Histological Features and Biocompatibility of Bone and Soft Tissue Substitutes in the Atrophic Alveolar Ridge Reconstruction

The reconstruction of the atrophic alveolar ridges for implant placement is today a common procedure in dentistry daily practice. The surgical reconstruction provides for the optimization of the supporting bone for the implants and a restoration of the amount of keratinized gingiva for esthetic and functional reasons. In the past, tissue regeneration has been performed with autogenous bone and free gingival or connective tissue grafts. Nowadays, bone substitutes and specific collagen matrix allow for a complete restoration of the atrophic ridge without invasive harvesting procedures. A maxillary reconstruction of an atrophic ridge by means of tissue substitutes and its histological features are then presented

Effectiveness and compliance of an oscillating-rotating toothbrush in patients with dental implants: a randomized clinical trial

BackgroundThe aim of this randomized clinical trial was to assess the efficacy of an oscillating-rotating toothbrush in reducing plaque and inflammation around dental implants.MethodsEighty patients presenting dental implants were enrolled in this study and assigned randomly to two different groups: 40 patients in the test group and 40 in the control one. Each patient in the test group received an oscillating-rotating toothbrush while in the control group patients kept using the manual toothbrush. Furthermore, the test group received a special toothbrush head designed for dental implants and another one for natural teeth. Domiciliary oral hygiene instructions were given to both groups. Periodontal parameters like plaque index (PI), bleeding on probing (BoP), and probing pocket depth (PPD) were recorded at the baseline and after 1 and 3months.ResultsAt the end of the study, the difference of plaque and bleeding indices with the baseline was statistically significant for both test and control groups (P0.05). No significant differences were appreciated concerning the PPD.ConclusionsThe oscillating-rotating toothbrush can be successfully used for the plaque and bleeding control of the peri-implant tissues

Drought tolerance in grapevine rootstocks: an association genetics approach

Water deficit is widely recognized as one of the major constraint in the Mediterranean and semi-arid regions where a large part of the world's premium wines are produced. Since the introduction of new varieties in the wine industry is not so straightforward, breeding grapevine rootstocks for tolerance to drought is becoming a key strategy for the future. A Genome Wide Association Study (GWAS) and a Candidate Gene (CG) approach were used to investigate the genetic basis of drought response mechanisms in an ad hoc core-collection consisting of 96 different genotypes of Vitis spp. and hybrids, selected to ensure the maximum genetic variability of a larger population of commercial, germplasm and new bred rootstocks. The physiological and growth responses to water deficit of more than 500 one-year old potted cuttings were evaluated over 30 days in semi-controlled conditions. For each genotype, three well-watered control plants were mantained at 90% of the Field Capacity (FC) determined by gravimetric method and three plants were subjected to water stress. After 7 days, water deficit was gradually established to reach first a moderate stable water deficit (50% FC for 7 days) and then a more severe and stable water deficit (30% FC for 7 days). Finally, stressed plants were fully irrigated to evaluate the level of plant recovery. Stomatal conductance was correlated with plant growth evaluation (leaves and shoots biometric measures) to define different response classes and thermal infrared imaging was implemented for the first time as a valuable remote sensing tool for high-throughput phenotyping in a GWAS experiment. Acknowledgements: Italian "Progetto AGER, bando Viticoltura da Vino" (SERRES, 2010-2105

A high performance liquid chromatography method for determination of hydroxyzine hydrochloride in syrup

A simple isocratic method for quantification of hydroxyzine dihydrochloride by HPLC with UV detection at 232 nm in syrup has been developed and validated. Separation was achieved on a C18 column (250 x 4.6 mm, 5 μm) maintained at 90 ºC with 0.5 mol/L potassium dihydrogen phosphate buffer : acetonitrile (1:1, v/v) as mobile phase at a flow rate of 2.0 mL/min. The method was proven to be linear over the range of 80–120 μg/mL, accurate (recovery = 97.8 %), precise (coefficient of variation = 1.52 % for sample) and robust.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Juvenile paradental cyst : presentation of a rare case involving second molar

