clinical, radiological, and histological features together with the surgical management of a dentigerous cyst associated with a compound odontoma. Following surgical removal of the lesion, no recurrence was observed after 12 months of follow-up.

Evaluation of Breaking Force of Different Suture Materials Used in Dentistry: An In Vitro Mechanical Comparison.

The success of surgical procedures is strictly related to the biomechanical properties of the suture. Mechanical comparisons are scarcely reported in the literature, so the purpose of the present study was to evaluate and compare the mechanical behavior of different sutures commonly used in oral surgery in terms of traction resistance. Sutures made of eight different materials were analyzed: silk (S), polyglycolide-co-caprolactone (PGCL), polypropylene (PP), rapid polyglycolide (rPGA), standard polyglycolide (PGA), polyamide (PA), polyester (PE), and polyvinylidene fluoride (PVDF). For each material, three different sizes were tested: 3-0, 4-0, and 5-0. The breaking force of each suture was assessed with a uniaxial testing machine after being immersed in artificial saliva at 37 °C. The outcomes analyzed were the breaking force, the needle-thread detachment breaking-point and the node response after forward-reverse-forward (FRF) tying when subjected to a tensile force. The 3-0 rPGA provided the maximum resistance, while the lowest value was recorded for the 5-0 PGCL. In general, 3-0 and 4-0 gauges showed non-statistically significant differences in terms of needle-thread detachment. The highest needle-thread detachment was found for the 3-0 PGA, whereas the lowest value was observed for the 5-0 PGCL. After tying the knot with an FRF configuration, the thread that showed the highest resistance to tension was the 3/0 silk, while the thread with the lowest resistance was the 5/0 silk. These data should be considered so that the operator is aware of as many aspects as possible on the behavior of various materials to ensure successful healing.

A Clinical and Radiographic Evaluation of Zirconia Dental Implants: 10-Year Follow-Up.

PURPOSE: The aim is to evaluate the survival and success rates, as well as the marginal bone loss (MBL) and periodontal indexes, of zirconia implants with 10-year follow-up. MATERIALS AND METHODS: 10 patients were selected and 26 one-piece zirconia implants were used for the rehabilitation of single tooth or partially edentulous ridge. After 10 years, a clinical-radiographic evaluation was performed in order to estimate peri-implant tissue health and marginal bone loss. RESULTS: The survival and success rates were 100%. The average marginal bone loss from baseline to 120 months after surgery was 0.92 ± 0.97 mm. CONCLUSION: One-piece zirconia dental implants are characterised by high biocompatibility, low plaque adhesion, and absence of microgap that can be related to the clinical success of these implants.

Buccal Peri-Implant Soft Tissue Augmentation by Means of a Porcine Collagen Matrix: A Proof of Concept Technical Note.

The quality and quantity of peri-implant soft tissues at the crestal portion of dental implants are important aspects to consider for a long-term successful implant-supported rehabilitation. Some relevant factors attributed to the implant health include mucosal thickness and keratinization. In this respect, many techniques and materials have been described to augment and improve buccal peri-implant soft tissues. Over the last few years, newly developed xenogeneic collagen matrices have been introduced in peri-implant plastic surgery to replace autogenous soft tissue grafts; however, data remain controversial so far. Thus, the purpose of the present report was to present a novel surgical technique conceived to augment buccal peri-implant soft tissues in combination with a volume-stable porcine collagen matrix. The rationale and the fundamental concepts that led to the use of a xenogeneic matrix to increase soft tissue volumes were also discussed.

Autogenous Chin Block Grafts in the Aesthetic Zone: A 20-Year Follow-Up Case Report.

The successful use of osseointegrated implants in the treatment of partial or complete edentulism requires a sufficient bone support. Whenever rehabilitation in atrophic edentulous areas is needed, bone augmentation procedures are recommended. The aim is to provide adequate amount of supporting bone to achieve a prosthetically guided implant placement. This in turn leads to functional and aesthetic improvements that can be maintained on the long term. Bone grafting of the atrophic site can be performed either prior to implant placement or at the time of implantation. Irrespective of the timing, bone augmentation by means of autogenous bone grafts is a reliable technique, as confirmed by several studies. On the other hand, long-term evidence on the use of autogenous chin block grafts in preprosthetic implant surgery is still scarce. Thus, the purpose of the present case is to report the 20-year clinical and radiological outcome of autogenous chin block grafts used to augment a bilateral defect due to agenesis of the upper lateral incisors for implant placement purposes.

Adjunctive application of antimicrobial photodynamic therapy in the prevention of medication-related osteonecrosis of the jaw following dentoalveolar surgery: A case series.

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating complication strongly associated to antiresorptive agents. The present study aimed to describe the use of antimicrobial photodynamic therapy (aPDT) in the prevention of MRONJ. METHODS: The sample consisted of 11 non-oncologic osteoporotic subjects in therapy with non-intravenous antiresorptive agents, requiring tooth extractions and/or implant removal. After minimally invasive surgical extractions, each alveolar socket was debrided and bony edges were smoothened. At this point, aPDT was performed using methylene blue-based phenothiazine chloride dye irradiated with a hand-held 100 mW diode laser with a wavelength of 660 ±â€¯10 nm. Flaps were sutured to achieve first intention closure. Soft tissue healing was promoted with weekly applications of low-level laser therapy for 6 weeks. Recall visits were scheduled weekly for the first two months and monthly thereafter up to 6 months. At the 6-month appointment, healing was assessed clinically and radiographically. RESULTS: A total of 62 surgical extractions were performed in both jaws, including 51 natural elements and 11 dental implants. No intraoperative complications were observed. Immediate post-operative period was generally uneventful except for mild pain and ecchymosis that occurred rarely and resolved spontaneously. Healing proceeded uneventfully, with no clinical or radiological prodromal manifestations of MRONJ up to the latest follow-up visit. CONCLUSIONS: aPDT might constitute a promising preventive treatment to reduce the risk of MRONJ in non-oncologic osteoporotic patients treated with non-intravenous antiresorptive agents that underwent dentoalveolar surgery.

Dental implants placed in resorbed alveolar ridges reconstructed with iliac crest autogenous onlay grafts: A 26-year median follow-up retrospective study.

PURPOSE: To evaluate the long-term outcome of dental implants placed with a staged procedure in resorbed alveolar ridges reconstructed with iliac crest autogenous onlay grafts. MATERIALS AND METHODS: All consecutive patients treated with iliac crest onlay bone grafts and dental implants were retrospectively evaluated. During the appointment, clinical and radiological examinations were conducted to assess implant survival. A survived implant was defined as an implant still stable and in function at the follow-up visit. Implant survival was estimated at the implant level using Kaplan-Meier analyses. The cumulative survival rate was estimated using a life-table analysis. Subgroup analyses were performed for age, position, and type of retention using the log-rank test. A p-value of <0.05 was considered statistically significant. RESULTS: The cohort consisted of 21 female subjects receiving a total of 140 rough-surface titanium implants. Of them, 128 survived and 12 failed, yielding a cumulative survival rate of 91.1% over a median survival time of 312 months. Implants supporting cement-retained prostheses exhibithed lower survival rate compared to screw-retained restorations (p = 0.001). CONCLUSION: Implants placed in bone augmented with iliac crest onlay grafts showed high long-term survival rates. Cement-retained restorations were more prone to develop implant failures.