Since its inception, modern dentistry has been a discipline in continuous evolution. Thanks to this progress, the prosthetic rehabilitation of the edentulous patient can now be effectively addressed by multiple therapeutic approaches rooted in the decision-making marriage between patient and clinician in both partial and total edentulous patients. From a historical perspective, the aesthetic-functional restoration of the completely edentulous maxillary arch has been subverted in the possibilities of intervention by the introduction of implantology, which has made it possible to overcome the otherwise mandatory use of removable devices with complete mucous support (1). The current study is intended to be an example of this evolution by describing one out of five clinical cases performed. Furthermore, it is intended to demonstrate how the newly proposed implant-prosthetic techniques, where a fixed implant rehabilitation is not possible due to age constraints, lack of bone support or unfavourable mechanical-aesthetics parameters, allow the rehabilitation of the upper total edentulous jaw with a removable device without a solidarizing intermediate bar to rely upon for the implants. The implants and the whole rehabilitation are, however, consolidated thanks to the stability provided by the presence of a telescopic connection, combining viable long-term survival (2) with optimal results for the patient in terms of cost (3), comfort, chewing capability (4), aesthetics and home hygiene.

The object of this study was to compare, through meta-analysis, the accuracy in implant placement obtained in Dynamic Navigation (DN) with Static Navigation (SN) and with Conventional Free-Hand Surgery (CS) and to provide some useful clinical parameters to consider during the planning phase of the intervention. A meta-analysis was performed, dividing the selected studies into two groups based on the statistical technique adopted: DN vs CS and DN vs SN. The heterogeneity between the various studies was assessed with the homonymous test and quantified with I2. The results were graphically represented using a forest plot. Egger’s test and funnel plot was used to investigate the “small study effect”. The search was performed through the PubMed database, and the Cochrane Library database identified 448 articles. After applying the inclusion criteria, 14 articles were selected and used for quantitative synthesis (meta-analysis). From the results obtained from this meta-analysis, it can be stated that the DN mode allows for better accuracy than conventional surgery, the most used type of surgery, and is comparable to static navigation, the gold standard for accuracy.

Rapid palatal expansion can determine an improvement of the sagittal relationship between maxilla and mandible. The purpose of this study was to evaluate the skeletal and dentoalveolar effects of the upper and lower jaws on the sagittal plane in subjects treated with acrylic-splint rapid palatal expander before growth peak. 36 patients aged 6-10 years with a cervical vertebral maturation stage of CS1 or CS2 were selected. Skeletal and dentoalveolar variables on the cephalometric traces of the lateral teleradiographs were measured before (T0) and at the end (T1) of the orthodontic treatment. The same variables were measured in a subgroup (20 subjects) of the same sample, characterized by a skeletal Class II malocclusion (ANB >= 4 degrees) at T0. Statistics used was paired samples t-test. The p-value was considered statistically significant for P<0.05. In the whole sample ANB showed a significant decrease (-0.96 +/- 1.75 degrees). Pg-OLp and Co-OLp + Pg-OLp increased of 4.25 +/- 6.07 mm and 4.89 +/- 6.65 mm respectively. FMA angle showed a significant decrease (-1.26 +/- 2.47 degrees). In the subgroup with skeletal Class II malocclusion the results were similar, but it was also registered a significant increase of SNB (1.37 +/- 2.14 degrees). In addition to the correction of the cross-bite, the treatment with acrylic-splint rapid palatal expander determined an improvement of the dento-basal discrepancy in the maxilla, an improvement of the skeletal maxillo-mandibular relationships, an anterior repositioning and length increase of the mandible and a facial height reduction.

Nowadays, the best possible approach in respect to the patient is that tailored on the "person", intended as the result of the balance between the patient's requirements and expectations, the latter being influenced by contemporary society's over-information without a proper preparation. It is therefore possible to obtain an efficient and effective treatment by recovering the doctor-patient relationship, which is fundamental to guarantee the respect of the therapist's pragmatic and common-sense guidance whilst satisfying the patient's needs. The reported case serves as an example of this choice, combining the psychological support with a valuable minimally invasive surgical implant-prosthetic rehabilitation.

