Topical Tocopherol for treatment of reticular oral lichen planus: randomized, double-blind, crossover study

This randomized, double-blind, placebo-controlled crossover study assessed the efficacy of topical tocopherol acetate compared with placebo in easing oral discomfort in patients with reticular oral lichen planus (ROLP)

Decellularization and Delipidation Protocols of Bovine Bone and Pericardium for Bone Grafting and Guided Bone Regeneration Procedures

The combination of bone grafting materials with guided bone regeneration (GBR) membranes seems to provide promising results to restore bone defects in dental clinical practice. In the first part of this work, a novel protocol for decellularization and delipidation of bovine bone, based on multiple steps of thermal shock, washes with detergent and dehydration with alcohol, is described. This protocol is more effective in removal of cellular materials, and shows superior biocompatibility compared to other three methods tested in this study. Furthermore, histological and morphological analyses confirm the maintenance of an intact bone extracellular matrix (ECM). In vitro and in vivo experiments evidence osteoinductive and osteoconductive properties of the produced scaffold, respectively. In the second part of this study, two methods of bovine pericardium decellularization are compared. The osmotic shock-based protocol gives better results in terms of removal of cell components, biocompatibility, maintenance of native ECM structure, and host tissue reaction, in respect to the freeze/thaw method. Overall, the results of this study demonstrate the characterization of a novel protocol for the decellularization of bovine bone to be used as bone graft, and the acquisition of a method to produce a pericardium membrane suitable for GBR applications

Guided implant surgery and sinus lift in severely resorbed maxillae: A retrospective clinical study with up to 10 years of follow-up

Objectives In the posterior maxilla, due to the presence of maxillary sinus, residual bone height lower than 3mm is a critical factor that can affect implant stability and survival. The use of guided surgery may facilitate the surgical procedures and the implant insertion in case of severely resorbed maxillae. Moreover, it may have beneficial effects on the long-term survival and success of implant-supported restorations. This study aimed to evaluate implant supported restorations on severely resorbed maxilla (<3 mm) after sinus lift with collagenated xenograft and guided surgery. Methods Forty-three patients with need for implant rehabilitation and residual bone height between 1 and 3 mm were recruited. Surgical and prosthetical aspects were planned following digital approach with the use of Realguide 5.0 (3diemme, Varese, Italy). Lateral window sinus lift was performed and implants were placed simultaneously to the augmentation procedure with a tooth-supported pilot drill surgical template. A pre-hydrated collagenated porcine bone matrix was adopted as regenerative material. Computer-aided-design/computer-aided-manufacturing (CAD/CAM) restorations were delivered after six months of healing. Milled titanium chamfer abutments with CAD/CAM crowns were used. Bone height at implant site level was measured using an image software analysis applied to the pre- and post-surgical radiographs and at the follow-up. Biological and technical complications were recorded during all the follow-up periods. Results Fifty-four sinus were treated. After a mean follow-up time of 5.11 years (SD: 2.47), no implants were lost nor showed signs of disease. The mean pristine bone height was 2.07 mm (SD: 075). At the final evaluation the augmented sinus height was 12.83 mm (SD: 1.23). Two cases experienced minor perforation of the membrane, while five patients developed minimal post-operative complications, completely resolved with pharmacologic therapy. No mid-term biological complications were experienced by the patients. No cases experienced peri-implant mucositis and peri-implantitis during the whole follow-up period. Four patients (7.4%) faced an unscrewing of the prosthesis. Conclusions The present study showed the efficacy in the mid-term of the digital planning and the guided surgery in restoring severely resorbed posterior maxilla with dental implants

