Smile esthetic evaluation of mucogingival reconstructive surgery

To assess the difference in smile esthetic impact of Coronally Advanced Flap (CAF) with or without the adjunct of a collagen matrix (CMX) used as root coverage procedures. Subjects with esthetic demands showing multiple upper gingival recessions of at least 2 mm, without interproximal attachment loss and cervical abrasion no more than 1 mm were recruited and randomized to CAF plus CMX or CAF alone. The Smile Esthetic Index (SEI) was adopted to quantify the quality of the smile recorded at baseline and 12 months after treatment for each treatment group. In addition, between group difference in the SEI was calculated. 24 Patients were treated and analysed. At baseline, mean gingival recession depths were 2.3 ± 0.7 mm for Test group and 2.6 ± 1.0 mm for Control group. After 1 year, the residual recession depth was 0.3 ± 0.4 mm in the CAF + CMX group and 0.6 ± 0.3 mm in the control group. The SEI at baseline was 8.1 ± 1.0 and 7.9 ± 0.7 for Test and Control group, respectively. The between groups difference at 12 months in SEI was 0.4 (95% C.I. − 0.0 to 0.8, P = 0.0697). Twelve months after treatment, CAF + CMX provided a similar SEI compared to CAF alone and the adjunct of a collagen matrix did not show a different impact on the smile esthetic appearance

Natural or Palatal Positioning of Immediate Post-extraction Implants in the Aesthetic Zone? Five-year Outcomes of a Multicentre Randomised Controlled Trial

PURPOSE. To evaluate whether there is a difference in aesthetic outcomes when positioning immediate post-extractive implants in the “central” position (where the natural tooth would be in relation to adjacent teeth/implants) as opposed to roughly 3 mm more pala-tally. MATERIALS AND METHODS. Just after tooth extraction, 20 patients requiring one single immediate maxillary post-extraction implant, from second premolar to second premolar, were randomly allocated to receive one implant positioned in either the natural “central” position (central group; 10 patients), or about 3 mm more palatally (palatal group; 10 pa-tients) according to a parallel-group design at two different centres. When needed, sites were reconstructed, and bone-to-implant gaps were filled with granules of anorganic bovine bone and covered by resorbable collagen barriers. Implants were left submerged for 4 months and rehabilitated with provisional crowns, replaced after 4 months by definitive metal-ceramic crowns. Patients were followed up to 5 years after loading. Outcome measures were: crown and implant failures; complications; aesthetics, assessed using the pink aesthetic score (PES); peri-implant marginal bone level changes; and patient satisfaction, recorded by blinded assessors. RESULTS. Three patients from each group dropped out within 3 years after loading. Five years after loading, there were no significant differences between the two groups in median PES score, assessed by a blind assessor, (central: 10 [IQR: 5.5], palatal: 8.5 [IQR: 6.75], median difference =-1.0; 95% CI:-7.0 to 4.0; P = 0.571); median bone level (central: 0.45 mm [IQR: 1.76], palatal: 0.45 mm [IQR: 1.93], median difference = 0 mm; 95% CI:-1.7 to 3.0; P = 1.000); bone level changes (central: 0.15 mm [IQR: 0.70], palatal:-0.05 mm [IQR: 1.23], median difference =-0.20 mm; P = 0.471); implant failures (one in each group, 14%, difference in proportion = 0.00; 95% CI:-0.39 to 0.39; P = 1.000); or complications (two palatal group patients and one central group patient, difference in proportion = 0.14; 95% CI:-0.28 to 0.52; P = 1.000). Furthermore, patients from both groups were equally satisfied with both function and aesthetics (both P = 0.699). CONCLUSIONS. These preliminary results suggest that positioning of immediate post-ex-traction implants 3 mm more palatally may not, in fact, improve aesthetics; however, the sample size of the present study was very limited, and larger trials are therefore required to confirm or refute these findings

O(alpha_s) Spin-Spin Correlations for Top and Bottom Quark Production in e+ e- Annihilation

