The aim of this review was to assess efficacy and acceptance of aesthetic zirconia crowns (ZCs) compared to the traditionally employed stainless steel crowns (SSCs) for primary teeth restoration. A comprehensive literature search was completed for the relevant keywords in Scopus and Medline databases. Resulting article abstracts and full texts were screened to determine final inclusion. Eighteen articles were included from the initial search. There is still little evidence to support the use of one type of crowns over another for primary teeth, in particularly for ZCs, lately introduced in pediatric restoration. The gold standard for restoring decayed primary teeth is still represented by SSCs, despite the growing importance of the aesthetic issue related to their use. Aesthetic ZCs resulted in having adequate properties to be employed for the treatment of decayed primary teeth, such as mechanical resistance, limited plaque adhesion, wear behavior and natural appearance. There is still a paucity of literature clinically evaluating the efficacy of ZCs for primary teeth restoration, but they can be considered a promising alternative to SSCs. This field of research has to be more deeply explored to improve dental care in children affected by early childhood caries.
BACKGROUND: The infraorbital foramen (IOF) is an essential anatomical structure for maxillary block anesthesia in dental practice and maxillofacial surgery. The literature also reports the importance of knowing the morphometric characteristics of the IOF because it can be damaged. The aim of our study was to determine anthropometric characteristics of infraorbital foramen in Senegalese population in relationship with the sex. METHODS: A total of 87 CT-Scan of patients were included in our sample and data collected from patient's cerebral CT-Scan. The transverse and vertical diameters of the IOF and its distance to the nearest point of the infraorbital margin, lateral nasal border and lower border of the maxillary were measured, and the shape determined. RESULTS: Eighty-seven CT-scan of patients were analyzed. This research showed that the transverse diameter of the left IOF in female subjects was 5.05 +/- 0.205 and 4.97 +/- 0.22 in male patients. The mean vertical diameter of the right foramen found in our study was 5.30 +/- 0.191 for the female subject and 5.28 mm +/- 0.137 for the men foramen was located at 46% on the line above the 2nd premolar. The right IOF was round in 52% of subjects. An accessory IOF was found in 20% of female subjects. CONCLUSIONS: Knowledge of the precise anatomical location of IOF is important in surgical procedures and reduce the relative risks during clinical procedures. This study showed many differences in the location of the IOF with Caucasians measurements done.
Background Most nasal cutaneous malignancies occur on the caudal third of the nose. Commonly, following resective surgery, the surgeon is requested to reconstruct the ala. Small skin defects of the nose may be left healing by secondary intention, although this may sometimes create an unpleasant scar. In the present paper we describe a 1-step reconstruction of the distal area of nasal ala, alar facial sulcus and cheek, with a segmented melolabial interpolated flap. Methods A 59-year-old man was operated for basal cell carcinoma involving the distal area of nasal ala and alar-cheek sulcus. The reconstruction was performed in 1-stage with a segmented melolabial interpolated flap used to reconstruct the anatomical missing subunits. Results Tumor-free margin was larger than the infiltrating region. No postoperative complications were observed. Conclusions The melolabial flap is a suitable option for the reconstruction of the nose, although the reconstruction of nasal ala is usually performed in 2-steps: the first one is performed to transfer the tissue and close the defect; the second, is performed to reshape the convexity of the ala and the concavity of the alar facial sulcus. In the present case, we do not perform a 2-steps reconstruction, we just reshaped the flap to perfectly fit the defect in 1-stage. The flap, supplied by collateral arteries from the facial and angular arteries, could be segmented for a better surgical outcome also during the harvesting stage if multiple anatomical subunits have to be reconstructed, with no need of a second surgical step that could be frustrating for the patient.
