Graphene-doped Poly(methyl-methacrylate) as an enhanced biopolymer for medical device and dental implant.

Graphene-doping procedure represents a useful procedure to improve the mechanical, physical and biological response of several PMMA-derived polymers and biomaterials for dental applications. The aim of the study was to evaluate measure water sorption, water solubility and tolerance trough the rabbit pyrogen testing pyrogen detection of Graphene doped Poly (methyl methacrylate) (PMMA) compared with PMMA as potential materials for dental implant device. A total of 8 aged and unaged samples Graphene doped PMMA and PMMA were tested for water sorption and water solubility of the specimens. The experimental condition was evaluated according to the ISO 20795-1:2013 protocol. The biopolymer tolerance was evaluated in vivo on animals through the pyrogen detection test, acute intracutaneous and systemic irritation test. After wet conditioning both of Graphene doped PMMA and PMMA reported an increase of the weight. All the experimental samples showed a drastic low level of water sorption and solubility. Graphene doped PMMA unaged specimens showed a stability of physical and optical feature after the treatment. The Graphene doped PMMA has not shown pyrogens, an intradermal and systemic irritant effect on animals. The Graphene-doped PMMA satisfy the standard requirements and provide a physical and optical stability of the compound after the treatment. Further in vivo findings are required for future clinical application of the compound.

Xanthelasma palpebrarum removed with Atmospheric Plasma technique: 11-year follow up.

Xanthelasma palpebrarum is a subcutaneous lesion of the lid and cause a cosmetical issue. The aim of the present study was to evaluate the atmospheric plasma treatment for the treatment of xanthelasma with an 11-year follow up. Seventy-two patients with bilateral xanthelasma and 26 patients with unilateral xanthelasma by atmospheric plasma technique known also as voltaic arc dermabrasion (VAD, Europe Medical s.r.l. Montesilvano (PE), Italy). Photographs were obtained at the baseline and after the procedure and analyzed by an independent observer. The evaluation of the results was made 2 months after this single treatment with 11 years of follow up. The subjects average age was 48.5 years (range 41-63 years). All subjects were elected for a single session for the lesion removal. The erosion is epithelialized from the lesion margins and the dermal basal cells. After 2 months from the treatment, the result was scored as 4 (clearing of lesions > 75%, complete resolution) in 66 patients for a total of 104 lesions treated; scored as 3 in 24 patients for a total of 48 lesions, and as 2 in nine patients for a total of 18 lesions. No subjects scored 0 or 1. A total of 8 lesions showed mild erythema in the treated areas for 1 month. Numerous approaches were proposed for xanthelasma exeresis such as a surgical treatment especially in case of excessively large lesions or lesions involving the medial canthus that could produce a more limited skin laxity rapidly induces a risk of ectropion. In conclusion, the effectiveness of the present investigation suggest that the atmospheric plasma is a useful therapeutic option for the treatment of xanthelasma palpebrarum.

Malar augmentation with Hyaluronic acid enriched with glycine and proline: a clinical evaluation.

The aging process causes skin modification and wrinkle formation with an alteration of the face harmony and imperfections. The aim of the present investigation was to evaluate a cross-linked hyaluronic acid enriched with glycine and proline for zygomatic malar region infiltrations. A total of twenty healthy female patients were treated for zygomatic hypotonia. The level of patients and surgeon satisfaction was evaluated by global aesthetic improvement scale (GAIS) at baseline, immediately after the procedure and at 6 months from the treatment. The healing phase was uneventful, and no complications were reported in the perioperative and follow-up periods. No significant differences were reported between patients and surgeon GAIS score (p<0.05). A significant difference of GAIS score was reported immediately after the procedure and at 6 months if compared to the baseline (p<0.05). The cross-linked hyaluronic acid enriched with glycine and proline is a useful biomaterial for zygomatic- malar augmentation with no significant local complications and a high stability and satisfaction level of the procedure.

Bacterial adherence to silk and expanded polytatrafluorethilene sutures: an in vivo human study.

