Three-dimensional bone regeneration by means of non-resorbable membranes versus titanium meshes in association with dubble variable thread tapered implants. Randomized clinical trial.

PURPOSE: The aim of this randomized clinical trial is to compare 2 different approaches for Guided Bone Regeneneration (GBR) in posterior region of atrophic mandibles regarding: I) the amount of vertical bone regeneration, II) the type and frequencies of surgical and healing complications, III) the implants primary stability and the osseointegration rate. MATERIAL AND METHODS: Forty partially edentulous patients with atrophic posterior mandible, who require a three-dimensional bone regeneration and an implant-prosthetic rehabilitation, were treated according the following protocol. Patients were randomly divided into two study group: 20 patients were treated with non-resorbable d-PTFE titanium-reinforced membranes (group A); and 20 patients with titanium mesh covered by cross-linked collagen membranes (group B). All patients received two or more double variable thread tapered implants and a mixture of autogenous bone and bone allograft according to one-stage GBR approach. In each group were evaluated the amount of vertical bone regeneration and the insertion torque value (IT) and implant stability quotient (ISQ) of all implants. In addition, all complications were analyzed, distinguishing between “surgical” and “healing” complications. RESULTS: The vertical bone regeneration was 4.3 ± 1.2 mm in the group A and 4.2 ± 1.1 in the group B. 99% of implants showed an optimal primary stability with insertion torque values > 35 Ncm and ISQ values > 60. All implants achieved a successful osseointegration. In the group A, surgical and healing complication rates were 5.0% and 15.9% respectively, In the group B, complication rates were 15.0% and 21.1% respectively. CONCLUSIONS: The preliminary results of this RCT suggested that both GBR approaches are predictability and effectiveness for the restoration of atrophic posterior mandible. Double variable thread tapered implants permitted to achieve an adequate primary stability in order to perform an one-stage GBR approach.PURPOSE: The aim of this randomized clinical trial is to compare 2 different approaches for Guided Bone Regeneneration (GBR) in posterior region of atrophic mandibles regarding: I) the amount of vertical bone regeneration, II) the type and frequencies of surgical and healing complications, III) the implants primary stability and the osseointegration rate. MATERIAL AND METHODS: Forty partially edentulous patients with atrophic posterior mandible, who require a three-dimensional bone regeneration and an implant-prosthetic rehabilitation, were treated according the following protocol. Patients were randomly divided into two study group: 20 patients were treated with non-resorbable d-PTFE titanium-reinforced membranes (group A); and 20 patients with titanium mesh covered by cross-linked collagen membranes (group B). All patients received two or more double variable thread tapered implants and a mixture of autogenous bone and bone allograft according to one-stage GBR approach. In each group were evaluated the amount of vertical bone regeneration and the insertion torque value (IT) and implant stability quotient (ISQ) of all implants. In addition, all complications were analyzed, distinguishing between “surgical” and “healing” complications. RESULTS: The vertical bone regeneration was 4.3 ± 1.2 mm in the group A and 4.2 ± 1.1 in the group B. 99% of implants showed an optimal primary stability with insertion torque values > 35 Ncm and ISQ values > 60. All implants achieved a successful osseointegration. In the group A, surgical and healing complication rates were 5.0% and 15.9% respectively, In the group B, complication rates were 15.0% and 21.1% respectively. CONCLUSIONS: The preliminary results of this RCT suggested that both GBR approaches are predictability and effectiveness for the restoration of atrophic posterior mandible. Double variable thread tapered implants permitted to achieve an adequate primary stability in order to perform an one-stage GBR approach

Adherence to cancer screenings: is the telephone survey a good method of investigation?

*INTRODUCTION* - In order to define subjective variables, the methodology on the assessment of the women participation to screening programs to prevent cervical cancer is presented. *MATERIALS AND METHODS* - The study was conducted using a structured questionnaire administered by telephone to a sample of women invited to screening, regardless of their real participation to the Pap test. The phone calls were made within 2 days prior to the Pap test session. The questionnaire contained 12 closed questions. *RESULTS* - We contacted a total of 1206 women: a total of 1100 women (93.70%) received the invitation letter and answered to the questionnaire. *CONCLUSIONS* - The chosen procedure obtained a high percentage of women who agreed to be interviewed