Objective Odontogenic keratocyst (OKC) can be classified as an oral lesion representing the third most common cyst of the jaws characterized by a high rate of recurrence. OKC was accepted as a neoplastic lesion in the 2005 WHO classification and it was called keratocystic odontogenic tumor (KCOT). However, in the 2017 classification of odontogenic tumors, OKC was moved back into the cyst category. This study aims to evaluate clinically, radiographically and through the histological examination the healing of a patient with OKC who underwent surgery with a marsupialization approach. Design An 83-year-old female patient, presented deformation of the right hemi-mandibular region and paresthesia of the right hemi-labium, during intraoral examination it was possible to detect an eggshell crackle on palpation of the anterior edentulous mandible, moreover, the patient reported a growth of the lesion over time that prevented her from using the removable prosthesis. Methods At the OPT it was possible to appreciate a unilocular area that extended from the parasymphyseal region to the right hemi-mandible. The CT scan showed massive erosion that only partially spared the lower cortex and involvement of the mental foramen. Results Checks following surgery show healing also confirmed by instrumental check-ups. Conclusions Surely this study offers a valid alternative to more invasive and debilitating surgical treatments.
BACKGROUND: This study evaluated the effect of different polymerization modes and duration on the degree of conversion (DC) of resin cement under different types of ceramics.METHODS: Ceramic materials were divided into 3 groups (N.=60): group 1, Cerasmart; group 2, Vita Enamic; and group 3, Vita Mark II. Each group was then divided into three subgroups (N.=20) according to the polymerization mode (A: low-intensity; B: high-intensity; and C: soft-start). Subgroups were then divided into two further groups according to the polymerization time (I: 10 s; and II: 20 s). DC of light-cured resin cement beneath different kinds of ceramics was tested using FTIR spectroscopy. Results were compared to a control group cured without overlying ceramic.RESULTS: While the type of ceramic and mode of polymerization showed a significant effect on the DC of resin cement, polymerization duration did not. Vita Mark II group showed the highest DC of resin cement followed by Vita Enamic and Cerasmart. High- and low-intensity polymerization modes did not show significant difference, but both showed significantly lower DC when compared to soft start mode.CONCLUSIONS: Type of ceramic and polymerization mode showed a direct effect on the DC of resin cement.
Objective The purpose of this systematic review was to determine the possible risk factors related to pathophysiology of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) and identify adequate treatment strategies available and success rates. Evidence acquisition We performed a search for publications about the treatment of BRONJ, published between 2003 and 2018 in the PubMed/Medline data base using the key words: 'Bisphosphonate-Associated Osteonecrosis of the Jaw' OR 'Bisphosphonate Osteonecrosis' OR 'BRONJ', based on the list of MeSH and DeCS. Evidence synthesis According to preestablished criteria for data collection concerning the treatment of BRONJ, we found 19 articles covering a total of 400 patients. Treatments that showed good outcomes were Ozone, PRF, PRP/Debridement/Laser bio-stimulation, Laser surgery and Laser surgery/Laser bio-stimulation. HBO did not achieve good results and was used in only 10 patients. BRONJ is a rare condition in patients with osteoporosis/other pathologies using BP orally. These patients had long exposure time and cumulative doses of BPs until onset of the lesion. The oncological patients were exposed to more potent intravenously administered BPs such as pamidronate and zoledronate. These patients had a shorter exposure time until onset of the lesion. Conclusions The treatment of BRONJ is still under debate and there are promising treatments that need randomized trials with larger numbers of patients to confirm their results. Patients receiving BPs or those who will start treatment should be encouraged to perform preventive dental treatment and maintain good oral hygiene.
