Bruxism in Children and Adolescents with Down Syndrome: A Comprehensive Review.

The role of bruxism in children and adolescents with Down syndrome, the most often diagnosed congenital syndrome, is still unclear. Therefore, this study aims to conduct a narrative review of the literature about bruxism in children and adolescents with Down syndrome to identify the prevalence, risk factors, and possible treatments of this disorder. Although an accurate estimate of its prevalence could not be inferred, it appears that bruxism is more prevalent in Down syndrome individuals rather than in the general pediatric population. No gender difference was observed, but a reduction in its prevalence was described with increasing age (around 12 years). The variability in the diagnostic techniques contributed to the heterogeneity of the literature data. Clinicopathological features of Down syndrome, such as muscle spasticity, oral breathing, and a predisposition to obstructive sleep apnea, may suggest a higher prevalence of bruxism in this patient group. Finally, given the paucity of studies on the management of bruxism in this population, it was not possible to outline a standard protocol for the non-invasive treatment of cases in which an observational approach is not sufficient.

Periodontal disease: an oral manifestation of psoriasis or an occasional finding?

Even if the existence of oral psoriasis has been suggested, it is still a debated issue. Indeed, oral inflammatory diseases may histologically resemble psoriasis-related oral lesions. However, an increased prevalence of fissured tongue and geographic tongue has been associated with psoriatic patients, being a transitory and permanent lesion, respectively. Recently, it was hypothesized that gingivitis and periodontitis share the same underlying inflammatory pathogenetic process of psoriasis. Thus, in the present study, psoriatic patients were investigated for oral mucosa lesions prevalence as well as gum disease. Results displayed an increased association between gingivitis/periodontitis and psoriasis, which may suggest common underlying pathogenic risk factors. However, large-scale studies are needed to evaluate the real prevalence of gingivitis and periodontitis in these patients, to consider them a comorbidity of psoriasis.

Technical and biological complications related to crown to implant ratio: a systematic review.

AIM: To review the occurrence of prosthetic failure and biological complications with respect to the crown to implant (C/I) ratio. METHODS: Accurate search was made on the subject C/I ratio with the following criteria: (1) studies on humans with data on prosthetic failure and/or biological complications related to C/I ratio; (2) partial edentulous patients; (3) randomized clinical trials, prospective, longitudinal, retrospective, and multicenter studies with a minimum of 48 months mean follow-up; (4) language: English; (5) radiographic measurements by peri-apical x-ray; (6) implant material: titanium; and (7) no implant type selection was applied. RESULTS: Six articles were considered eligible for full-text analysis. Unfavorable C/I ratio can be considered a potential risk factor for single crown and abutment loosening (C/I ratio ≥ 1.46) and abutment fractures in posterior areas (C/I ratio ≥ 2.01). CONCLUSIONS: Despite the limited data, high C/I ratio may be related to some prosthetic failures. Unfavorable C/I ratio does not affect biological complications and implant failure.

Implants placed in sites of previously failed implants: a systematic review.

PURPOSE: The aim of this study was to systematically review the literature on implant placement in sites of previously failed implants and to assess survival and success rates of the replacement implants to investigate the effectiveness of the procedure. MATERIALS AND METHODS: MEDLINE and Cochrane Oral Health Group databases were used to identify articles published between 1985 and 2011. Six articles were selected for a total of 334 patients (338 implants). RESULTS: The survival rate ranged from 71% to 100%. The survival rate for implants placed for the second time (third attempt) in the sites of previously failed implants was 83.75%. No studies included in this review reported the cumulative success rate except for the prospective one, which reported a 93.7% success rate. The main limitations of the present systematic review have been the scarce number of patients and implants in the analyzed studies and the lack of large well-designed case-control long-term trials. CONCLUSIONS: Survival rates of implants placed in the areas of previously failed implants are low, although they should not discourage clinicians from a second or even a third attempt.

Active implant peri-apical lesion: a case report treated via guided bone regeneration with a 5-year clinical and radiographic follow-up.

Implant peri-apical lesion (IPL) is a periapical lesion, usually asymptomatic, in which the coronal portion of the implant achieves a normal bone to implant interface. A case of IPL following immediate implant placement and treated with guided bone regeneration (GBR) principles is described. Five-year clinical and radiographic follow-up with cone-beam assessment showed complete healing of the bone. GBR principles applied to IPL could completely solve the lesion.