Varicella notification in immigrants: a brief report from Ferrara, Italy

Background and Aim of the work - We conducted a survey of varicella cases' notifications in the immigrant population in the province of Ferrara, Italy. Materials and Methods – We collected notifications of infectious disease between 2002 and 2006. Results and discussion - At the end of 2006, the 4.5% (14252 subjects) of total population of the province of Ferrara and its province was represented of immigrants from foreign countries. In this context, between 2002 and 2006, a total of 1969 cases of varicella, including 3.1% related to migrants, were reported. Among immigrants, there were 36 cases in males, and 26 in females. The cases were notified in the 64.5% by the hospital emergency service, in the 16.1% by the paediatrician and in 19.4% by the general practitioner. The incidence appears similar in both populations in childhood: this fact could means an integration in the local epidemiology for varicella of the immigrant school-children

Plasma rich in growth factors in human extraction sockets: a radiographic and histomorphometric study on early bone deposition

Objectives To determine whether and to what extent the additional application of plasma rich in growth factors ( PRGF ) to an extraction socket may influence the early bone deposition, as assessed by micro‐computed tomography (micro‐ CT ) scan as well as histomorphometric markers. Material and methods Twenty‐eight patients (age range: 34–74 years) contributing 36 extraction sockets were included in the study. Sockets were either treated with PRGF ( PRGF group; 18 sites in 11 patients) or left to spontaneous healing (control group; 18 sites in 17 patients). Radiographic and histomorphometric analysis was performed on bone cores trephined from each healing socket after 4–6 (T1) or 7–10 (T2) weeks of healing. Results Patients treated with PRGF application showed (i) similar bone volume and tissue mineral content, (ii) a trend, although not statistically significant, toward a greater number of CD 68+ cells (at T 1 and T 2) and v VW + cells (at T1), and (iii) a similar OCN staining score throughout the study, when compared with control group. Conclusions Plasma rich in growth factors‐treated group did not show any enhancement in early (4 and 8 weeks) bone deposition compared with control group.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/100296/1/clr12033.pd

The 'Alternating Osteotome Technique': a surgical approach for combined ridge expansion and sinus floor elevation. A multicentre prospective study with a three-year follow-up

The aim of this multicentre prospective study was to evaluate the efficacy and safety of a surgical approach based on a novel osteotome technique, in order to obtain both alveolar ridge expansion and sinus floor elevation. Partially edentulous patients requiring an implant-prosthetic rehabilitation with a fixed prosthesis in the posterior maxilla were included in this study according to pre-established inclusion and exclusion criteria. All implants were placed after site preparation with the 'Alternating Osteotome Technique', which consists of the use of alternating concave and convex osteotomes. After a 4 to 6-month healing period, all implants were restored with a definitive fixed prosthesis. Clinical and radiographic examinations were scheduled over a 36-month follow-up of functional loading according to a well-established protocol. Statistical analysis was used to detect any significant differences or correlations (P = 0.05). Seventy-six patients were consecutively treated with a total of 120 implants in three different centres. The mean ridge expansion and sinus floor elevation were 1.8 ± 0.3 and 2.5 ± 0.7, respectively. After three years of functioning, the implant success rate was 99.1% since one implant had failed and the mean marginal bone loss was 0.6 ± 0.3 mm. No complications occurred during the intraoperative and postoperative periods. All parameters analysed were stable and steady throughout the three-year follow-up. The 'Alternating Osteotome Technique' enables the dental surgeon to achieve an adequate implant osteotomy with limited ridge expansion and sinus floor elevation, increasing modestly the vertical and horizontal dimensions of the alveolar crest but reducing significantly the risk of surgical complications

Spotlight on measles 2010: Increased measles transmission in Ferrara, Italy, despite high vaccination coverage, March to May 2010

We report an increase in the incidence of measles in a population with consistently high and improving immunisation coverage in Ferrara province, northern Italy. During the first six months of 2010, 19 cases were confirmed, 10 of which were hospitalised. General practitioners, paediatricians and local healthcare authorities were alerted about the outbreak and asked to notify all suspected cases. We need to further increase immunisation coverage and to maintain and implement the monitoring system

Patient-reported outcomes and complication rates after lateral maxillary sinus floor elevation: a prospective study

