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

Bennett movement of mandible: a comparison between traditional methods and a 64-slices CT scanner

OBJECTIVE:compare the values of the Bennett angle measured by an average value articulator with the ones measured by a 64 slices Computed Tomography (CT). METHODS: we have studied a patient aged 72. Maxillary and mandibular impressions were obtained from the patient and placed on the average value articulator using wax-ups and a facial arch in order to perform the Bennett angle measurations by such device. CT measurements were carried out using templates in order to block the Patient in the correct mandibular position. RESULTS:our study has demonstrated that the measurements of the Bennett angle obtained with the average value articulator are consistent with the ones obtained with the 64 slices CT. CONCLUSIONS: CT scanning is a useful method, alternative to conventional procedures, as the average value articulator for Bennett angle measurements, and it could become an important diagnostic tool in the gnathological and rehabilitative area

Osteonecrosis caused by Bisphosphonates: a clinical case

The osteonecrosis of the maxillares caused by bisphosphonates (OMB) either wrongly known or not reconised in earlier times became nowadays very important among the dentists and maxillo-facials surgeons because of the potential serious consequences that might bring in the oral cave of the patients, who are suffering already for their base condition. The goal of our work was to verify if a deep treatment and an attentive observation with a close follow-up can bring to the resolution of serious cases of ostenecrosis of the maxillares by bisphosphonantes. Although without a statistic value our case report put the basis for a chance to execute wider casistic studies

invisalign treatment in periodondal patient: case report

Scope of work. To evaluate the results obtained from the use of removable orthodontic aligners in patients with periodontal and systemic issues to improve the aesthetics of the smile. Materials and methods. Invisalign technique, a new technique based on the use of orthodontic removable transparent overlay representing the mechanotherapy. This technique through a dedicated software (Clin-Check) enables you to view the 3D resolution of the malocclusion. Results. In the case study examined the results support the Invisalign treatment in periodontal patients with a systemic disease, both for an easier home oral hygiene and also to maintain alignment and an aesthetic smile achieved without the use of invasive techniques. Conclusion. The Invisalign orthodontic treatment is ideal for patients with periodontal problems. The removal of the masks ensures control of normal oral hygiene but also requires the cooperation of the patient during the treatment