A double-blind randomized-controlled trial comparing the desensitizing efficacy of a new dentifrice containing carbonate/hydroxyapatite nanocrystals and a sodium fluoride/potassium nitrate dentifrice.

BACKGROUND AND AIM: Several dentifrices have shown to be effective in reducing dentine hypersensitivity (DH), but more effective products are needed. The aim of the study was to evaluate the desensitizing efficacy of a new dentifrice based on zinc-carbonate hydroxyapatite (CHA) nanocrystals. METHODS AND MATERIALS: Using a double-blind, randomized design, the new dentifrice was compared with potassium nitrate/fluoride dentifrice (active control). The participant's DH was evaluated at baseline and after 4 and 8 weeks using airblast (primary outcome), tactile, cold water and subjective tests (secondary outcomes). RESULTS: The final sample consisted of 70 subjects with baseline DH; 36 received the new dentifrice and 34 the control one. Both dentifrices were largely effective; the percentage of score reduction from baseline to 8 weeks was greater than 28% for all tests (and greater than 55% for the cold water test) in both groups. As compared with controls, experimental subjects had a significantly greater improvement in the airblast test score (mean percentage of reduction of 46.0%versus 29.4% in controls) and the subjective test score (47.5%versus 28.1%, respectively), with both differences already being significant after 4 weeks. In contrast, there was no significant difference between groups for either the tactile or cold water tests at any time point and with any outcome. CONCLUSIONS: This study documented that the new dentifrice containing zinc-CHA nanocrystals significantly reduced dentinal hypersensitivity after 4 and 8 weeks, supporting its utility in clinical practice.

Dental Care Access and the Elderly: What Is the Role of Teledentistry? A Systematic Review.

A high level of unmet oral health needs is very common among elderly people. In a society that is getting older and that has been hit so hard by the coronavirus pandemic, the development of new strategies aimed at enhancing general and oral health status should be crucial in order to promote healthy aging. The aim of this systematic review is to assess the feasibility of Teledentistry in communities or in a domiciliary setting where elderly people live. A structured and systematic research was performed on the major electronic databases for studies published in English until 30 June 2020: the PubMed, Cochrane Library, Web of Science, Scopus, and CINAHL databases. A total of 13 articles were identified through database searching using combinations of keywords. Out of 13 papers, eight abstracts were reviewed to assess if they were coherent with the aim of the study, and full texts were retrieved. After abstract reviews, seven articles were selected for closer inspection. Of these, six were assessed for eligibility. Four papers were aimed at assessing patients and health practitioners experiences about Teledentistry, three studies reported a cost analysis and cost description of Teledentistry in residential aged care facilities, and two studies investigated the feasibility and accuracy of Teledentistry for diagnosis dental pathology. The implementation of Teledentistry in residential aged care facilities and in home-assistance programs could be a viable tool for the management of oral care in people who cannot access dental care.

Italian Response to Coronavirus Pandemic in Dental Care Access: The DeCADE Study.

The aim of the study was to evaluate the impact of the coronavirus pandemic on the willingness, anxiety and concerns of Italian people on undergoing dental appointments. An anonymous survey was posted online on social media on 11 May 2020 and was completed by 1003 respondents in one week. Multiple correspondence analysis and multiple logistic regression were used to evaluate the association between socio-demographic characteristics, dental care access, contagion fear of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), trust in dentists regarding sanitization procedures and perception of the impact of the risk of contagion on dental care. Subjects with a high level of education, attending public dental offices and that are used to go to dental offices for urgent care would not feel comfortable in undergoing a dental appointment and would prefer to postpone or cancel dental visits, waiting for a decrease in the number of the contagions. Moreover, the risk of canceling or postponing the appointment at the dentist was 1.59 times greater in those who claimed to be strongly influenced by SARS-CoV-2. Fear of coronavirus disease (COVID-19), new cases decrease and the not urgent nature of dental visits influenced more than the lowered income household on upcoming or resuming dental appointments. In the next months, despite the forecasted economic crisis caused by coronavirus pandemic, fear and anxiety generated by the spread of the virus will impact more than the lowered familiar income with regards to access to dental care.

Effect of four different finishing and polishing systems on resin composites: roughness surface and gloss retention evaluations.

