Evaluation of Sterify Gel as an Adjunctive Treatment to Scaling and Root Planing in Promoting Healing of Periodontal Pockets: A Split-Mouth Randomized Controlled Trial.

Background: Periodontal disease is a common infectious disease that leads to the destruction of tooth-supporting structures. Current treatments, such as scaling and root planing (SRP), have limitations in deep and complex pockets, and antibiotic use carries the risk of resistance. Sterify Gel, a medical device composed of polyvinyl polymers, hydroxytyrosol, nisin, and magnesium ascorbyl phosphate, offers a new approach to periodontal care. This study aims to evaluate the safety and efficacy of Sterify Gel as an adjunctive treatment to SRP in promoting the healing of periodontal pockets. Methods: The study includes 34 patients with moderate to advanced chronic periodontal disease. Randomization assigned one site for SRP alone (control) and the other site for SRP with Sterify Gel (treatment). Periodontal parameters were evaluated at baseline, 1, 2, and 3 months after treatment bacterial contamination was assessed through quantitative PCR at baseline and 3 months after treatment. Statistical analysis was conducted using ANOVA and Wilcoxon test. Results: Treatment with Sterify Gel and SRP demonstrated significant improvements in pocket depth, gingival recession, and clinical attachment level compared with SRP alone. Bleeding and plaque indexes, pain perception, tooth mobility, and furcations showed no significant differences between the two groups. The treatment group showed a reduction in bacterial contamination at 3 months. Conclusions: Sterify Gel in combination with SRP shows the potential for improving periodontal health by promoting healing and reducing periodontal pockets. It may offer benefits in preventing bacterial recolonization and reducing reliance on antibiotics.

Impact of Smoking Habit on Peri-Implant Indicators following Different Therapies: A Systematic Review.

Peri-implant disease and its treatment is becoming a major concern for clinicians as the number of implants placed each year is rising. Smoking is a common habit, and it is associated with an increased risk of developing peri-implant disease. The role of smoking in the response to peri-implant treatment has never been investigated. Searches were conducted in electronic databases to screen articles published until August 2021. The included studies had at least two groups of patients: peri-implant disease only or peri-implant disease and smoking status. Outcomes of interest included plaque index (PI), probing depth (PD), bleeding on probing (BoP), radiographic crestal bone loss (CBL), and analysis of peri-implant sulcular fluid. Seven hundred and forty-nine articles were found in the databases, only 71 articles potentially qualified. A total of seven studies with a minimum follow-up of six months were included. There is no homogeneity in the diagnosis, smoker definition and treatment proposed. All surgical and non-surgical treatment have statistically significantly different outcomes in smokers and nonsmokers. Recognizing this study's limitations, we conclude that smoking might play a significant role on the outcome of peri-implant disease treatment. None of the proposed treatments appear to be significantly more effective.

Effects on Muscular Activity after Surgically Assisted Rapid Palatal Expansion: A Prospective Observational Study.

The study aims to investigate the modifications in the temporalis and the masseter activity in adult patients before and after SARPE (Surgically Assisted Rapid Palatal Expansion) by measuring electromyographic and electrokinesographic activity. 24 adult patients with unilateral posterior crossbite on the right side were selected from the Orthodontic Department of the University of Milan. Three electromyographic and electrokinesographic surface readings were taken respectively before surgery (T0) and 8 months after surgery (T1). The electromyographic data of both right and left masseter and anterior temporalis muscles were recorded during multiple tests: standardized maximum voluntary contraction (MVC)s, after transcutaneous electrical nerve stimulation (TENS) and at rest. T0 and T1 values were compared with paired Student's t-test (p < 0.05). Results: Significant differences were found in the activity of right masseter (p = 0.03) and right temporalis (p = 0.02) during clench, in the evaluation of right masseter at rest (p = 0.03), also the muscular activity of masseters at rest after TENS from T0 to T1 (pr = 0.04, pl = 0.04). No significant differences were found in the activity of left masseter (p = 0.41) and left temporalis (p = 0.39) during clench and MVC, in the evaluation of left masseter at rest (p = 0.57) and in the activity during MVC of right masseter (p = 0.41), left masseter (p = 0.34), right temporalis (p = 0.51) and left temporalis (p = 0.77). Results showed that the activity of the masseter and temporalis muscles increased significantly after SARPE during rest and clenching on the side where the cross-bite was treated.

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.

Behavior of Soft Tissue around Platform-Switched Implants and Non-Platform-Switched Implants: A Comparative Three-Year Clinical Study.

