Aesthetic satisfaction in lip and palate clefts: a comparative study between secondary and tertiary bone grafting

Lip and palate cleft represent one of the most frequently occurring congenital deformity, which includes dental anomalies, such as variation in tooth number and position. In case of hypodontia implant-prosthetic rehabilitation offers significant advantages in terms of function, aesthetics and quality of life and bone graft is usually needed. Secondary bone grafting, generally performed in the mixed dentition phase (years 8-11) seems to be the most successful method to allow for rehabilitation. It's often necessary to perform a tertiary bone grafting in adult age in order to achieve better bone quantity and quality before implant placement. Aim of this retrospective study was to evaluate the aesthetic perception that patients had of themselves comparing dental implants placed in tertiary grafted alveolar cleft sites with a previous secondary grafting to only secondary grafting. Between 2009 and 2012, fourteen alveolar cleft were treated with implant rehabilitation and eleven of them received tertiary bone grafting six months prior to implant placement. All patients were questioned to give a score from 1 to 10 their aesthetic satisfaction of their smile before and after implant rehabilitation and during pre-surgery provisional rehabilitation. At the end of their prosthesis rehabilitation patients who received tertiary bone grafting resulted more satisfied than those who had secondary bone grafting only (9.5 vs 8)

Gingival hyperplasia around dental implants in jaws reconstructed with free vascularized flaps: a case report series

Free vascularized flaps are the gold standard for reconstruction of the facial skeleton after surgical ablation of pathologies or when important atrophy of the jaws exists. A frequent problem seen during prosthetic rehabilitation after reconstruction with free vascularized flaps is the onset of hyperplastic granulomatous reactive tissue around the prosthetic abutment of the implant. The features of this phenomenon seem to be directly related to the characteristics of the periimplant tissue and of the manufacturing materials of the prosthesis and abutments. This complication can be seen quite often; we found it in 7 of 40 patients (17.5%). It does not seem to significantly affect the survival rate of implants. The aim of the study was to analyze the behavior of such lesions and to suggest our clinical approach with the management of these kinds of patients and complications. To remove gingival hyperplasia, we used either a traditional cold scalpel or an electric cautery or laser. We had good results using these tools. The onset of this phenomenon was not influenced by either the kind of implant and free flaps used or by the local conditions of the patients (such as radiotherapy). The number of recurrences was highly influenced by the oral hygiene of the patients

Histological and immunohistochemical evaluation of mandibular bone tissue regeneration

The purpose of the study was to perform an immunohistochemical and histological evaluation of samples taken from different bone regeneration procedures in atrophic human mandible. 30 patients (15 men and 15 women, age range of 35-60 years), non-smokers, with good general and oral health were recruited in this study and divided into three groups. The first group included patients who were treated with blood Concentration Growth Factors (bCGF), the second group included patients who were treated with a mixture of bCGF and autologous bone, while the third group of patients was treated with bCGF and tricalcium phosphate/hydroxyapatite (TCP-HA). Six months after the regenerative procedures, all patients undergone implant surgery, and a bone biopsy was carried out in the site of implant insertion. Each sample was histologically and immunohistochemically examined. Histological evaluation showed a complete bone formation for group II, partial ossification for group I, and moderate ossification for group III. Immunohistochemical analysis demonstrated a statistically significant difference between the three groups, and the best clinical result was obtained with a mixture of bCGF and autologous bone

Monolithic zirconia and digital impression: case report

The aim of this study is to present a clinical case of a full arch prosthetic rehabilitation on natural teeth, combining both digital work-flow and monolithic zirconi

Sensor for Distance Measurement Using Pixel Grey-Level Information

An alternative method for distance measurement is presented, based on a radiometric approach to the image formation process. The proposed methodology uses images from an infrared emitting diode (IRED) to estimate the distance between the camera and the IRED. Camera output grey-level intensities are a function of the accumulated image irradiance, which is also related by inverse distance square law to the distance between the camera and the IRED. Analyzing camera-IRED distance, magnitudes that affected image grey-level intensities, and therefore accumulated image irradiance, were integrated into a differential model which was calibrated and used for distance estimation over a 200 to 600 cm range. In a preliminary model, the camera and the emitter were aligned

Wood Anatomical Traits Respond to Climate but More Individualistically as Compared to Radial Growth: Analyze Trees, Not Means

Wood encodes environmental information that can be recovered through the study of tree-ring width and wood anatomical variables such as lumen area or cell-wall thickness. Anatomical variables often provide a stronger hydroclimate signal than tree-ring width, but they show a low treeto-tree coherence. We investigate the sources of variation in tree-ring width, lumen area, and cell-wall thickness in three pine species inhabiting sites with contrasting climate conditions: Pinus lumholtzii in wet-summer northern Mexico, and Pinus halepensis and Pinus sylvestris in dry-summer north-eastern Spain. We quantified the amount of variance of these three variables explained by spring and summer water balance and how it varied among trees. Wood anatomical variables accounted for a larger inter-individual variability than tree-ring width data. Anatomical traits responded to hydroclimate more individualistically than tree-ring width. This individualistic response represents an important issue in long-term studies on wood anatomical characteristics. We emphasized the degree of variation among individuals of the same population, which has far-reaching implications for understanding tree species’ responses to climate change. Dendroclimatic and wood anatomical studies should focus on trees rather than on the mean population series