BACKGROUND: Finishing and polishing procedures play a crucial role to achieve the best aesthetic result of direct restorations. Many manufacturers to the clinicians offer different finishing and polishing systems. This study aims to examine the behavior of four different finishing and polishing systems on the roughness, gloss and morphology surface of one resin composite. METHODS: Twelve Filtek XTE Supreme (3M ESPE) discs were prepared and divided into 4 groups (N.=3), depending on the different finishing and polishing systems: Group 1 (GP1) Sof-Lex Extra-Thin XT discs; Group 2 (GP2) Sof-Lex Coarse black disc, multi-fluted bur, Sof-Lex Diamond Polishing System Spirals; Group 3 (GP3) Sof-Lex Coarse black disc, multi-fluted bur, Sof-Lex Diamond Polishing System Spirals, Diamond Twist SCL; Group 4 (GP4) with Sof-Lex Coarse black disc, multi-fluted bur and Occlubrush. The roughness and gloss were evaluated and then samples examined by Scanning Electron Microscopy (SEM) to analyse the morphology after finishing and polishing. RESULTS: Regarding the surface roughness, GP1 and GP2 showed similar values for Ra, Ry, Rz and Rq parameters; while GP3 displayed the lowest values in all parameters; GP4 had the highest Ra value. Regarding the gloss, the values decreased as follows: GP3>GP2=GP4>GP1 (P<0.05). Scanning electron micrographs showed the abrasion of the samples with an increase in the surface roughness in GP1 and GP4. One-way ANOVA followed by Tukey's Test was used for statistical evaluations (P<0.05). CONCLUSIONS: The roughness and gloss surface of resin composites depend on the finishing and polishing systems used. This study demonstrates that satisfactory gloss outcomes are obtained using a system based on diamond paste.

Anorexia, Oral Health and Antioxidant Salivary System: A Clinical Study on Adult Female Subjects.

The aim of this study was to compare the oral health status and salivary antioxidant system between patients diagnosed with anorexia nervosa (AN) and healthy controls. A total of 25 female AN patients and 25 matched healthy controls were enrolled. Clinical parameters and saliva samples were collected for each patient. Two questionnaires to investigate oral health and hygiene were administered. Superoxide Dismutase (SOD) activity and High Reactive Oxygen Species (hROS) were evaluated. Salivary concentration of SOD was significantly higher in subjects with AN compared with control group (1.010 ± 0.462 vs. 0.579 ± 0.296 U/mL; p = 0.0003). No significant differences between groups were identified for hROS (233.72 ± 88.27 vs. 199.49 ± 74.72; p = 0.15). Data from questionnaires indicated that, although most of the patients recognized the oral hygiene importance in maintaining a good oral health, more than half of them had poor oral hygiene. Altered biochemical composition of saliva in patients with AN could be interpreted as an effective defence mechanism against oxidative stress. Moreover, despite the discrepancy between clinical findings and perception of the oral health in AN population arose, the quality of life of these patients appears not to be significantly affected by their dental condition.

Beyond Head and Neck Cancer: The Relationship Between Oral Microbiota and Tumour Development in Distant Organs.

An altered oral microbiota has been linked with the development of several oral diseases, such as dental caries, periodontal disease, and oral stomatitis. Moreover, poor oral health has been linked to head and neck cancer, particularly oral cancer. In recent years a growing number of studies indicate that oral microbiota could be involved in the development of primary tumours outside of head and neck region. The aim of this article is to review the recent studies based on high-throughput technology to present evidences of a relationship between oral microbiota and "non-head and neck tumours." Oral dysbiosis seem to be more pronounced in patients with tumours of gastrointestinal tract, in particular oesophageal, gastric, pancreatic, and colorectal cancers, paving the way for developing specific oral microbiota test to allow early cancer detection. Regarding other tumour types, the results are promising but highly preliminary and still debated. Currently, there are several factors that limit the generalization of the results, such as the small sample size, the lack of adequate clinical information about patients, the different sequencing techniques used, and biological sample heterogeneity. Although only at the beginning, the analysis of oral microbiota could be the next step in the evolution of cancer therapy and will help clinicians to develop individualised approaches to cancer prevention and treatment.

Treatment of periodontal intrabony defects with demineralized freeze-dried bone allograft in combination with platelet-rich plasma: a comparative clinical trial.

