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1.
Int Dent J ; 71(1): 21-26, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33616049

RESUMEN

A new coronavirus (Sars-CoV-2) was detected in China at the end of 2019 and has since caused a worldwide pandemic. This virus is responsible for an acute respiratory syndrome (COVID-19), distinguished by a potentially lethal interstitial bilateral pneumonia. Because Sars-CoV-2 is highly infective through airborne contamination, the high infection risk in the dental environment is a serious problem for both professional practitioners and patients. This literature overview provides a description of the clinical aspects of COVID-19 and its transmission, while supplying valuable information regarding protection and prevention measures.

2.
Dent Mater ; 36(12): 1645-1654, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33187771

RESUMEN

OBJECTIVE: To evaluate the effects of N,N'-dicyclohexylcarbodiimide (DCC), an ethanol-based dentin cross-linker, on the immediate and long-term microtensile bond strength (µTBS) and nanoleakage expression of a universal adhesive employed in self-etch mode (SE) or etch-and-rinse mode (ER). The effect of DCC on the dentinal MMP activity was also investigated by means of in-situ zymography. METHODS: Eighty freshly extracted human molars were sectioned to expose mid-coronal dentin surfaces. The teeth were assigned to one of the following groups, according to the dentin surface priming/adhesive approach: (G1): DCC pre-treatment and Scotchbond Universal (SBU) in ER mode; (G2): SBU in ER mode; (G3): DCC pretreatment and SBU in SE mode; (G4): SBU in SE mode. µTBS test was performed immediately (T0) or after 1-year aging (T12) in artificial saliva. Ten additional teeth per group were prepared for nanoleakage evaluation (N = 5) and for in-situ zymography (N = 5). RESULTS: Three-factor analysis of variance revealed significant difference for the variables DCC pretreatment, application mode and aging (p < 0.05) for both microtensile bond strength testing and in-situ zymography. Nanoleakage analysis revealed reduced marginal infiltration of DCC experimental groups both at T0 and T12. SIGNIFICANCE: The use of an ethanol-based primer containing DCC appears to be promising in preserving the stability of the adhesive interface of a universal adhesive, especially in the SE mode.

3.
Quintessence Int ; : 2-7, 2020 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-33118005

RESUMEN

The extraction of a tooth with root resorption can be a complicated procedure and can result in the removal of a significant amount of alveolar bone. In the anterior maxilla, esthetic rehabilitation of damaged sites with implant-supported crown could require multiple surgeries. Patients often ask for an alternative, and minimally invasive treatments are generally preferred. In this paper, a clinical case of implant-supported crown in a site affected by root resorption is described. Immediate implant was placed leaving some root fragments in the osteotomy site, thus avoiding invasive extractive surgeries. A minimally invasive flapless technique with a computer-guided implant placement procedure was used. After 8 years, clinical and radiologic data were stable, gingival tissues around the implant appeared healthy, no dark translucency appeared through marginal gingiva around the implant, and there was no pathologic probing pocket depth or bleeding on probing. In the presence of root resorption and ankylosis, computer-guided surgery could be helpful to prepare a precise implant site through various tissues, such as partially resorbed root remnants.

4.
Minerva Stomatol ; 2020 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-32960524

RESUMEN

BACKGROUND: Due to droplet production and exposure to saliva and blood, dental practitioners are at high risk of COVID-19 contagion during their routine procedures. The aim of this study is to investigate the behavior of Italian dentists and to analyze their reactions in relation to Sars-CoV-2 pandemic professional restrictive measures. METHODS: An online structured survey composed of 40 questions has been sent to dental practitioners all over Italy to investigate their behavior and to analyze their reactions in relation to Sars-CoV-2 pandemic restrictive measures introduced by the Italian national administrative order of 10 March 2020 (DM-10M20). RESULTS: 1109 dentists replied. To assess concerns and psychological responses the sample was divided into two groups based on the number of cases registered in their work area. In the first group were included all the responders working in the Italian regions that had more than 15,000 confirmed cases of COVID-19 as of April 29, 2020. The second group included responders working in the Italian regions that had less than 15,000 confirmed cases. The 45.2% of the respondents showed minimal anxiety, 34.5% showed mild anxiety, 13.9% showed moderate anxiety, while 6.4% showed a score indicative of a severe level of anxiety. CONCLUSIONS: The COVID-19-related emergency condition had a highly negative impact on dental practices in Italy. Those who completed the survey reported practice closure or reduction during the lockdown, and a high level of concern about the professional future for all dental practitioners. Concerns related to professional activity were accompanied by severe anxiety levels.

