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A new Coronavirus, the seventh member of the Coronaviridae family, identified as SARS-CoV-2, spread in late December 2019 in the territory of Wuhan in China. CoV-2019 can be transmitted directly from person to person by respiratory drops, direct contact and contaminated material. Furthermore, 2019-nCov penetrates cells similarly to the SARS coronavirus, i.e., through the ACE2 receptor. This may promote human-to-human transmission. Patients and dental professionals are exposed daily to pathogenic microorganisms, including viruses and bacteria, which infect the oral cavity and respiratory tract. Dental procedures carry the risk of 2019-nCoV infection due to their specificity. Direct transmission regards the distance between operator and patient, exposure to saliva, blood and other body fluids, the use of sharp instruments and "droplet-generating" rotating instruments, contact with the conjunctival mucosa, and finally the contact with droplets produced by coughing and nasal secretion of an infected individual without mask at short distance, increasing the biological risk for the operator. In light of the pandemic linked to COVID-19, although there is no clear scientific evidence in the literature, it is necessary to identify protections with regard to clothing, operating protocols, disinfection of environments and management of waiting rooms and front offices. This paper is a basis for operative indications for dentists and other health care professionals in phase 2 post lockdown for both private and public structures.
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COVID-19 , Pandemias , China/epidemiologia , Controle de Doenças Transmissíveis , Odontologia , Humanos , SARS-CoV-2RESUMO
BACKGROUND: Aesthetic porcelain veneers proved to be a long-term reliable prosthetic solution, ensuring minimal invasiveness. The use of veneers requires an adhesive cementation technique, so maintaining as much enamel as possible is to ensure lasting success. A diagnostic mock-up is a key tool that allows a preview of the outcome of the aesthetic restoration: it is obtainable both in an analog and digital way. With the recent developments in impression technology and the ever so fast growing use of CAD-CAM technologies it is useful to understand the pros and cons of either one of these techniques (analog and digital) in order to identify the easier and more convenient workflow in aesthetic dentistry. METHODS: After taking pictures and impressions of the dental arcs of a patient in need of aesthetic rehabilitation, 52 resin models were produced and a digital drawing of the smile was outlined. Both an analog and a digital wax-up were obtained from two of the 52 models: the latter was obtained using digital impressions and a dedicated software. The analog wax-up was then used to produce 25 matrices that have later been used to mould 25 resin mock-ups using a traditional moulding protocol (Control Group - CG). The digital wax-up was used to mill 25 PMMA mock-ups. Each mock-up, both milled and moulded (total 50), was then laid on the other 50 resin models as a digital impression of it was taken. The STL. files of the milled mock-ups were compared with the 3D CAD wax-up made using a specific software. The STL. files of the analog printed mock-ups were compared with the traditional wax-up design. A statistical analysis was carried out to evaluate the difference between the groups. RESULTS: The statistical analysis showed a significant difference (P > 0.01) between the mean value of the distance between the points of the overlapping STL. meshes in GC (0.0468 mm) and in TG (Test Group - TG) (0,0109 mm). CONCLUSIONS: The study showed a difference in accuracy between traditional moulded and milled mock-ups compared to their original wax-up. The data analysis reports that the digital method allows for greater accuracy. Within the limitations of this study, a fully digital workflow is to considered more reliable when it come to creating an esthetic mockup: the digital procedure has been shown to be more accurate than the one made manually which is much more operator dependent and it brings an increase to the chance of error, and that could ultimately affect the final result.