BACKGROUND: The aim of the present randomized, double-masked, clinical trial was to compare platelet-rich plasma (PRP) combined with a demineralized freeze-dried bone allograft (DFDBA) to DFDBA mixed with a saline solution in the treatment of human intrabony defects. METHODS: Sixty interproximal intrabony osseous defects in 60 healthy, non-smoking subjects diagnosed with chronic periodontitis were treated in this study. Thirty subjects each were randomly assigned to the test group (PRP + DFDBA) or the control group (DFDBA + saline). Clinical and radiographic measurements were made at baseline and at the 12-month evaluation. RESULTS: Compared to baseline, the 12-month results indicated that both treatment modalities resulted in significant changes in all clinical parameters (gingival index, bleeding on probing, probing depth, clinical attachment level, and gingival recession; P <0.001) and radiographic parameters (hard tissue fill and bone depth reduction; P <0.001). However, the test group exhibited statistically significantly greater changes compared to the control group in probing depth reduction (4.3 +/- 1.7 mm versus 2.6 +/- 2.2 mm; P <0.05) and clinical attachment gain (3.5 +/- 2.1 mm versus 2.3 +/- 2.4 mm; P <0.001). CONCLUSIONS: Treatment with a combination of PRP and DFDBA led to a significantly greater clinical improvement in intrabony periodontal defects compared to DFDBA with saline. No statistically significant differences were observed in the hard tissue response between the two treatment groups, which confirmed that PRP had no effect on hard tissue fill or gain in new hard tissue formation.

An Overview on Current Non-invasive Diagnostic Devices in Oral Oncology.

Oral squamous cell carcinoma (OSCC) is the most common head and neck malignancy, and despite advances in cancer therapies, the overall 5-year survival rate has remained below 50% over the past decades. OSCC is typically preceded by potentially malignant disorders (PMD), but distinguishing high-risk from low-risk PMD is challenging. In the last years, several diagnostic methods as light-based detection systems (LBDS) have been proposed to facilitate the detection of OSCC and PMD. Furthermore, the recent evolution of nanotechnology may provide new opportunities to detect PMD and OSCC at an early stage. Indeed, several preclinical studies showed the potential of nanotechnology to enhance diagnostic accuracy. For these reasons, it is fundamental to conduct studies to evaluate the efficacy of nanotechnology implementation in LBDS. The aim of this article is to review the current literature on LBDS and to provide a summary of the sensitivity and specificity of each technique, and possible future applications of nanotechnologies. The LBDS showed great potential for screening and monitoring oral lesions, but there are several factors that hinder an extensive use of these devices. These devices seem to be useful in assessing lesion margins that must be biopsied. However, to date, conventional oral examination, and tissue biopsy remain the gold standard for OSCC diagnosis. The use of nanotechnologies could be the next step in the evolution of LBDS, thus providing devices that can help clinicians to detect and better monitor oral lesions.

Assessment of antiplaque effectiveness of chlorhexidine-soaked gauze compared to chlorhexidine mouth rinse: Randomized clinical trial.

AIM: The aim of the present study was to compare the efficacy of a disposable gauze soaked with chlorhexidine and rolled up on the finger vs chlorhexidine mouth rinse (CM) to maintain oral hygiene. METHODS: In this single-blind, randomized trial, both groups were instructed to brush their teeth and use the 0.12% chlorhexidine intervention twice per day (experimental group: toothbrushing + chlorhexidine-soaked gauze; control group: toothbrushing + mouth rinse). The main outcome was the change in full mouth plaque index scores from baseline to 2 weeks. Secondary outcomes were the patient's appreciation (visual analog scale) and the bleeding index. RESULTS: The final sample consisted of 60 young patients: 31 in the experimental group and 29 in the control group. After 2 weeks, both interventions were effective in reducing plaque index. The percentage of score reduction was 33% in the experimental group and 30% for the controls, with no significant difference between groups. Both interventions reduced the bleeding index, but this reduction was significant only in the experimental group (P < .001). CONCLUSIONS: There is no difference between chlorhexidine-soaked gauze and CM regarding plaque control. In addition, gauze soaked with chlorhexidine was significantly more effective in reducing the bleeding index score and was appreciated by the patients.

Nuclear Survivin as a Prognostic Factor in Squamous-Cell Carcinoma of the Oral Cavity.

