Upper-lip laser frenectomy with a diode laser in a pediatric patient: a case report.

The case report aims to describe the parameters of performing upper labial frenectomy with the use of diode laser beams without infiltrated local anaesthesia. A 6-year-old patient was referred by the orthodontist for assessment of the upper anterior labial frenum. The dental treatment plan reported only the presence of caries on deciduous teeth and seals on the first permanent molars. The clinical examination reported the presence of a high attachments of labial frenum with a pathologically attachment and the presence of a diastema supports this theory. The laser used to remove the frenulum was a diode laser used with a wavelength of 980 nm with 320 microns of fiber in contact with a power of 2.0 W in continuous wave mode. The clinical examination showed an acceptable healing by secondary intention of the wound and the initial functional recovery of a physiological upper lip movements. The patient reported that the procedure was well tolerated. The diode laser can be used with good result for the removal of pathological frenum. The diode laser can be used in pediatric dentistry because of its application, adequate coagulation, no need for sutures and less inflammation and pain.

The health of soft tissues around four dental implants loaded immediately supporting a 4-year-old fixed screw-retained prosthesis.

The aim of this study was to assess the soft tissues health around the implant/abutment interfaces of fixed screw-retained prosthesis supported by four dental implants after at least 1-year in function. All the implants were placed between December 1, 2015 and April 30, 2019. Digital implant surgical planning was performed for all the complete-arch rehabilitations and then full-guided surgery was performed. The fixed-interim prostheses were delivered the day of the surgery and replaced by definitive prostheses after the healing period. Patients were followed-up to determinate peri-implant scores, such as Plaque Score (PS) and Bleeding on Probing (BoP). A total of 160 implants were placed in 37 patients, whereas 3 patients received both arches rehabilitated. A total of 40 complete-arch rehabilitations were performed, 26 in the maxilla and 14 in the mandible. Only 5 implants failed resulting in an overall implant survival rate of 96.9%. BoP was detected around 6 implants (3.7%) and 16 implants showed a superficial amount of plaque resulting a Plaque Score of 10%. Within the limitation of this study, it seems that the use of a fixed screw-retained prostheses supported by four dental implants to rehabilitate edentulous jaws could be a valid treatment option in the short and medium term without critical peri-implant issues. However, several perspective studies with longer follow-up are needed to achieve more predictable results.

Full-digital workflow to rehabilitate a high value aesthetic zone. A case report.

Replacing missing teeth in the aesthetic area is a clinical challenge which must be solved by a multidisciplinary approach in order to obtain an esthetic and functional implant-prosthetic rehabilitation. First therapeutic choice should be the less invasive option, in accordance with patients' expectations. The present clinical case presents the rehabilitation of the upper incisor group using a full-digital workflow to reduce operative time, costs and patient discomfort. The use of computer-guided-surgery and 3D technologies, as intraoral scanners or cone-beam-computed-tomography, allows the clinician to visualize all patient's information when planning the rehabilitation in order to obtain a more predictable and a less invasive surgery.

Rehabilitation of a severe mandibular atrophy with four millimeter extra-short implant and guided bone regeneration (GBR): case report with 7-years follow-up.

The aim of this study was to report the use of extra-short and short implants in combination with Guided Bone Regeneration (GBR) to rehabilitate a case of severe mandibular reabsorption. A 55-yearold female patient asked for a fixed implant supported rehabilitation in 4.5 - 4.6 zone which showed severe atrophy. It was decided to use an extra-short 4 mm length and 4.1 mm Ø, Roxolid and SLActive implant (Straumann Standard Plus Regular Neck, Institut Straumann AG) in 4.5 position and a short 6 mm length and 4.8 mm Ø, Roxolid and SLActive implant (Straumann Standard Plus Wide Neck, Institut Straumann AG) in 4.6 position. The implants supported cemented fixed prosthesis. Examinations were performed at the day of the surgery and up to 7-years in function to evaluate implant stability and periapical radiography. One extra-short implant and one short implant were placed. After 7 years in function no biological or prosthetic complication were recorded. Within the limitation of this case report, the use of short and extra-short implants to support fixed prosthesis seem to be a feasible treatment alternative in severe mandibular atrophy.

Diode laser as an adjunct to nonsurgical chronic periodontitis therapy: a review.

