Immediate-loading post extractive implants: indications, advantages and limits

The possibility of rehabilitating immediately an edentulous patient offers today remarkable advantages because it satisfies the patient’s demands for comfort, aesthetics, and functionality and reduces the surgical stages for the professional. In the last years clinicians and companies have been concentrating their efforts in the development of new surgical techniques and biomaterials in order to speed up the osteointegration process, which fosters the functionality, that is the immediate-loading. This clinical report, based on the analysis of the literature and on the presentation of a case report, shows how satisfying results in functionality and aesthetic can be obtained by a careful diagnosis and an accurate therapeutic planning, reducing at the same time the stress for the patient and the surgical stages for the professional. In any case, it is necessary to have the rehabilitations with immediate-loaded implants directed by workers with a good knowledge and experience in surgery, periodontology, and prosthesis or by a work team able to face all the complications such advanced rehabilitations may cause

Dentin Exposure after Tooth Preparation for Laminate Veneers: A Microscopical Analysis to Evaluate the Influence of Operators’ Expertise

Background: To assess the quantity of dentin exposure detected by 3 operators with different clinical expertise for 2 designs of tooth preparation for laminate veneers: window (WI) and butt joint (BJ). Methods: 20 intact maxillary central incisors were collected and then prepared for laminate veneers to a depth of 0.6 mm, with a cervical mini-chamfer finish line of 0.3 mm. Each prepared tooth was analyzed by 3 operators with different expertise: undergraduate student (ST), general practitioner (GP), and prosthodontist (PR), at sight under magnification. Besides descriptive statistics (CI 95%), 2-way ANOVA and Games–Howell tests were used to analyze differences among groups (α = 0.05). Results: The means of percentage and area of detected dentin exposure were WI = 30.48%, 21.57 mm2; BJ = 30.99%, 21.97 mm2; ST/WI = 22.82%, 16.44 mm2; GP/WI = 58.05%, 40.64 mm2; PR/WI = 10.55%, 7.63 mm2; ST/BJ = 28.99%, 20.83 mm2; GP/BJ = 40.56%, 28.32 mm2; PR/BJ = 23.42%, 16.75 mm2. Significant differences were found between ST/WI vs. GP/WI (p = 0.005) and GP/WI vs. PR/WI (p < 0.001). Conclusions: There was no difference in detection of exposed dentin among operators with different expertise for BJ preparation, whereas differences were found between the general practitioner and the other 2 operators in WI. Moreover, the quantity of exposed dentin was not related to different tooth preparation designs

Comparing the TiOblast and Osseospeed surfaces. Histomorphometric and histological analysis in humans

The aim of the present study was to compare two implant surfaces, the TiOblast (Astra Tech) surface, manufactured by blasting the surface and already present in literature and the Osseospeed (Astra Tech) surface, manufactured by blasting and treating the surface with fluoride ions and recently launched onto the market with the modified surfaces of the latest generation. This study is part of a more extensive research project whose protocol required the insertion of 10 couples of implants; thus in the present discussion partial data are being taken into consideration, with an eye at collecting more data in the future, regarding both microscopy and histomorphometric histological analysis on 5 couples of implants. The purpose of the study is to investigate how the modified surfaces of the latest generation can guarantee a greater osseointegration both from a qualitative and quantitative level compared to the surfaces presently used and that they may represent the first example of "bioactivity", that is, an active interaction with the processes of new bone formation and tissue healing

Implant surgery and oral anticoagulant therapy: case report

This work aims to assess the risks both thromboembolic that bleeding of a management protocol “non-conservative” in patients on oral anticoagulant therapy (OAT) to be undergoing implant surgery. We decided to take a surgical “non-conservative” protocol, to insert four implants in the aesthetic zone, without using flapless surgery and the surgical template. In accordance with the hematologist, the value of INR is lowered and warfarin was replaced with heparin low molecular weight, to have a better coagulation’s control. The modern guidelines impose a protocol of conservative management in patients with OAT, with minimally invasive surgery, flapless, and use of surgical template to reduce the risk of uncontrolled bleeding. This, thanks to the teamwork between dentist and hematologist, thanks to careful adjustment of INR and the use of local haemostatic agents, were not encountered any problems with bleeding or intra or postoperative. Surgical treatment of patients with OAT is a real problem for the oral surgeon, to treat every time in association with the hematologist. Applying this type of surgical procedure, different from today’s guidelines, in our experience there were no post-operative complications (bleeding or bleeding); osseointegration has not been compromised and the prosthetic rehabilitation was completed successfully

Digital work-flow

The project presents a clinical case in which the digital work-flow procedure was applied for a prosthetic rehabilitation in natural teeth and implants. Digital work-flow uses patient’s photo for the aesthetic’s planning, digital smile technology for the simulation of the final restoration and real time scanning to register the two arches. Than the scanning are sent to the laboratory that proceed with CAD-CAM production. Digital work-flow offers the opportunities to easily speak with laboratory and patients, gives better clinical results and demonstrated to be a less invasiveness method for the patient. Intra-oral scanner, digital smile design, preview using digital wax-up, CAD-CAM production, are new predictable opportunities for prosthetic team. This work-flow, compared with traditional methods, is faster, more precise and predictable

Novel HBsAg mutations correlate with hepatocellular carcinoma, hamper HBsAg secretion and promote cell proliferation in vitro

An impaired HBsAg-secretion can increase HBV oncogenic-properties. Here, we investigate genetic-determinants in HBsAg correlated with HBV-induced hepatocellular carcinoma (HCC), and their impact on HBsAg-secretion and cell-proliferation