Pharmacologic modulation of clodronate in local therapy of periodontal and implant inflammation.

Bisphosphonates are drugs used in the treatment of a variety of osteometabolic diseases. Recently they have been the object of research and studies on their potential application in dentistry and orthopedics. In particular, clodronate (non-aminobisphosphonates) has been studied, due to its reversible activity in comparison to apoptotic osteoclasts, the intrinsic action which stimulates the differentiation and activity of the osteoblasts, their antinflammatory activity, antipain and antioxidant action, represent the rational to estimate their clinical efficacy, for local use in dentistry, implatology, orthopaedic, rheumatology, oncology and dermatology

Soft tissue augmentation applying a collagenated porcine dermal matrix during second stage surgery: A prospective multicenter case series

BACKGROUND The achievement and preservation of an adequate amount of soft tissue around implants is a critical factor for the prognosis of the treatment. PURPOSE To evaluate the effectiveness of a porcine dermal matrix applied during second stage implant surgery for horizontal soft tissue augmentation and preservation of dimensional stability. MATERIALS AND METHODS Twenty patients (mean age 50.2 ± 11.9 [SD] years) candidate to implant therapy and requiring soft tissue augmentation were recruited in four centers. Augmentation was performed in 24 cases. A porcine dermal matrix was placed into a buccal split-thickness pouch during uncovering surgery. Silicone impressions were taken before surgery (T0), 2 weeks later at suture removal (T2), 6 months (T3), and 24 months (T4) post augmentation. Dimensional changes of soft tissue were evaluated using superimposition of digitalized study casts. RESULTS Nineteen patients (23 implants) could be evaluated at 6 months and 13 patients (17 implants) at 24 months. After 6-month follow-up, there was a significant dimensional gain respect to baseline, averaging 0.83 ± 0.64 mm (P 0.5 mm in 65.2% and 64.7% of the cases, respectively. Soft tissue shrinkage averaged 34.2% ± 77.0% from T2 to T3 (P < .01) and did not change thereafter (P = .39). Shrinkage was more consistent in the posterior mandible than in the maxilla, but not significantly (P = .23 at 6-month and .36 at 24-month). No adverse events occurred. CONCLUSION Within the limitations of this prospective case series, the use of a porcine dermal matrix may provide consistent soft tissue augmentation that maintains up to 24-month follow-up, although graft shrinkage may occur in the first 6 months, depending on the location of surgery

Prevalence of Peri-Implantitis: A Multi-Centered Cross-Sectional Study on 248 Patients

The aim of this multicenter cross-sectional study was to determine the prevalence of peri-implantitis and to assess its association with several patient- and implant-related factors. Patients with at least one implant, who came for a recall visit to one of the four centers over a period of five months, were enrolled. Presence of peri-implantitis (defined as bleeding on probing, exudate/suppuration, bone loss > 0.2 mm/year and increased pocket depth) and several other variables (e.g., smoking habits, history of periodontitis, diabetes) were recorded. Out of 248 enrolled patients (1162 implants), 10 patients had at least one implant with peri-implantitis (4.03%); a total of 14 implants were affected (1.20%). A statistically significant association between peri-implantitis and diabetes was found (OR 8.65; CI: 1.94–38.57). Smoking more than 10 cigarettes per day (OR: 0.53; CI 0.03–9.45) and history of periodontitis (OR: 2.42; CI: 0.49–11.89) were not found to be statistically associated with peri-implantitis. Even if implant therapy is a consolidated treatment, biological complications do happen. Strict supportive therapy recalls could lead to lower rates of peri-implantitis and earlier diagnosis