Solid state protein monolayers: morphological, conformational, and functional properties

We have studied the morphological, conformational, and electron-transfer (ET) function of the metalloprotein azurin in the solid state, by a combination of physical investigation methods, namely atomic force microscopy, intrinsic fluorescence spectroscopy, and scanning tunneling microscopy. We demonstrate that a “solid state protein film” maintains its nativelike conformation and ET function, even after removal of the aqueous solvent

High fidelity numerical fracture mechanics assisted by RBF mesh morphing

The study and design of cyclically loaded structures cannot neglect the evaluation of their fatigue behavior. Today numerical prediction tools allow adopting, in various industrial fields, refined and consolidated procedures for the assessment of cracked parts through analyses based on fracture mechanics. An high level of detail can be obtained through the use of well consolidated FEM methods, allowing an accurate and reliable calculation of the flaw Stress Intensity Factor (SIF) and its resulting prediction in terms of crack propagation. A challenging step for this computational workflow remains, however, the generation and update of the computational grid during crack evolution. It is in this context that radial basis functions (RBF) mesh morphing is emerging as a viable solution to replace the complex and time-consuming remeshing operation. The flaw front is updated, according to its propagation, by automatically deforming the numerical grid obtaining an evolutionary workflow suitable to be used for industrially-sized numerical meshes (many millions of nodes). A review of applications, obtained by exploiting FEA (Ansys Mechanical) and mesh morphing (RBF Morph) state of-the-art tools, is presented in this work. At first the proposed workflow is applied on a circular notched bar with a defect controlled by a two-parameters evolution. The same approach is then refined and demonstrated for a Multi Degree of Freedom (MDoF) case on the same geometry and on the vacuum vessel port stub from the fusion nuclear reactor Iter

Microbiological profiles of dental implants in metabolic syndrome patients: a case-control study

There is a lack of knowledge on the possible influence of systemic conditions on peri-implantitis. The aim of this case-control study is to evaluate the difference in terms of oral patho-gens’ concentrations in the peri-implant sulcus of a group of patients affected by metabolic syndrome (Mets) compared to healthy subjects. For each patient, peri-implant sulcular biofilm samples were obtained by inserting two sterile endodontic paper points in the deepest aspect of the peri-implant sulcus for 30 s. The quantitative real-time polymerase chain reaction was performed to evaluate total bacterial counts of six pathogens. Patients were screened for peri-implant diseases and clinical and radiographic parameters were recorded. A total of 50 patients was enrolled in the study, 25 affected by Mets and 25 healthy. Significantly higher bacterial counts were discovered for Aggregatibacter Actinomycetemcomitans (p = 0.0008), Prevotella Intermedia (p = 0.0477) and Staphylococ-cus Aureus (p = 0.034) in MetS patients compared to healthy subjects. Performing a sub-group anal-ysis, considering peri-implant status and dividing patients by MetS diagnosis, no statistically sig-nificant (p < 0.05) differences were found. For the first time, a correlation between MetS presence and a greater prevalence of some bacterial species in the peri-implant sulcus was reported, irrespec-tively from peri-implant status (health vs disease)

The treatment of peri-implant diseases: A new approach using HYBENX® as a decontaminant for implant surface and oral tissues

Background: Peri-implantitis is a pathological condition characterized by an inflammatory process involving soft and hard tissues surrounding dental implants. The management of periimplant disease has several protocols, among which is the chemical method HYBENX®. The aim of this study is to demonstrate the efficacy of HYBENX® in the treatment of peri-implantitis and to compare HYBENX® with other chemical agents used in the surgical treatment of peri-implantitis. Methods: The present study included a population of ten subjects with severe peri-implantitis. The procedure used in the study involves the application of HYBENX® after open-flap debridement. Each patient has been followed for 12 months after a single application of the decontaminant agent. Clinical and radiographical parameters were recorded at baseline, 3 months, and 12 months after treatment completion. Results: At baseline, a mean pocket probing depth (PPD) of 7.3 - 0.5 mm and a mean clinical attachment level (CAL) of 8.8 - 0.8 mm was recorded. An average residual PPD of 4.2 - 0.5 mm and a mean CAL of 5.2 - 0.8 mm were observed after 1 year. Additionally, the average of bone gain was about 3.4 mm, with a mean marginal bone level (MBL) change from 5.8 mm (baseline) to 2.4 mm (12 months). In total, 90% of the treated implants reached the success rate after the 1-year follow-up. Only in one case out of ten treated implants was resolution of the disease not achieved. Conclusion: Clinical improvements highlight that the procedure of open-flap debridement (OFD) + HYBENX® may be considered an effective technique in the treatment of peri-implantitis. From the results obtained, it can be concluded that the use of HYBENX® in the surgical treatment of peri-implantitis is promising. Overall, this protocol demands further studies to better understand the role and potential benefits of HYBENX® in the treatment of peri-implantitis