A proposed protocol for ordinary and extraordinary hygienic maintenance in different implant prosthetic scenarios

Prevention of peri-implantitis involves the early diagnosis of peri-implant mucositis. This article presents a protocol of hygienic maintenance in different implant prosthetic scenarios: single crown, fixed partial prosthesis, fixed full-arch, and overdentures. Others clinical conditions have to be taken into consideration: patient compliance; history of periodontitis; implants placed in augmented bone; short, zygomatic, pterygoid, and tilted implants; and complex prosthesis with false gingiva. Two levels of implant maintenance are described: ordinary, performed by dental hygienist, and extraordinary, carried out by both dentist and hygienist. Extraordinary maintenance also involves the removal and decontamination of the prosthetic structure. To obtain an effective prevention of peri-implantitis, one must plan ordinary and extraordinary hygiene in relation to the type of rehabilitation and clinical parameters

Primary enamel permeability: a SEM evaluation in Vivo

Aims. The aim of this study was to evaluate in vivo the occurrence of outward fluid flow on primary tooth sound enamel surface. Methods. Sixty primary upper canines from preadolescent patients (mean age 8.0±1.9) and 24 retained primary upper canines from adult subjects (mean age 35.0±1.8). The enamel surface was gently polished and air dried for 10 s. An impression was immediately obtained by vinyl polyxiloxane. Replicas were then obtained by polyether impression material, gold coated and inspected under SEM. The hydrophobic vinyl polyxiloxane material enabled to obtain in situ a morphological image of the presence of droplets, most likely resulting from outward fluids flow through outer enamel. For each sample three different representative areas of 5µ2 in the cervical, medium and incisal third were examined and droplets presence values was recorded. All data were analyzed by by Fisher’s exact test. Results. Primary enamel showed a substantial permeability expressed as droplets discharge on its surface. Droplets distribution covered, without any specific localization, the entire enamel surface in all the samples. No signs of post-eruptive maturation with changes in droplets distribution were observed in samples from adult subjects. No statistically significant differences (P = .955) were noted in the percentage distribution of enamel area covered with droplets among the two group studied. Conclusions. SEM evaluation of droplets distribution on enamel surface indicated a substantial permeability in primary teeth, accordingly with histological features, without changes during aging and suggested a strong relationship between enamel permeability and caries susceptibility with an important clinical involvement in bonding procedures

In vitro comparison of root surface treatment effect between root scaling with ultrasonic inserts and gracey curette and polishing with different cleaning pastes

The aim of this study was the morphological evaluation of root surfaces subjected to manual (curette) and ultrasonic (conventional and diamond tips) scaling. The surface was then polished with a rubber cup and three medium-sized pastes. Ninety teeth were randomly divided into three groups of 30 and subjected to three different root instrumentation: (1) manual instrumentation with a Gracey\uae curette; (2) ultrasonic instrumentation with a standard steel tip (Universal Perio S-SERIES: USU, Hu-Friedy, Chicago, IL, USA) at a power equal to 50%; and (3) with a diamond tip (Punta Piezo Serie E Scaling, Hu-Friedy, Chicago, IL, USA) at a power of 20%. Each group of the instrumented teeth was then divided in three subgroups of 10 and subjected to 30 s of rubber polishing with three different polishing pastes with medium grain sizes in single-dose cups: (1) Ultrapro Tx cool mint medium\uae; (2) Stomyprox media\uae; and (3) Nupro medium orange\uae. Polyether root surface replicas were then taken from all 90 samples and analyzed by SEM to evaluate surface morphology after scaling and polishing procedures. All scaling techniques caused an alteration of the root surface without statistically significant difference, whereas polishing resulted in maintenance or improvement of the surface texture

Coronoid hyperplasia. A case report.

Coronoid hyperplasia is a rare condition which is macroscopically characterized by an increase in the dimensions of the coronoid process resulting from an abnormal bony elongation of histologically normal bone. Unilateral cases are more frequent than bilateral ones and can recognize a number of etiological factors, such as exostoses, osteochondroma, traumatic events, inflammatory reactions, neoplasia and manifestations secondary to other pathologies. Etiopathogenesis of bilateral forms has not yet been clarified: in the literature hints to both developmental and endocrine abnormalities are present, and a familiar pattern of inheritance has been evidenced. The poor specificity of signs and symptoms associated with coronoid hyperplasia, which are similar to those of other more frequent forms of temporomandibular disorders, present some problems of differential diagnosis. An accurate assessment must be based on a clinical and anamnestical approach aiming at the identification of pathognomonic clinical symptoms. Considering its limits (such as the possible presence of artefacts and image distortions), orthopantomography has a poor diagnostic usefulness. In this case, magnetic resonance (MR) allowed to evaluate disk-condyle relationship, but it could be also useful to evaluate post-operative complications. In the case of coronoid hyperplasia, the computed tomography (CT) is fundamental for a correct differential diagnosis. CT also allows surgical planning due to its accuracy to detect coronoid process volume and morphology. The present case report is an example of the need for a correct differential diagnosis between the different types of temporomandibular disorders, and it also lends support to the importance of requesting modern imaging techniques during the diagnostic process of the rare or complex cases