INTRODUCTION The aim of this literature review was to determine the benefits of hyperbaric oxygen therapy after bone reconstruction procedures in humans and identify information that may be useful for the development of optimal protocols for hyperbaric oxygen therapy to stimulate bone healing. EVIDENCE ACQUISITION We searched the electronic database PubMed/Medline for studies published between January 1999 and December 2018, using the key words: 'bone' or 'bone graft' and 'mandible reconstruction' or 'jaw reconstruction' and 'hyperbaric oxygen' or 'HBO'. First, the titles and abstracts of the studies found were evaluated and those that corresponded to the aims of this review were pre-selected for analysis of the full text. Subsequently, the full texts were analyzed, and those that met the eligibility criteria were pre- selected for the review. The full texts of studies whose abstracts did not provide enough data for decision were also evaluated. Two examiners independently assessed eligibility, risk of bias and extracted data. EVIDENCE SYNTHESIS A total of 2237 studies were found according to pre- established criteria for data collection, of which only 5 studies were included in this systematic review. Although we observed positive results in the included studies, there are still few standardized clinical studies in the literature, assessing hyperbaric oxygen therapy after extensive bone reconstructive procedures. CONCLUSIONS It is difficult to compare results found in different studies due to the variety of methodological and clinical conditions assessed.
In the last few years the surgical treatment of patients with maxillary sinus disease has shifted from more invasive maneuvers to more conservative approaches in order to save intraoral mucosa. Recently, some authors have proposed a modification to the classical Caldwell-Luc's approach (CL) for the removal of dental implants displaced into the maxillary sinus. The modified approach involves a fenestrated approach to the maxillary sinus. The bony pedicled windows of maxillary sinus in some selected cases may limit some of the most common complications and it may reduce healing times.Evaluation of the middle term results of a maxillary fenestrated sinus approach as an alternative technique to CL and review of literature.From 2013 to 2017 thirty-one patients were treated with the CL modified technique, most of which for foreign bodies, displacement of endodontic material and implants in the maxillary sinus, large mucoceles and odontogenic maxillary sinusitis. All patients were subjected to clinical, and in some cases radiological, from 6 months to 18 months follow-up. Different combinations of Keywords and MeSH term were used for the bibliographic research in the main search engines (PubMed, Cochrane library, Medline). Inclusion criteria - fenestrated approach to the maxillary sinus, postoperative complications, description of the operative case.No complications occurred in the intraoperative period and during the months of follow-up. There has been no recurrence of the starting problem and all treated patients were free from residual maxillary pathology 18 months after surgery. Four works meeting the inclusion criteria were identified. The surgical fenestrated approach to the maxillary sinus is a valid alternative to the classical Caldwell-Luc techniques that, alone or in combination with endoscopic sinus surgery, allow to treat foreign bodies of maxillary sinus, of mucoceles and other diseases of the maxillary sinus. The proposed technique does not require particular surgical skills, it does not increase the operating time and can also be performed under local anesthesia.
The management of anxiety and fear of patients experiencing medical treatment is always a major issue. Dentistry is a branch of medicine that is daily in managing these problems, especially in the case of pediatric patients. Odontophobia can be managed in different ways, and the purpose of this study is to eventually review which methods are currently accepted and which are the most effective.The literature analysis was conducted on a number of articles, suitably skimmed, after a first research, obtained from the most common scientific databases. The number of works included in the review is 28.From the RCTs evaluated we could highlight that there are different methods in the literature, equally effective and certainly conditioned by the systemic condition of the patient. Another chapter instead turns out to be that linked to the management of the syndromic patient.It is clear that there are different methods and equally different ways to manage our patients in the event of non-cooperation in the case of dental care. In addition to proper management by the clinician, in the literature methods linked to audiovisual distractions, hypnosis or pharmacological methods that produce conscious sedation are effectively reported.
