Bone Regeneration in Implant Dentistry: Role of Mesenchymal Stem Cells

This chapter focuses on a review of the activity of non-embryonic mesenchymal stem cells used to regenerate jaw bones in dentistry. Recent research of non-embryonic stem cells provides new possibilities for noninvasively obtaining new autologous bone from stem cells provided by various tissues from the same patient. Disaggregation of biologic tissue harvested from the patients during surgery permits extraction of stem cells from a small sample of connective tissue obtained from the patient’s lingual mucosa or from the postextraction surgical site where the endosseous implant will be inserted

Differences between panoramic and Cone Beam-CT in the surgical evaluation of lower third molars

The aim of this study was to evaluate the ability to identify the contiguity between the root of the mandibular third molar and the mandibular canal (MC) in panoramic radiographs compared with Cone Beam-CT. Panoramic radiographs of 326 third molars and CBCT radiographs of 86 cases indicated for surgery and considered at risk were evaluated. The following signs were assessed in panoramic radiographs as risk factors: radiolucent band, loss of MC border, change in MC direction, MC narrowing, root narrowing, root deviation, bifid apex, superimposition, and contact between the root third molar and the MC. Radiographic signs associated with absence of MC cortical bone are: radiolucent band, loss of MC border, change in MC direction, and superimposition. The number of risk factors was significantly increased with an increasing depth of inclusion. CBCT revealed a significant association between the absence of MC cortical bone and a lingual or interradicular position of the MC. In cases in which panoramic radiographs do not exclude contiguity between the MC and tooth, careful assessment the signs and risks on CBCT radiographs is indicated for proper identification of the relationships between anatomic structures

Micro-Raman Spectroscopy of Dental Implants Subjected to Different Surface Treatments

The aim of the study was to qualitatively investigate the structure of the surface layer of TiO2 on dental implants made of Ti-6Al-4V subjected to different manufacturing treatments. M (machined), B (Al2O3-blasted), E (HNO3HF-etched), B + E and A (B + E + anodized) implants and a further group receiving the same treatments as the first group with the addition of a final decontamination with cold plasma were included in the study. Examination was performed using micro-Raman spectroscopy. The surface treatments evaluated did not achieve the formation of crystalline TiO2. The increase in the complexity of surface treatment produced a proportional increase in the thickness of amorphous TiO2 oxide. In the B + E group, the plasma treatment enhanced the amorphous oxide thickness of TiO2. The other surfaces treated by plasma decontamination did not show a difference to the respective untreated ones. The investigated surface treatments did not change the crystalline cage of TiO2 in Ti-6Al-4V implants but affected the thickness of the oxide layer. The biological response could be influenced by different oxide thicknesses. Additional information on superficial TiO2 structural organization can be obtained by micro-Raman evaluation of dental implants. Dental implants with B + E + plasma and A superficial treatments allowed the maximum formation of the amorphous oxide thickness

Nanofeatured Titanium Surfaces for Dental Implantology: Biological Effects, Biocompatibility, and Safety

Nanotechnology enables the control and modification of the chemical and topographical characteristics of materials of size less than 100 nm, down to 10 nm. The goal of this review is to discuss the role of titanium substrates as nanoscale surface modification tools for improving various aspects of implantology, including osseointegration and antibacterial properties. Techniques that can impart nanoscale topographical features to endosseous implants are described. Since the advent of nanotechnology, cellular specific functions, such as adhesion, proliferation, and differentiation, have been better understood. By applying these technologies, it is possible to direct cellular responses and improve osseointegration. Conversely, modulating surface features by nanotechnology could have the effect of decreased bacterial colonization

Oral Hygiene Practice among Hospitalized Patients: An Assessment by Dental Hygiene Students

Aim: An epidemiological study was carried out, in hospital wards, with the aim of assessing the oral health status of patients subjected to multiple medical treatments. Material and Methods: The study was conducted at Fondazione IRCCS Policlinico San Matteo (Pavia, Italy). A questionnaire was submitted to patients for the evaluation of oral hygiene devices used; then, a clinical examination was conducted to collect Decayed Missing Filled Teeth (DMFT) index, Plaque Index (PI), and Marginal Gingival Index (MGI) values. Results: Manual toothbrushes were used by a wide range of the sample study (65–100% among hospital wards), together with mouthwash (20–80%); interproximal aids were used by few patients (the lowest recorded value was 33.3%). Conclusion: dental hygienists could be integrated into hospital wards as oral hygiene procedure instructors, for the improvement of the oral health conditions of hospitalized patients

A Retrospect of the Special Issue "Second Edition of Innovative Solutions for Oral Healthcare"

: Medicine and oral health are constantly progressing through a series of small advancements that, together, lead to significant discoveries and breakthroughs [...]

Le lesioni pariapicali implantari: etiopaogenesi e trattamento terapeutico

Etiopatogenesi delle lesioni periapicali implantari e possibilità terapeutiche attuali mediante trattamento antibiotico, chirurgico, antimicrobico, laser terapi

Nerve damage resulting from oral surgery and medical legal implications

Aim During oral surgery and implantology in particular, nerve damage can occur. This event falls in the group of iatrogenic injuries and may lead to medical litigation. Case description Two cases of legal dispute subsequent to lower alveolar nerve damage after implant surgery are reported. Discussion and conclusion In relation with the cases, a detailed analysis of the most common causes of such injuries is presented, as well as the diagnostic techniques and possible treatments are proposed. In addition, the various procedures leading to the evaluation of biological damage are illustrated

Patients Taking Direct Oral Anticoagulants (DOAC) Undergoing Oral Surgery: A Review of the Literature and a Proposal of a Peri-Operative Management Protocol

Patients on anticoagulant therapy for the prevention of cardiovascular accidents present an increased risk of bleeding following dental and oral surgery. Four recently introduced non-vitamin K antagonist oral anticoagulants, namely dabigatran etexilate (direct thrombin inhibitor), rivaroxaban, apixaban, and edoxaban (Xa factor direct inhibitor), are widely spreading for convenience of use compared to the older drug class. Dental management of patients taking these drugs has substantial differences compared to patients on vitamin K antagonist therapy. Anticoagulation is not assessed directly through a hematological test, but indirectly by renal function. The interventions must be scheduled at the time of minimum blood concentration of the drug. Bleeding can occur even after several days following the surgery. The interaction with drugs administered for dental care must be carefully evaluated. The peri-operative diet can influence the risk of bleeding. Local measures favoring coagulation must be adopted. The interventions with higher risk must be divided into multiple less invasive interventions. Although antidotes exist for these drugs, their use does not seem necessary for dental interventions that have been planned optimally. Furthermore, in this review of the literature a decision protocol is proposed for the evaluation of the suspension of the anticoagulant drug before oral surgery. Cessation of any anticoagulant should only be made in consultation with the patient's general practitioner/cardiologist, who will weigh up the risk of bleeding from the proposed procedure with the risk of thrombosis/stroke in each individual patient