Background/Objectives: This literature review aims to provide guidance on the treatment of recurrent aphthous stomatitis (RAS) based on studies published over the past 10 years. Methods: This study included randomized clinical trials involving human patients from 2013 and 2023, published in any language. The trials examined both pharmacological and non-pharmacological treatments for aphthous lesions, mainly focusing on the adult population, with pain management as the primary outcome. The research was conducted using PubMed, EMBASE, and CINHAL databases. Results: Most of the 45 analyzed studies focused on non-pharmacological therapies, which led to positive results with minimal adverse effects or contraindications, even when compared to cortisone-based treatments. Laser therapy also showed excellent results, particularly in the immediate post-treatment period. Non-pharmacological therapies appeared to offer the best risk–benefit ratio for patients suffering from RAS. Conclusions: Treatment should be individualized based on the patient’s specific form of RAS, and laser therapy can be used either as a standalone treatment or as an adjunct to other treatments considered in the review.

Background: Peri-implantitis, the most prevalent cause of implant failure, is a multifaceted issue that is influenced by various factors that promote biofilm formation around the implant. Although various innovative methods for microbiological decontamination of dental implants exist, a universally accepted standard protocol has not yet been established. However, the potential of a device that generates an electric current (Ximplant®) in reducing the survival of microorganisms within the biofilm is a promising development. Methods: In this in vitro study, five dental implants, contaminated using a microbial culture from a sample of saliva of a patient suffering from peri-implantitis, were decontaminated using the Ximplant® peri-implantitis protocol. The experimental conditions included a simulated peri-implant site and a subsequent fluorescent assessment of the Live/Dead microbial population. Results: The qualitative and quantitative image analyses showed a predominant dead light signal on the treated sample, demonstrating the potential efficacy of applying the electrostatic field to the contaminated implant surface in reducing the viability of the microorganisms within the biofilm around dental implants. Conclusions: These findings could inspire a new era in peri-implantitis treatment.

Background. Mucositis and peri-implant disease are pathological conditions found following bacterial colonization on the peri-implant soft tissues and on the implant fixture during implant-prosthetic rehabilitation, from single edentulism to full-arch rehabilitation. The therapeutic approaches to the two pathological conditions use surgical and non-surgical therapeutic protocols, with the aim of eliminating the bacterial biofilm from the implant surface, through the use of mechanical, chemical or photodynamic agents. The aim was to evaluate the effect of the electric field generated by the Ximplant machine on the bacterial load and on the biofilm grown on the dental implants. Materials and methods. Twenty-eight dental implants were contaminated with the saliva of a donor, and subsequently fifteen implants were treated with the electric field generating machine while twelve were not treated. The bacterial biofilm was then measured by resazurin assay, both on treated and untreated implants. Results. The results revealed a difference between treated and untreated implants in terms of biofilm activity,as assessed by color change using the resazurin assay. Treated implants (n = 15) showed no color change across all observation time points (2 hours, 1 day, 2 days, 3 days), indicating an absence of bacterial activity or residual biofilm. Conversely, all untreated implants (n = 12) exhibited a consistentcolor change starting at 2 hours, suggesting persistent biofilm activity. A sterile implant used as a negative control (n = 1) showed no color change throughout the experiment, confirming the absenceof contamination. Conclusion.The study showed preliminary success of the electrofield in reducing microbial populations and destroying clinical biofilm, compared to a sterile implant as a control

Background. This article aims to report the case of a seven-year-old girl affected by a numerical dental anomaly. Supernumerary teeth can lead to secondary dental eruption disturbance dental crowding and bone cysts formation. Even though the clinical and instrumental documentation was adequate to make a correct diagnosis and a surgicalorthodontic treatment plan, a technical error during the surgical phase can lead to the extraction of the permanent bud instead of the supernumerary tooth. The presented case highlights the 2-year follow-up of the immediate reimplantation of the avulsed tooth after the attempt to extract the supernumerary bud and provides the clinician with the most precise awareness and knowledge of possible medico-legal implications regarding surgery at the wrong site. Materials and Methods. During the extraction attempt, the clinician mistakenly extracted the wrong dental element, the bud of the permanent 1.1, and proceeded to reimplant it. After 11 months, a second dentist extracted the correct supernumerary tooth. The case defines guidelines applicable in outpatient clinical practice to manage complications in the best possible way. Results and conclusion. The therapy of supernumerary teeth is extraction. Further work is needed to monitor why a wrong tooth extraction occurs and how it can be prevented; this will be possible by reporting incidents, analyzing the root causes, and clearly and thoroughly educating the clinician on his medico-legal responsibilities.