We present the full O(alpha_s) longitudinal spin-spin correlations for heavy-quark pair production at e+ e- high-energy colliders in closed analytical form. In such reactions, quark and antiquark have strongly correlated spins, and the longitudinal components are dominant. For the explicit computation of the QCD bremsstrahlung contributions, new phase-space integrals are derived. Explicit numerical estimates are given for t t_bar and b b_bar production. Around the Z-peak, QCD one-loop corrections depolarize the spin-spin asymmetry for bottom quark pairs by approximately -4%. For top pair production, we find at 350GeV a 0.6% increased polarization over a value of 0.4 in the longitudinal correlation. For more than 1 TeV the O(alpha_s) corrections enhance depolarization to -2% in the top-pair case.Comment: 17 pages (Latex) + 6 figures (PostScript) [final version of manuscript as to appear in Physics Letters B

Oral lichen planus and diabetes mellitus. A clinico-phatological study

A study was made of 72 patients with oral lichen planus associated (n = 28) or not with diabetes mellitus (n = 44). No significant differences were observed between both groups in terms of the location of the lichen planus lesions on the buccal mucosa, palate, gums or floor of the mouth. On the other hand, the diabetics exhibited a greater frequency of oral lichen planus on the tongue. Atrophic-erosive lesions were more common in patients with lichen planus associated with diabetes. Finally, no differences were observed between the two groups in terms of absolute inflammatory infiltrate in the connective tissue of the oral lichen planus lesions.Nous avons effectué une étude sur deux groupes de patients atteints de lichen plan buccal, le premier associé au diabètes sucré (N = 28) et le second (N = 44) sans cette association. Nous n’observons pas de différences significatives entre eux, en ce qui concerne la localisation du lichen plan dans la muqueuse buccale, le palais, les gencives ou le plancher bouche. Nous trouvons cependant une plus grande fréquence de la localisation au niveau de la langue dans le lichen plan avec diabètes. Mais en même temps, nous détectons une fréquence plus importante de lésions atrophiques-érosives dans le premier groupe que dans le second.En dernier lieu, il n’existe pas de différences entre les deux, en ce qui concerne la quantité, en valeur absolue, de l’infiltration inflammatoire dans les tissus conjonctifs des lésions buccales du lichen plan

Intentional replantation for the management of maxillary sinusitis

Aim. To present a case that emphasizes the importance of the use of intentional replantation as a technique to successfully treat a periapical lesion and an odontogenic maxillary sinusitis through the alveolus at the same time. Summary. This case report presents a patient with odontogenic maxillary sinusitis secondary to periapical disease of a maxillary molar that had previously received root canal treatment. The molar was extracted, with drainage and rinsing of the maxillary sinus. The apices were resected extra-orally, and the retrograde cavity was prepared with ultrasound and retrograde filling using silver amalgam. The tooth was then replanted. After 2 years, the patient was asymptomatic, periapical radiography showed no evidence of root resorption and computed tomography scanning demonstrated the resolution of maxillary sinusitis

Impact of abutment geometry on early implant marginal bone loss. A double-blind, randomized, 6-month clinical trial

Objectives The objective of this study was to analyze the impact of the abutment width on early marginal bone loss (MBL). Material and Methods A balanced, randomized, double-blind clinical trial with two parallel experimental arms was conducted without a control group. The arms were “cylindrical” abutment and “concave” abutment. Eighty hexagonal internal connection implants, each with a diameter of 4 × 10 mm, were placed in healed mature bone. The main variable was the peri-implant tissue stability, which was measured as MBL at 8 weeks and 6 months. Results The final sample consisted of 77 implants that were placed in 25 patients. 38 (49.4%) were placed using the cylindrical abutment, and the other 39 (50.6%) were placed using the concave abutment. The early global MBL of −0.6 ± 0.7 mm in the cylindrical abutment group was significantly higher than it was in the concave abutment group, in which the early global MBL was −0.4 ± 0.6 mm (p = .030). The estimated effect size (ES) was negative for the cylindrical abutment (ES = −1.3730, CI −2.5919 to −0.1327; t-value = −2.4893; p = .0139), therefore implying a loss of mean bone level, and it was positive for the concave abutment (ES = 2.8231; CI: 1.4379 to 4.2083; t-value = 4.0957; p = .0002), therefore implying an increase in the average bone level. Conclusions The concave abutments presented significantly less early MBL at 6 months post-loading than classical cylindrical abutments did