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Desenho Assistido por Computador , Técnica de Moldagem Odontológica , Planejamento de Prótese Dentária , Estética Dentária , Técnica de Moldagem Odontológica/instrumentação , Humanos , Imageamento Tridimensional/métodos , Masculino , SorrisoRESUMO
OBJECTIVES: The aim of our work was to evaluate the role of nitric oxide (NO) in the in vitro response of human gingival fibroblasts (HGFs) to 1, 5, 10, and 100 µM doses of zoledronic acid (ZA), a bisphosphonate largely used in the clinical practice and for which several adverse effects are reported. MATERIALS AND METHODS: Phase contrast microscopy and live/dead staining were used to evaluate HGFs morphology; cell viability, collagen type I and interleukin 6 (IL-6) secretion were evaluated by 3-[4,5-dimethyl-thiazol-2-yl-]-2,5-diphenyl tetrazolium bromide (MTT) and enzyme-linked immunosorbent assay (ELISA) assays. Reactive oxygen species (ROS) production and mitochondrial membrane potential were evaluated by flow cytometry; NO production and NOS activity by spectrophotometric analysis; endothelial NOS (eNOS) and neuronal NOS (nNOS) expression by immunofluorescence. RESULTS: Viable fibroblasts are evidenced in control sample while floating dead cells and cells close to detachment phase in ZA-treated sample, in agreement with decreased level of collagen type I. Control sample shows higher number of viable cells respect to ZA-treated one and ROS production increases when ZA is added. Released NO in ZA-treated sample appears higher and NO overproduction is related to increased nNOS activity. IL-6 secretion level is higher in ZA-treated sample than in control one. CONCLUSIONS: Our results suggest ROS involvement in NO overproduction, due to nNOS recruitment, both at low and high doses. In turn, NO release seems to be able to trigger the inflammatory response only when high doses are administered, thus confirming the ZA cytotoxic effect on HGFs. CLINICAL RELEVANCE: The knowledge of ZA-mediated cytotoxicity mechanisms on HGFs allows to better understand drug pharmacological activity.
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Conservadores da Densidade Óssea/farmacologia , Difosfonatos/farmacologia , Fibroblastos/efeitos dos fármacos , Gengiva/citologia , Imidazóis/farmacologia , Óxido Nítrico/fisiologia , Adulto , Sobrevivência Celular/efeitos dos fármacos , Colágeno Tipo I/metabolismo , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Imunofluorescência , Humanos , Interleucina-6/metabolismo , Ácido ZoledrônicoRESUMO
Aim: The rising average age increases edentulous cases, demanding more implant-prosthetic rehabilitation, with cardiovascular diseases being significant factors. This study compared healthy patients (CG = Control Group) and those with cardiovascular disease (TG = Test Group) for implant survival, Marginal Bone Loss (MBL), peri-implant tissue level parameters as Periodontal Screening and Recording (PSR), Plaque Index (PI), Bleeding on Probing (BoP) Peri-implant Probing Depth (PPD), and surgical complications. Smoking impact on both groups and medication influence in the TG were secondary outcomes. Patients underwent full-arch implant prosthetic rehabilitation. Methods: Implant survival rate, MBL, and surgical complications were recorded during the monitoring period (7 years), while peri-implant parameters were assessed at the end of the observational time. A total of 26 and 28 CG and TG patients were recruited, respectively. Results: A total of 128 implants were placed in CG, while 142 in the TG. Implant survival and MBL showed no significant differences (p > 0.05). Nevertheless, peri-implant parameters were more unfavorable in TG. The only significant surgical complication was higher bleeding rates in the TG (p < 0.05). Conclusions: Cardiovascular patients showed similar implant survival and MBL but had adverse peri-implant parameters and increased bleeding rates. Higher smoking levels may relate to unfavorable implant outcomes. Further investigation is needed on drug impact with larger samples.
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AIM: The objective of this in vitro study was to compare reused and sterilized versus new healing abutments to assess whether a decontamination and sterilization process performed on resued healing abutments was sufficient to remove residual proteins. The two groups were comparable with respect to patient safety. MATERIALS AND METHODS: During the period from September 2022 to October 2023, healing abutment screws were selected and divided into two groups according to whether they were new or previously used in patients. The samples were subjected to a decontamination and sterilization protocol, and results from sample sterility evaluation and assessment of surface protein levels were recorded. RESULTS: The obtained results revealed a significant difference in the OD562 nm values between new and reused healing abutment samples. The assay demonstrates how treated healing abutments were still contaminated by residual proteins. CONCLUSION: Within the limitations of the present study, although from an infectious point of view sterilization results in the total eradication of pathogens, surface proteins remain on reused healing abutments.