Objectives Oral surgery morbidity is highly variable based on patients' characteristics and kind of surgical intervention. However, poor data are available in the literature regarding patient outcomes after oral surgery. The aim of this retrospective study was to evaluate patient-reported outcome and complication rates after maxillary sinus floor elevation. Materials and methods Data from the records of patients undergoing maxillary sinus elevation have been collected from a private dental office. Patient-reported outcome has been assessed using a 100-mm visual analog scale to evaluate the post-operative pain (VAS(pain)) experienced in the first week following surgery and visual rating scales to evaluate discomfort level (VRSdiscomfort: 0 to 4) and willingness to repeat the same surgical procedure (VRSwillingness: 0 to 3). Analgesics intake, swelling onset and duration, and ecchymosis have been also recorded. Results VAS(pain) showed moderate values in the first 2 days (< 50) post-surgery, with a tendency to progressively decrease over the next 2 days. Average assumption of painkillers was 3.93 +/- 3.03. Discomfort level (VRSdiscomfort) after surgery was low (median: 1; IR: 1-0), while willingness to undergo the same surgical procedure was very high (77.63% of patients). Swelling and ecchymosis were experienced by 97.36% and 51.32% of patients, respectively, with a mean duration of 4.09 +/- 1.43 and 2.21 +/- 2.31 days, respectively. Membrane perforation occurred in 4 cases. Other post-operative complications were not observed. Conclusions Maxillary sinus grafting is a safe procedure, with a low complication rate and moderate morbidity that is well tolerated by patients. Particular attention is needed in case selection, surgical planning and operator expertise. © 2021, The Author(s)

The Accuracy of Computer-Assisted Implant Surgery Performed Using Fully Guided Templates versus Pilot-Drill Guided Templates

Purpose. Computer-assisted stereolithographically guided surgery allows an ideal implant placement for prosthetic restoration. Two types of stereolithographic templates are currently available: a fully guided template and a pilot-drill guided template. The purpose of this study was (i) to evaluate the accuracy of implant insertion using these types of surgical templates and (ii) to define parameters influencing accuracy. Materials and Methods. 20 patients were enrolled and divided into 2 study groups: in group A, implants were placed using CAD-CAM templates with fully guided sleeves; in group B, implants were placed with a template with only pilot-drill guided sleeves. Pre- and postoperative computed tomographies were used to measure differences between final positions of implants and virtually planned positions. Three linear discrepancies (coronal, apical, and depth) and two angular ones (buccolingual and mesiodistal) were measured. Correlations between accuracy and jaws of interest, implant length and diameters, and type of edentulism were also analysed. Results. A total of 50 implants were inserted in 15 patients using CAD-CAM templates: 23 implants in group A and 27 in group B. The mean coronal deviations were 1.16 and 1.11 mm (P = 0.35), respectively; the mean apical deviations were 1.65 and 1.71 mm (P = 0.22); the mean depth deviations were 0.95 and −0.68 mm (P = 0.032); the mean buccolingual angular deviations were 4.16° and 6.72° (P = 0.042); and the mean mesiodistal ones were 2.81° and 5.61° (P = 0.029). In addition, the accuracy was statistically influenced only by implant diameter for coronal discrepancy (P = 0.035) and by jaw of interest for mesiodistal angulation (P = 0.045). Conclusion. Fully guided implant surgery was more accurate than pilot-drill guided surgery for different parameters. For both types of surgery, a safety margin of at least 2mm should be preserved during implant planning to prevent damage to nearby anatomical structures

Patient Opinions on the Helpfulness of External Rehabilitative Activities in Residential Psychiatric Care: A Pilot Study

INTRODUCTION: This study explores the patient opinions about the helpfulness of the External Rehabilitative Activities (ERA) delivered in two residential facilities for psychiatric rehabilitation. METHODS: We administered a Questionnaire developed to assess general helpfulness, helpfulness of specific therapeutic processes and satisfaction with the ERA to a sample of 46 psychiatric patients participating in at least three external activities. RESULTS: The External Rehabilitative Activities, tested by the ERA-Questionnaire, were considered helpful or very helpful by most of the patients. The therapeutic process with the highest score was "relaxation", followed by "general helpfulness", "socialization", "knowledge of social context", "community integration". The least-valued process was "autonomy". CONCLUSION: This pilot study has shown that psychiatric patients consider ERA helpful and rate more helpful the specific therapeutic processes, such as relaxation and socialization, that assure symptomatic relief and interaction with the outside world