Potentially malignant diseases of the oral mucosa that have a risk of conversion to oral squamous cell carcinoma, are described as precancer, premalignant, intraepithelial neoplasia, and potentially malignant disorders. The etiology includes oral habits associated with tobacco, heavy alcohol, betel nut chewing, and human papilloma virus (HPV) infection. Diagnosis of OPLs typically relies on visual observation by experienced practitioners followed by biopsy and analysis under a microscope. The main purpose of this study was epidemiological and clinical analysis of patients with oral premalignant lesions diagnosed and treated in our collaborative healthcare structures. Oral premalignant lesions were more common in men than women. Buccal mucosa was the most common location of oral premalignant lesions in our study (31.03%), followed by floor of the mouth (22.4%). Homogenous leukoplakia was the most common type of leukoplakia (present in 44.8% of patients), followed by lichen planus (25.8%). The degree of dysplasia was associated with the type of oral premalignant lesions but not significantly with their size.

The use of ozone in medicine and dentistry is well-supported in the scientific literature, particularly for its antibacterial, antiviral, anti-inflammatory, and anti-edema effects. These benefits are achieved through reductions in pro-inflammatory substances, stimulation of neoangiogenesis, and enhanced production of antioxidant enzymes. Additionally, ozone is pain-relieving by inactivating algogenic mediators and inducing endorphin release. Although ozone application devices are standard in conventional medicine, they are less so in dentistry and often have reduced performance. This study aims to evaluate the effectiveness of a specific ozone therapy device in managing postoperative pain and promoting healing in patients undergoing impacted third-molar extractions. Materials and methods: Patients scheduled for the extraction of impacted third molars were enrolled in a randomized split-mouth study to receive either ozone therapy or conventional antibiotic treatment. The Visual Analog Scale (VAS) assessed pain intensity and healing progress. Results: Patients treated with ozone therapy reported significantly lower pain levels and demonstrated qualitatively improved healing compared to the control group, with statistical significance. Conclusions: The study supports the use of ozone therapy in routine dental surgical practice, highlighting its favorable cost/benefit profile. Ozone therapy can be beneficial for impacted third-molar surgeries and broader applications in oral surgery. Keywords: Ozone therapy in dentistry, OZONE DTA equipment, Third molar extraction and soft tissue healing.

Aim: The maxillary sinus lift is a crucial surgical procedure performed to increase the vertical height of the remaining bone, often required before implant placement. Several techniques are used to approach the maxillary sinus, with varying results. Among them, it is possible to mention the minimal invasive sinus elevation (MISE) technique. Methods: This paper provides a comprehensive review of the MISE technique, its materials, and surgical methods. It analyzes the outcomes compared to conventional methods and discusses its applicability in different clinical scenarios. Results: The MISE technique has proven effective in increasing bone height with a lower risk of membrane perforation compared to traditional methods. It offers high implant success rates and minimal post-operative complications, with strong patient outcomes regarding bone regeneration and implant stability. This section will analyze these results with both quantitative and qualitative evaluations. Conclusions: The MISE technique notably improves sinus lift procedures, providing a minimally invasive method with reliable clinical results. Its predictability and lower risk of membrane perforation make it well-suited for implant surgeries involving sinus elevation. Future studies should explore long-term results and refine the technique for broader clinical use.

Besides the functional issues, lateral incisor agenesis represents a significant aesthetic drawback (1). The decision about the treatment plan is complex due to the long-term success, which is not easy to achieve. It has to be discussed with the orthodontists to choose the closure, using permanent canines to replace the missing teeth, or maintaining the spaces, for example, with Maryland bridges or implants. The main advantage of orthodontic gap closure is that this approach preserves the natural architecture of the complex and soft tissues. However, canines and premolar sizes and shapes should be adjusted to mimic the replaced teeth, eventually resorting to odontoplasty or veneers (13). This article aims to show clinical protocols and procedures for the Split Crest without any graft. The biggest problem in agenesis cases is the thickness of the bone, which is bucco-palatal and associated with the need for proper functional and esthetic rehabilitation. In the case that we reported, because of the lack of thickness, we performed a minimally invasive split crest, which allowed us to correct the implant insertion with immediate loading by a temporary crown, just for aesthetic reasons.