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The aim of this study is to highlight the properties of ozone as an aid to non-surgical therapy compared to non-surgical therapy alone. This study included thirty Caucasian patients (eighteen women and twelve men) aged between 35 and 65, recruited at the Oral Hygiene and Prevention Center of the Dental Clinic of the Vita-Salute San Raffaele University, at the San Raffaele hospital in Milan. The periodontal probing was recorded with a PC-PUNC 15 manual probe (Hu Friedy) at time 0; the scaling and root planing session was performed at T1 with or without the aid of ozone therapy, and then, the patients were re-evaluated at one month (T2), three months (T3), and six months (T4). The results obtained show that there are not statistically significant differences in terms of reduction in clinical periodontal indices such as plaque, bleeding, and pocket depth between the two groups. Therefore, treatment with ozoral gel would not seem to improve non-surgical periodontal therapy alone. However, clinical periodontal indices significantly improved in patients treated with non-surgical therapy and ozone gel. From this point of view, ozone gel can be used as an aid to non-surgical therapy due to its excellent characteristics, in particular, its powerful virucidal action.
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The aim of this in vitro study is to try to identify a treatment in the field of professional oral hygiene techniques that is ideal and less invasive with regard to prosthetic restorations, chosen in lithium disilicate and feldspar ceramics. Seventeen veneers were prepared (eight in lithium disilicate and nine in feldspar ceramic) and each of them was attached to an extracted tooth. The treatment groups were initially contaminated in the Microbiology Laboratory of Università Vita-Salute San Raffaele. After 24 h they were treated with four different methods of professional oral hygiene and were then sent to the Microscopy Laboratory, in which they were analysed by SEM, with 180X, 250X, and 500X magnification, to assess any damage caused to the treated surfaces. The SEM analysis produced 64 images that were evaluated by an experienced dentist, and the use of the prophetic cup seemed to be the most suitable among the evaluated treatments. However, from a microbiological point of view, this method was the least effective in terms of reducing bacterial growth. In this regard, the use of a prophylactic rubber cup combined with a 0.20% chlorhexidine gel is recommended during professional oral hygiene sessions for the maintenance of aesthetic prosthetic restorations.
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The aim of this comparative retrospective clinical study was to assess the effect of age on immediate loaded full-arch mandibular rehabilitation in younger vs. elderly patients. Patients with an age between 45 and 60 years (younger group, YG) or with an age more or equal to 75 years (older group, OG), requiring a mandibular full-arch rehabilitation were scheduled for the present study. Implant and prosthetic failure, biological and prosthetic complications, and peri-implant marginal bone level changes were recorded until a 7-year follow-up. Sixty-six patients were included in the study; a total of 264 implants were placed and, in total, 66 "all-on-four" rehabilitations were delivered. In total, 33 patients were scheduled in the YG and 33 patients in the OG. At the 7-year follow-up, an overall implant failure rate of 1.14% was reported. Moreover, at the 7-year radiographic evaluation, peri-implant crestal bone loss averaged 1.12 ± 0.91 mm for the YG and 1.04 ± 1.01 mm for the OG. No statistically significant differences were found between the YG and OG except for the rate of peri-implantitis, which was statistically higher in the YG. The present study reported that immediate fixed mandibular full-arch rehabilitation is a viable procedure in elderly people of equal or more than 75 years of age.
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The main objective of this review is to verify the validity of laser therapy in the treatment of dentin hypersensitivity, an extremely common problem in patients, with Nd: YAG lasers or high- and/or low-power diode lasers to obtain a definitive protocol for the treatment of hypersensitivity, given the multiplicity of laser treatments proposed by the numerous authors evaluated. The authors performed an electronic search on PubMed, favouring it as a search engine. Lasers represent a means of treating dentin hypersensitivity, used alone and/or in conjunction with specific products for the treatment of such a pathology. The selected articles that examined diode lasers were divided according to the wattage (w) used: low-level laser therapy protocols, i.e., those using a wattage of less than 1 W, and high-level laser therapy protocols, i.e., those using a wattage of 1 W or more. Regarding the Nd: YAG laser, it was not necessary to subdivide the studies in this way, as they used a wattage of 1 W or more. A total of 21 articles were included in the final selection. Laser therapy was found to be effective in the treatment of dentin hypersensitivity. However, the level of effectiveness depends on the laser used. The results obtained from this review show that both the Nd: YAG laser and the diode laser (high and low power) are effective in the treatment of dentin hypersensitivity. However, the high-power laser appears to be more effective in combination with fluoride varnish and the Nd: YAG laser achieved greater long-term benefits than the diode laser.