After oral surgery, bacterial adhesion to suture can cause surgical site infections and delay wound healing. Microbial adherence to the suture is influenced by its physical configuration and chemical structure. The aim of this study was to compare in vivo the bacterial adhesion to two suture materials used in oral surgery: silk and monofilament expanded polytetrafluoethilene (e-PTFE). After sinus lift surgery, 15 flaps were sutured with silk (nonabsorbable, organic, braided, 4.0) and 15 were sutured with e-PTFE (nonabsorbable, synthetic, monofilament, 4.0). Seven days after surgery, bacterial adherence, in terms of percentage of the surface covered, was evaluated for each suture material by scanning electron microscope (SEM). Onto silk suture, plaque consisted of a few cocci and a higher proportion of rods and filamentous-shaped bacteria, with some mineralized plaque. Onto e-PTFE speciments, only small colonies of a few cocci or no bacteria were observed, with empty spaces between the colonies and no plaque mineralization. The surface covered by bacteria on e-PTFE specimens was significantly lower than that of silk sutures. (22.1% ±4.96% vs 54.3% ± 7.9%; P =0.0001). The results of the present study suggest that multifilament structure of silk favours a greater bacterial adherence, proliferation, and persistence, so monofilament and e- PTFE suture should be preferred in oral surgery.

Peri-implant disease caused by residual cement around implant-supported restorations: a clinical report.

Cement-retained restorations on implants ensures better passive fit and aesthetics, simplicity of fabrication and a homogenous load distribution during function, compared to screw-retained restorations, but it is associated to biological complications following the difficulty to remove cement excess. In fact, residual cement is a predisposing factor to peri-implant tissue inflammation and periimplantitis, because promotes plaque retention of bacteria, due to rough surface. This is especially true since radiographs should not reveal the cement excess and cements commonly used for the cementation of implantsupported prostheses have poor radiodensity. This report documents a case of clinical and radiographic findings of peri-implant disease associated with excess cement extrusion. Two months after cement removal, resolution of inflammation occurred. A good method of cementation, an accessible margin of restoration and the use of ZnOE cement instead of methacrylate cement, should help to prevent cementrelated peri-implant disease.

Clinical evaluation of efficacy and tolerance of a skin reconditioning compound for anti-aging.

Facial aging involves all facial structures located at different levels: bones soft tissues and skin with a reduction of the extracellular matrix. The aim of the study was to evaluate the efficacy of the injectable solution antiaging complex composed by non-reticulated hyaluronic acid (HA) and amino acids vitamins and antioxidants conveyed with mesotherapy technique in subjects with different expressions of aging. 114 patients with different expressions of aging were enrolled in this study with mean age (49±6). HA and amino acids vitamins and antioxidants complex solution Neofound (Love Cosmedical, Castagneto, Italy) was injected on the dermal plane or superficial subdermal plane. Among the various imperfections, fine roughness surface irregularities skin firmness brightness/discoloration cutaneous hydration were those with the greatest response to therapy. The clinical data showed that the medical device Neofound is effective and safe to treat various skin signs of chrono and photoaging thanks to its ability to protect tissues from oxidative stress and hydrate the skin.

Correlation between occlusal trauma and oral microbiota: a microbiological investigation.

The occlusal trauma has been defined as an injury to the periodontium resulting from occlusal forces that exceeds the reparative capacity of the attachment apparatus. Currently, the effects of occlusal trauma on tooth support tissues, the onset and the progression of periodontal disease are still debated. In fact, researchers started evaluating the possible effects of occlusal discrepancies on incidence, progression, and treatment outcomes of periodontitis, but all the results underlined the more significant role played by microbiological flora. The results of this study show that after 60 days of treating the occlusal trauma, a significant reduction was achieved in the periodontal bacterial flora.

White spot lesions in orthodontics: prevention and treatment. A descriptive review.

White spot lesions (WSL) are demineralizations of the enamel found on the tooth surfaces. WSL are considered incipient non-cavitated caries caused by bacterial plaque activity. Subjects with malocclusion such as dental crowding and fixed orthodontic appliances have a greater number of retention sites and consequently difficulty in cleaning and greater predisposition to caries. In fact, WSL are a frequent side effect of orthodontic fixed treatments. The prevention and resolution of this problem is the goal of any orthodontist because untreated WSL can lead to the formation of deeper dental caries and restorative treatment with consequent compromise of patient satisfaction with the aesthetic result obtained at the end of the orthodontic treatment. This review is intended not only for orthodontists but also for general and pediatric dentists who want to learn how to correctly prevent, and treat this unsightly problem. On the market there are many products sold to achieve this goal, some of them can be managed independently by the patient at home, others require the intervention of the dentist. The purpose of this literature review is to understand how these substances work, to identify with which of the currently most widespread the best results have been obtained and then to provide useful information to guide the clinician in choosing the most suitable one for the patient.