Oral squamous-cell carcinoma (OSCC) and most human tumors are characterized by an imbalance of regulatory mechanisms controlling cell processes such as apoptosis. Survivin, a member of the inhibitor of apoptosis family, is overexpressed in most solid and hematological malignancies and correlates with a reduced overall survival rate. Thus, the aim of this study was to find a correlation between nuclear Survivin expression and clinicopathologic data and the prognosis in OSCC patients. A total of 152 OSCC samples were investigated by immunohistochemistry for nuclear Survivin expression. Then, Survivin was scored semiquantitatively using an immunoreactivity score (IRS), calculated by multiplying the percentage of positive cells with the staining intensity. Using a digital image analysis software, OSCC patients were stratified into 4 groups. Results showed that patients with a lower IRS score displayed better survival rates than patients with a higher IRS score, reaching statistical significance. As the expression of Survivin at the nuclear level seems to suggest a poor prognosis in OSCC patients, the evaluation of nuclear Survivin IRS may be a useful tool to identify patients with more aggressive and disseminated disease, influencing follow-up and therapeutic protocols.

Cystic lesions of the jaws: a retrospective clinicopathologic study of 2030 cases.

OBJECTIVE: The aim of this study was to perform an epidemiologic analysis of cases of jaw cysts treated from 1973 to 2012 at the Dentistry and Maxillofacial Surgery Unit of the Verona Hospital, Italy, and to compare the data obtained with those published in the literature. STUDY DESIGN: A retrospective survey of 2030 patients treated for jaw cysts from 1973 to 2012 was performed. The lesions were classified according to the 2005 World Health Organization histologic classification, and the following variables were analyzed: age, gender, histopathologic diagnosis, and site of onset. RESULTS: Of 2030 total lesions, there were 1970 odontogenic cysts (97.04%), 50 nonodontogenic cysts (2.46%), and 10 pseudocysts (0.49%). Of the patients, 314 were children (15.47%), and 1716 were adults (84.53%). Mean age was 37.24 years, with a male/female ratio of 1.71:1. CONCLUSIONS: There is a wide variety of cysts, some of which are subject to variations according to gender, localization, and age.

A Double-Blind Randomized Trial Comparing Implants with Laser-Microtextured and Machined Collar Surfaces: Microbiologic and Clinical Results.

PURPOSE: The purpose of this study was to compare the clinical outcome of and determine the differences in periodonto-pathogenic microbiota around two types of implant collar surfaces: laser-microtextured (test) vs machined (control). MATERIALS AND METHODS: Seventeen patients (11 periodontally healthy, and 6 periodontally compromised) were selected to receive the two different implants, placed randomly, in two edentulous sites. Six months following the surgical placement of the dental implants, subgingival plaque samples were collected using paper points from the peri-implant sulcus and from the sulcus of an adjacent tooth. The presence of five putative periodontal pathogens, namely, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola, and Tannerella forsythensis, was assessed using real-time polymerized chain reaction (RT-PCR). Peri-implant parameters and intraoral radiographs were recorded up to 1 year after abutment connection. RESULTS: In the main population, and in the periodontally compromised subgroup, the total number of periodontal pathogens around test implant sites was lower than control implant sites and adjacent tooth sites, with a statistically significant difference (P < .05). In periodontally healthy patients, the mean probing pocket depth for the test implant was 1.31 ± 0.51 mm, compared with 2.66 ± 0.83 mm for the control implant, while in periodontally compromised patients, it was 1.61 ± 0.58 mm for the test implant, compared with a mean value of 2.84 ± 1.0 mm for the control implant. CONCLUSION: Implants with a laser-microtextured collar surface are not more vulnerable to pathogenic microflora colonization than implants with a machined collar surface. In both of the subgroups of patients (periodontally healthy and periodontally compromised), implants with a laser-microtextured collar surface have a better clinical outcome at 1 year of loading, compared with implants with a machined collar surface.

Expression of p73 and TRAIL in odontogenic cysts and tumors.

Odontogenic tumors are a group of lesions arising from the odontogenic apparatus. Although the mechanism of oncogenesis and tumor progression in these lesions remains unknown, certain proteins, such as those involved in apoptosis, seem to be involved in the differentiation and proliferation of odontogenic epithelial cells. The aim of this study was to analyze the expression of p73 and TNF-related apoptosis-inducing ligand (TRAIL) in odontogenic tumors and cysts, and to clarify changes in the expression of these proteins. Immunohistochemical analysis was performed on 21 ameloblastomas, 15 keratocystic odontogenic tumors and 15 dentigerous cysts. We carried out quantitative assessment of p73 and TRAIL expression by determining the percentages of positive cells on a continuous scale. Five cases of orthokeratinized odontogenic cyst were also examined. The percentages of cells immunohistochemically positive for p73 were 52.6 ± 25.4% in ameloblastomas, 76.0 ± 13.1% in keratocystic odontogenic tumors, and 26.7 ± 30.7% in odontogenic cysts, whereas the corresponding figures for TRAIL were 57.6 ± 16.1%, 8.9 ± 10.0%, and 1.5 ± 0.5%, respectively. Imbalance of the apoptosis pathway, with dysregulation of p73 and TRAIL, seems to play a role in the oncogenesis of odontogenic tumors.(J Oral Sci 58, 459-464, 2016).