To verify the influence of platform-switching (PS) on soft tissue behavior by comparing the soft tissue stability around implants with and without PS, during three years of follow-up. The study included patients treated with fixed dentures supported by implants with an internal connection. The radiographic distance between the first bone-to-implant contact (FBIC) and the implant shoulder was assessed. Additionally, the presence of keratinized facial mucosa and the prosthetic crown height (TH) were monitored for three years from the delivery of the definitive crown. These parameters were measured for two different groups: platform-switched implants in the PS group and non-platform-switched (NPS) implants in the NPS group. Seventy-seven implants were considered in the statistical analysis. After three years, the overall FBIC mean value was 0.31 ± 1.00 mm. However, the mean FBIC was 0.66 ± 0.97 mm for the NPS group and -0.05 ± 0.91 mm for the PS group. Moreover, a mean recession of 0.54 ± 1.39 mm was measured for the NPS group, whereas a mean coronal migration of 0.17 ± 0.95 mm was measured for the PS group. A significant correlation was also found between the presence of PS and ΔTH (p ≤ 0.01) over the three years of follow-up. The absence or presence of platform-switching would appear to affect the tendency of the gingival buccal margin towards recession or creeping. Additionally, implant-abutment platform-switching seems to help prevent peri-implant soft tissue recession over time when compared to implants without PS.

Clinical Outcome of Dental Implants after Maxillary Sinus Augmentation with and without Bone Grafting: A Retrospective Evaluation.

(1) Background: The purpose of the present study was to retrospectively evaluate and compare the outcome of two sinus augmentation grafting protocols using a xenograft or blood clot alone over a 72-month follow-up. (2) Methods: Patients who received simultaneous lateral sinus floor augmentation and implant placement were included. Subjects were divided into two groups according to the grafting material, namely xenograft or blood clot, and into sub-groups based on the residual alveolar bone height (RABH) below the maxillary sinus, namely 4 to 6 mm or >6 mm. Kaplan-Meier survival estimates were calculated for each material group and for each sub-group at 1, 3, and 6 years. (3) Results: In total, 289 implants inserted in 136 patients with a one-stage procedure were considered. A total of 35 failures were registered. Overall survival rates were 94.2% for xenograft and 85.9% for blood clot alone at 1 year, 91.1% and 81.6% at 3 years, and 91.1% and 78.7% at 6 years. (4) Conclusions: In patients with 4-6 mm RABH, graftless interventions exploiting blood clot alone were not as successful as those using xenograft. When the RABH is low, sinus floor augmentation associated with grafting materials should be preferred whenever possible.

Can transfer type and implant angulation affect impression accuracy? A 3D in vitro evaluation.

Impression accuracy is fundamental to achieve a passive fit between implants and the superstructure. Three transfer types were tested to evaluate the differences in impression accuracy and their efficiency in case of different implant angles. A master model with four implant analogues placed at 0°, 15° and 35° was used. 27 impressions were taken with three different types of impression coping: closed tray technique coping (CT), open tray technique coping (COT) and telescopic open tray coping (TOT). The impressions were poured. Analogues were matched with scan bodies to be scanned and exported in STL. An implant bar was designed from each STL and another one from the master model. A comparison between these bars was obtained. Linear and angular measurements for every type of coping were calculated for different angulations. The collected data were analyzed with ANOVA test (95% of confidence). Student's t test showed a significative discrepancy (p ≤ 0.001) on linear and angular measurements on Δx, Δy, Δz with different transfer types as well as diverse implant positioning angles (p ≤ 0.001). Within the limitations of this study, it can be concluded that the coping type and the implants divergence may be significant parameters influencing the impression accuracy.

A Call for Action to Safely Deliver Oral Health Care during and Post COVID-19 Pandemic.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak started just a couple of months ago and it grew rapidly causing several deaths and morbidities. The mechanism behind the transmission of the virus is still not completely understood despite a multitude of new specific manuscripts being published daily. This article highlights the oral cavity as a possible viral transmission route into the body via the Angiotensin converting enzyme 2 receptor. It also provides guidelines for routine protective measures in the dental office while delivering oral health care.

Influence of Bone Quality, Drilling Protocol, Implant Diameter/Length on Primary Stability: An In Vitro Comparative Study on Insertion Torque and Resonance Frequency Analysis.