Complicanze nella terapia implantare: la perimplantite

Peri-implantitis is an inflammatory disease, affecting the soft surrounding tissue and supporting bone around dental implants. Although described as one of the most common complications in the treatment with dental implants, the underlying mechanisms, etiopathology and pattern of subsequent bone loss in peri-implantitis has been poorly described. In our study, we are focusing on the identification of possible genetic factors in peri-implantitis as associating factors in developing this pathological condition. Using a CGH array, we screened the DNA of 35 patients to identify the presence of a genetic imbalance potentially correlated with peri-implantitis. The data obtained confirmed presence of small duplication in the VEGF-A gene. Expression of this gene resulted in lower expression of endothelial markers, such as CD31 and von Willebrand factor, in peri-implantitis tissue versus healthy tissue. Moreover, detailed analyses of bone biomarkers revealed the presence of an imbalance in bone turnover in favor of osteoclastogenesis rather than osteoblastogenesis. High expression levels of RANKL and HGF, both of which are involved in bone resorption, and low levels of RUNX, RHOA, and WNT, which are involved in bone formation, indicated an important imbalance in the normal bone turnover process. In addition, high expression of zinc finger protein 467, a regulator of osteoblast/adipocyte commitment, and the presence of adipose-like tissue suggested the occurrence of a de-regulative process at the mesenchymal stem cell levelLa Perimplantite è una malattia infiammatoria, che colpisce i tessuti molli e l'osso di supporto attorno agli impianti dentali. Sebbene sia descritta come una delle più comuni complicanze nel trattamento con impianti dentali, non sono mai stati descritti il meccanismo attraverso cui si sviluppa, l’eziopatogenesi e il modello della successiva perdita ossea. Nel nostro studio, ci siamo concentrati sull'individuazione di possibili fattori genetici associati allo sviluppo di questa condizione patologica. Utilizzando un array CGH, abbiamo analizzato il DNA di 35 pazienti per identificare la presenza di uno squilibrio genetico potenzialmente correlato con la perimplantite. I dati ottenuti confermano la presenza di piccole duplicazioni nel gene VEGF-A. L'espressione di questo gene ha determinato una bassa espressione di marcatori endoteliali, come CD31 e il fattore di Von Willebrand, nel tessuto con perimplantite, al contrario che nel tessuto sano. Inoltre, analisi dettagliate dei marcatori ossei hanno rivelato la presenza di uno squilibrio del turnover osseo a favore di osteoclastogenesi piuttosto che osteoblastogenesi. Alti livelli di espressione di RANKL e HGF, che sono entrambi coinvolti nel riassorbimento osseo, e bassi livelli di Runx, RHOA, e WNT, che sono coinvolti nella formazione ossea, hanno indicato uno squilibrio importante nel normale processo di turnover osseo. Inoltre, l'alta espressione di proteine zinc finger 467, un regolatore della relazione osteoblasti/adipociti, e la presenza di tessuto adiposo hanno suggerito il verificarsi di un processo de-regolativo a livello delle cellule staminali mesenchimali

Systemic Diseases and Biological Dental Implant Complications: A Narrative Review

The relationship between periodontitis and such systemic disorders as diabetes, cardiovascular disease and obesity has been extensively investigated. There is less scientific evidence available, however, regarding the influence of systemic diseases on the risk of late failure of dental implant rehabilitation due to peri-implantitis. The aim of the present study was to review the literature on the role of several common systemic disorders (diabetes, obesity, cardiovascular disease, hypertension and osteoporosis) in the onset of peri-implantitis. A database search initially yielded 2787 studies of potential interest published up to 1 March 2022 (993 in PubMed; 908 in Web of Science; and 886 in Scopus). After removing 1190 duplicate articles and checking the titles, abstracts and full texts for relevance, 70 articles were selected for the present analysis. Only cohort, case-control studies and clinical case series were considered. Most of the literature concludes for no association between diabetes, cardiovascular disease, hypertension or osteoporosis and the risk of peri-implantitis. On the other hand, almost all the studies that investigated obesity as a risk factor for implant rehabilitation found a positive association between the two. Further longitudinal studies are needed to better understand the effects of systemic diseases on rehabilitation with dental implants

Graphene based scaffolds effects on stem cells commitment.

Graphene is a flat monolayer of carbon atoms, arranged in a two-dimensional hexagonal structure, with extraordinary electrical, thermal, and physical properties. Moreover, the molecular structure of graphene can be chemically modified with molecules of interest to promote the development of high-performance devices. Although carbon derivatives have been extensively employed in industry and electronics, their use in regenerative medicine is still in an early phase. Study prove that graphene is highly biocompatible, has low toxicity and a large dosage loading capacity. This review describes the ability of graphene and its related materials to induce stem cells differentiation into osteogenic, neuronal, and adipogenic lineages

Selection of Collagen Membranes for Bone Regeneration: A Literature Review

Several treatment modalities have been proposed to regenerate bone, including guided bone regeneration (GBR) where barrier membranes play an important role by isolating soft tissue and allowing bone to grow. Not all membranes biologically behave the same way, as they differ from their origin and structure, with reflections on their mechanical properties and on their clinical performance. Collagen membranes have been widely used in medicine and dentistry, because of their high biocompatibility and capability of promoting wound healing. Recently, collagen membranes have been applied in guided bone regeneration with comparable outcomes to non-resorbable membranes. Aim of this work is to provide a review on the main features, application, outcomes, and clinical employment of the different types of collagen membranes. Comparisons with non-resorbable membranes are clarified, characteristics of cross-linked collagen versus native collagen, use of different grafting materials and need for membrane fixation are explored in order to gain awareness of the indications and limits and to be able to choose the right membrane required by the clinical condition