The aim of this review was to investigate the additional effects of diode laser irradiation in combination with nonsurgical periodontal therapy. An electronic search of publications was established from three electronic databases: Cochrane, PubMed and Web of Science. The search strategy used a combination of controlled vocabulary and free-text words. Inclusion and exclusion criteria were defined by the authors before the start of the study. The inclusion criteria were all studies published in English language, randomized controlled trials, based on human subjects. All trials were designed to evaluate the efficacy of the diode laser therapy as an adjunct to nonsurgical periodontal therapy in the treatment of chronic periodontitis patients. All studies analyzed are not older than five years. The search resulted in 188 titles. After the analysis of the abstracts, an article was excluded because it was not relevant for the study and two because it treated aggressive periodontitis. At the end only 6 articles were included in the qualitative analysis. The potential role in chronic periodontal disease treatment of diode laser is still not demonstrated. Several studies regard the diode laser therapy, but there is still heterogeneity for what it concerns research and clinical protocols. As a result, several randomized controlled trials are needed to obtain certain data.

Clinical fitting of a cast metal post and core obtained by means of an intraoral optical scanning (IOS) and digital workflow.

Customization of post-and-cores using computer-aided-design and computer-aided-manufacturing (CAD-CAM) requires the scanning of a pattern and the subsequent digital design. This case report describes the production of a CAD-CAM customized post-and-core designed from an intraoral scan and milled from a metal block. The use of an intraoral scanner (IOS) for post-endodontic rehabilitation could lead to a faster and more efficient CAD-CAM customized post-and-core realization. The use of a high resistance material such as metal is paramount in cases with high loss of coronal structure. The patient has been treated with bisphosphonate (BP) for years. The risk of osteonecrosis of the jaw after extraction was high.

Immediate restoration of a single upper central integrating digital workflow and a novel dental implant: a case report.

The aim of this study is to report the integrated digital workflow with a novel dental implant to rehabilitate a single tooth in a high value aesthetic zone. A 50-year-old man asked to rehabilitate tooth 1.1. The use of an integrated digital workflow in combination with computer guided surgery allow the clinician to visualize all patient's information when planning the rehabilitation in order to obtain a more predictable and a less invasive surgery. After two months of follow-up there were no biological or prosthetic issues. Within the limitation of this study, the digital workflow to rehabilitate a high value aesthetic zone could improve predictability and accuracy in immediate loading restoration.

Short implants (≤6mm) as an alternative treatment option to maxillary sinus lift.

The aim of this systematic review was to evaluate survival rate of short dental implants placed in the posterior area of the maxilla. The electronic literature search of studies published between January 1, 2010 and February 29, 2020 was performed using specific word combinations. The outcome was to meta-analyse the implant survival rate (ISR). The search generated 238 potential studies. After screening procedures, only nine randomized controlled trials fulfilled the inclusion criteria and were selected for qualitative and quantitative analysis. ISR of short implants ranged from 91.9% to 100%, while standard-length implants ISR ranged from 82.9% to 100% with a follow-up from 1 to 5 years in function. The risk ratio difference was 1.24 (95% confidence interval: 0.63-2.45, P=0.52) for short dental implants failure when compared with standard dental implants, and was not statistically significant. Based on the evidence of the included studies, short implants (≤6mm) reported high survival rates over short to medium follow-up in posterior maxilla, but the long-term success is as yet not demonstrated.

In vitro evaluation of the post-space depth reading with an intraoral scanner (IOS) compared to a traditional silicon impression.

OBJECTIVES: The aim of the study was to assess the depth and quality of the post-space reading, using an IOS without scan-post, compared to a traditional silicon technique. METHODS: Six extracted bicuspids were decoronated and endodontically treated. After having prepared the space for the posts, a structure in pink acrylic resin was created with two resin elements. At the center of the structure one sample was put at a time. Digital and traditional impressions were taken for each sample.Digital impressions were developed through the Computer-aided design (CAD) software in order to integrate the scanner results into a three-dimensional grid to make the measurements. A K-file was used to measure the length of the post-space of each sample obtained through the traditional silicon impression and subsequently the measurement results were reported on a millimeter gauge. Furthermore, an assessment of the width of the entrances of the post-spaces was carried out. RESULTS: The mean reading depth discrepancy expressed in percentages (19.58%) indicates that the digital impression with current technologies fails to impress clearly the post-space. Standard deviation of the data expressed in percentage is 13.89, suggesting that the values were not similar to each other. In two cases the digital technique has achieved less than 10% difference compared to the traditional technique, but there have been also cases in which the variation in depth has reached almost 40%.The samples that showed the minor discrepancy between the two techniques expressed the widest post-space entrance. CONCLUSIONS: In this in vitro study, the application of the IOS for the post-space reading in order to deliver an anatomic post has been proven to be still not reliable, as there are still depth reading limitations for the narrow root channels. In fact, in this type of channels it is difficult to reach with the light beam of the IOS the deepest areas of the post-space, with a consequent incomplete post-space reading.