The aim of this study was to evaluate the influence of bone quality, drilling technique, implant diameter, and implant length on insertion torque (IT) and resonance frequency analysis (RFA) of a prototype-tapered implant with knife-edge threads. The investigators hypothesized that IT would be affected by variations in bone quality and drilling protocol, whereas RFA would be less influenced by such variables. The investigators implemented an in vitro experiment in which a prototype implant was inserted with different testing conditions into rigid polyurethane foam blocks. The independent variables were: bone quality, drilling protocol, implant diameter, and implant length. Group A implants were inserted with a conventional drilling protocol, whereas Group B implants were inserted with an undersized drilling protocol. Values of IT and RFA were measured at implant installation. IT and RFA values were significantly correlated (Pearson correlation coefficient: 0.54). A multivariable analysis showed a strong model. Higher IT values were associated with drilling protocol B vs A (mean difference: 71.7 Ncm), implant length (3.6 Ncm increase per mm in length), and substrate density (0.199 Ncm increase per mg/cm3 in density). Higher RFA values were associated with drilling protocol B vs A (mean difference: 3.9), implant length (1.0 increase per mm in length), and substrate density (0.032 increase per mg/cm3 in density). Implant diameter was not associated with RFA or IT. Within the limitations of an in vitro study, the results of this study suggest that the studied implant can achieve good level of primary stability in terms of IT and RFA. A strong correlation was found between values of IT and RFA. Both parameters are influenced by the drilling protocol, implant length, and substrate density. Further studies are required to investigate the clinical response in primary stability and marginal bone response.

Influence of the implant-abutment connection on the ratio between height and thickness of tissues at the buccal zenith: a randomized controlled trial on 188 implants placed in 104 patients.

BACKGROUND: To compare tissue response to two implant systems, featuring internal hexed connections with different designs. METHODS: Patients enrolled in this randomized controlled trial were assigned to two groups. In Group 1, patients were treated with implants with a 5° conical internal hexed connection (Anyridge®, MegaGen, South Korea). In Group 2, patients were treated with implants with an internal hexed connection (Core®, Kristal, Italy). After implant placement and a provisionalisation period of 12 months, impressions were taken, stone casts were poured and digitised with a desktop scanner (D700®, 3Shape, Copenhagen, Denmark). In a digital environment, for each fixture, two values were collected at the buccal zenith: the height of the peri-implant mucosa (mucosal height; MH), calculated from the vestibular shoulder of the implant analogue to the upper gingival margin of the supra-implant tissue; and the width of the peri-implant mucosa (mucosal thickness; MT), calculated from the vestibular shoulder of the analogue to the external mucosa point perpendicular to the implant major axis. The mean and standard deviation for MH and MT, as well as their ratios, were calculated for each group; the sectors in which the implants were placed were also considered. Finally, correlation between MH, MT, connection type and sector was assessed by Pearson's correlation coefficient, with significance level set at 0.05, and a confidence interval (CI) set at 95%. RESULTS: Data deriving from 188 implants placed in 104 patients were evaluated. The mean MH values were 3.32 (± 0.12) and 2.70 (± 0.16) mm for Groups 1 and 2, respectively. The mean MT values were 4.37 (± 0.16) and 3.93 (± 0.18) mm for Groups 1 and 2, respectively. Group 1 showed higher MH and MT values and a better ratio (1.50 ± 0.88) than Group 2 (1.81 ± 1.20). The MH, MT and MH/MT ratio were significantly influenced both by sector (p = 0.015) and group (p = 0.047). CONCLUSIONS: Within the limits of this study, the 5° connection implants supported a more extended tissue height and thickness at the buccal zenith, and a better ratio between them. TRIAL REGISTRATION: This study was retrospectively registered in Clinicaltrials.gov, with number NCT04160689, dated 13/11/2019.

Correlation between Buccal Bone Thickness at Implant Placement in Healed Sites and Buccal Soft Tissue Maturation Pattern: A Prospective Three-Year Study.

