Oral health related quality of life in cleft lip and palate patients rehabilitated with conventional prostheses or dental implants

Cleft lip and/or palate (CLP) is the most common congenital craniofacial abnormality, with a prevalence of 9.92 per 10,000 live births. In treating patients with CLP, oral rehabilitation is definitely a very important phase of the treatment in order to improve the patient's oral health related quality of life (OH-QoL). The aim of this retrospective study is to assess the OH-QoL in patients rehabilitated with different prosthetic options, thus comparing the conventional treatments, which include removable partial dentures and fixed partial dentures, with the implant-supported prostheses

A tooth preparation technique in fixed prosthodontics for students and neophyte dentists

The aim of this study was to evaluate a novel technique of tooth preparation in fixed prosthodontics suitable for dental students and neophyte dentists.MATERIALS AND METHODS: Twenty-four dental students of the sixth-year class were recruited to verify the predicibility of this technique. Each student prepared two mandibular second premolars on a typodont for a dental crown with a 90° shoulder finishing line. One tooth was prepared using standard procedures taught in the prosthodontic dental course; the other tooth was prepared with the new technique. Three Professors of Prosthodontics of the same University evaluated the result on the basis of 10 criteria. RESULTS: A statistically significant difference between the two techniques was found in 8 out of 10 criteria. The new technique showed higher values (p<0.05) in 7 criteria, while the conventional technique had better results in just 1 criterion. Moreover, the total sum of values was higher for the new technique (total 41.2±3.98, p<0.05) compared to the conventional technique (total 38.12±5.18, p<0.05). CONCLUSIONS: This study showed that the results were less dependent on manual abilities and personal experience with the novel technique. It could helps dental students and neophyte dentists in their learning curve

A randomized clinical trial about presence of pathogenic microflora and risk of peri-implantitis: comparison of two different types of implant-abutment connections

OBJECTIVE: The aim of this in vivo study was to evaluate two different types of implant-abutment connections: screwed connection and cemented connection, analyzing peri-implant bacteria microflora as well as other clinical parameters. PATIENTS AND METHODS: Twenty implants were selected, inserted in 20 patients, 10 with a screwed implant-abutment connection (Group 1) and 10 with a cemented implant-abutment connection (Group 2). The peri-implant microflora was collected, after at least 360 days from the prosthetic rehabilitation, using paper points inserted in peri-implant sulcus for 30 s. Polymerase chain reaction (PCR) Real-time analyzed the presence of 9 bacteria periodontal-pathogens and Candida albicans. RESULTS: Our findings showed that bacteria colonized all Groups analyzed, the average bacterial count was 3.7 E +08 (±1.19) in Group 1, compared to 2.1 E +08 (±0.16) in Group 2; no statistically significant differences were observed (p>0.0.5). In Group 1, however, bacterial colonization of peri-implant sulci was over the pathogenic threshold for 5 bacteria, indicating a high-risk of peri-implantitis. Also in Group 2, results showed a microflora composed by all bacteria analyzed but, in this case, bacterial colonization of peri-implant sulci was over the pathogenic threshold for only 1 bacterium, indicating a lower risk of peri-implantitis. Moreover, clinical parameters (PPD > 3 mm and m SBI > 0) confirmed a greater risk of peri-implantitis in Group 1 compared to Group 2 (p<0.05). CONCLUSIONS: We concluded that, also after only 360 days, implants with screwed connection showed a higher risk of peri-implantitis that implants with cemented connection

Implant survival and success rates in patients with risk factors: results from a long-term retrospective study with a 10 to 18 years follow-up