Orthodontic retention is the maintenance of the teeth in their ideal position from an aesthetic and functional point of view. The aim of this work is to illustrate the different orthodontic retainers. For this study we proceeded with a research of the abstract concerning this topic from the scientific archive "Pubmed" using terms relating to orthodontic retainers: 40 articles were selected from the research. In addition, 4 textbooks related to this topic have also been consulted. 7 fixed and 10 removable retainers have been identified. The most used retainers are the bonded ones for the lower arch and the Hawley and/or vacuum-formed ones for the upper one. Although numerous studies relating to orthodontic retention have been performed, there is no definitive evidence to identify the best type of orthodontic retainer.

Photometric analysis is a facial aesthetics evaluation method which is useful for diagnosis and treatment planning. This system is increasingly applied since there is growing attention to aesthetic improvement and occlusal correction as objectives of orthodontic treatment. Ten articles regarding aesthetic analysis on photos were identified through scientific archives and analysed. The diagnostic rationale, the scientific reliability and the methods used were identified to help clinicians in their practice. Photometric analysis represents an effective, reliable and cheap system for the analysis of craniofacial morphology of the face profile. This analysis can be achieved in subjective or objective ways; the latter modality provides greater reproducibility of the results as well as a good assessment of the harmony between the external craniofacial structures, including soft tissue contribution; it also provides repeatable and reliable measurements, thus enabling a rapid acquisition of the facial image, with long-term durability. Through facial profile photometric analysis it is possible to obtain proportionality, angular and linear measurements. These measures are useful as parameters for an optimal definition of the conditions of normality, harmony and profile balance.

Sander bite jumping appliance (BJA) is a functional appliance used to correct Class II malocclusion in growing patients. The aim of this study was to identify the dento-skeletal effects in patients treated with BJA before growth peak and to compare these effects with the ones obtained in a similar group treated with the Andresen activator (AA). Twenty subjects with class II relationship of the skeletal bases and cervical vertebrae maturation stage 1 or 2 were enrolled in the study and treated with BJA. This group were compared to 14 subjects treated with AA. Cephalometric analyses were carried out using landmarks derived from the analyses of Pancherz, Ricketts, Tweed and Steiner. After treatment with BJA Pg/OLp increase was 7.40±3.81 mm (P<0.001); Pg/OLp+Co/OLp significantly heightened from T0 to T1 (T0: 82.20±4.65 mm vs T1: 89.62±4.27, P<0.001). Overjet (is/OLp - ii/OLp) significantly decreased from T0 to T1 (T0: 7.40±2.31 mm vs T1: 3.05±1.34 mm, P<0.001). Molar relationship improved passing from 1.46±1.68 mm at T0 to -3.56±2.04 mm at T1 (P<0.001). No statistically significant differences were found between BJA and AA groups at T0 and T1. BJA treatment determined a Class II malocclusion correction in all patients. The correction of molar relationship was mainly due to the increase in mandibular length; the correction of the overjet was due to the increase in mandibular length, to the slight pro-inclination of the lower incisors and the mild retro-inclination of the upper incisors. No significant differences were found in effectiveness between BJA and AA.

The infant, like the young un-cooperative or odontophobic patient, constitute the most complex type of patient to be treated and it is frequent in modern society. The treatment of these patients is necessary to resolve the infectious-antalgic urgency and subsequently to build the patient/doctor relationship for continuing general dental care. Conscious sedation is the only way to approach this type of patient. Where therapeutic success with traditional sedation techniques is not achieved, as frequently happens in these patients, sedation with ketamine is the extreme ratio for the purpose of effective resolution of the dental problem, obviously carried out within facilities authorized for these anesthesiological modalities such as private outpatient surgery structures where, when necessary, it is possible to carry out the treatments also under general anesthesia as well as with ketamine.

The introduction of computer-assisted and guided surgery has radically improved the possibility of using all available bone for implant support, reducing the need for extensive grafting procedures and allowing for better implant placement and restoration. Moreover, fresh frozen homologous bone (FFB) grafts have shown good osteoconductive properties and biocompatibility with results comparable to autologous bone patients. The purpose of this retrospective cohort study was to evaluate the survival and the success rate of implants and related fixed full arch prosthesis at the 5 to 8 years follow-up when performed with immediate function using a flapless surgical procedure and computer-aided technology (NobelGuide®, Nobel Biocare® AB, Goteborg, Sweden) in patients previously treated with FFB grafts; treated at the University of Verona with the NobelGuide® system from January 2007 to December 2012 with at least 5 years follow-up were reviewed. Survival implants and survival prosthesis' percentage reached 95% in a 5 to 8-year period. This study indicates that patients previously augmented with FFB graft for maxillary or mandibular bone atrophy can be safely treated with implant supported prosthesis based on the NobelGuide® protocol, with the aid of computer-generated guide.