BACKGROUND: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new coronavirus detected in China at the end of 2019. Because SARS-CoV-2 is highly infectious due to contamination in the air, there is a high risk of infection in the dental environment which is represents a serious problem for professionals and students (dentistry and dental hygiene). In Italy, since February 23, 2020, the government has suspended all teaching activities of schools and universities. METHODS: An anonymous questionnaire was administered to the students of the degree courses in Dental Hygiene of the Emilia Romagna Region, one of the most affected regions in Italy. The survey was intended to highlight the practical and emotional consequences of the emergency of COVID-19 on educational activities and in the training of students. RESULTS: The survey was sent to the 150 students enrolled in the universities of Bologna, Ferrara and Modena and Reggio Emilia; 141 of them completed it (94%). Since the start of the COVID-19 pandemic, several surveys have been proposed to measure the impact of this emergency situation on dental professionals; at present, however, there are still no assessments for dental hygiene degree courses, in particular aimed at assessing the psychological impact on students. CONCLUSIONS: Students consider the dental hygienist as a risky profession, while the risk taken by patients is considered as low. Given the concern reported the students, it would be useful to address the issue of proper assessment of risk during the university training of dental hygienists.
BACKGROUND The aim of this study was to evaluate the effectiveness of a tailored treatment dental program in adolescents in combination with a professional oral hygiene. METHODS Ninety-three adolescents (43 males and 50 females; mean age: 14±1.1 years) were included in this study and Plaque Index (PI) and simplified basic periodontal examination (BPE) were measured for each patient at T0 (screening) and at T1 (after 30 days). At T0 a professional dental hygiene treatment was performed and a tailored oral hygiene instruction protocol was adopted. All data were statistically analyzed using Student's t-test and the level of significance was set at P<0.05. RESULTS A statistically significant decrease of PI was found from T0 (2.3±0.6) to T1 (0.9±0.3) (P<0.05). Moreover, also a significant decrease (P<0.05) of BPE was observed after 30 days. Girls exhibited a higher significant BPE index improvement (0.47±0.2) in comparison to boys (0.3±0.1) at the end of the follow-up (P<0.05). CONCLUSIONS A tailored oral hygiene instruction protocol has resulted in a decreased plaque accumulation and gingival inflammation.
BACKGROUND:Chronic kidney disease (CKD-HD) patients undergoing routine hemodialysis have been reported to have oral signs and symptoms due to disease process or various comorbidities like diabetes mellitus (DM). Both CKD and DM can cause oral changes. Hence this study aimed to evaluate the prevalence of oral symptoms and signs in CKD-HD patients and to rule out DM as possible confounding factor for the oral findings.METHODS:Oral manifestations were assessed in 102 CKD-HD patients, and compared with 100 DM patients and 101 non-diabetic patients with no renal impairment.RESULTS:Most common symptom reported by patients with CKD-HD were xerostomia, altered taste. The most prevalent objective findings were oral dryness. There was statistically significant difference in symptoms and signs between CKD-HD and non-CKD patients. However, no significant difference between CKD-HD with and without DM.CONCLUSIONS:This study showed increased prevalence of oral findings in CKD patients. It also revealed that Diabetes mellitus cannot be a contributing factor for increased prevalence of oral manifestations in CKD patients.
BACKGROUND: Lysyl oxidase (LOX) is a copper amine oxidase which belongs to the LOX multigene family and is normally involved in cross-linking of stromal collagen fibers. LOX expression has been found to be associated with increased episodes of recurrence, metastasis and overall poor prognosis in renal cell carcinomas and melanomas. This study aimed to assess the effects of LOX on the prognosis of oral squamous cell carcinoma (OSCC), which is one of the most common cancers in India. METHODS: The immunohistochemical expression of lysyl oxidase using LOX2 primary antibody was assessed at the tumor proper, invasive tumor front and peritumoral stroma in tissue sections from 40 cases of histologically proven OSCC. RESULTS: LOX expression was elevated in OSCC patients who had lymph node metastasis and in those who died of disease. No significant variation was seen with histological grade. CONCLUSIONS: LOX has a 'pro-neoplastic' effect as it modulates the host stroma to favor increasing tumor mass and worsening prognosis. Increased expression of LOX causes increased collagen fiber cross-linkage that stiffens the stromal matrix. This increases compressive stresses contributing to tissue hypoxia that elevates Rho GT Pase-dependent cytoskeletal tension leading to erratic tumor cell morphogenesis that in turn confers motility to these cells resulting in metastasis. Inhibitors of LOX can potentially down-regulate LOX levels in the tumor micro-environment by controlling tissue hypoxia and curtailing the production of hypoxic LOX molecules.