BACKGROUND: Optimal aesthetic implant restoration is a combination of a visually pleasing prosthesis and adequate surrounding peri-implant soft tissue architecture. This study describes the influence of the residual buccal bone thickness (BBT), measured at the time of implant placement, on the soft tissue maturation during three years of follow-up. METHODS: Seventy-eight implants were enrolled in the present study. The BBT was assessed at the surgical stage and each case assigned to Group 1 (BBT values ≤0.5 mm), Group 2 (BBT values >0.5 and <1.5 mm), or Group 3 (BBT values ≥1.5 mm). Only native bone and healed sites were included. The tooth height (TH), based on the distance between the buccal free gingival margin at the zenith level and the crown incisal edge, according to the main axis of the tooth, was monitored at one, two, and three years from the final prosthodontic rehabilitation to determine any occurrence of recession or coronal repositioning of the gums over time. A Pearson Two-Tailed test was applied and the significance level set at p ≤ 0.05. RESULTS: For BBT values ≤0.5 mm, the buccal gum at three years showed an average recession of 1.22 ± 0.41 mm. For BBT values >0.5 and <1.5 mm, the buccal gum also showed recession of 0.64 ± 0.29 mm. In contrast, for BBT values ≥1.5 mm, the buccal gum showed coronal growth of 0.77 ± 0.22 mm. The differences between the groups were significant (p ≤ 0.01) at all times. CONCLUSION: The BBT at the time of implant placement was found to affect the buccal gingival margin stability over three years of observation.

A Comparative 3D Finite Element Computational Study of Three Connections.

Masticatory overload on dental implants is one of the causes of marginal bone resorption. The implant-abutment connection (IAC) design plays a critical role in the quality of the stress distribution, and, over the years, different designs were proposed. This study aimed to assess the mechanical behavior of three different types of IAC using a finite element model (FEM) analysis. Three types of two-piece implants were designed: two internal conical connection designs (models A and B) and one internal flat-to-flat connection design (model C). This three-dimensional analysis evaluated the response to static forces on the three models. The strain map, stress analysis, and safety factor were assessed by means of the FEM examination. The FEM analysis indicated that forces are transmitted on the abutment and implant's neck in model B. In models A and C, forces were distributed along the internal screw, abutment areas, and implant's neck. The stress distribution in model B showed a more homogeneous pattern, such that the peak forces were reduced. The conical shape of the head of the internal screw in model B seems to have a keystone role in transferring the forces at the surrounding structures. Further experiments should be carried out in order to confirm the present suppositions.

Current state of the art in the use of augmented reality in dentistry: a systematic review of the literature.

BACKGROUND: The aim of the present systematic review was to screen the literature and to describe current applications of augmented reality. MATERIALS AND METHODS: The protocol design was structured according to PRISMA-P guidelines and registered in PROSPERO. A review of the following databases was carried out: Medline, Ovid, Embase, Cochrane Library, Google Scholar and the Gray literature. Data was extracted, summarized and collected for qualitative analysis and evaluated for individual risk of bias (R.O.B.) assessment, by two independent examiners. Collected data included: year of publishing, journal with reviewing system and impact factor, study design, sample size, target of the study, hardware(s) and software(s) used or custom developed, primary outcomes, field of interest and quantification of the displacement error and timing measurements, when available. Qualitative evidence synthesis refers to SPIDER. RESULTS: From a primary research of 17,652 articles, 33 were considered in the review for qualitative synthesis. 16 among selected articles were eligible for quantitative synthesis of heterogenous data, 12 out of 13 judged the precision at least as acceptable, while 3 out of 6 described an increase in operation timing of about 1 h. 60% (n = 20) of selected studies refers to a camera-display augmented reality system while 21% (n = 7) refers to a head-mounted system. The software proposed in the articles were self-developed by 7 authors while the majority proposed commercially available ones. The applications proposed for augmented reality are: Oral and maxillo-facial surgery (OMS) in 21 studies, restorative dentistry in 5 studies, educational purposes in 4 studies and orthodontics in 1 study. The majority of the studies were carried on phantoms (51%) and those on patients were 11 (33%). CONCLUSIONS: On the base of literature the current development is still insufficient for full validation process, however independent sources of customized software for augmented reality seems promising to help routinely procedures, complicate or specific interventions, education and learning. Oral and maxillofacial area is predominant, the results in precision are promising, while timing is still very controversial since some authors describe longer preparation time when using augmented reality up to 60 min while others describe a reduced operating time of 50/100%. TRIAL REGISTRATION: The following systematic review was registered in PROSPERO with RN: CRD42019120058.

Ratio between Height and Thickness of the Buccal Tissues: A Pilot Study on 32 Single Implants.

