A tooth preparation technique in fixed prosthodontics for students and neophyte dentists

The aim of this study was to evaluate a novel technique of tooth preparation in fixed prosthodontics suitable for dental students and neophyte dentists.MATERIALS AND METHODS: Twenty-four dental students of the sixth-year class were recruited to verify the predicibility of this technique. Each student prepared two mandibular second premolars on a typodont for a dental crown with a 90° shoulder finishing line. One tooth was prepared using standard procedures taught in the prosthodontic dental course; the other tooth was prepared with the new technique. Three Professors of Prosthodontics of the same University evaluated the result on the basis of 10 criteria. RESULTS: A statistically significant difference between the two techniques was found in 8 out of 10 criteria. The new technique showed higher values (p<0.05) in 7 criteria, while the conventional technique had better results in just 1 criterion. Moreover, the total sum of values was higher for the new technique (total 41.2±3.98, p<0.05) compared to the conventional technique (total 38.12±5.18, p<0.05). CONCLUSIONS: This study showed that the results were less dependent on manual abilities and personal experience with the novel technique. It could helps dental students and neophyte dentists in their learning curve

Accuracy and precision of an intraoral scanner in complex prosthetic rehabilitations: an in vitro study

The main purpose of this study is to measure the accuracy and the precision of the intraoral optical scanner CS3500® (Carestream Dental LLC, Atlanta, USA) in complex clinical situations as full arch rehabilitations on impl ants. 50 scans of the acrylic resin model were performed by using CS3500® (Carestream Dental LLC, Atlanta, USA) scanner. Each scan was compared with the virtual model derived from scanning with the laboratory scanner Dscan3® (Enhanced Geometry Soluti on, Bologna, Italy) to measure a possible misalignment. The alignment error was found to be 79,6 ( ± 12,87)  m. The measurement was taken at the level of 2 distal scan - abutments. The scanner's precision ranges from 24 to 52  m , depending on the dist ance between scan - abutment. CS3500® (Carestream Dental LLC, Atlanta, USA) intraoral scanner has detected a valid device in the execution of complex rehabilitations on implants. His accuracy and precision values fall within the range established in li terature to define acceptable the prosthetic fitting on full arch implant rehabilitation

Pleomorphic adenoma rehabilitative treatment in growing up patient: a 20-years follow-up

OBJECTIVE: Although tumors of minor salivary glands are rare, the pleomorphic adenoma is the most common pathology among the benign neoplasm and can be found with high prevalence in the junction between hard palate and soft palate. Most of the maxillary tumors are surgically treated through either a total or partial maxillectomy. However, surgical defects lead to both clinical and psychologic disorders for the patient. A postoperative obturator prosthesis is a good option in patients who underwent maxillectomy. It allows to restore both masticatory and speaking functions, as well as aesthetic appearance. When reconstruction of the surgical site is possible, an implant-supported prosthesis can be considered to guarantee a better function and aesthetic's rehabilitation. CASE REPORT: This clinical report presents the prosthetic rehabilitation of a patient who underwent maxillectomy because of a pleomorphic adenoma of hard palate minor salivary glands. The patient was treated with a palatal obturator prosthesis first and with an implant-supported prosthesis after surgical site's reconstruction and complete healing. CONCLUSIONS: The rehabilitation of the patient after maxillectomy through both these devices was an excellent option and provided clinical benefits, improving the patient's quality of life, allowing the patient's reinsertion into societ

Gingival reactive lesions in orally rehabilitated patients by free revascularized flap