Spectroscopic and Mechanical Properties of a New Generation of Bulk Fill Composites.

Objectives: The aims of this study were to in vitro evaluate the degree of conversion and the microhardness properties of five bulk fill resin composites; in addition, the performance of two curing lamps, used for composites polymerization, was also analyzed. Materials and Methods: The following five resin-based bulk fill composites were tested: SureFil SDR®, Fill Up!™, Filtek™, SonicFill™, and SonicFill2™. Samples of 4 mm in thickness were prepared using Teflon molds filled in one increment and light-polymerized using two LED power units. Ten samples for each composite were cured using Elipar S10 and 10 using Demi Ultra. Additional samples of SonicFill2, (3 and 5 mm-thick) were also tested. The degree of conversion (DC) was determined by Raman spectroscopy, while the Vickers microhardness (VMH) was evaluated using a microhardness tester. The experimental evaluation was carried out on top and bottom sides, immediately after curing (t0), and, on bottom, after 24 h (t24). Two-ways analysis of variance was applied to evaluate DC and VMH-values. In all analyses, the level of significance was set at p < 0.05. Results: All bulk fill resin composites recorded satisfactory DCs on top and bottom sides. At t0, the top of SDR and SonicFill2 showed the highest DCs-values (85.56 ± 9.52 and 85.47 ± 1.90, respectively), when cured using Elipar S10; using Demi Ultra, SonicFill2 showed the highest DCs-values (90.53 ± 2.18). At t0, the highest DCs-values of bottom sides were recorded by SDR (84.64 ± 11.68), when cured using Elipar S10, and Filtek (81.52 ± 4.14), using Demi Ultra. On top sides, Demi Ultra lamp showed significant higher DCs compared to the Elipar S10 (p < 0.05). SonicFill2 reached suitable DCs also on bottom of 5 mm-thick samples. At t0, VMH-values ranged between 24.4 and 69.18 for Elipar S10, and between 26.5 and 67.3 for Demi Ultra. Using both lamps, the lowest VMH-values were shown by SDR, while the highest values by SonicFill2. At t24, all DC and VMH values significantly increased. Conclusions: Differences in DC and VMH among materials are suggested to be material and curing lamp dependent. Even at t0, the three high viscosity bulk composites showed higher VMH than the flowable or dual curing composites.

Bone scintigraphy and SPECT in the evaluation of the osseointegrative response to immediate prosthetic loading of endosseous implants: a pilot study.

PURPOSE: Several recent medical reports have focused attention on the possible application of skeletal scintigraphy imaging in odontostomatology. The aim of the present report was to assess the influence of immediate prosthetic loading on peri-implant osteoblastic activity through bone scintigraphy. MATERIALS AND METHODS: Implants were placed in 2 healthy women. A nuclear medicine investigation with single-photon emission-computed tomography (SPECT) was performed for both patients at 30 and 90 days after implant placement. The study was completed with acquisitions of planar images of the skull in an anterior view and the use of regions of interest (ROIs) of the same size in the area corresponding to immediate loading and in the opposite hemimandible (at the control sites). Count density ratios (counts/pixel) obtained from each ROI were used for a quantitative/relative assessment. Tomographic images were evaluated with a qualitative method. The spatial resolution of the reconstructed tomograms and of the planar images was approximately 7 mm. RESULTS: Routine planar methodology provided a direct measure of cellular activity of the examined areas. The difference in count density ratio registered from the same ROI between the first and the second scintigraphy revealed the course of peri-implant osteoblastic activity, which was very high in the first month and then declined during subsequent months. DISCUSSION AND CONCLUSION: In spite of the small number of involved patients, the results obtained from this pilot study suggest that nuclear medicine may hold possible advantages in implant dentistry for those who seek to clarify the still unknown aspects of osteoblastic activity.