COVID-19 and Oral Surgery: a narrative review of preoperative mouth rinses

Cilj: Obaviti narativni pregled predloženih preoperativnih protokola za ispiranje usne šupljine prije oralno-kirurških zahvata da bi se u aerosolu suzbila pojavnosti virusa SARS-CoV-2. Izvori: Pretražene su znanstvene baze podataka PubMed, MedLine, CINAHN i Scopus kako bi se pronašli relevantni radovi objavljeni do trećeg tjedna travnja 2020. godine. Ovo istraživanje dopunjeno je pretraživanjem putem internetske tražilice te ručnim pretraživanjem međunarodnih i nacionalnih smjernica. Odabir istraživanja: Uključena su istraživanja i protokoli u kojima se predlaže preoperativno ispiranje usta kao mjera tijekom pandemije virusa COVID-19. S obzirom na to da je dostupan mali broj istraživanja, obavljen je pregled narativne literature. Ukupno se 15 referencija (11 članaka i 4 smjernice) smatralo mjerodavnima i kritički je analizirano. Zaključak: Rezultati pokazuju visoku heterogenost u predloženim protokolima. Potrebna su daljnja istraživanja da bi se bolje razumjele značajke i epidemiološka obilježja novog virusa te da bi se ispitala učinkovitost uobičajenih antiseptika protiv virusa SARS-CoV-2 u budućim kliničkim ispitivanjima. No upotreba klorheksidina, vodikova peroksida, providon-jodida i cetilpiridinijeva klorida, sa svrhom prevencije širenja bolesti uzrokovane virusom COVID-19, u različitim je časopisima opisana kao poželjna.Objective: To provide a narrative review of the preprocedural mouth rinse protocols suggested for oral surgery in order to contrast the presence of SARS-CoV-2 in aerosol. Sources and Methods: Electronic searches were performed in medical databases PubMed, Medline, CINAHN and Scopus to identify relevant studies published up until the third week of April 2020. This research was supplemented by exploration through a web-based search engine as well as a manual search for international and national guidelines. Studies and protocols which suggested preoperative mouth rinsing as a recommended measure during the COVID-19 outbreak were included. Given the small number of studies, a narrative literature review was conducted. In total, 15 references (11 articles and 4 guidelines) were considered relevant and were critically analysed. Conclusion: The findings show a high heterogeneity in the protocols suggested. Further research is required to better understand the viral features and epidemiologic characteristics of this new virus and to test the efficacy of commonly used antiseptics against SARS-CoV-2 in future clinical trials. However, the use of chlorhexidine, hydrogen peroxide, PVP-I and cetylpyridinium chloride in contrasting the spread of Covid-19 is described as advisable and substantial in different publications

How to avoid intraoperative and postoperative complications in maxillary sinus elevation

Maxillary sinus floor elevation, via the lateral approach, is one of the most predictable bone augmentation procedures performed in implant dentistry. but both intra- and postoperative complications can occur, and some of them are severe. Our aim is as follows: To review the pertinent literature on the topic, especially assessing the risk factors related to complications. To give clinical recommendations to minimize intra- and postoperative complications with the ultimate scope of improving the standard of clinical care and patient safety

Gingival phenotype assessment methods and classifications revisited: a preclinical study

Objective To compare gingival phenotype assessment methods based on soft tissue transparency on different backgrounds and assessor experience levels. Methods For this purpose, 24 gingival specimens were retrieved from pig jaws with tissue thicknesses from 0.2 to 1.25 mm. Three methods were assessed: periodontal probe PCP12 (thin/thick), double-ended periodontal probe DBS12 (thin/moderate/thick) and colour-based phenotype probe CBP (thin/moderate/thick/very thick). Each sample was photographed with each probe underneath and categorized whether the probe was visible or not using different coloured backgrounds. To measure experience level influence, dentists, dental undergraduate students and laypersons (n = 10/group) performed the evaluation. Results PCP12 probe showed a threshold between 0.4 and 0.5 mm. To distinct between thin and moderate thick gingiva, a comparable range for DBS12 was found while moderate thickness was between 0.5 and 0.8 mm and for thick above 0.8 mm. CBP also showed a comparable threshold of 0.5 mm for thin versus moderate as compared with the other methods; above 0.8 mm, predominantly a very thick tissue was measured. In general, the background colour had a minor impact on PCP12 and DBS12, and investigator experience showed no clear influence on GP assessment. Conclusion Based on probe transparency and within the limitation of a preclinical study, we suggest GP differentiation into three entities: thin ( 0.8 mm; low risk). Clinical relevance All three GP assessment methods are easy to perform and seem to have a high predictive value with a three entities classification for DBS12 and CBP

Maxillary segmental micro osteotomy: a human cadaver study on the efficacy of the technique