Stabilized zirconia ceramics for dental applications.

The research is aiming to obtain at room temperature a new ceramic material containing partially stabilized zirconia with different oxides after sintering used for dental and other technological purposes. Our research proposes a new method based on the use of stabilized zirconia with other oxides to obtain optimized dental material with a lower cost price and / or improved properties to allow wider use of these products to an increased number of patients in dental offices. X-ray diffraction, SEM analysis. FTIR spectroscopy, UVVis and density measurements were accomplished for the three ceramic systems. The correlation between the microstructure and the spectroscopic properties of zirconium stabilized by FTIR spectroscopy, UV-Vis helps understanding the mechanisms associated with the formation of high (tetragonal and / or cubic) temperature zirconia. Along with the simple, less costly preparation method and high purity of the ceramic products our study offers a highly desirable product for technological applications.

The bad relationship, osteo-decay and diabetes type 2 searching for a link: a literature review.

The diabetes and osteoporotic metabolic diseases are characterized by a wide prevalence of the population worldwide and correlated to alteration of the bone tissues. Several cofactors could influence the clinical course and the biochemistry of the pathologies such as human microbiome, nutrition characteristics, gut microbiota activity and interactions with vitamin K and D across IGF/GH and TP53 signaling pathways and the glucose/energy as mechanism for bone tissue health. Moreover, also the calories and sugar consumption seem to be correlated to an increased inflammatory state with several consequences for hematopoiesis and host tissues response. The aim of the present literature review was to highlight the role of osteoporotic diseases and diabetes type 2 link for the bone metabolism. The literature cases showed that a correlation between bone-gut-kidney-heart-CNS-Immunity crosstalk seems to be linked with bone metabolism and health regulation. Moreover, also the aging process could represent a valuable co-factor for the sustaining of the metabolic disorders upon a multi-systemic level.

Management of anterior open-bite in the deciduous, mixed and permanent dentition stage: a descriptive review.

Anterior open bite is one of the most complex malocclusions to manage. The interaction of skeletal, dental, and soft tissue effects can contribute to develop an anterior open bite. The skeletal open bite requires a more complex approach of treatment to reach function, aesthetics, and stability. The approaches vary depending on the causative factors and the age of patients. Treatment approaches for open bite patients differ when dealing with adults and growing patients. The aim of this descriptive review was to summarize the main existing treatment strategies for anterior open bite, from the noninvasive behavioural shaping to the orthodontic intrusion with skeletal anchorage.

The effectiveness of autologous demineralized tooth graft for the bone ridge preservation: a systematic review of the literature.

Resorption of alveolar ridge after tooth extraction often compromises dental implant placement and esthetic. Alveolar ridge preservation is a common procedure performed in order to preserve the pontic site for a prosthetically ideal position. This procedure has already become an indisputable need. Tooth matrix as bone substituted material poses osteoconduction and osteoinduction properties and as autologous graft, this material is free of antigenic reaction. This biomaterial allows the threedimensional reconstruction of the bone, is easy to prepare and has a low cost. The aim of this review is to summarize and put in evidence the properties of tooth as bone substitute and its use in alveolar ridge preservation. Keyword: autologous tooth, autologous graft, bone regeneration, bone substitute, alveolar ridge preservation, alveolar ridge augmentation, socket preservation.

The integumentary system and its microbiota between health and disease.

The aim of the present investigation was to evaluate the essential physiological functions of the skin microbiota in human health and diseases. The main characteristics of the normal microbiota in the different anatomical sites have been reported in relation to the main factors, such as the effect of age, on its composition and stability for the eubiosis condition. Moreover, the present overview analyzed the functions and composition and the correct functionality of the skin microbiota in the light of current knowledge. According to several evidence is important preserving the eubiosis of the commensal microbes of the microecosystem (symbiotic and pathogenic), and probiotics are able to counteract the conditions of dysbiosis. Also, it has been shown that there is a crosstalk between gut and skin microbiota that affects human health and is still being studied, and its relationship to the current pandemic SARS-CoV-2.