5.
J Oral Implantol ; 2020 Aug 11.
Artículo en Inglés | MEDLINE | ID: mdl-32780815

RESUMEN

In 2020, a highly infective new pathogen (Sars-CoV-2) spread from China to the whole globe, and became responsible of an acute respiratory syndrome, often asymptomatic but potentially lethal, named COVID-19. Airborne and direct contact contamination are the major infection pathways of Sars-CoV-2 and it has been shown that virus spread can also happen in absence of clinical symptoms. SARS-CoV-2 transmission during dental procedures can happen through inhalation of droplets from infected patients or direct contact with mucous membranes, oral fluids, and contaminated instruments. Both sinus lift and implant surgeries often involve bleeding and exposure to oral fluids, and a rubber dam could be used to reduce direct contact and the amount of potentially infected aerosol. The aim of this short case presentation is to illustrate how the use of a rubber dam could be extremely useful in preventing COVID-19 exposure during flapless trans-crestal sinus lift procedures.

6.
Artículo en Inglés | MEDLINE | ID: mdl-32650590

RESUMEN

This review provides a detailed description of matrix metalloproteinases (MMPs), focusing on those that are known to have critical roles in bone and periodontal disease. Periodontal disease is an inflammatory process initiated by anaerobic bacteria, which promote the host immune response in the form of a complex network of molecular pathways involving proinflammatory mediators such as cytokines, growth factors, and MMPs. MMPs are a family of 23 endopeptidases, collectively capable of degrading virtually all extracellular matrix (ECM) components. This study critically discusses the available research concerning the involvement of the MMPs in periodontal disease development and progression and presents possible therapeutic strategies. MMPs participate in morphogenesis, physiological tissue turnover, and pathological tissue destruction. Alterations in the regulation of MMP activity are implicated in the manifestation of oral diseases, and MMPs comprise the most important pathway in tissue destruction associated with periodontal disease. MMPs can be considered a risk factor for periodontal disease, and measurements of MMP levels may be useful markers for early detection of periodontitis and as a tool to assess prognostic follow-ups. Detection and inhibition of MMPs could, therefore, be useful in periodontal disease prevention or be an essential part of periodontal disease therapy, which, considering the huge incidence of the disease, may greatly improve oral health globally.


Asunto(s)
Metaloproteinasas de la Matriz , Enfermedades Periodontales , Periodontitis , Citocinas , Humanos , Enfermedades Periodontales/metabolismo , Periodontitis/metabolismo
7.
Int Dent J ; 2020 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-32623723

RESUMEN

A new coronavirus (Sars-CoV-2) was detected in China at the end of 2019 and has since caused a worldwide pandemic. This virus is responsible for an acute respiratory syndrome (COVID-19), distinguished by a potentially lethal interstitial bilateral pneumonia. Because Sars-CoV-2 is highly infective through airborne contamination, the high infection risk in the dental environment is a serious problem for both professional practitioners and patients. This literature overview provides a description of the clinical aspects of COVID-19 and its transmission, while supplying valuable information regarding protection and prevention measures.