BACKGROUND As there are few studies in Europe describing characteristics of breath malodor for large groups of patients, this retrospective study was designed to analyse the etiology of halitosis among patients attending a breath malodor center in Northern Italy. METHODS Clinical records of 547 consecutive patients were reviewed and data on self-perceived halitosis, organoleptic scores, volatile sulphur compound (VSC) levels, and oral health condition were extracted and analysed. RESULTS The prevalence of intra-oral halitosis was 90.7%. In 21 patients no objective signs of breath malodor could be found. Periodontitis and gingivitis were the main cause of bad breath in 33.9% of subjects and in combination with tongue coating in 55.2%. Only eight subjects have tongue coating as the only cause of halitosis. Ear, nose and throat (ENT)/extra-oral causes were found in 5.2% of the patients. VSC concentrations were lower in the psychogenic halitosis group, whereas no statistically significant differences were detected when comparing intra-oral and extra-oral halitosis except for (CH3)2S. CONCLUSIONS Psychogenic halitosis is a rare condition among subjects complaining of suffering from bad breath. The most prevalent cause of halitosis is intra-oral, in particular a combination of tongue coating and periodontal disease. Tongue coating is rarely the primary cause of oral malodor.
BACKGROUND: Aggressive periodontitis is a progressive disease that can cause tooth loss within a short period of time. Mast cells are found in tissues with various allergic and inflammatory conditions including periodontal disease through the release of cytokines, chemokines, and proteolytic enzymes. Given the findings of some studies on the related role of mast cells, this study was conducted to determine the number of mast cells in aggressive periodontitis. METHODS: This study was conducted on 30 participants divided into two groups visiting the Faculty of Dentistry of University of Medical Sciences. A total of 15 participants with aggressive periodontitis and 15 healthy participants were investigated. For counting mast cells, toluidine blue staining was used. The percentage of mast cells and demographic factors were evaluated in the two groups and the results were analyzed in SPSS using descriptive statistics and independent t-tests. A P value <0.05 was considered significant. RESULTS: The mean percentage of mast cells in the aggressive periodontitis group was 27.1 +/- 8.9 which was significantly higher than that of the healthy group, i.e. 12.6 +/- 5.1 (P<0.001). CONCLUSIONS: In general, the results of the study showed that the percentage of mast cells in the aggressive periodontitis group was more than two times higher than that of the healthy group, which is indicative of an increase in the number of mast cells in aggressive periodontitis disease.
BACKGROUND: The objective was to examine the microshear bond strength values of different dual resin cements to computer-aided design (CAD)/computer-aided manufacturing (CAM)-created ceramics containing lithium disilicate, which underwent different surface treatments. METHODS: Two dual resin cements (RelyX ARC and RelyX Ultimate) and three surface treatments of lithium disilicate ceramic blocks (Ceramic Primer (CP; containing silane) plus Adper Scotchbond Multipurpose (ASM) adhesive; CP plus Single Bond Universal (SBU) adhesive; and SBU adhesive alone) were tested. The SBU adhesive includes silane in its formulation. Each sample underwent a microshear test and bond strength values were subjected to analysis of variance (ANOVA) followed by Tukey's test (a=0.05). Fracture patterns were also observed with light microscopy. RESULTS: RelyX ARC treated with CP+ASM or CP+SBU presented resistance values that were significantly higher than the same treatments for RelyX Ultimate. Conversely, for the blocks treated with SBU alone, the mean resistance value for RelyX Ultimate was higher than that of RelyX ARC. Regarding the different types of treatment for each resin, the mean resistance value of RelyX ARC treated with CP+ASM was significantly highest, followed by treatment with CP+SBU and SBU treatment alone. Meanwhile, RelyX Ultimate treated with CP+ASM or CP+SBU presented resistance values that were significantly higher than SBU treatment alone. In all of the groups, an adhesive fracture pattern was predominantly observed. CONCLUSIONS: The present results indicate thatsilanization is important for ASM and SBU adhesives to be effective.
