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

Expanding drug resistance through integron acquisition by IncFI plasmids of Salmonella enterica Typhimurium.

We conducted a 30-year retrospective analysis of IncFI plasmids from Salmonella enterica serotype Typhimurium. These plasmids have been associated with the emergence of epidemic clones of multidrug-resistant Salmonella. Molecular and genetic evidence indicates that IncFI plasmids are evolving through sequential acquisition of integrons carrying different arrays of antibiotic- resistance genes

Oral health conditions and cardiovascular diseases in elderly italian patient

BACKGROUND: The objective of this study was to investigate the associations between oral health status and presence of cardiovascular diseases (CVD) in elderly patients. METHODS: The study population consisted of 533 patients (308 females, 225 males) aged 65 to 98 years. The mean age of patients was 73.93 (±7.8 standard deviation (SD)). Patients were asked to visit the Geriatric Dentistry Department of “Policlinico Umberto I” of Rome for a routine check of their oral health status. All subjects gave informed, signed consent to participate in the study. A predesigned medical history questionnaire including social status, habits, medical history, general health and drug assumption were filled by each patient. Medical history, particularly focused on CV D and common atherosclerotic risk factors (arterial hypertension, diabetes, body mass index, etc.) have been recorded. Dental status was detected measuring the Decayed, Missing, and Filled Teeth (DMFT) and Community Periodontal Index (CPI) indexes. Geriatric Oral Health Assessment Index (GOHAI ) was also used to evaluate masticatory function, oral self-perception and psychosocial impact on patients. The chi-square test with a 95% confidence level was used to assess qualitative variables. Odds ratios (ORs) and stepwise logistic regression were used to calculate risk estimates; the independent variables: age, gender, DMFT, CPI index, GOHAI index score, and tooth loss were included in the statistical model. P value <0.05 was considered a statistically significant cut-off. RESULT S:S: The mean of the DMFT was 13.8 (SD: 7.1). Among all patients, 8.6% (n = 46) had more than 12 decayed teeth, 43.7% (n = 233) had more than 12 missing teeth. A total of 122 patients (52.4%) had more than 18 missing teeth. No difference between females and males was seen in DMFT and CPI index. GOHAI data were worst for females and it significantly decreased with age. Vascular diseases affected 69.8% of subjects (n = 372). Patients with CVD had less education and oral care (P < 0.05), higher CPI index and lower of filled teeth (P < 0.05). Moreover, the number of missing teeth was higher in patients with vascular disease and patients with more than 18 missing teeth have 2.5 times greater risk of CVD. CVDs are also associated with type 2 diabetes mellitus, underweight, and obesity (P < 0.05).CONCLUSIONS: From the finding of this study, it can be confirmed a significant link between CVD and oral health. A cooperation among geriatrician, cardiologist, and dentist is suitable to counteract the development of CVD and to early identify patients risk of CVD

Neutron sources based on medical Linac

The paper proposes the study of a novel photo-neutron source based on a medical high-energy electron Linac. Previous studies by the authors already demonstrated the possibility to obtain with this technique a thermal neutron flux of the order of 107 cm−2 s−1. This paper shows possible Linac’s setup and a new photo-converter design to reach a thermal neutron flux around 6 × 107 cm−2 s−1, keeping a reasonable high quality of the beam with respect to fast neutron and gamma contaminations