The aim is to discuss four cases of gingival reactive hyperplastic lesions in patients with a history of excision of oral neoplastic lesions and rehabilitation by a free revascularized flap of the iliac crest. One female and 3 male patients were referred due to the presence of exophytic lesions at the rehabilitated sites. The clinical examination revealed that the poor oral hygiene was the common trigger factor in all the cases, in addition to trauma from the upper left second molar in the first case, pericoronitis related to a partially erupted lower right third molar in the third case, and poor stability of an upper removable partial denture in the fourth case. All the cases were subjected to elimination of these suspected triggering factors, exclusion of dysplasia, excisional biopsy by CO2 laser, and five follow-up visits. The histological examination of all the cases confirmed the diagnosis of pyogenic granuloma. These presented cases suggest that the limitations in oral functions and maintaining the oral hygiene measures following the free revascularized flap reconstruction surgery probably played a role in the development of gingival reactive hyperplastic lesions with presence of trigger factors such as local trauma, chronic infection, or inadequate prosthesis

Immediate implant loading: a comparison of trabecular metal and tapered screw-vent dental implants

Aims: The aim of the present study is to compare osteointegration and marginal bone loss of immediately loaded Trabecular Metal® and Tapered Screw-Vent® Dental Implants (Zimmer Dental Inc., Carlsbad, CA, USA). Methods: Eighty-seven (87) patients were selected and randomly divided into Group A and Group B. Twenty-six (26) patients were enrolled in Group A, and were rehabilitated using Zimmer Trabecular Metal Dental Implants®. Sixty-one (61) patients were enrolled in Group B, and were rehabilitated using Zimmer Tapered Screw-Vent Dental Implants®. Results: The mean value of marginal bone loss after one year was 0.44 ± 0.40 mm for Group A and 0.95 ± 0.62 mm for Group B (p<.003). Mean marginal bone loss after 18 months was 0.46 ± 0.42 mm for group A and 0.97 ± 0.65 mm for group B (p<.003). No TM implant was lost (Group A), whereas one TSV implant (Group B) was lost before osseointegration and was not included in the statistical analysis. Conclusion: Both Trabecular Metal and Tapered Screw-Vent dental implants showed satisfying levels of osteointegration and marginal bone loss; however, statistical analysis revealed a value significantly lower of marginal bone loss for TM. Thus, it may be deduced that when implants are immediately loaded, the average loss of marginal bone around the TM implants is lower than that of the Tapered Screw-Vent implants

Validation of an intra-oral scan method versus cone beam computed tomography superimposition to assess the accuracy between planned and achieved dental implants: a randomized in vitro study

Computer aided implantology is the safest way to perform dental implants. The research of high accuracy represents a daily effort. The validated method to assess the accuracy of placed dental implants is the superimposition of a pre-operative and a post-operative cone beam computed tomography (CBCT) with planned and placed implants. This procedure is accountable for a biologic cost for the patient. To investigate alternative procedure for accuracy assessment, fifteen resin casts were printed. For each model, six implants were digitally planned and then placed following three different approaches: (a) template guided free hand, (b) static computer aided implantology (SCAI), and (c) dynamic computer aided implantology (DCAI). The placement accuracy of each implant was performed via two methods: the CBCT comparison described above and a matching between implant positions recovered from the original surgical plan with those obtained with a post-operative intraoral scan (IOS). Statistically significant mean differences between guided groups (SCAI and DCAI) and the free hand group were found at all considered deviations, while no differences resulted between the SCAI and DCAI approaches. Moreover, no mean statistically significant differences were found between CBCT and IOS assessment, confirming the validity of this new method

Head and neck osteosarcoma—the ongoing challenge about reconstruction and dental rehabilitation

Head and Neck osteosarcoma is an uncommon disease. Hitherto, the treatment is surgical resection and survival is influenced by the presence of free margins. However, the dimension of the resection may represent a hurdle for an adequate Quality of Life (QOL). Maxillofacial district is a narrow space where the function, esthetics and patient’s relational skills fit together like the gears of a clock. The functional results depend on the type of reconstruction and prosthetic rehabilitation that are both important to guarantee a good aesthetic result and finally increase the patient’s self-esteem. This study aims to report our experience about head and neck (HN) osteosarcoma focusing the attention on reconstructive and dental-rehabilitative problems. It is a retrospective study all patients were surgically treated in our department. Subjects with histological diagnosis of HN osteosarcoma, treated between 2005 and 2017 were included. The demographic characteristics, surgical treatment, eventually secondary reconstruction and prosthetic rehabilitation, performed in the same department, have been collected. The QOL was assessed through the EORTC QLQ-H&amp;N35 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35) questionnaire. Fifteen patients were enrolled, eight received a free flap microsurgical reconstruction. Dental rehabilitation was performed in five cases and a mobile prosthesis was always delivered. Eighteen implants were inserted in fibula bones for three patients; highly porous implants were use

