Kidney stones in renal transplant recipients: A systematic review.

INTRODUCTION: Lithiasis in renal graft recipients might be a dangerous condition with a potential risk of organ function impairment. EVIDENCE ACQUISITION: A systematic literature search was conducted through February 2023. The primary objective was to assess the incidence of lithiasis in kidney transplant (KT) recipients. The secondary objective was to assess the timing of stone formation, localization and composition of stones, possible treatment options, and the incidence of graft loss. EVIDENCE SYNTHESIS: A total of 41 non-randomized studies comprising 699 patients met our inclusion criteria. The age at lithiasis diagnosis ranged between 29-53 years. Incidence of urolithiasis ranged from 0.1-6.3%, usually diagnosed after 12 months from KT. Most of the stones were diagnosed in the calyces or in the pelvis. Calcium oxalate composition was the most frequent. Different treatment strategies were considered, namely active surveillance, ureteroscopy, percutaneous/combined approach, or open surgery. 15.73% of patients were submitted to extracorporeal shock wave lithotripsy (ESWL), while 26.75% underwent endoscopic lithotripsy or stone extraction. 18.03% of patients underwent percutaneous nephrolithotomy whilst 3.14% to a combined approach. Surgical lithotomy was performed in 5.01% of the cases. Global stone-free rate was around 80%. CONCLUSIONS: Lithiasis in kidney transplant is a rare condition usually diagnosed after one year after surgery and mostly located in the calyces and renal pelvis, more frequently of calcium oxalate composition. Each of the active treatments is associated with good results in terms of stone-free rate, thus the surgical technique should be chosen according to the patient's characteristics and surgeon preferences.

Bone regeneration after removal of a mandibular cyst and following prosthetic rehabilitation with implants. Case report.

This study shows the spontaneous bone regeneration after a Partch II surgical operation without using filling materials. The following functional and esthetic rehabilitation was made with overdenture on implants even in the recovery zone. A male patient, 59 years old, with a cystic lesion of 3.5 mm diameter in the mandibular bone was submitted to surgical enucleation of this neoformation. Postoperative radiological examinations, orthopantomography and TC DentaScan were performed to value the bone regeneration. Four implants of 10 mm diameter and 4.1 mm length were subsequently fixed in the mandibular bone and also in the regeneration area. Then, the rehabilitation of the patient with an overdenture on implants was possible. Radiographic controls after cystic enucleation showed a good recovery of the region occupied by the neoformation. The implants fixed proved to be solid and it was possible to carry out an overdenture on them. The cystectomy alone, performed with conservative technique, without subsequent filling of the remaining cavity with biointegrative materials, permitted bone regeneration also in a large remaining cavity. This regeneration was sufficient to guarantee the success of the subsequent overdenture on implants, and very good functional and esthetic results in a patient totally edentulous in the mandibular bone.

The "piercing technique". A new procedure in impacted lower third molar surgery. Analysis of 802 consecutive extractions.

AIM: Our objective is to rationalize the odontotomic phase during the extraction of lower third molars. This study also evaluated the side effects and complications after the piercing technique utilized for surgery. METHODS: A total of 802 consecutive extractions of impacted lower third molars class B and C of Pell and Gregory were performed by the same surgeon in 506 patients with the ''Piercing Technique''. The incidence of complications and side effects was evaluated at 10, 21, 30, 60, 90 and 180 days. RESULTS: None of the patients had sensory impairment of the lingual nerve, mandibular fractures, displacement of the tooth in soft tissues or intra and post-operative haemorrhage. CONCLUSIONS: The data suggest that the ''Piercing Technique'' is very safe, minimally invasive and easy to apply in impacted lower third molar surgery. This surgical procedure represents the first operative stage of odontotomy and permits us to have a point of dental reference, that makes odontectomy as similar as possible to the ideal that we have thought. With this technique it is possible to inject anaesthetic into the dental pulp in cases of hypersensibility. It is also possible to have a point for insertion of angular elevators by making piercings in the tooth.

[Impacted third molars and facial typology]. / Inclusione dei terzi molari mandibolari e tipologia facciale.

BACKGROUND: The increasingly frequent removal of asymptomatic or pathology free lower third molars raises several questions. In this paper, the relationships between inclusion of impacted third molars and facial typology, in studied in order to have a further evaluation parameter for their removal. METHODS: The study was carried out an 50 cephalometric radiographs. The patients, 25 males and 25 females, have been submitted to surgical treatment at our oral Surgery Department to remove the lower impacted third molarst. RESULTS: Among patients admitted for impacted third molars removal there was a larger percentage of brachyfacial (84% of the males, 71% of the females) in comparison with normofacial (8% of the males, 19% of the females) and dolichofacial (8% of the males, 10% of the females). CONCLUSIONS: The facial type, characterised by a shortened vertical dimension of the lower third of the face and an anticlockwise mandibular growth, presents a greater risk of included wisdom teeth.

Piezosurgery vs High Speed Rotary Handpiece: a comparison between the two techniques in the impacted third molar surgery.

OBJECTIVE: The aim of the Study was to compare the impacted third molar surgical technique by means of the high speed rotary handpiece with the piezoelectric one. MATERIALS AND METHODS: 192 patients have been selected among those who had to undergo a third molar surgical extraction. These patients' surgeries have been performed by means of one of the techniques, randomly chosen. Each patient has undergone the same analgesic therapy (paracetamol 1000 mg tablets). Each surgery has been performed by the same surgeon. The patients were asked to fill in a questionnaire concerning the postoperative pain ("happy face pain" rating scale). RESULTS: The average duration of the surgeries performed by means of the high speed rotary handpiece was 32 minutes, while the duration of the ones performed by means of the piezoelectric handpiece was much longer (54 minutes). The postoperative pain values were almost equal. CONCLUSIONS: In conclusion, the osteotomy performed by means of the traditional technique still represents the gold standard in the impacted third molar surgery. The piezoelectric technique may be an effective choice, especially for the less skilled surgeons, in order to guarantee the protection of the delicate locoregional anatomical structures.