Bone damage induced by different cutting instruments: an in vitro study

The aim of this study was to compare the peripheral bone damage induced by different cutting systems. Four devices were tested: Er:YAG laser (2.94 mm), Piezosurgery, high-speed drill and low-speed drill. Forty-five bone sections, divided into 9 groups according to different parameters, were taken from pig mandibles within 1 h post mortem. Specimens were fixed in 10% buffered formalin, decalcified and cut in thin sections. Four different parameters were analyzed: cut precision, depth of incision, peripheral carbonization and presence of bone fragments. For statistical analysis, the Kruskal-Wallis test was applied to assess equality of sample medians among groups. All sections obtained with the Er:YAG laser showed poor peripheral carbonization. The edges of the incisions were always well-shaped and regular, no melting was observed. Piezosurgery specimens revealed superficial incisions without thermal damage but with irregular edges. The sections obtained by traditional drilling showed poor peripheral carbonization, especially if obtained at lower speed. There was statistically significant differences (p<0.01) among the cutting systems for all analyzed parameters. Er:YAG laser, gave poor peripheral carbonization, and may be considered an effective method in oral bone biopsies and permits to obtain clear and readable tissue specimens

Design of an epithermal column for BNCT based on D–D fusion neutron facility

Abstract Boron Neutron Capture Therapy (BNCT) is currently performed on patients at nuclear reactors. At the same time the international BNCT community is engaged in the development of alternative facilities for in-hospital treatments. This paper investigates the potential of a novel high-output D–D neutron generator, developed at Lawrence Berkeley National Laboratory (CA, USA), for BNCT. The simulation code MCNP-4C is used to realize an accurate study of the epithermal column in view of the treatment of deep tumours. Different materials and Beam Shaping Assemblies (BSA) are investigated and an optimized configuration is proposed. The neutron beam quality is defined by the standard free beam parameters, calculated averaging over the collimator aperture. The results are discussed and compared with the performances of other facilities

Digital impression on transmucosal vertical neck® implants: evaluation of soft tissues stability

BACKGROUND: The literature indicates that 0.5 to 1.5 mm of gingival recession most often occurs within the first months after implant placement or abutment connection. The aim of this study is to test the validity of the new Biotype implant design (Vertical Neck®) to evaluate the effect of a concave transmucosal profile on the vertical stability of soft tissues at the facial aspect of dental implants, taking advantage of the benefits deriving from intraoral digital impression. METHODS: The study was carried out at the Department of Oral and Maxillofacial Sciences, Sapienza - University of Rome. A 45-years-old patient was selected. He didn’t show periodontal and systemic diseases. Mono edentulous sites were either in maxilla (1.6) and in mandible (3.6). After the sign of the informed consent form, according to the World Medical Declaration of Helsinki, the surgical phase was performed. Mini-invasive osteotome sinus floor elevation in atrophic maxilla was used to insert a transmucosal Vertical Neck® implant with 4.8 mm diameter and 8 mm length. In mandible was used a transmucosal Vertical Neck® implant with 4.1 mm diameter and 8 mm length. Six months later a digital impression was taken with an intraoral optical scanner (CS3500, Carestream Dental, Atlanta, GA, USA). A Simbiosi® Scan Body was applied on implants. Periapical radiographs were taken in order to show the right linkage between devices and implants. Straight titanium abutmentswere used and periapical radiographs were made to evaluate a correct marginal fit on implants. Two monolithic zirconia crowns were realized with a CAM system. RESULTS: No recession in soft tissue was observed. The gingival level remained stable at 12 months. Vertical Neck® implants have shown a good relationship with bone and soft tissues. Also the aesthetic goals have been reached. CONCLUSIONS: Biotype transmucosal Vertical Neck® implants have been projected to allow the placement of prosthetic border into an area of 2 mm of eight instead of predetermined point. Because of its intrinsic feature, the biological width is respected. Thanks to the management of the impression into a digital format (intraoral scan and CAD/CAM system), the final crowns resulted to be more accurate than with a traditional system; infact, common mistakes linked to clinical and laboratory process have been avoided

Draft Genome Sequence of the Carboxydotrophic Alphaproteobacterium Aminobacter carboxidus Type Strain DSM 1086

Aminobacter carboxidus is a soil Gram-negative alphaproteobacterium belonging to the physiological group of carboxydobacteria which aerobically oxidize CO to CO2. Here, we report the draft genome sequence of the A. carboxidus DSM 1086 type strain and the identification of both form I and form II CO dehydrogenase systems in this strain