8.
Artículo en Inglés | MEDLINE | ID: mdl-32429193

RESUMEN

The outbreak and diffusion of the Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-CoV-2) and COronaVIrus Disease 19 (COVID-19) have caused an emergency status in the health system, including in the dentistry environment. Italy registered the third highest number of COVID-19 cases in the world and the second highest in Europe. An anonymous online survey composed of 40 questions has been sent to dentists practicing in the area of Modena and Reggio Emilia, one of the areas in Italy most affected by COVID-19. The survey was aimed at highlighting the practical and emotional consequences of COVID-19 emergence on daily clinical practice. Specifically, it assessed dentists' behavioral responses, emotions and concerns following the Sars-CoV-2 pandemic restrictive measures introduced by the Italian national administrative order of 10 March 2020 (DM-10M20), as well as the dentists' perception of infection likelihood for themselves and patients. Furthermore, the psychological impact of COVID-19 was assessed by means of the Generalized Anxiety Disorder-7 test (GAD-7), that measures the presence and severity of anxiety symptoms. Using local dental associations (ANDI-Associazione Nazionale Dentisti Italiani, CAO-Commissione Albo Odontoiatri) lists, the survey was sent by email to all dentists in the district of Modena and Reggio Emilia (874 practitioners) and was completed by 356 of them (40%). All dental practitioners closed or reduced their activity to urgent procedures, 38.2% prior to and 61.8% after the DM-10M20. All reported a routinely use of the most common protective personal equipment (PPE), but also admitted that the use of PPE had to be modified during COVID-19 pandemic. A high percentage of patients canceled their previous appointments after the DM-10M20. Almost 85% of the dentists reported being worried of contracting the infection during clinical activity. The results of the GAD-7 (General Anxiety Disorder-7) evaluation showed that 9% of respondents reported a severe anxiety. To conclude, the COVID-19 emergency is having a highly negative impact on the activity of dentists practicing in the area of Modena and Reggio Emilia. All respondents reported practice closure or strong activity reduction. The perception of this negative impact was accompanied by feelings of concern (70.2%), anxiety (46.4%) and fear (42.4%). The majority of them (89.6%) reported concerns about their professional future and the hope for economic measures to help dental practitioners.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Odontólogos/psicología , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Adulto , Ansiedad/epidemiología , Betacoronavirus , Coronavirus , Odontología/estadística & datos numéricos , Miedo , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Equipo de Protección Personal , Rol Profesional , Encuestas y Cuestionarios
9.
J Dent ; 85: 25-32, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30998949

RESUMEN

OBJECTIVE: This in vitro study evaluated at baseline (T0) and over time (T12 months), the effect of a multi-mode universal adhesive compared with two experimental formulations blended with different concentrations of benzalkonium chloride (BAC), on bond strength and endogenous enzymatic activity. METHODS AND MATERIALS: Specimens were assigned to the following groups according to the adhesive protocol: G1) All-Bond Universal (ABU) self-etch (SE); G2) ABU + 0.5% BAC SE; G3) ABU + 1% methacrylate BAC SE; G4) ABU etch-and-rinse (E&R); G5) ABU + 0.5% BAC E&R; G6) ABU + 1% methacrylate BAC E&R. Gelatin zymography was performed on dentin powder obtained from eight human third molars. Endogenous enzymatic activity within the hybrid layer was examined using in situ zymography after 24 h (T0) or 1-year storage in artificial saliva (T12). Forty intact molars were prepared for microtensile bond strength test at T0 and T12. Results were statistically analyzed with three-way ANOVA (α = 0.05). RESULTS: Gelatin zymography assay and in situ zymography quantification analyses indicated that all the BAC-containing formulations decreased matrix metalloproteinase expression. However, in situ zymography showed a general trend of enzymatic activity increase after aging. Microtensile bond-strength testing showed decrease in bond strength over time in all the tested groups; performances of the 1% methacrylate BAC experimental groups were worse than the control. CONCLUSIONS: BAC-containing adhesives reduce endogenous enzymatic activity both immediately and over time. However, independently from the adhesive employed, increase in the gelatinolytic activity over time and decrease in bond strength was found (especially in the BAC + 1% methacrylate groups), probably due to impaired polymerization properties. CLINICAL SIGNIFICANCE: Adhesives containing protease inhibitors are practical and efficient tools in clinical practice for enhancement of the longevity of dental restorations. However, extensive investigation of the mechanical and adhesive properties of the material is necessary prior to their clinical use.


Asunto(s)
Compuestos de Benzalconio/química , Recubrimiento Dental Adhesivo , Dentina , Recubrimientos Dentinarios , Humanos , Ensayo de Materiales , Cementos de Resina , Resistencia a la Tracción
10.
Biomed Res Int ; 2019: 4386709, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30891457

RESUMEN

Although the number of complications and failures in bone augmentation procedures is still relatively high, these problems remain poorly documented. Moreover, the literature concerning reconstructive techniques and the treatment of their complications in the anterior areas rarely considers the final esthetic result. The aim of this paper is to propose a new classification of bone augmentation complications in the esthetic area, providing treatment guidelines useful for the management of these cases. Failures of bony regeneration procedures can be mainly divided into partial failures and complete failures. A partial failure can be solved with a corrective surgical intervention: this second surgery can have success or may not be able to provide the desired esthetic result. When the bone reconstructive procedure fails totally, a complete failure occurs and the whole procedure has to be repeated. This new intervention can have success but also this new reconstructive surgery can fail in the same way as the first, causing important damage and a compromise solution that will hardly be acceptable from an esthetic point of view. Bone augmentation techniques are not completely predictable and are not always able to guarantee the expected result, especially in the atrophic anterior maxilla. Complications and failures can often occur and this possibility must always be clearly explained to those patients with high esthetic demands and expectations.


