Blood wettability of different dental implant surfaces after different pre-treatments: Ultrasonic instrumentation, platelet-rich fibrin coating, and acid etching. An in vitro study

Background: The blood wettability of titanium implant surfaces favors primary osseointegration and tissue healing in peri-implantitis. The current study aims to evaluate this property on the main different kinds of surfaces, brand new and after treatments. Methods: grade IV titanium disks were used, five machined, five laser-treated, five sandblasted. The experiment was on four steps. Between each step, specimens were sterilized. At the end of each step, a 4 mu L blood drop was put on the samples, and contact angles were calculated. The steps consisted of-1: no treatment; 2: surface instrumentation with an ultrasonic titanium tip; 3: platelet-rich fibrin (PRF) coating and drying with sterile gauze; 4: etching with phosphoric acid, rinse and saline solution and air-drying. At the end of each phase, a blood drop was placed on the surfaces. Blood for PRF preparation and for calculation of contact angles was collected from a single source. Results: average wettability decreased after instrumentation, and increased after the PRF application to a superior level both to the first and second steps. The highest wettability was obtained after etching. This trend is statistically significant for machined and sandblasted surfaces. Conclusions: In the clinical environment, PRF and phosphoric acid used for conditioning exposed implant surfaces can be used for the healing of peri-implant tissues

Controllo della stabilità dento-scheletrica in pazienti disgnatici sottoposti ad intervento combinato.

Vedasi l'allegat

Ultrasonic Instrument Effects on Different Implant Surfaces: Profilometry, Energy-Dispersive X-ray Spectroscopy, and Microbiology In Vitro Study

Purpose: To assess the effects of grade IV titanium ultrasonic tip instrumentation on different grade IV titanium implant surfaces and compare the decontamination of different implant surfaces using chlorhexidine, blue laser, or ozone. Materials and Methods: Profilometry and energy-dispersive x-ray spectroscopy (EDS) analyses were performed on smooth, laser-micropatterned, and sandblasted grade IV titanium sample disks before (t(0)) and after (t(1)) ultrasonic instrumentation with an ultrasonic grade IV titanium tip. Samples were also incubated with a Streptococcus sanguinis culture. Each surface type was then treated with chlorhexidine, blue laser, or ozone (three test groups + control group). Scanning electron microscopy (SEM) images were taken after bacterial growth and after decontamination. Results: After ultrasonic instrumentation, surface roughness (R-a) decreased on sandblasted and micropatterned surfaces, whereas it remained substantially unvaried on the smooth surface. SEM images revealed that the laser-micropatterned structure remained substantially unvaried after instrumentation. EDS revealed a minimal quantity of carbon and iron, found in the laser-treated and sandblasted group at t(0). A minimal quantity of aluminum and oxygen was found on the sandblasted surface at t(0) and t(1). Ozone therapy achieved the highest decontaminating effect, regardless of implant surface topography. Conclusion: Among the alternative therapies to ultrasonic instrumentation with titanium tips, ozone appears to be effective regardless of the type of implant surface; it can be used for the decontamination treatment of implants without altering the surface structure

Associated orthodontic, surgical and hematological menagement of Cooley's anemia-report of a case.

Cooley s anaemia or b-thalassaemia or mediterranean anaemia is a blood disease characterised by malformation of the skull and long bones, which confers a typical appearance on the patient. The complete development of facial abnormalities can be prevented by an intensive blood transfusion programme or by bone-marrow-transplantation. At the present time these therapeutic strategies would be able to help these patients grow and develop, live a prolonged life and avoid bad surgical RESULTS. The aim of this study was to evaluate the feasibility of orthodontic and maxillofacial surgical corrective treatment associated with an appropriate transfusion therapy in a b-thalassemic patient. The patient enrolled in the study was affected by major b-thalassemia and diagnosis was performed as an infant. She was referred to our centre at puberty for dento-maxillofacial disorders. Clinical, haematological and radiographic evaluation permitted a complete diagnosis. She received a combined haematological, orthodontic and maxillofacial surgical treatment. Controls for evaluating the statement of results obtained were performed at different times after the end of the therapy and have shown that the therapeutic objectives had been achieved and maintained. At the present time, complete diagnostic and therapeutic haematological strategies cannot be carried out on a large scale, especially in countries where health resources are limited. This objective reason, associated with possible low patient compliance, explains why we still encounter severe facial deformities resulting from erythroid hyperplasia. Our results suggest that this facial disfigurement requires surgical and orthodontic correction by consolidated surgical-orthodontic techniques performed according to the appropriate anaemia therapy. Although this is a preliminary study, initial encouraging results show no relapse three years after the end of the therapy. L’anemia di Cooley, conosciuta come ß-talassemia od anemia mediterranea, è una malattia ematologia caratterizzata da malformazione del cranio e delle ossa lunghe, che conferisce al paziente un aspetto tipico. Il completo sviluppo delle anomalie facciali può essere prevenuto mediante un intensivo programma emo-trasfusionale od attraverso il programma di trapianto del midollo osseo. Al presente queste strategie terapeutiche potrebbero essere in grado di evitare il conseguimento di risultati parziali o l’ingenerarsi di recidive. In letteratura sono riportati ben pochi esempi di trattamento in campo oro-maxillo-facciale e non esistono evidenze completamente documentate sulla possibilità sulla possibilità di pervenire ad un compenso clinico odontoiatrico stabilizzato di questi pazienti. Lo scopo di questo studio era di studire e valutare la concreta possibilità di eseguire con successo, su tali pazienti, un trattamento riabilitativo complesso. La paziente compresa in questo studio era affetta da ß-talassemia major con diagnosi avvenuta in età infantile. In età puberale aveva già sviluppato ampi disordini dento-maxillo-facciali. La paziente, previo “staging” clinico odontoiatrico, chirurgico, ed ematologico è stata sottoposta a trattamento combinato ematologico, ortodontico e chirurgico maxillo-facciale. I controlli per la valutazione dei risultati ottenuti furono eseguiti a tempi differenti dal termine della terapia dento-maxillo-facciale (con un follow-up complessivo di 3 anni) ed hanno dimostrato che gli obbiettivi terapeutici consistenti nel ripristino di normali rapporti funzionali ed estetici dento-scheletrici sono stati raggiunti e mantenuti. A tutt’oggi, strategie complete diagnostiche e terapeutiche su tali pazienti non hanno la possibilità oggettiva di essere eseguite come si dovrebbe e su larga scala, soprattutto in paesi con risorse sanitarie limitate. Tali pazienti, infatti, quando scompensati ematologicamente sono pressoché in perenne mutazione somatica per cui anche le strategie terapeutiche odontoiatriche e chirurgiche vanno adattate a tale situazione. È , però, imperativo che un compenso ematologico sia comunque raggiunto ai fini di una pianificazione terapeutica razionale e della stabilizzazione dei risultati. Il nostro studio che appare dotato di un follow-up inusualmente lungo in rapporto a questi casi, ci appare estremamente incoraggiante in rapporto alla oggettiva possibilità conseguita di ottenere buone correzioni e di renderle stabili in pazienti, già per molti versi, condannati a molti disagi. PMID: 1137863

Therapeutic Protocol in the Reconstruction of Facial Fractures.

Vedasi l'allegat

Trattamento chirurgico del morso aperto.

Vedi allegat