Compliance of children with removable functional appliance with microchip integrated during covid-19 pandemic: a systematic review.

Treatments with removable appliances are widely used in Europe to correct dento-skeletal dysgnatia in the growth phase that is a period of poor cooperation of the patients. Adherence to the wear-time prescription is often not achieved and it represent the main argument against the use of removable devices. Suspected non-compliant behavior with the wear time prescription is often the subject of medico-legal disputes, which can deteriorate doctor-patient relationship. The use of microchips allows to document objectively and clarify the patient's behavior. To conduct a systematic review of the orthodontic literature to identify the factors associated with compliance in orthodontic treatment. We conduct a systematic review that aimed to identity the factors associate with compliance in orthodontic treatment. The main purpose was to assess the objective levels of time of use of the removable appliances and the self-reported levels. A literature search was conducted by the electronic databases PubMed and Cochrane Library. The following search terms were used: compliance functional removable orthodontic appliance. Randomized and nonrandomized controlled trials, prospective cohort studies, case series, qualitative and mixed-methods studies objectively assessing compliance levels were included in the study. A total of 94 articles were identified by PubMed and 14 articles by Cochrane. The papers selected were included for the qualitative analysis and categorized according to the subjects age, the clinical appliance, compliance factors, wear time and monitoring. Removable appliances are an important part of orthodontic treatment, used in growth phase of the patient. Collaboration with removable functional devices determines success / failure in treatment.

Drug-induced gingival overgrowth: an in vitro study on cyclosporine and human gingival fibroblasts.

Gingival overgrowth is a serious side-effect that accompanies the use of cyclosporine. Up to 97% of the patients submitted to immunosuppressant drugs have been reported to suffer from this side-effect. Several conflicting theories have been proposed to explain the fibroblast's function in gingival overgrowth. To determine whether cyclosporine alter the inflammatory responses, we investigated its effects on gingival fibroblast gene expression as compared with untreated cells. Fragments of gingival tissue of healthy volunteers (11-year-old man, 68-year-old-woman and 20-year-old-man) were collected during operation. Cells were incubated with cyclosporine and gene expression of 29 was investigated in gingival fibroblasts cell culture, compared with untreated cells. The gene expression level was significantly deregulated only for 10 genes (CCL1, CCR1, CCR4, CCR5, CCR10, IL1A, IL1B, IL5, IL6R and TNFSF10) that were found to be downregulated except for TNFSF10. These results seem to demonstrate that cyclosporine has no inflammatory effect on healthy gingival fibroblast. In the future, it would be interesting understand, the possible effect of the drug on inflammation of patients affected by gingival hyperplasia.

Narrow single tooth implants for congenitally missing maxillary lateral incisors: a 5-year follow-up.

INTRODUCTION: The maxillary lateral incisor epidemiologically represents the second most common congenitally absent teeth. In literature, different approaches have been proposed, such as canine teeth substitution, traditional prosthetic rehabilitation, adhesive restoration or single-tooth implant. The aim of this investigation was to evaluate the clinical and radiographical effectiveness of narrow single tooth implant treatment for missing maxillary lateral incisors. MATERIALS AND METHODS: A total of 11 subjects, in seven cases bilaterally, were treated in the Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, with a radiographical follow-up at 5 years from the loading. RESULTS: At the follow up, no bone defects or pathological gingival probing were present around the peri-implant tissues. No mechanical complications, such as loss of the crown fixation screws or fracture, were reported. CONCLUSIONS: Narrow implants represent a predictable optional treatment for maxillary lateral incisor restoration, with a high-level aesthetic and functional outcome of the rehabilitation.

Cortical bone lamina approach for mandibular large cystic defect: a case report.