Background: Mucositis and peri-implantitis are pathologies that may be encountered during dental implant rehabilitation. Therapeutic strategies for their resolution range from non-surgical to surgical treatments and aimed at eliminating the biofilm from the implant’s surface, through mechanical, chemical or photodynamic agents. Aim: The aim was to evaluate the effect of the electric field generated by the Ximplant machine on the bacterial load and on the biofilm grown on dental implants. Materials and Methods: Ten dental implants were brought into contact with a donor’s saliva, then five implants were treated with the electric field and four were not treated. Bacterial biofilm was then measured by resazurin assay, both on treated and untreated implants. Results: The study showed the preliminary success of the electrofield in reducing the microbial population and destroying the clinical biofilm, compared with a sterile implant as control.

Background and Objectives: Third molar (wisdom tooth) extraction is one of the most common surgical procedures in oral and maxillofacial surgery. Traditional rotary instruments and burs have long been the standard tools for this procedure. However, recent advancements in surgical techniques, such as piezoelectric surgery, have gained popularity due to their purported advantages in terms of precision, safety, and postoperative outcomes. This systematic review aims to evaluate the efficacy, safety, and clinical outcomes of third molar surgery performed using burs versus piezoelectric surgery. Materials and Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was performed using the PubMed, Scopus, Web of Science, and Cochrane databases to identify relevant studies published up until October 2024. Randomized controlled trials (RCTs), clinical trials, and comparative studies assessing third molar surgery using either burs or piezoelectric instruments were included. The primary outcomes evaluated were surgical time, postoperative pain, swelling, nerve damage, and healing time. The data extraction and quality assessment were performed independently by two reviewers using standardized tools, and any discrepancies were resolved by a third reviewer. Results: A total of five studies met the inclusion criteria, and the meta-analysis revealed that piezoelectric surgery resulted in significantly lower postoperative pain and swelling compared to traditional bur techniques (p < 0.05). Additionally, the incidence of nerve injury was lower in the piezoelectric group, though the difference was not statistically significant. Surgical time was found to be longer with piezoelectric devices, but this was offset by improved healing outcomes and patient comfort. Conclusions: Piezoelectric surgery offers a less traumatic alternative to traditional burs for third molar extraction, with reduced postoperative morbidity and enhanced patient outcomes. Although the longer surgical duration may be a drawback, the overall benefits, particularly in terms of pain management and tissue preservation, support the adoption of piezoelectric techniques in clinical practice. Further high-quality randomized trials are recommended to strengthen the evidence base for these findings.

Aim: The loss of dental elements causes anatomical, functional, aesthetic, and psychological changes that reduce the patient’s quality of life and comfort. This study aims to show how implant-prosthetic restorations with full-arch immediate loading can be appropriately performed by an anatomically guided method. Materials and methods: Two case reports of two male patients aged 69 and 60 years old who needed an implant-prosthetic full arch rehabilitation were documented to describe the surgical treatment. Discussion: Human anatomy is the basis of any surgical treatment, so in oral surgery, the operator must have a detailed knowledge of the loco-regional anatomy of the head-neck district. For this reason, it is essential to know the topographical limits of the noble structures typically found in daily clinical practice to perform a precise surgical act under safe conditions. The validity of a complete dental arch rehabilitation method is emphasized in literature by inserting two axial implants positioned orthogonally to the occlusal plane in the anterior region and two distal implants inclined with a maximum of 30° distally in the posterior region. The literature reports of inclined implants have been proposed as an alternative to traditional protocols in rehabilitating edentulous jaws. All this can be achieved by carefully studying the clinical case at the beginning of the clinical and radiographic examination. In addition, knowledge of the anatomical reference points must be taken as a reference to obtain a method that is reproducible and adaptable to more clinical cases depending on bone mineralization. Conclusion: Although it may seem excessively invasive, this method allows us to obtain optimal and reproducible results. It allows us to exploit not only the biomechanical advantages obtained by the structure of the prosthetic polygon but above all, those biological ones based on knowledge of the physiology of bone remodeling.