OBJECTIVE: Risk factors for implant therapy are represented by all general and local conditions that through various mechanisms can increase either short-term and long-term failure risk. The aim of this study is to assess the implant survival and implant success rates with single and multiple risk factors. PATIENTS AND METHODS: To address the research purpose, a retrospective cohort study was designed and implemented, including a sample of 225 patients with a total of 871 implants placed. The following risk factors were considered: smoking, bruxism, bone augmentation procedures and the presence of load risk (implants with crown/implant relation > 0.8; angulation > 25°; presence of cantilever). Follow-up ranged from 10 years to 18 years (average follow-up 13.6 years). Failures were subdivided into short-term failures, before the prosthetic phase, and long-term failures, after definitive prosthesis. The success criteria published by Albrektsson and Zarb were adopted. A Cox proportional hazard regression model was used to calculate hazard ratio, with a statistically significant p-value <0.05. RESULTS: Out of the 871 implants placed, 138 did not meet the success criteria, (success rate 84.16%), sixty (43.47%) were classified as "early failure" and seventy-eight as "late failure" (56.53%). A total of 70 dental implants were removed, with a survival rate of 91.96%. CONCLUSIONS: The presence of a single risk factor does not imply a marked increase of failure risk. Among the analyzed factors, the one that proved to be the most dangerous was bruxism, even when presented as the only risk factor. Bruxism with load risk proved to be the most dangerous association (success rate 69.23%) and could be included among the absolute contraindications for implant treatment

Early wound healing score (EHS): an intra- and inter-examiner reliability study

The early wound healing score (EHS) was introduced to assess early wound healing of periodontal soft tissues after surgical incision. The purpose of this study is to evaluate the intra- and inter-examiner reliability of the EHS. Six examiners with different levels of training and clinical focus were enrolled. Each examiner was trained on the use of the EHS before starting the study. Thereafter, 63 photographs of three different types of surgical incisions taken at day 1, 3 or 7 post-operatively were independently evaluated according to the proposed assessment method. A two-way random intra-class correlation coefficient (ICC) and 95% confidence interval (CI) were used to analyze the intra- and inter-examiner reliability for the EHS. The inter-examiner reliability for the EHS was 0.828 (95% CI: 0.767-0.881). The intra-examiner reliability ranged between 0.826 (95% CI: 0.728-0.891) and 0.915 (95% CI: 0.856-0.950). The results therefore show an "almost perfect agreement" for intra- and inter-examiner reliability. The EHS provides a system for reproducible repeated ratings for the early healing assessment of incisions of periodontal soft tissues. Even when used by examiners with different clinical experience and specialty, it shows a high correlation coefficient

Knowledge and attitude towards retrograde peri-implantitis among Italian implantologists: a cross-sectional survey

Abstract Background: Retrograde peri-implantitis (RPI) is a pathological entity with an unclear etiology (e.g., overheating during implant insertion, residual infection of the tooth replaced by the implant or the endodontic lesion of neighboring teeth) and an extremely low prevalence and has been scarcely investigated. Therefore, the aim of this cross-sectional survey was to evaluate the knowledge and attitude of Italian implantologists regarding RPI. Methods: An anonymous questionnaire was sent via email to implantologists randomly selected, including a section about demographic information and questions related to RPI origin, radiographic representation, symptoms and treatment options. All questions were multiple answer and close-ended. Binomial logistic regression was performed to investigate the relationship between correct answers and the following independent variables: age, years of experience and number of dental implants placed per year. Results: In total, 475 implantologists completed the questionnaire, with a response rate of 46.3%. Based on the results of the study, incorrect answers were associated with less experienced participants (&lt;80 implants/year) for all questions evaluated, with the exception of treatment strategies. Furthermore, 26.7% of the survey takers did not recognize radiographic representation of RPI and 35.5% picked "implant removal" when asked about treatment modality. Conclusions: The majority of participants were able to recognize symptoms and indicated the probable causes of RPI; however, around 30% of them showed very limited knowledge of available management strategies

The role of new porcine collagen membrane (Mucoderm®) in soft tissue augmentation procedure

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Medication-related osteonecrosis of the jaw

In 2014, the nomenclature of bisphosphonate-related osteonecrosis of the jaw (BRONJ) was changed in medication-related osteonecrosis of the jaw (MRONJ) to include osteonecrosis of the jaw caused by non-bisphosphonates (BPs) drugs. MRONJs are a rare drug adverse reaction associated with BPs and other antiresorptive (denosumab) and antiangiogenetic therapies. MRONJ pathophysiology is not completely elucidated, and three risk factors should be considered: Local factors, underlying disease and kind of medication. MRONJ aff ects considerably patient’s quality of life, so it is important to know pathology and risk factor in order to prevent or treat immediately the disease. Various BRONJ staging systems are used by clinicians: In 2006 Ruggero at al. proposed a clinical staging system with three diff erent levels based on signs and symthoms; in 2009 American Association of Oral and Maxillofacial Surgeons implemented it with Stage 0. Marx in 2007 was the only one who divided the stages on the basis of the lesion’s size. Bedogni in 2012 proposed a clinical-radiological staging system. The aim of this review is to summarize the current diagnosis, prevention and treatment strategies