This study evaluated the bone healing of the residual cavity after enucleation of mandibular inflammatory cyst by using only a coverage with cortical bone barrier. This study was conducted at the dental clinic of the Medical, Oral and Biotechnology Sciences Department of Chieti in February 2015. A 36-year-old male patient, D.G.M., had a mandibular inflammatory cyst (with a diameter of about 33.9x20.3mm) treated by surgical enucleation, subsequent apicectomy of the elements involved (4.1, 3.1, 3.2, 3.3, 3.4) and coverage of residual defect with a porcine cortical bone barrier (Bone Lamina). Postoperative clinical and radiographic examinations were performed at 3 and 9 months (panoramic radiographs) and at 12 and 24 months (CBCT Dental scan) respectively after cystic enucleation surgery. Uneventful healing and filling of the residual cavity was carried out. The computed analysis of the postoperative radiographs showed bone regeneration of cortical in terms of thickness increase at 12 and 24 months and showed mean values of reduction in size of the residual cavity of 92.1% after 12 months and 96.53% after 24 months. The volume of residual cavity (3123 mm3 in 2015) was seen to decrease (243.6mm3 at 12 months and 108.5 mm3 at 24 months). In this case report the Bone Lamina prevented tissue collapse within the defect and could maintain structural integrity throughout the period required for bone regeneration; it also has the advantage of resorbable membranes, avoiding a second surgery for its removal.

In vitro interface changes of two vs three narrow-diameter dental implants for screw-retained bar under fatigue loading test.

The mechanical failure of a dental implant is clinically related to a prosthetic overload dissipated on the fixture/abutment complex. The aim of this investigation was to evaluate the fracture strength of two vs three narrow-diameter dental implant configurations for screw-retained bars. Different configurations of screw-retained bars on two narrow-diameter dental implants (Group I) and screw-retained bars on three narrow-diameter dental implants (Group II) were tested under a static fracture loading. A total of 20 specimens, 10 for each group were evaluated. The fracture loading point was significatively higher in Group I (p<0.05). The experimental groups reported high levels of fracture strength under loading that encourages the clinical application of screw-retained bars supported by multiple narrow-diameter implants.

A 10-year retrospective comparative human study on screw-retained versus cemented dental implant abutments.

The aim of this 10-year retrospective study was to evaluate the long-term reliability, survival rate and mechanical and biological complications of single-crown implant rehabilitations with two different types of fixture-abutment connections: screw-retained abutments (SRAs) with internal hexagonal connection, and cemented retained abutments (CRAs). A total of 300 single implant-supported crowns were analysed, which had been inserted between 2004 and 2007. Patients were classified according to two groups: the SRA group (n = 150) and the CRA group (n = 150). The primary outcome was marginal bone loss (MBL) on peri-apical radiographs. Bleeding on probing (BOP) and probing depth (PD) were also evaluated. Moreover, prosthetic complications were recorded. Analysis of variance (ANOVA) was used to evaluate the differences between the groups. The overall implant failure rate was 4.2%. The overall positive BOP index was 81.9% of the sites under investigation, as 83.4% for SRA and 80.4% for CRA. Moreover, >5 mm PD demonstrated a rate of 21.0% for CRA, and 13.8% for SRA. The primary outcome of mean MBL was 2.09±1.07 mm for SRA and 1.54±1.20 mm for CRA. Analysis of variance of MBL showed statistical significance for the difference between these two groups (P less than 0.001). For the mechanical aspects, an overall 12.5% of complications occurred. No implant or abutment fractures were recorded. Although complications occurred, the results from this 10-year retrospective study show that these two methods have positive long-term follow-up. With MBL significantly greater for the SRA group than the CRA group, the clinical use of CRA is encouraged in terms of the lower bone resorption rate.

Complication in third molar extractions.

Mandibular third molars (MM3s) are responsible for pericoronitis, primary and/or secondary crowding of the dentition, odontogenic tumors and cysts, periodontal defects associated with the posterior part of mandibular second molars. Tooth extraction is indicated for prophylactic and therapeutic purpose in patients with problems caused by impacted teeth. Common postoperative complications associated with third molar extraction are alveolitis (0.5e32.5%), infection (0.9e4.2%), postoperative bleeding (0.2e1.5%), transient dysfunction of the inferior alveolar nerve (0.6e5.5%), and permanent dysfunction of the inferior alveolar nerve (0.1e0.9%). A literature review reveals number of individual case reports of accidental displacement to various anatomical locations, namely, the infratemporal fossa, pterygomandibular space, lateral pharyngeal space, submandibular space, and sublingual space.