Asunto(s)
Aumento de la Cresta Alveolar/clasificación , Estética Dental , Maxilar/patología , Maxilar/cirugía , Atrofia , Materiales Biocompatibles/química , Regeneración Ósea , Resorción Ósea/patología , Coronas , Implantes Dentales , Porcelana Dental/química , Humanos , Colgajos Quirúrgicos , Resultado del Tratamiento
11.
Open Dent J ; 12: 837-845, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30505364

RESUMEN

Background: Periodontitis is a multifactorial infection caused by a complex of pathogenic bacterial species that induce the destruction of periodontal structures. Objective: The aim of this study is to evaluate the presence and bacterial load of six periodontal pathogens bacteria, measured at initial visit and after osseous surgery in patients affected by chronic periodontitis and treated between 2005 and 2007. Methods: This cohort study was carried out on a sample of 38 consecutive patients affected by severe chronic periodontitis, diagnosed at baseline on the basis of probing depths equal to 6.68 ± 1.47 mm. On each subject, a microbiological test was performed before periodontal initial therapy and after osseous surgery (one year later). Five compromised teeth were chosen for each patient (the same teeth, before and after surgery), for a total of 190 teeth. Real-time PCR based analysis computed total bacterial load of the samples and quantified six periodontal pathogens: Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum and Prevotella intermedia. Data collection was made consulting medical charts. Results: Pocket probing depth reduction after surgery was 4.50 ± 1.54 mm (p=0.0001). The mean number of sites with bleeding at baseline was 2.08 ± 1.17 and 0.58 ± 1.00 after surgery (p=0.001). The mean number of sites with suppuration at baseline was 0.26 ± 0.86 and 0 after surgery (p=0.02). Cell count of each pathogen and total cell count were significantly higher at baseline than after surgery. Almost all bacteria presented a mean percentage reduction equal to that of the total count, except for Aa and Pi, which seemed to show a greater resistance. The difference of bacterial load, both before and after surgery, between smokers and non-smokers was not statistically significant (p<0.05). A statistically significant correlation was detected between pocket probing depth variation and bleeding on probing variation before and after the surgery, controlling for age (r=0.6, p=0.001). No significant correlations were observed between pocket probing depth and bacterial loads, except for Pg (r=0.5, p=0.001), Tf (r=0.6, p=0.001) and Td (r=0.4, p=0.02). Conclusions: Reduction of presence and bacterial load of the examined periodontal pathogens bacteria after osseous surgery, along with periodontal pocket reduction, appeared to be essential to achieve and maintain periodontal stability over years.

12.
Eur J Oral Implantol ; 11(2): 235-240, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29806670

RESUMEN

PURPOSE: To present a case of a woman referred for the management of displacement of one implant in her right posterior mandible that had occurred three days previously. MATERIALS AND METHODS: After implant placement, the practitioner was no longer able to detect the implant and inserted a second one at the same site without taking a control radiograph. At the end of surgery, when a radiograph was finally taken, the first implant appeared displaced into the mandible body. The patient suffered total paresthesia on the right lower lip and chin. A flap was raised and bone osteotomies were performed on the lateral side of the mandible to create a rectangular cortical bone window that was removed. The implant was stuck by the second implant placed coronally, and only after unscrewing this second implant was it possible to remove the first one. RESULTS: After 18 months, the patient recovered full sensitivity. CONCLUSIONS: In cases of implant displacement, it is always recommended that appropriate radiographs are performed to visualise where the implants could have been displaced in order to avoid more serious consequences.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Mandíbula , Femenino , Humanos , Persona de Mediana Edad
13.
Artículo en Inglés | MEDLINE | ID: mdl-29023618

RESUMEN

This paper presents a technical description of the inlay technique performed with an allograft block in the reconstruction of a severely atrophic posterior mandible. It includes a histologic case series of five patients treated with the same grafting procedure and rehabilitated with dental implants 2 months after placement of the graft. The histologic analysis showed large amounts of newly formed bone in tight connection with the allograft and large marrow spaces with intense cellular activity and the presence of osteocytes. Allografts might serve as an alternative to autogenous and heterologous grafting in posterior mandible augmentation using the inlay technique.