???Pull-through??? Resection for Total and Subtotal Glossectomy Involving the Posterior Third of Tongue

The lower lip-splitting incision associated with different types of mandibulotomy, in order to obtain wide access to total or subtotal glossectomy, is described. In those cases, high rates of functional and aesthetic deficit and postoperative morbidity (more in cases of patients in which adjuvant radiotherapy has been performed) are described. We present our experience in the treatment of patients undergoing total or subtotal glossectomy and contemporary reconstruction with flaps, and without lip-splitting incision and mandibulotomy. Materials and Methods: Data about patients affected by malignant tumors requiring total or subtotal (posterior third of the tongue) resection that were treated at our department from January 2004 to December 2014 were retrospectively reviewed. Data evaluated included: T and N stage, resection margins, operation time, and post-operative complications, such as fistula and flap necrosis. Results: 41 patients were identified. In two cases microscopic infiltration of one margin was found (R1); in one case a close margin was identified. In 26 cases reconstruction was performed using free flaps, and in the remaining cases a pectoralis major flap was used. In three cases postoperative complications were observed. Discussion and conclusions: In theory, lip-splitting and mandible discontinuity could allow for increased access and tumor visualization, and could facilitate flap positioning. Nevertheless, in our experience, it is not necessary in the case of total or subtotal glossectomy

Evaluation of a novel technique for closure of small palatal fistula

A palatal fistula is a pathological condition that connects the nasal cavities with the oral cavity. An oral–nasal fistula is reported as a possible post-surgical complication after the removal of oral carcinomas. The presence of a palatal fistula affects the patient’s quality of life, making it necessary to apply a prosthetic device, such as a palatal plate, to keep the nasal cavities separated from the oral one. There are several surgical techniques to close a palatal fistula, but it is not possible to define the optimal technique as the approach is extremely dependent on the characteristics of the fistula. The aim of this article is to propose a minimally invasive technique to reduce the size of palatal fistulae and to reduce the surgical difficulty (NSPF). A total of 20 patients fulfilled the inclusion criteria and were checked every two weeks. The fistula was injured with a needle every 2 weeks. Fifteen patients who healed with complete closure of the fistula reported no need for a palatal protection plate to eat, drink and speak normally. It is possible to conclude that the NSPF protocol is a valid approach for the non-surgical reduction of palatal fistulae, and it is possible, when the appropriate conditions are present, to achieve complete closure. Keywords: oral surgery; palatal fistula; minimally invasiv

Overview of Candida albicans and Human Papillomavirus (HPV) Infection Agents and their Biomolecular Mechanisms in Promoting Oral Cancer in Pediatric Patients

Oral carcinoma represents one of the most common malignancies worldwide. Oral squamous cell carcinomas (OSCCs) account over 90% of all oral malignant tumors and are characterized by high mortality in the advanced stages. Early diagnosis is often a challenge for its ambiguous appearance in early stages. Mucosal infection by the human papillomavirus (HPV) is responsible for a growing number of malignancies, particularly cervical cancer and oropharyngeal carcinomas. In addition, Candida albicans (C. albicans), which is the principal fungi involved in the oral cancer development, may induce carcinogenesis through several mechanisms, mainly promoting inflammation. Medical knowledge and research on adolescent/pediatric patients' management and prevention are in continuous evolution. Besides, microbiota can play an important role in maintaining oral health and therefore all human health. The aim of this review is to evaluate epidemiological and pathophysiological characteristics of the several biochemical pathways involved during HPV and C. albicans infections in pediatric dentistry