Survival of short dental implants ≤7 mm: A review

The first long-term successful outcome of short dental implants was demonstrated by Frieberg et al. in 1991, however, the definition of “short” implants is still controversial and without uniform consensus nowadays. The specific aim of this review was to evaluate and to compare cumulative survival rate (CSR) of short dental implants of the two groups. The survival rate of short dental implants was the primary outcome variable to be extracted and analyzed. An electronic search was conducted through the Medline (PubMed) database of the National Library of Medicine, and EMBASE to find all relevant articles published between January 1, 1990, and April 30, 2015. The electronic search identified 347 publications, which were all carefully screened by title and abstract. About 65 articles qualified for a thorough full-text analysis: 35 studies were excluded because CSR% was not calculable. Finally, 30 studies with relevant data on CSR were selected to be included in this review. Articles were divided into two groups: All relevant articles published between 1991 and 2000 as Group 1 and between 2001 and 2015 as Group 2. In Group 1 CSR was 83.53% ± 19.46%, a considerable statistically significant difference compared to 93.65% ± 7.94% of Group 2. This review further identified the causes of failure: In Group 1 the majority of short implant failures occurred early, within the first 4 months, for an insufficient quantity of bone tissue. In Group 2, causes of early failures considered were low bone quality while prosthetic reasons were responsible for delayed failures

Association between subclinical atherosclerosis and oral inflammation: a cross-sectional study

Background: The aim of this cross-sectional study was to investigate the association between carotid intima-media thickness (c-IMT) values and periodontal and peri-implant diseases in a sample of patients with hypertension. Methods: A total of 151 participants with presence of at least one dental implant in function for&nbsp;&gt;5 years were recruited. Anthropometric measurements, 24-h ambulatory blood pressure monitoring, ultrasound assessment of carotid arteries (c-IMT and presence of plaque) were recorded and venous blood samples obtained. An oral examination was performed by calibrated examiners to ascertain prevalence and severity of periodontal and peri-implant diseases. Binomial logistic regression was performed to investigate the potential association between various measures of exposure of dental diseases and predictors of cardiovascular risk (c-IMT&nbsp;&gt;&nbsp;0.9&nbsp;mm and presence of plaque or their combination). Results: Diagnosis of periodontitis (OR 6.71, 95% CI: 2.68-16.76, P&nbsp;&lt;&nbsp;0.001), cumulative mucosal/gingival inflammation (Periodontal Screening and Recording score) (OR 1.25, 95% CI:1.12-1.41, P&nbsp;&lt;&nbsp;0.001), and mucositis (OR 3.34, 95% CI:1.13-9.85, P&nbsp;&lt;&nbsp;0.05) were associated with c-IMT&nbsp;&gt;&nbsp;0.9&nbsp;mm and/or plaque presence independent of age, sex, smoking, 24&nbsp;h systolic blood pressure and body mass index differences. No statistically significant results were noted for peri-implantitis. Linear regression models confirmed a positive association of cumulative mucosal/gingival inflammation (β&nbsp;=&nbsp;0.011, SE 0.002, P&nbsp;&lt;&nbsp;0.001), diagnosis of periodontitis (β&nbsp;=&nbsp;0.114, SE 0.020, P&nbsp;&lt;&nbsp;0.001), and peri-implant diseases (β&nbsp;=&nbsp;0.011, SE 0.002, P&nbsp;&lt;&nbsp;0.001) with increased c-IMT values. Conclusions: This study confirms a positive association between mucosal/gingival inflammation and subclinical atherosclerosis assessed by c-IMT values and the presence of carotid plaque in patients with hypertension, independent of traditional cardiovascular risk factors. Future studies are needed to further characterize this relationship