Asunto(s)
Trasplante Óseo , Implantes Dentales , Incrustaciones , Mandíbula/patología , Mandíbula/cirugía , Procedimientos Quirúrgicos Reconstructivos/métodos , Aloinjertos , Atrofia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Orales/métodos
14.
Eur J Oral Implantol ; 10(3): 263-278, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28944355

RESUMEN

PURPOSE: To compare the effectiveness of 6.0 to 8.0 mm-wide diameter implants, placed immediately after tooth extraction, with conventional 4.0 or 5.0 mm diameter implants placed in a preserved socket after a 4-month period of healing in the molar region. MATERIALS AND METHODS: Just after extraction of one or two molar teeth, and with no vertical loss of the buccal bone in relation to the palatal wall, 100 patients requiring immediate post-extractive implants were randomly allocated to immediate placement of one or two 6.0 to 8.0 mm-wide diameter implants (immediate group; 50 patients) or for socket preservation using a porcine bone substitute covered by a resorbable collagen barrier (delayed group; 50 patients), according to a parallel group design in one centre. Bone-to-implant gaps were filled with autogenous bone retrieved with a trephine drill used to prepare the implant sites for the immediate wide diameter post-extractive implants. Four months after socket preservation, one to two 4.0 or 5.0 mm-wide delayed implants were placed. Implants were loaded 4 months after placement with fixed provisional restorations in acrylic, and replaced after 4 months by fixed, definitive, metal-ceramic restorations. Patients were followed to 1 year after loading. Outcome measures were: implant failures, complications, aesthetics assessed using the pink esthetic score (PES), peri-implant marginal bone level changes, patient satisfaction, number of appointments and surgical interventions recorded, when possible, by blinded assessors. RESULTS: Three patients dropped out 1 year after loading from the immediate group vs six from the delayed group. Five implants out of 47 failed in the immediate group (10.6%) vs two out 44 (4.6%) in the delayed group, the difference being not statistically significant (difference in proportion = 6.0%, 95% CI: -8.8% to 20.8%, P = 0.436). In the immediate group 10 patients were affected by 10 complications, while in the delayed group four patients were affected by four complications. The difference was not statistically significant (difference in proportion = 12%, 95% CI: -2% to 26%, P = 0.084). At delivery of the definitive prostheses, 4 months after loading, the mean total PES score was 9.65 ± 1.62 and 10.44 ± 1.47 in the immediate and delayed groups, respectively. At 1 year after loading, the mean total PES score was 9.71 ± 2.71 and 10.86 ± 1.37 in the immediate and delayed groups, respectively. The Total PES score was statistically significantly better at delayed implants both at 4 months (mean difference = 0.79; 95% CI: 0.05 to 1.53; P = 0.03) and at 1 year (mean difference = 1.15; 95% CI: 0.13 to 2.17; P = 0.02). Marginal bone levels at implant insertion (after bone grafting) were 0.04 mm for immediate and 0.11 mm for delayed implants, which was statistically significantly different (mean difference = 0.07; 95% CI: 0.02 to 0.12; P < 0.0001). One year after loading, patients in the immediate group lost on average 1.06 mm and those from the delayed group 0.63 mm, the difference being statistically significant (mean difference = 0.43 mm; 95% CI: 0.15 to 0.61; P < 0.0001). All patients were fully or partially satisfied both for function and aesthetics, and would undergo the same procedure again both at 4 months and 1 year after loading. Patients from the immediate group required on average 7.48 ± 1.45 visits to the clinician and 2.14 ± 0.49 surgical interventions and to have their definitive prostheses delivered vs 10.30 ± 0.99 visits and 3.08 ± 0.40 surgical interventions for the delayed group, the difference being statistically significant (P < 0.001 for visits, and P < 0.001 for surgical interventions). CONCLUSIONS: Preliminary 1 year follow-up data suggest that immediate placement of 6.0 to 8.0 mm wide diameter implants in molar extraction sockets yielded inferior aesthetic outcomes than ridge preservation and delayed placement of conventional 4.0 to 5.0 mm diameter implants.