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A significant number of people, following acute SARS-CoV-2 infection, report persistent symptoms or new symptoms that are sustained over time, often affecting different body systems. This condition, commonly referred to as Long-COVID, requires a complex clinical management. In Italy new health facilities specifically dedicated to the diagnosis and care of Long-COVID were implemented. However, the activity of these clinical centers is highly heterogeneous, with wide variation in the type of services provided, specialistic expertise and, ultimately, in the clinical care provided. Recommendations for a uniform management of Long-COVID were therefore needed. Professionals from different disciplines (including general practitioners, specialists in respiratory diseases, infectious diseases, internal medicine, geriatrics, cardiology, neurology, pediatrics, and odontostomatology) were invited to participate, together with a patient representative, in a multidisciplinary Panel appointed to draft Good Practices on clinical management of Long-COVID. The Panel, after extensive literature review, issued recommendations on 3 thematic areas: access to Long-COVID services, clinical evaluation, and organization of the services. The Panel highlighted the importance of providing integrated multidisciplinary care in the management of patients after SARS-CoV-2 infection, and agreed that a multidisciplinary service, one-stop clinic approach could avoid multiple referrals and reduce the number of appointments. In areas where multidisciplinary services are not available, services may be provided through integrated and coordinated primary, community, rehabilitation and mental health services. Management should be adapted according to the patient's needs and should promptly address possible life-threatening complications. The present recommendations could provide guidance and support in standardizing the care provided to Long-COVID patients.
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COVID-19 , Geriatria , Humanos , Criança , Síndrome de COVID-19 Pós-Aguda , COVID-19/epidemiologia , COVID-19/terapia , SARS-CoV-2 , Acessibilidade aos Serviços de SaúdeRESUMO
The aim of this retrospective clinical study was to evaluate and compare implant survival, marginal bone loss, and clinical and prosthetic complications in healthy patients and patients with type I diabetes undergoing full arch implant-prosthetic rehabilitation. A total of 47 patients needing total fixed rehabilitation of one or both arches were enrolled for this study. Based on the absence of any systemic diseases (Group A) or the presence of type I diabetes (Group B), the sample was divided into two groups. According to the grade of bone atrophy in the posterior region, patients received full arch rehabilitation (of one or both jaws) with 6 axial implants or, if the residual posterior bone height was insufficient, All-on-Four rehabilitation and a total 236 dental implants were placed. Follow-up visits were performed 1 week after surgery, at 3 and 6 months and then once a year for the next 10 years. No statistically significant differences between groups were recorded about implant survival rates, marginal bone loss, or clinical and prosthetic complications. However, concerning complications, post-surgical bleeding and wound infection were recorded in Group A more than in Group B. In cases of compensated diabetes compensation, implant placement could be considered a safe procedure.
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Implantes Dentários , Diabetes Mellitus , Carga Imediata em Implante Dentário , Falha de Restauração Dentária , Seguimentos , Humanos , Carga Imediata em Implante Dentário/métodos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
PURPOSE: The aim of this case-control study was to investigate the occurrence of bleeding events related to maxillary sinus elevation with a lateral window in patients under direct oral anticogulant therapy. MATERIALS AND METHODS: Seventyseven consecutive patients were scheduled for unilateral maxillary sinus floor elevation using a lateral window approach. Participants were divided into two groups: group A, formed by 37 patients who were under novel oral anticoagulation therapy (rivaroxaban/apixaban), and a control group, composed of 40 healthy subjects. Within group A, assumption of direct oral anticoagulants was not suspended nor modified before surgical procedures. Time (early/delayed) and site (intraoral/extraoral) of bleeding episodes were recorded in both groups of patients, in addition to bleeding severity (mild, moderate, or severe). RESULTS: Maxillary sinus floor elevation was performed in all patients. One dropout happened due to intraoperative membrane perforation. Overall bleeding episodes were comparable in both groups, chi-square (1) = .68, P = .41. Early intraoral bleeding events were more common in absolute terms, but also occurred with approximately the same frequency in both group A and the control group (Fisher exact tests: P = 1.00 and P = .375, respectively). No severe bleeding was observed in any of the attended patients. CONCLUSION: Within the limitations of this case-control study, maxillary sinus floor augmentation with a lateral window approach can be safely administered to patients who are under direct oral anticoagulation therapy when specific recommendations are instituted.