The aim of this article was to describe a rare case of paradental cyst of the permanent mandibular second molar. A 14-year-old girl was referred to Oral Surgery Department, Dental Clinic, IRCSS Fondazione Ca\u2019 Granda, University of Milan, Italy, for the evaluation of the deep probing located on the buccal aspect of her erupted mandibular left second molar. Clinical signs of inflammation were absent and the mucosa around the second molar appeared clinically normal. Pulp tests for the second molar were positive. The evaluation of the panoramic radiograph did not revealed radiolucency. The Cone-beam tomography showed a well-defined semilunar-shaped radiolucency demarcated by a fine radiopaque line. The cyst was enucleated. The histopathologic analisys revealed the presence of hyperplastic, non-keratinized squamous epithelium with heavy, dense inflammatory cell infiltrate in the epitelium and connective tissue wall. This analysis associated with macroscopic, clinical and radiografic examination confirmed the diagnosis of paradental cyst. A clinic-pathologic correlation, incorporating the surgical, radiographic and histologic findings, is required to obtain the final diagnosis of paradental cyst. Today, the treatment of choice is simple enucleation and thorough curettage of the cyst without extraction of the involved tooth, but if CT demonstrates erosions in the buccal or lingual cortices, marsupialization should be the treatment of choic

Evaluation of postoperative discomfort after impacted mandibular third molar surgery using three different types of flap

Objective: The surgical extraction of an impacted third molar involves a wide range of consequences such as trismus, swelling, and pain, as well as more significant complications, temporary or permanent, that can manifest altered sensitivity of the tongue or lips. The purpose of this prospective study was to evaluate the effects of three different flaps on postoperative discomfort considering trismus, edema, and pain, after the extraction of impacted third molars. The data derived from the analysis of the surgical trials performed at the Oral Surgery Unit, Department of Surgical, Reconstructive and Diagnostic Sciences, IRCCS Policlinico, University of Milan, directed by Professor F. Santoro, MD. Method and Materials: This study, developed over 2 years, involved 238 patients for a total of 238 extractions of impacted mandibular third molars. The 238 surgeries were performed on 114 men and 124 women: 54 avulsions were performed with the elevation of an envelope flap (Group 1), 48 avulsions through the elevation of a triangular flap (Group 2), and the remaining 136 avulsions were performed using a trapezoidal flap (Group 3). Results: Trismus was significantly reduced (P<.05) in patients treated with envelope flap, as was the swelling perceived by the patient (P<.05). Pain was closely related to the elevation of a mucoperiosteal flap and osteotomy. Our study does not reveal statistically significant differences between the three types of flap used; however, the number of analgesic tablets taken was lower in cases of elevation of a less traumatic flap (envelope and triangular flaps). Conclusion: The data collected in this study indicate the envelope flap as the most suitable for the reduction of the expression of postoperative complications such as swelling and trismus

Long-term survival rate of implants placed in conjunction with 246 sinus floor elevation procedures : results of a 15-year retrospective study

Objectives The aim of the present long-term study was to retrospectively evaluate the survival rate of implants placed in regenerated maxillary sinuses and to assess the influence of hypothetical predictors of implant failure. Methods A database including 218 patients who received dental implants after sinus lift procedures was analyzed. The following variables were systematically included and evaluated: type of graft material used, number of surgeries performed, and use of membranes to cover the lateral antrostomy and/or to repair accidental Schneiderian membrane perforations. The Kaplan-Meier estimator was used for comparisons among the groups. Results A total of 589 dental implants were positioned in 246 grafted sinuses and were in function for 3-186 months. The Kaplan-Meier cumulative survival rate was 98.3% after 15.5 years of follow-up. All implant losses occurred within 52 months (4.3 years) after augmentation. According to the log-rank test, no statistically significant difference was shown between each patient/implant variable (p > 0.05). Conclusions Despite the limitations inherent in this type of study, no statistically significant differences between the groups could be found. Intraoperative Schneiderian membrane perforations did not affect the outcome of the implants positioned. Clinical significance The present long-term study is intended as a reference for clinicians approaching sinus floor elevation surgery in order to provide them with relevant operative findings. Since all the drawbacks occurred within the first 5 years, medium-term follow-up studies could be suitable for further retrospective evaluations

Do ultrasonic dental scalers interfere with implantable cardioverter defibrillators? An in vivo investigation

OBJECTIVES: To test the in vivo effects of an ultrasonic dental scaler on various implanted cardioverter defibrillator (ICD) models. METHODS: 12 consecutive patients with ICDs had continuous both electrocardiogram monitoring and device interrogation to detect interferences during the use of an ultrasonic dental scaler. RESULTS: No interferences were detected by any ICD. Evaluation of the electrocardiograms for each patient failed to show any abnormalities in pacing during testing. CONCLUSION: The results of this study suggest that the routinary clinic use of piezoelectric dental scalers do not interfere with the functioning of any of the tested ICDs. CLINICAL SIGNIFICANCE: Ultrasonic dental scalers have been suspected of electromagnetic interference (EMI) with the normal functioning of ICDs and the use of this type of equipment for patients with these devices has been controversial. This is the first in vivo study to investigate EMI of ICD activity during the operation with ultrasonic dental scaler