BACKGROUND:Limited information is available on the application of diode laser in the treatment of peri-implant diseases. The aim of this study was to investigate the clinical efficacy of the adjunctive application of diode laser in the non-surgical treatment of peri-implant mucositis during a 12-month follow-up period.METHODS:The sample was composed of 73 systemically healthy patients with one implant diagnosed with peri-implant mucositis (bleeding on probing [BoP] with no loss of supporting bone). Implants were randomly assigned to mechanical debridement with hand and powered instruments and 980-nm diode laser application (test group, N.=38) or mechanical debridement alone (control group, N.=35). At the completion of active treatment patients were included in a periodontal maintenance program. Recalls were provided every three months in both treatment groups for reinforcement in oral hygiene instructions and professional implant cleaning with rubber cups. Baseline parameters were repeated at 3 and 12 months postoperatively.RESULTS:Intragroup analysis showed that plaque index, BoP and probing depth presented statistically significant improvements when compared with baseline values (all P<0.001). No statistically significant difference in clinical outcomes was observed between treatment groups at each time point. At 12 months no significant difference in the percentage of sites showing BoP resolution was observed between test (60.9%) and control treatment (52.6%), as well.CONCLUSIONS:Based on the present results, the adjunct use of diode laser showed little but not statistically significant additional benefits in the treatment of peri-implant mucositis after an observation period of one year.
BACKGROUND Currently in dentistry, scientific research has been conducted in the study of dental implants. Being able to optimize dental implants, in all its mechanical and biological components, is the main objective of the research. The purpose of this article was to evaluate the structure and the molecular features of dental implant titanium alloy. METHODS Two different internal hexagonal connection systems belonging to FDS76® have been used as sample. Beyond the literature search, fixture and abutment surface through an X-Ray Fluorescence (XRF) method have been analyzed. RESULTS The surfaces have achieved an excellent level of quality and low impurity, according to commercial pure titanium alloy. CONCLUSIONS This information will surely bring useful information to evaluate the quality of this type of alloy and possibly improve its features.
BACKGROUND:During dental implants placement and bone augmentation procedures, it is important to determine the presence and location of mandibular canal anatomical variation in order to avoid injuries to inferior alveolar bundle. This study aimed to describe the prevalence and configuration of mandibular canal branching in the posterior region of the mandible using cone beam computed tomography (CBCT).METHODS:The interpretation of the images was conducted according to the presence, classification and location of the mandibular canal. Horizontal and vertical distances from mandibular canal in the ramus region to the molar region was recorded. CBCT images of 751 patients, 486 women (64.7%) and 265 men (35.3%), with a mean age of 54.57 (±13.23; 14-93) years, were interpreted by one calibrated examiner.RESULTS:Out of 1502 hemi-mandibles images, mandibular canal variations were observed in 130 (8.6%). Sixty-four (49.2%) mandibular canal variations were identified on the right side and 66 (50.8%) on the left side. The mean distances between superior cortical of the mandibular canal and the base of mandible, buccal cortical of mandibular canal and buccal cortical bone, and superior cortical of mandibular canal and alveolar ridge were 12.16 mm (±2.68), 4.17 mm (±1.30), and 12.97mm (±4.01), respectively. Type I mandibular canal variation was the most frequent (68; 52.2%), followed by type III (34; 26.1%).CONCLUSIONS:Prevalence of mandibular canal variations was 8.6%, type I was the most common and its direction showed proximity with lingual surface in the second molar region.