Osseointegrated implants are considered one of the best treatments for dental prosthetic rehabilitation. (Papaspyridakos et al., 2013, Brånemark et al., 1969). In cases of posterior maxillary atrophy, dental rehabilitation with osseointegrated implants is challenging as there is less bone volume (pneumatisation of the maxillary sinus) and poor bone quality (type III and IV according to Misch’s classification). In 1989, Tuslane and Tessier first described pterygoid implants, which can now be considered one of the rehabilitation solutions for patients with posterior maxillary atrophy. The present study was conducted to evaluate the survival and success rates of pterygoid implants 3 years after placement. The surgical activity was conducted from January 2017 to January 2019 with a sample of 37 edentulous patients (partially and/or totally) characterized by poor bone quality and quantity in the posterior maxillary area. The results of this study supported the research hypothesis because the survival and success rates of the pterygoid implants were 99%

BACKGROUND:The purpose of this study is to report clinical and instrumental changes after RA.DI.CA splint therapy for temporomandibular joint disc displacement without reduction.METHODS:Subjects affected by disc dislocation without reduction were recruited between July 2020 and May 2022 based on inclusion and exclusion criteria and treated with RA.DI.CA. splints over a period of 6 months. Clinical data were collected at each phase of the study (T0, T1, T2). Magnetic resonance imaging and electrognathography data were recorded at the beginning (T0) and at the end (T2) of the study. ANOVA with post-hoc contrasts was performed to assess differences in outcome measures over time. The Wilcoxon test was used to evaluate changes in disc-condyle angle between before- and after-treatment MRI. A two-tailed value of p < 0.05 was regarded as significant.METHODS:Ten patients completed the study. There were statistically significant differences over time for arthralgia, headache, neck pain, and mouth opening. Disc recapture and an improved quality of mandibular movement were recorded in 70% of subjects. The clinical and instrumental improvements are probably due to the orthopedic action of RA.DI.CA splint treatment, which allows for a greater degree of joint mobilization.CONCLUSIONS:The purpose of this therapy is to recover the disc position if possible and achieve an adequate joint functional adaptation that avoids the progression of the structural damage and the recurrence of symptoms.

The preparation of the implant site in guided surgery procedure takes place without irrigation, which could lead to increased friction of the drills with the formation and release of debris or metal particles. The presence of metal particles in the peri-implant tissue could represent a trigger for macrophage activity, bone resorption processes, and consequent implant loss. According to the guided surgical protocol, the study aimed to evaluate the presence of metal particles deposited during implant site preparation. Twenty-five adult porcine ribs from the same adult individual were chosen due to their trabecular bone structure, similar to facial bones. The samples were all 8 cm (length) × 3 cm (depth) × 2 cm (width) and were further subdivided to obtain 50 elements of 4 cm × 3 cm × 2 cm. Plexiglass was used to create structures such as surgical guides so that their function could be mimicked, and the guided implant site preparation sequence could be performed with them. The drill kit used in this study is a guided surgery drill kit characterized by high wear resistance, high yield strength, and good corrosion resistance. This same kit was used 50 times in this way to prepare 50 different implant sites and evaluated at different edges and number of preparation (T0-neutral edge, T1-1 full preparation, T2-10, T3-20, T4-30, T5-40, and T6-50) by SEM-EDX to assess the presence of any metal deposition. The presence of metal residues in the implant site increased according to the cycles of use of the drills. We have observed that in the first three groups, there is no presence of metals. This is evident in groups T3 and T4. Finally, the presence of metal residues becomes significant in the study’s last two groups of samples. The study highlighted how the lack of irrigation in the work site leads the deposition of metal particles and in addition to a reduction in the efficiency of the drills, resulting in less precise cutting, altering the shape of the prepared site, and, lastly, reducing the primary stability of the implants.

Internal derangement (ID) in the temporomandibular joint (TMJ) is defined as a mechanical problem of the joint that interferes with its function. It is attributed to an abnormal interaction among the articular disc, condyle, and joint eminence. The aim of this study is to evaluate diagnostic efficacy of non-invasive hand-carried ultrasonography instrumentation (US) to provide high-level images for a correct diagnosis of ID. Twenty-eight ID patients, 15 female and 13 males, were examined both clinically and by MRI images in order to achieve a diagnosis of ID (using Helkimo index). Then, they were submitted to US examination with a 12 MHz transducer by using hand-carried instrumentation by a clinician that was blind to their diagnosis and clinical data. TMJ US examination was performed with the mouth closed and mouth open, with proper technique. Each position was then evaluated with two different orientations of the transducer. US showed acceptable results in identifying bone structures. Lower values of diagnostic efficacy were obtained for disc position during joint movements with respect to MRI images. MRI still represents the gold standard for the identification of joint structures. If not corroborated by clinical and anamnestic data, the diagnostic efficacy of US in identifying the position of the disc during opening and closing jaw movements appears limited than compared to MRI.