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Levantamento do Assoalho do Seio Maxilar , Anticoagulantes/efeitos adversos , Estudos de Casos e Controles , Implantação Dentária Endóssea/métodos , Humanos , Seio Maxilar/cirurgia , Levantamento do Assoalho do Seio Maxilar/efeitos adversos , Levantamento do Assoalho do Seio Maxilar/métodosRESUMO
BACKGROUND: COVID-19 pandemic has disrupted the daily work of the dental professionals, assuming unprecedented economic, managerial, and psychological implications. The aim of this cross-sectional survey was to analyze the extent of the impact linked to the imposed working conditions on the Italian dental team. METHODS: The survey was administered with a web-based form (Google Forms®; Google LLC, Mountain View, CA, USA) to Italian dentists and hygienists. To be enrolled in the study, participants had to reach the adulthood and agree to sign the privacy policy. The impact of COVID-19 was analyzed through a 27-items questionnaire, which was divided into 4 main domains: personal protective equipment (PPE), operative procedures, secretarial organization, and self-reported quality of life (including e-learning appraisal). RESULTS: A total of 614 between dentists and dental hygienists completed the questionnaire. Compared to the prepandemic period, the use of PPE such as face shields, surgical caps and disposable gowns were implemented after the COVID-19 outbreak. Almost the whole interviewed (99.9%) received the COVID-19 vaccine. An increased use of preoperatory mouthwashes and rubber dam was referred during the pandemic, while aerosolization (i.e., ultrasound) was drastically reduced. A certain number of respondents (30% dentists, 27% hygienists) suffered from work-related stresses during the pandemic until they desired to change jobs. E-learning was considered beneficial for the 70% of participants. CONCLUSIONS: COVID-19 pandemic influenced dental professionals' life, leading to a rearrangement of professional, managerial, and cultural life for both dentists and hygienists even after 1 year from the outbreak.
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COVID-19 , Adulto , COVID-19/epidemiologia , Vacinas contra COVID-19 , Estudos Transversais , Odontólogos/psicologia , Humanos , Pandemias/prevenção & controle , Qualidade de Vida , SARS-CoV-2RESUMO
OBJECTIVE: The aim of this study was to evaluate and compare the effectiveness of the ultrasonic piezoelectric inserts of EMS Steel Tip A, EMS Peek, and IS-TiP-STS-3E© in reducing peri-implant bacterial load without compromising the surface of implants during professional oral hygiene in the follow-up. MATERIALS AND METHODS: Thirteen implants were examined (Winsix, Biosafin, Ancona, Italy). The implants were divided into five groups and analyzed with a SEM microscope and microbiological analysis to evaluate the possible modification of structure and the bacterial load reduction. RESULTS: The control and A, B, and C test groups were initially contaminated in vitro with Streptococcus mutans. Subsequently, the A, B, and C test groups were treated by an only expert operator in standard conditions. Test groups A, B, and C were inoculated for 3 hr and, furthermore, microbiologically analyzed. CONCLUSION: The gold standard of an implant maintenance is a significant reduction of the bacterial load without becoming aggressive. According to our results, despite the limitations of the study, the authors recommend the least aggressive IS-TiP-STS-3E© , but combined with an antimicrobial agent to reduce the bacterial load, because the IS-TiP-STS-3E© did not show appreciable results versus the EMS Peek in reducing the bacterial load.