Asunto(s)
Implantación Dental , Implantes Dentales de Diente Único , Carga Inmediata del Implante Dental , Diente Molar/cirugía , Extracción Dental , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Resultado del Tratamiento
15.
Open Dent J ; 11: 187-199, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28567143

RESUMEN

BACKGROUND: Nowadays, there are many techniques to compensate bone atrophies of the posterior maxilla in order to obtain an implant-supported rehabilitation. OBJECTIVE: This case series describes the Ebanist technique: a sinus lift procedure to be used in case of extremely resorbed bone crests (≤3 mm) allowing simultaneous implant placement. METHODS: With a dedicated cylindrical trephine bur, it is possible to harvest a cylinder of bone from a fresh mineralized frozen homologous bone block graft and to simultaneously create a trapdoor on the recipient site. The trapdoor cortical bone is detached from the sinus membrane and removed. Dental implant is placed into the graft before the grafting procedure since the cylindrical block, once inserted in the recipient area, is not able to oppose sufficient resistance to the torque needed for implant placement. RESULTS: Second-stage surgery and following prosthetic rehabilitation were performed after 5 months. In all cases, implant stability was manually checked and no pathological symptoms or signs were recovered at any follow-up visit. CONCLUSION: This technique can be considered a valid procedure for implant therapy on atrophic posterior upper maxillae, when the residual bone crest is extremely resorbed.

16.
Implant Dent ; 26(5): 790-795, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28445234

RESUMEN

PURPOSE: This article describes the digitoclastic technique, an innovative procedure for coronal displacement of the lingual flap. The new technique has the potential to obtain primary flap closure without surgical risks to the anatomical structures on the lingual side of the mandible. MATERIALS AND METHODS: Reconstruction of an atrophic mandible with guided tissue regeneration (guided bone regeneration) and implant placement is described, using the digitoclastic technique to displace the lingual flap coronally. RESULTS: Coronal flap displacement was sufficient to obtain complete passive coverage of the grafted area. No bleeding or neurosensory complications were recorded, and no membrane exposure occurred. CONCLUSIONS: The digitoclastic technique reduces the risk of damage to the lingual nerve and minimizes the amount of bleeding during surgery, allowing progressive and controlled retraction of the flap until the desired detachment is achieved.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Mandíbula/cirugía , Colgajos Quirúrgicos/cirugía , Lengua/cirugía , Regeneración Tisular Dirigida/métodos , Humanos
17.
J Clin Periodontol ; 44(1): 51-57, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-27801940

RESUMEN

AIM: To evaluate the association between risk scores generated with a simplified method for periodontal risk assessment (Perio Risk), and tooth loss as well as bone loss during supportive periodontal therapy (SPT). MATERIALS & METHODS: Data related to 109 patients (42 males; mean age: 42.2 ± 10.2 years, range 22-62) enrolled in a SPT programme for a mean period of 5.6 years were retrospectively obtained at two specialist periodontal clinics. Patients were stratified according to Perio Risk score (on a scale from 1 - low risk to 5 - high risk) as calculated at the end of active periodontal therapy. Risk groups were compared for tooth loss as well as the changes in radiographic bone levels occurred during SPT. RESULTS: The mean number of teeth lost per patient during SPT varied from 0 to 1.8 ± 2.5 for patients with a risk score of 1 and 5 respectively (p = 0.041). Mean radiographic bone loss during SPT was ≤0.5 mm in all risk groups, without significant inter-group differences. CONCLUSIONS: Periodontal risk assessment according to Perio Risk may help to identify patients at risk for tooth loss during SPT.


Asunto(s)
Índice Periodontal , Periodontitis/complicaciones , Periodontitis/terapia , Pérdida de Diente/diagnóstico , Pérdida de Diente/etiología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Medición de Riesgo/métodos , Pérdida de Diente/prevención & control , Adulto Joven
18.
Biomed Res Int ; 2016: 2952530, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27366741