This study aimed to evaluate the effectiveness of using ultrashort implants in the rehabilitation of jaws of fragile patients. The aim of the study was to retrospectively evaluate the survival rate of full-arch prosthetic rehabilitation on ultrashort implants, length 4 mm, 4 mm in diameter in the premolar and canine area and 4.5 mm in diameter in the molar area, with the insertion torque of 60 Nw and immediate loading. Nineteen patients were evaluated for 3 years clinically and radiographically. The significant majority of the patients at the 3 year follow-up (T4) presented a stable and functional implant-supported prothesis, and the survival rate of the implants was 85%, with a loss of 16 implants on 114 implants. The combination of the innovative implant surfaces and the correct project of the prostheses, with the related implant connection, determined a different timing in the therapy, allowing to obtain an immediate loading, which is currently demanded by patients. This and recent reports on short and ultrashort implant usage in atrophic jaws offer a good solution in critical cases. In conclusion, within the limits of the study, the full-arch rehabilitation with immediate loading on ultrashort implants showed good results with few postoperative complications and related low biological cost.

Psoriatic arthritis (PsA) is an inflammatory chronic arthritis associated with psoriasis. Currently, data about gender differences in clinical manifestation and therapeutic outcomes of PsA are limited. Frequently, women manifest a peripheral disease while men have an axial localization. Moreover, women display higher disease activity and physical activity limitations, if compared to men. Although the involvement of the temporomandibular joint (TMJ) is quite rare, it can seriously impact the quality of life. The morpho-functional peculiarities of TMJ require a multidisciplinary approach to perform a correct diagnosis and a successful treatment. Here, we report a case of a woman affected by PsA involving TMJ treated by combining pharmacological therapy and an occlusal splint. The coordination between different specialties led to a complete remission of clinical symptoms and a regression of lesions.

(1) Surgical intervention becomes crucial in situations in which lack of action would cause a decrease in quality of life for the patient. As healthcare professionals, our next objective is to reduce patient fear perception. This work’s aim is to illustrate how physical tridimensional models can serve not only as confidence boosters for the patient, but also as a valid tool to aid both the clinician and the fostering of a patient–doctor relationship. (2) An example case managed using a stereolithographic model in the pre-surgical planning stage is presented in which surgical planning was carried out by analysis of radiographic investigations combined with a tridimensional resin model derived from the patient’s x-ray exam. (3) Successful enucleation, surgical debridement, and stable follow-up shows the effectiveness of the applied surgical protocol, confirming that planification using a physical representation of the tridimensional exam aids in the correct surgical management of said lesions. (4) The effectiveness o101f the surgical act itself as well as the follow-up showing ossification of the bony lesion and absence of relapse of a highly recurrent lesion confirms the effectiveness of the tools used for this surgical intervention.

Aspergillus related sinusitis is a fungal infectious disease that, despite its diffusion, is still not well acknowledged to dental operators. Due to the anatomophysiology characteristics of the maxillary sinus, the diagnosis of non-invasive aspergillus sinusitis relies on clinical and imaging signs, and on the medical history of the patient. Here, we present a clinical case describing a fungus ball, which diagnosis resulted particularly difficult, due to the presence of concomitant dental interventions in the same maxillary area. A 50 years-old woman, without any medical issue, came to the private dental practice complaining about nasal discharge from the left side. Dental arch were subjected to several treatments; to better understand the working plan, an orthopantomogram was performed, revealing a radiopacity in the left sinus. The conebeam computed tomography showed the obstruction of the maxillary sinus, and clarified the presence of mycetoma calculus. The patient underwent surgical Caldwell-Luc intervention and mycetoma sampling; the following in-vitro investigations revealed the presence of Aspergillus Niger. The one-year followup showed no recurrence of the infection. The reported case is aimed to underline how mycetoma is a benign condition, still unknown to dentists despite its large diffusion. Moreover, the authors want to highlight that an endodontic treatment can offer a favourable environment to mycetoma formation.