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Implantes Dentários , Peri-Implantite , Carga Bacteriana , Implantes Dentários/microbiologia , Humanos , Projetos Piloto , Streptococcus mutansRESUMO
The purpose of this randomized controlled trial was to compare the immediate-loading protocol, in single restorations in the esthetic zone, by comparing the digital workflow in a test group (TG) vs. the analogical workflow in a control group (CG). A total of 50 patients were enrolled, requiring single hopeless tooth extraction. Twenty-five patients (TG) were randomly assigned to the immediate-loading protocol using the digital workflow, and twenty-five patients (CG) were assigned to the conventional workflow. Clinical and radiographic parameters were evaluated at the time of implant insertion (baseline) and after 3, 6 and 12 months, respectively. A clinician blind to conditions measured the Pink Esthetic Score (PES), as well as patient satisfaction. At 12-month follow-up, a cumulative survival rate of 100% was reported for all implants. No failures or biological complications were observed. No statistically significant differences were detected in the mean values of marginal bone loss and PES between the TG (0.12 ± 0.66 mm for MBL, 7.75 ± 0.89 for PES) and the CG (0.15 ± 0.54 mm for MBL, 7.50 ± 0.89 for PES). In 11 cases of TG, and 10 cases of CG, a one-year follow-up period showed an increased marginal bone level. No statistically significant differences were found in the mean total PES between test (7.75 ± 0.89) and control (7.5 ± 0.81) conditions. Furthermore, a customer satisfaction survey showed that patients preferred the digital workflow over the conventional workflow procedure (97.6 ± 4.3 vs. 69.2 ± 13.8). Digital workflow was more time-efficient than conventional workflow (97.2 ± 7.3 vs. 81.2 ± 11.3). Within the limitations of this study, no statistically significant differences were found between digital and traditional workflow.
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Purpose: Some authors have highlighted the danger of intraoral use of rotating instruments which can produce droplets and aerosols. During the Covid lockdown phase, dental operators were limited to providing emergency treatment that could not be postponed. Therefore, it is necessary for the dental team to restart safely to treat neglected oral diseases that may also affect systemic health. The role of the dental hygienist has apparently changed for procedures performed close to the patient's oral cavity, particularly in terms of the droplets and aerosols produced during oral hygiene practices. Through an analysis of the most recent literature on the use of dedicated PPE and changed post-Covid 19 work processes, and a review of the differences between manual causal therapy and mechanical therapy in terms of outcome after oral hygiene treatment, we define how the role of the dental hygienist can change positively. Materials and Methods: Narrative reviews of the literature in terms of PPE adopted and oral hygiene procedures performed were carried out in Pubmed. Results: 188 articles from February 2020 to May 2020 using the search terms 'dentistry' and 'covid-19' were examined. 10 reviews of the literature were performed using the search terms 'mechanical procedures' and 'manual hygiene'. Conclusion: Only continuous update of evidence-based literature on the new standards in oral hygiene procedures and the different results yielded by different procedures can ensure a safe working environment for the dental hygienist while supporting the dentist in this phase of the pandemic.
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COVID-19 , Higiene Bucal , Controle de Doenças Transmissíveis , Higienistas Dentários , Humanos , SARS-CoV-2RESUMO
OBJECTIVE: HiPS stem cells are commonly used for the study of medical disorders. Thelaboratory in which this study was conducted uses these cells for examining the treatment and cureof neurodegenerative diseases. Bone regeneration poses the greatest challenge for an oral surgeonboth in terms of increased implant osseointegration and reducing bone healing times. The aim ofthis study was to validate the protocol in the literature to produce and then test in vitro osteoblastswith different nanomaterials to simulate bone regeneration. METHOD: hiPS clones (#2, #4, and #8)were differentiated into an osteoblast cell culture tested for alizarin red staining and for alkalinephosphatase testing at 14, 21 and 28 days, after the cells were plated. RESULTS: The cells showeddiffuse positivity under alizarin red staining and the alkaline phosphatase (ALP)-test, showingsmall formations of calcium clusters. CONCLUSION: Despite the limitations of our study, it is a startingpoint for further protocols, laying a solid foundation for research in the field of bone regenerationthrough the use of stem cells. .
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Diferenciação Celular , Odontologia , Nanoestruturas , Osteogênese , Células Cultivadas , Células-TroncoRESUMO
Progress of modern dentistry is accelerating at a spectacular speed in the scientific, technological and clinical areas. Practical examples are the advancement in the digital field, which has guaranteed an average level of prosthetic practices for all patients, as well as other scientific developments, including research on stem cell biology. Given their plasticity, defined as the ability to differentiate into specific cell lineages with a capacity of almost unlimited self-renewal and release of trophic/immunomodulatory factors, stem cells have gained significant scientific and commercial interest in the last 15 years. Stem cells that can be isolated from various tissues of the oral cavity have emerged as attractive sources for bone and dental regeneration, mainly due to their ease of accessibility. This review will present the current understanding of emerging conceptual and technological issues of the use of stem cells to treat bone and dental loss defects. In particular, we will focus on the clinical application of stem cells, either directly isolated from oral sources or in vitro reprogrammed from somatic cells (induced pluripotent stem cells). Research aimed at further unraveling stem cell plasticity will allow to identify optimal stem cell sources and characteristics, to develop novel regenerative tools in dentistry.