BACKGROUND: Previous studies have suggested that mucosal height is related to the bone level and soft tissue thickness. The purpose of this pilot study was to investigate the ratio between the height and width of the tissues around single implants with a conical connection and platform switching. METHODS: All patients receiving single implants (Anyridge®, MegaGen, Gyeongbuk, South Korea) and restored with single crowns, in a three-month period, were included in this study. After a provisionalization of 12 months, precision impressions were taken and stone casts were poured for measurements. For each implant, two values were collected at the buccal site: the mucosal height (MH), calculated from the vestibular shoulder of the implant to the upper gingival margin of the supra-implant tissue; and the mucosal thickness (MT), calculated from the vestibular shoulder of the analogue to the external mucosa point perpendicular to the implant major axis. Mean, standard deviation (SD), and confidence intervals (CI 95%) for MH and MT, as well as their ratios, were calculated. Correlation between MH and MT was assessed by Pearson's correlation coefficient, with significance level set at 0.05. RESULTS: 32 single Anyridge® implants were eligible for this evaluation. The mean MH was 3.44 mm (±1.28), the mean MT was 3.29 (±1.46). The average of the ratio between MH and MT of the supra-implant mucosa was therefore 1:1.19 (±0.55). The relation between MH and MT was statistically significant at p ≤ 0.01 (Pearson two-tailed 95% CI). CONCLUSIONS: Our study found a constant relationship between width and height of the peri-implant mucosa. However, our results are different from those of Nozawa et al., who found a ratio of 1:1.5 between height and thickness of the peri-implant tissues. This may be determined by the different sample and follow-up period, as well as by the implants used in our study.

Nitrogen Containing Bisphosphonates Impair the Release of Bone Homeostasis Mediators and Matrix Production by Human Primary Pre-Osteoblasts.

Bisphosphonates (BPs) represent the first-line treatment for a wide array of bone disorders. Despite their well-known action on osteoclasts, the effects they induce on osteoblasts are still unclear. In order to shed light on this aspect we evaluated the impact of two nitrogen containing bisphosphonates, Alendronate (ALN) and Zoledronate (ZOL), on human primary pre-osteoblasts. At first, we showed an inhibitory effect on cell viability and alkaline phosphatase activity starting from µM concentrations of both drugs. In addition, an inhibitory trend on mineralized nodules deposition was observed. Then low doses of both ALN and ZOL rapidly increased the release of the pro-inflammatory mediators TNFα and IL-1ß, while increased DKK-1 and Sclerostin, both inhibitors of osteoblastogenesis. Finally, ALN and 10-7M ZOL decreased the expression of type I Collagen and Osteopontin, while both drugs slightly stimulated SPARC production. With these results, we would like to suggest a direct inhibitory action on bone-forming cells by nitrogen containing bisphosphonates.

Decontamination of Customized Laser-Microtextured Titanium Abutments: A Comparative in Vitro Study of Different Cleaning Procedures.

The aim of this study was to evaluate different cleaning procedures for customized laser-microtextured titanium abutments. A total of 20 customized laser-microtextured abutments were randomized into four groups: no cleaning (control group), ultrasonic treatments + autoclave cycle (group 1), ultrasonic treatments + argon plasma (group 2), and only argon plasma (group 3). Surface contaminants were assessed through scanning electron microscopy and energy-dispersive x-ray spectroscopy microanalysis. In the control group, 99.96% of the abutment surfaces were contaminated with organic and inorganic pollutants. Group 3 showed the second highest contamination percentage, with almost 23% of the analyzed surfaces polluted. Samples in groups 1 and 2 were almost clean, with negligible traces of microparticles (0.009% and 0.047% of the surfaces were contaminated, respectively). These results were statistically significant for differences between control and test groups, and between groups 1 and 2 in comparison to 3 (P < .001). Abutment decontamination with argon plasma alone might not be as effective on laser-microtextured surfaces as other cleaning protocols.

Failed Blade Implant After 25 Years in Function: Case Description and Histologic Analysis.

This report describes a failed blade implant after 25 years in function in the left maxilla and the results of histologic analysis of peri-implant tissues. The blade was retrieved, and histologic findings revealed that it was not osseointegrated despite being successfully in function for so many years. The long-term function of blade implants without osseointegration can be attributed to biotolerance exhibited by the implant rather than actual osseointegration.

Advanced 3D Models Cultured to Investigate Mesenchymal Stromal Cells of the Human Dental Follicle.