RESUMEN

The aim of this preliminary prospective RCT was to histologically evaluate peri-implant soft tissues around titanium abutments treated using different cleaning methods. Sixteen patients were randomized into three groups: laboratory customized abutments underwent Plasma of Argon treatment (Plasma Group), laboratory customized abutments underwent cleaning by steam (Steam Group), and abutments were used as they came from industry (Control Group). Seven days after the second surgery, soft tissues around abutments were harvested. Samples were histologically analyzed. Soft tissues surrounding Plasma Group abutments predominantly showed diffuse chronic infiltrate, almost no acute infiltrate, with presence of few polymorphonuclear neutrophil granulocytes, and a diffuse presence of collagenization bands. Similarly, in Steam Group, the histological analysis showed a high variability of inflammatory expression factors. Tissues harvested from Control Group showed presence of few neutrophil granulocytes, moderate presence of lymphocytes, and diffuse collagenization bands in some sections, while they showed absence of acute infiltrate in 40% of sections. However, no statistical difference was found among the tested groups for each parameter (p > 0.05). Within the limit of the present study, results showed no statistically significant difference concerning inflammation and healing tendency between test and control groups.


Asunto(s)
Pilares Dentales , Boca/patología , Titanio/farmacología , Colágeno/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Boca/efectos de los fármacos , Gases em Plasma/farmacología , Cicatrización de Heridas/efectos de los fármacos
19.
Am J Orthod Dentofacial Orthop ; 149(4): 463-72, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27021450

RESUMEN

INTRODUCTION: Good periodontal status is essential for a successful treatment outcome of impacted maxillary canines. Whereas the surgical technique used for tooth uncovering has been shown not to affect the final periodontal status of palatally impacted canines, its effect on labially impacted canines is still unclear. METHODS: Searches of electronic databases through January 2015 and reference lists of relevant publications were used to identify studies evaluating the periodontal status of labially impacted canines after combined surgical-orthodontic treatment. Two reviewers independently screened the articles, extracted data, and ascertained the quality of the studies. RESULTS: Ninety-one studies were identified; 3 were included in the review. No included study examined the periodontal outcome of the closed eruption technique. Excisional uncovering was reported to have a detrimental effect on the periodontium (bleeding of the gingival margin, 29% vs 7% in the control group; gingival recession, -0.5 mm [SD, 1.0] vs -1.5 mm [SD, 0.8] in the control group; and width of keratinized gingiva, 2.6 mm [SD, 1.4] vs 4.1 mm [SD, 1.5] in the control group). Impacted canines uncovered with an apically positioned flap had periodontal outcomes comparable with those of untreated teeth. CONCLUSIONS: The current literature is insufficient to determine which surgical procedure is better for periodontal health for uncovering labially impacted canines.


Asunto(s)
Diente Canino/cirugía , Extrusión Ortodóncica/métodos , Índice Periodontal , Diente Impactado/cirugía , Encía/patología , Hemorragia Gingival/etiología , Recesión Gingival/etiología , Humanos , Queratinas , Colgajos Quirúrgicos/cirugía , Diente Impactado/terapia , Resultado del Tratamiento
20.
Oral Health Prev Dent ; 14(4): 329-37, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26870849

RESUMEN

PURPOSE: To compare prevalence and microbial load of six periodontal pathogens between Italian and Dutch patients affected by chronic periodontitis, using oligonucleotide probe technology. MATERIALS AND METHODS: Subgingival plaque samples data from 352 Italians and 115 Dutch periodontal patients were analysed and compared. Bleeding on probing, suppuration, probing pocket depth, clinical attachment level, age, gender, ethnicities and smoking habits were recorded. Presence and level of bacterial species were determined by realtime polymerase chain reaction under the identical microbiological protocol. Statistical analysis was performed using the chi-square test, Mann-Whitney U-test and binary unconditional logistic regression (α = 0.05). RESULTS: Between populations, only Treponema denticola and Porphyromonas gingivalis differed significantly, being more prevalent in the Italian group (p = 0.0001). Except for Tannerella forsythia, all bacterial loads differed significantly: Treponema denticola (p = 0.0001) and Prevotella intermedia (p = 0.001) were higher in Italians, while Porphyromonas gingivalis (p = 0.001), Fusobacterium nucleatum (p = 0.03) and Aggregatibacter actinomycetemcomitans (p = 0.001) were higher in Dutch patients. CONCLUSIONS: Significant differences in prevalence and bacterial load of periodontal pathogens exist between Italian and Dutch patients affected by chronic periodontitis. The microbiological profile, and particularly the bacterial load of pathogens, varied significantly between populations.


Asunto(s)
Bolsa Periodontal/microbiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice Periodontal , Estudios Retrospectivos
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