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Odontologia , Medicina Regenerativa , Células-Tronco , Engenharia Tecidual , Linhagem da Célula , Polpa Dentária/citologia , Humanos , Regeneração , Alicerces TeciduaisRESUMO
AIM: The aim of this study was to evaluate and compare two different techniques for the treatment of plaque-induced gingivitis, demonstrating whether the causal therapy supported by diode laser can allow a resolution of the edema caused by gingivitis in less time compared to the single traditional causal therapy. MATERIALS AND METHODS: Twenty-five patients between 20 and 60 years of age with a specific diagnosis of gingivitis were evaluated at the CLID-HSR oral hygiene department. Once the clinical parameters (bleeding index, plaque index, recession, and clinical attack level) were recorded, each of them was subjected to a professional oral hygiene session and instructed in correct home hygiene procedures. Through a split-mouth protocol for each individual patient, hemi-arches were treated by simple randomization to be treated with causal therapy supported by the action of the diode laser (experimental therapy) and which with traditional causal therapy (control therapy). A first intraoral scan was performed before therapy (T0), which was repeated 20 min after rinsing with CHX. The intraoral scans were repeated at a control 7 (T1) and 14 days (T2) after the session. For each intraoral scan, a volumetric value was calculated, proportional to the edema of the gingival tissues, using special digital software. The operator who carried out the volumetric measurements on the software was not aware of the therapy implemented on each half-arch. The operator who carried out the statistical analysis was not aware of the therapy applied to each group. The collected data were statistically compared in order to detect any differences between the volumetric variations between the two therapy groups and within the therapy groups over time. After evaluating the distribution of data by means of the Kolmogorov-Smirnov statistical test, the appropriate nonparametric tests were chosen to carry out the statistical comparisons. RESULTS: Based on the analysis of the gingival-periodontal health parameters and the volumetric value of the treated areas, no statistically significant differences were detected between the areas treated with the adjuvant action of the diode laser compared to those treated with causal therapy alone. CONCLUSIONS: With the limitations of this study, in accordance with the statistical results obtained, diode laser therapy does not allow a faster resolution of gingival edema compared to traditional therapy; the two treatment techniques for plaque-induced gingivitis, therefore, have the same efficacy.
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Edema/terapia , Gengivite/terapia , Lasers Semicondutores/uso terapêutico , Doenças Periodontais/terapia , Adulto , Índice de Placa Dentária , Gengiva , Humanos , Lasers Semicondutores/efeitos adversos , Pessoa de Meia-Idade , Índice Periodontal , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Advanced maxillary atrophy is one of the most common clinical scenarios where implant placement could become difficult. Nevertheless, a volumetric evaluation using a suitable diagnostic software could facilitate the implant planning. The purpose of the present study is to suggest the potential application of the maxillary retro-canine area as the designated location for virtual tilted implants. METHODS: A sample of Cone Beam Computed Tomography (CBCT) images from the Department of Dentistry (IRCSS San Raffaele, Milan, Italy) was evaluated. After a 3D anatomical evaluation, tilted implants were virtually positioned in the retro-canine regions. All the implants were inserted using the same procedure at 30° and 45° degrees of tilting. The length, palatal angulation and diameter of the placed implant were identified. RESULTS: A total of 220 tilted implants were placed. An average implant measurement of 13.51 mm in length and 3.42 mm in diameter were calculated. Additionally, an average buccal-palatal angulation of 6° was identified. Upon statistical analysis, the implant length was found to be significantly higher at 45° degrees of mesio-distal angulation than at 30° degrees (<0.0001). CONCLUSIONS: A considerable number of patients show a significant degree of bone atrophy. The implant-supported treatment plan can rely on three-dimensional imaging of the residual bone as a guiding tool to establish the most effective implant position for each specific case. In this study, it was found that an implant could have a greater length if its mesio-distal angulation was more accentuated. In addition, owing to the volumetric evaluation, it was possible to virtually insert tilted implants in almost all of the cases of atrophy. This could lead clinicians to consider the retro-canine area as a viable place to insert a longer tilted implant.