The rehabilitation of maxillary bone atrophy represents one of the main challenges of modern oral implantology. The use of zygomatic implants in the prosthetic rehabilitation of the patient affected by severe maxillary bone atrophy is another therapeutic alternative, not exempt from complications. The present study included 19 patients with edentulous maxillae who were treated between 2013 to 2015 with at least two zygomatic implants at the Department of Maxillofacial Surgery, Verona, Italy. The purpose of this retrospective longitudinal study was to evaluate sinus complications and radiological, periodontal and prosthetic evaluations of zygomatic implants technique in severe atrophic. Implant-prosthetic rehabilitation of the upper jaw edentulous severely atrophic using zygomatic implants represents one safe and repeatable technique. In terms of implant survival from our study showed an implant CRS (common reporting standard) of 98.5% and a prosthetic CRS 100% with a mean follow-up period of 19.2 months (range). Both recorded data are superimposed on major reported studies in literature.

Medication-related osteonecrosis of the jaw (MRONJ) is a major disease under study for over the last twenty years. Different classifications have been proposed and many therapies for the different stages have been applied. The evolution of treatments lead to an increasingly conservative approach. Numerous adjuvant treatments have been proposed in the last decade. All these complementary treatments have been proposed mainly to resolve or reduce the painful stress, predominantly caused by bacterial infection, simplifying the wound healing process and improving patients' compliance. Nowadays "secondary" treatments, such as autologous platelet concentrates (APCs, more specifically PRP, PRGF or PRF), hyperbaric oxygen (HBO), Auto/tetracycline fluorescence-guided bone surgery (AF-GBS/TF-GBS), medical drugs like teriparatide or the combination between pentoxifylline and tocopherol, fluorodeoxyglucose positron emission tomography (FDG-PET), laser and/or low-laser therapy and ozone therapy are more or less well documented and known considering their clinical effectiveness. The aim of the present review is the evaluation of the quantity and quality of scientific studies concerning this specific topic.

The atrophic posterior ridges are usually characterized by poor bone quality and quantity: this situation requires the use of bone regenerative techniques. Other alternative surgical approaches are investigated. Nowadays the use of trans-sinus implants offers some advantages due to its feasibility. Today, bone grafting may be practical, but depends on many factors, such as the type of bone graft used (autogenous, alloplastic, or xenograft), host response, age of the patient, various complications associated with grafting procedures, infection, and, most importantly, the time spent while the grafted material matures and is taken up by the bone. So, this case report describes the feasibility of an alternative surgical technique associated to PRP (Platelet Rich Plasma).

Bisphosphonate Related Osteonecrosis of the Jaw (BRONJ) is a pathology initially described in the early 2000s that has become increasingly common in clinical dentistry and maxillofacial practice due to the frequent use of bisphosphonates medical drugs (BPs) to treat various diseases such as osteoporosis, Paget's syndrome, osteomyelitis and in bone metastases secondary to tumors. Supragingival irrigation applied as monotherapy and in combination with root planning or BFs related bone necrosectomy revealed that supragingival irrigation with a variety of agents reduced the gingival microbial load and gingival inflammation. In this 4-year follow-up study we analyze the use of hydrogen peroxide (H2O2) as an antimicrobial agent for maintenance periodontal health, improving the longevity of teeth and oral cavity healing process.

Socket preservation is a surgical procedure whose aim is to limit the physiological resorption of the alveolar ridge that occurs after a dental extraction, in order to have sufficient bone to perform an implant placement. 16 articles regarding socket preservation procedures were identified through scientific archives and analysed. The biological rationale, the graft materials and the predictive factors are identified to help the clinicians in their practice. Socket preservation is an effective treatment to prevent bone resorption if performed after an atraumatic extraction with the use of biomaterials and membranes. It is also important not to forget local and systemic predictive factors.

The atrophic posterior ridges are usually characterized by poor bone quality and quantity: this situation requires the use of bone regenerative techniques. Other alternative surgical approaches are investigated. Nowadays the use of tilted implants offers some advantages due to its feasibility. Today, bone grafting may be practical, but depends on many factors, such as the type of bone graft used (autogenous, alloplastic, or xenograft), host response, age of the patient, various complications associated with grafting procedures, infection, and, most importantly, the time spent while the grafted material matures and is taken up by the bone. So this case report describes the feasibility of an alternative surgical technique.