The human dental follicle (hDF) contains the developing tooth and is involved in regulating tooth maturation and eruption. To investigate the mesenchymal stromal cells of the dental follicle, 2 three-dimensional (3D) culture models were used, based on a dynamic bioreactor: the Rotary Cell Culture System (RCCS™) and the 3D culture of precursor cells isolated from follicular tissue (human dental follicle cells [hDFCs]). The hDFCs were obtained from impacted third molars of 20 patients. Two 3D culture models were tested. In the first model, intact hDF explants were cultured in 3D conditions, preserving the original tissue architecture; they were studied using histomorphological and molecular analyses. The second model involved the 3D culture of hDFCs, which were characterized to evaluate their multipotency in terms of differentiation capability. Of the biomarkers known to characterize hDFCs, hDF precursors were selected for our study. The immunophenotype and in situ immunocytochemistry were evaluated for markers CD44, CD90, CD146, CD105, CD31, CD34, and CD45 Ag. The results show that the conditions provided by the RCCS preserve the original organizational architecture of the cells. The 3D conditions of the model enhanced differentiation in response to adipogenic, osteogenic, and chondrogenic inductive growth media. The immunophenotype and the immunocytochemistry showed generally high expression of CD90, CD44, and CD105, while CD146 expression was more restricted to ∼30% of cells. No expression was observed for CD31, CD34, and CD45 Ags. Two 3D tissue- and cell-based ex vivo models of the hDF supported the long-term maintenance of hDF-specific cell phenotypes and their ability to recapitulate typical cellular differentiation states. As such, these ex vivo models could be used to study the physiopathology of human odontogenesis. In addition, in a therapeutic context, they could be used to examine the role of specific chemical signals (e.g., new therapeutic agents) in the processes of dental tissue repair and regeneration.

Drug Loaded Gingival Mesenchymal Stromal Cells (GinPa-MSCs) Inhibit In Vitro Proliferation of Oral Squamous Cell Carcinoma.

Human mesenchymal stromal cells (MSCs) have been widely investigated both for regenerative medicine and their antinflammatory/immunomodulatory capacity. However, their ability to home pathological tissues suggested the development of strategies for using MSCs as carrier to deliver drug into tumor microenvironment. MSCs obtained from different tissues can be loaded in vitro with anti-cancer drugs by a simple procedures. In this report, we studied MSCs isolated and expanded from gingival papilla (GinPa-MSCs), by testing their ability to uptake and release three important anti-neoplastic drugs: Paclitaxel (PTX), Doxorubicin (DXR) and Gemcitabine (GCB). The efficacy of drugs releasing GinPa-MSCs was studied on a pancreatic cancer cell line and confirmed in vitro against a line of tongue squamous cell carcinoma (SCC154). Our results demonstrated that GinPa-MSCs efficiently incorporate the drugs and then released them in active form and in sufficient amount to produce a dramatic inhibition of squamous cell carcinoma growth in vitro. If compared with other MSCs sources, the collection of GinPa-MSCs is poorly invasive and cells can be easily expanded and efficiently loaded with anti cancer drugs. In particular, gemcitabine loaded GinPa-MSCs provide a good "cell-mediated drug delivery system" for a future potential application in the context of the oral oncology.

Influence of a Laser-Lok Surface on Immediate Functional Loading of Implants in Single-Tooth Replacement: Three-Year Results of a Prospective Randomized Clinical Study on Soft Tissue Response and Esthetics.

The purpose of the present prospective randomized study was to evaluate the influence of Laser-Lok microtextured surface on soft tissue peri-implant parameters and esthetics around immediate, functionally loaded implants for single-tooth replacement in the esthetic zone. This study included 77 patients divided into two groups based on different implants used: the control group had BioHorizons tapered internal non-Laser-Lok-type implants (NLL; n = 39) and the test group had BioHorizons tapered internal Laser-Lok-type implants (LL; n = 39). Outcome measures were survival, radiographic marginal bone-level changes, soft tissue parameters, and esthetics. One implant was lost in the test group and one in the control group, for a total survival rate of 96.1% after 3 years. Radiographically, mean crestal bone loss ± standard deviation was 0.59 ± 0.27 mm in the LL group compared with 1.17 ± 0.31 mm in the NLL group. A mean gain in papilla level of 0.41 ± 0.34 mm and 0.17 ± 0.36 mm was observed in the LL and the NLL groups, respectively, while the level of the midfacial peri-implant mucosa remained stable in both groups with no statistically significant differences (0.08 ± 0.42 mm for the LL group vs 0.06 ± 0.36 mm for the NLL group). The mean probing depth values in the LL and NLL groups were 0.58 ± 0.2 mm and 1.89 ± 0.3 mm, respectively. Within the limitations of this study, it was demonstrated that the clinical and esthetic outcome of immediate functional loading was more favorable for LL implants than for NLL implants.