Clinical management of a peri-implant giant cell granuloma

Purpose. Implant therapy plays an important role in contemporary dentistry with high rates of long-term success. However, in recent years, the incidence of peri-implantitis and implant failures has significantly increased. The peripheral giant cell granuloma (PGCG) rarely occurs in peri-implant tissues and it is clinically comparable to the lesions associated with natural teeth. Therefore, the study of possible diseases associated with dental implants plays an important role in order to be able to diagnose and treat these conditions. Materials and Methods. This report described a 60-year-old Caucasian male who presented a reddish-purple pedunculated mass, of about 2 cm in diameter, associated with a dental implant and the adjacent natural tooth. Results. An excisional biopsy was performed and the dental implant was not removed. Histological examination provided the diagnosis of PGCG. After 19-month follow-up, there were no signs of recurrence of peri-implantitis around the implant. Conclusion. The correct diagnosis and appropriate surgical treatment of peri-implant giant cell granuloma are very important for a proper management of the lesion in order to preserve the implant prosthetic rehabilitation and prevent recurrences

Childhood overweight-obesity and periodontal diseases: is there a real correlation?

Objective. The association between obesity and periodontitis has been extensively investigated in adults but not in young people. The aim of this study was to examine the association between overweight-obesity and periodontal disease in pediatric subjects. Methods. Controlled cross-sectional study involving 100 school children of both gender (50 M and 50 F) between 7 and 12 years of age (mean age 9,19 +/- 1,57). Two groups were formed based on Body Mass Index value: test group with BMI >= 25 Kg/m(2) and control group with BMI <= 24 Kg/m(2). Diet intake and oral hygiene habits were recorded by a specific questionnaire and the periodontal clinical parameters were evaluated. Results. The periodontal examination in the control group revealed a full-mouth plaque score (FMPS) value equal to 21.86% against 50.08% in the group of patients overweight/obese; the full-mouth bleeding score (FMBS) in the control group amounted to 12.7% against 26.24% of test group. No patient in either group included in the study presented a probing pocket depth (PPD) >= 3, so a significant difference regarding this value was not found. Regarding the frequency and quantity of food consumption, the number of obese patients who did not follow a balanced diet largely exceeded the number of normal-weight patients (70 versus 20%). Conclusions. These results focus the attention on the negative impact of obesity on gingival health in young subjects, probably due to a combination of metabolic and inflammatory profiles and the result of a careless attitude towards prevention diseases of the oral cavit

Potential use of human periapical cyst-mesenchymal stem cells (hPCy-MSCs) as a novel stem cell source for regenerative medicine applications

Mesenchymal stem cells (MSCs) are attracting growing interest by the scientific community due to their huge regenerative potential. Thus, the plasticity of MSCs strongly suggests the utilization of these cells for regenerative medicine applications. The main issue about the clinical use of MSCs is related to the complex way to obtain them from healthy tissues; this topic has encouraged scientists to search for novel and more advantageous sources of these cells in easily accessible tissues. The oral cavity hosts several cell populations expressing mesenchymal stem cell like-features, furthermore, the access to oral and dental tissues is simple and isolation of cells is very efficient. Thus, oral-derived stem cells are highly attractive for clinical purposes. In this context, human periapical cyst mesenchymal stem cells (hPCy-MSCs) exhibit characteristics similar to other dental-derived MSCs, including their extensive proliferative potential, cell surface marker profile and the ability to differentiate into various cell types such as osteoblasts, adipocytes and neurons. Importantly, hPCy-MSCs are easily collected from the surgically removed periapical cysts; this reusing of biological waste guarantees a smart source of stem cells without any impact on the surrounding healthy tissues. In this review, we report the most interesting research topics related to hPCy-MSCs with a newsworthy discussion about the future insights. This newly discovered cell population exhibits interesting and valuable potentialities that could be of high impact in the future regenerative medicine applications

Metals used in maxillofacial surgery

The goal of maxillofacial surgery is to restore the shape and functionality of maxillofacial region. In the past years, there has been a tremendous progress in this field because of significant advances in biotechnology that provided innovative biomaterials to efficiently reconstruct the maxillofacial injured region. By using appropriate selection of the implant biomaterial, it is possible to reconstruct the native tissue, both in form and function. The ideal biomaterial should mimic native tissues regarding density, strength, and modulus of elasticity. Autografts are currently the gold standard for replacement of missing tissues, but synthetic biomaterials have been widely used because they eliminate the discomfort to take the replacement tissue from the donor site. Among synthetic biomaterials, different metals may be utilized to efficiently reconstruct the maxillofacial injured region. This article makes an effort to summarize the most important metals in use in maxillofacial surgery, and point out advantages and disadvantage of each typ