Purpose: Ultrasonic bone cutting was recently introduced as a feasible alternative to the conventional tools of cranio-maxillofacial surgery because it offers improved precision and safety. This study examined the feasibility of minimally invasive orthodontic or preprosthetic surgery using a piezosurgery device for lateroposterior maxillary segmental osteotomy. Materials and Methods: Four fresh cadaveric heads were obtained for this study. Maxillary posterior osteotomy was performed using piezoelectric surgery. To preserve the vascular supply, only 1 vestibular incision was made during surgery. The Mectron Piezosurgery1 unit is a multipurpose device that uses micrometric ultrasonic piezoelectric vibrations with a variable frequency and cutting energy. The strategy for maxillary osteotomy included 1 horizontal osteotomy, 2 vertical osteotomies, and 1 palatal osteotomy performed transantrally without incision of the mucoperiosteum. The osteotomies were performed using a piezodevice (OT7-type inserts: 0.55 and 0.35mm). In total, 1 horizontal cut (3mmabove the roots of the teeth), 2 vertical bone cuts, and 1 palatal osteotomy were made without incision of the palatal mucoperiosteum. Gentle dissection of the buccal fat pad was used to promote the healing of hard and soft tissues in the osteotomized zone. Results: No damage to soft tissues, including the palatal mucosa, occurred. The buccal fat pad was mobilized easily without requiring an additional incision. The osteotomic sites were linear and clean in the palatal aspect. The integrity of the vascular network was maintained because of the lack of damage to the palatal mucosa. No chisels were used during the osteotomies. Discussion: This cadaveric study shows the feasibility of using piezosurgery for segmental maxillary osteotomy. This report outlines a new and simple application of segmental maxillary micro-osteotom

Osteometabolic profile: a possible tool in decision making for implant rehabilitation in patients under antiresorptive drugs

This comparative study included 146 patients that are under risk of developing MRONJ and needed oral rehabilitation with implant-supported prosthesis. All the included patients had metabolic profile assessments and were divided into two groups: G1-normal osteometabolic profile (92 patients), G2- altered osteometabolic profile (54 patients). All patients in G1, regardless of gender and type of prosthetic rehabilitation, showed a regular osseointegration process without any complications. However, 42 patients in G2 (77%) were diagnosed with MRONJ within six months afterimplant insertions, which did not compromise implant osseointegration and prosthetic rehabilitation. In other 12 patients (23%) in adjunct to ONJ development, implants did not osseointegrate. All patients with ONJ were successfully treated according to the SISBO pharmacological protocol.According to the results of this study, osteometabolic profile assessment can be considered a useful tool in terms of decreasing the risk of developing ONJ in patients

Management of a neurological lesion involving Canalis Sinuosus: A case report

This case report describes the management of a lesion involving the Canalis Sinuosus (CS), that is a bone channel originating from the infraorbital canal below the orbital margin and posterior to the infraorbital foramen and coursing in an anterolateral direction to the anterior wall of the nasal cavity. A female patient, 62y, ASA 1, wearing full mobile dentures, came to our clinic asking for upper jaw rehabilitation. Due to a severe bone atrophy, a graft procedure was performed and the placement of eight implants was planned. One week after implants were positioned, the patient referred pain in the upper right central incisor region, that was compatible with a normal post‐operative healing. After 15 days, since the symptoms worsened and became localized and persistent, a more detailed CBCT analysis was carried out. The images demonstrated that a CS on the right side was compressed by the apex of the implant in position #11. The implant was replaced with a shorter one and adequate pharmacological therapy was prescribed. All the symptoms completely disappeared after 30 days.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/166431/1/cid12977_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/166431/2/cid12977.pd

A Retrospective Periodontal Assessment of 137 Teeth After Featheredge Preparation and Gingittage

The aim of this study was to retrospectively evaluate the periodontal response of periodontally healthy teeth prosthetically restored using a featheredge finish line preparation combined with a light rotary curettage (gingittage). A total of 137 restored teeth were included in the study. Mean follow-up time was 18.2 months (range: 6 to 60 months). Bleeding on probing was noted in 18% of cases, while the Plaque Index was found to be 11%. The probing depth in 99.4% of cases was ≤ 3 mm. In only 7 cases (5.1%), a slight restoration margin exposure was recorded. Although randomized controlled studies with longer follow-up are advocated, the present investigation seems to suggest that this protocol is a viable procedure