Retrospective analysis of the correlation between the facial biotype and the inclination of the upper canine cusp axis to the occlusal plane

Permanent maxillary canines are the second most frequently impacted teeth and the prevalence of this clinical condition is estimated to be 1-2% in the general population. The diagnosis of maxillary canine impaction should be based on both clinical and radiographic examinations. The aim of this study was to evaluate the presence of a correlation between the facial biotype and the inclination of the upper cusp axis. A correlation between the total radicular length of the lateral incisors was also evaluated, by comparing the side of impaction with the healthy side. Twenty three patients with a diagnosis of unilateral upper cusp impaction were recruited. For each patient, dental casts and radiographic material (panoramic radiographs and lateral cephalograms) were examined. Statistical analyses were done with Spearman's rank correlation coefficient or Spearman's rho (V). X-ray examinations demonstrated that canine impaction was associated to other dental anomalies (32% of the sample). The mean S angle measurements were 22.9° ± 4.1°, and mean values of the T angle were 34.7°± 4.0°. The mean distance “d” value was 14.6 mm ± 1.2 mm. The mean values of the angle between the upper cusp axis and the perpendicular-to-Fh plane were 20.8 °± 2.6°. Among the 23 subjects recruited, 5 showed values included in the range 25°-45° and 1 an inclination > 45°. The results obtained in the present study demonstrate a significant inverse correlation between the MM angle and the inclination of the upper cusp axis to the perpendicular-to-Fh plan

Use of dermal-fat grafts in the post-oncological reconstructive surgery of atrophies in the zygomatic region: clinical evaluations in the patients undergone to previous radiation therapy

INTRODUCTION: Grafting of autologous adipose tissue can be recommended in some cases of facial plastic surgery. Rhabdomyosarcoma is a type of cancer that can also affect the orbit. Enucleation of the eye can cause atrophy of the corresponding hemiface and decreased orbital growth. CASE REPORT: We report a case of a female patient with a medical history of surgical enucleation of the right eyeball, who had received rhabdomyosarcoma radiation therapy in her youth. The patient presented with a depression in the right zygomatic region. We took a dermal-fat flap from the abdominal region, which had been previously treated. RESULTS: The surgical outcome, 48 hours, and much clearly 31 days after the surgery, revealed that the right zygomatic region had returned to its proper anatomical shape, although there were still signs of postoperative edema. DISCUSSION: Very damaged tissues, like those exposed to radiation therapy, are generally not suitable for grafting of adipose tissue. CONCLUSIONS: In the described case, we achieved a technically and aesthetically satisfying result despite the patient's medical history involving several perplexities about the use of autologous dermal-fat tissues, because of prior radiation therapy exposure. The clinical case shows that even a region exposed to radiation therapy can be a valid receiving bed for dermal-fat grafting

Sinus implants stabilization in Misch IV Class by means of S.I.S. device: a clinical study

In Misch Class IV dental implants are not normally placed at the same time as the sinus lift procedure. For this type of situation the use of several devices to immediately stabilise implants lacking in primary stability is proposed. Among these, the titanium S.I.S. plate results as being the most straightforward. This study proposes the evaluation of the effectiveness and stability of the results of this method in the short term on a greater number of patients, monitoring bones levels and implant stability. 14 patients were selected, 9 males and 5 females, aged between 43 and 75 years of age. Overall, 42 implants were placed in the upper posterior edentulous zones with Misch Class IV atrophy including first and second premolars and first molars, opposite fixed teeth, and were stabilised using the S.I.S. plate. Radiographic controls and ISQ measurements with AFR at 1, 6 and 12 months after loading testify to the stability of the bone levels which concur with success criteria found in literature. The technique described seems to be able to ensure success in cases of Misch Class IV with contemporaneous placement of the osseo-integrated implants. This clinical study, even if carried out on a small number of patients (14) and implants (42) represents the largest case history published. The technique described seems to ensure the success of cases of Misch Class IV with contemporaneous placement of osseo-integrated implants. The technique is straightforward and reproducible and does not cause further trauma. The S.I.S. allows for the stabilisation of the dental implants and the residual crest when there is a lack of primary stability. In Misch Class IV this means a considerable reduction in treatment times