Dentin dysplasia type I: a challenge for treatment with dental implants

<p>Abstract</p> <p>Background</p> <p>Dentin dysplasia type I is characterized by a defect of dentin development with clinical normal appearance of the permanent teeth but no or only rudimentary root formation. Early loss of all teeth and concomitant underdevelopment of the jaws are challenging for successful treatment with dental implants.</p> <p>Methods</p> <p>A combination of sinus lifting and onlay bone augmentation based on treatment planning using stereolithographic templates was used in a patient with dentin dysplasia type I to rehabilitate the masticatory function.</p> <p>Results</p> <p>(i) a predisposition for an increased and accelerated bone resorption was observed in our patient, (ii) bone augmentation was successful using a mixture of allogenic graft material with autogenous bone preventing fast bone resorption, (iii) surgical planning, based on stereolithographic models and surgical templates, facilitated the accurate placement of dental implants.</p> <p>Conclusion</p> <p>Bony augmentation and elaborate treatment planning is helpful for oral rehabilitation of patients with dentin dysplasia type I.</p

Scar-like lesion on dorsal nose (cellular neurothekeoma)

Neurothekeomas are tumors of neural differentiation and of unknown origin that occur in females at the 2nd and 3rd decades of life. They usually affect the face with an unspecific clinical aspect. The histological features include cellular or mixoid differentiation and immunohistochemistry can be positive for protein s-100, vimentin and epithelilal membrane antigen (EMA)

Experience versus complication rate in third molar surgery

OBJECTIVES: The records of 1087 patients who underwent surgical removal of third molar teeth were prospectively examined to analyse the possible relationship between postoperative complications and the surgeon's experience parameter. METHOD AND MATERIALS: Seven surgeons (three specialists in surgical dentistry [specialists SD] and four oral and maxillofacial Senior House Officers [OMFS residents]) carried out the surgical procedures. For each patient, several variables were recorded including age, gender, radiographic position of extracted teeth, treating surgeon, duration of surgery and postoperative complications. RESULTS: Analysis of the data revealed some differences in the incidence of complications produced by the specialists SD and OMFS residents. The main statistically relevant differences were increase the incidences of trismus, nerve paraesthesia, alveolar osteitis and infection in the resident-treated group, while the specialist-treated group showed higher rates of post-operative bleeding. CONCLUSION: The higher rate of postoperative complications in the resident-treated group suggests that at least some of the complications might be related to surgical experience. Further work needs to compare specialists of training programmes with different years of experience, using large cross – sectional studies

Present Status of Inclusive Rare B Decays

We give a status report on inclusive rare B decays, highlighting recent developments and open problems. We focus on the decay modes $B \to X_{s,d} \gamma$, $B \to X_s \ell^+\ell^-$ and $B \to X_s \nu \bar \nu$ and on their role in the search for new physics. Most of the inclusive rare B decays are important modes of flavour physics due to the small hadronic uncertainties. They can be regarded as laboratories to search for new physics. We collect the experimental data already available from CLEO and the $B$ factories BABAR and BELLE. We review the NLL and NNLL QCD calculations of the inclusive decay rates that were recently completed, and discuss future prospects, especially the issue of the charm mass scheme ambiguity. Finally, we analyse the phenomenological impact of these decay modes, in particular on the CKM phenomenology and on the indirect search for supersymmetry. We also briefly discuss direct CP violation in inclusive rare B decays, as well as the rare kaon decays $K^+\to \pi^+\nu\bar{\nu}$ and $K_L \to \pi^0 \nu \bar{\nu}$, which offer complementary theoretically clean information.Comment: 80 pages, 37 figures, latex, references added Invited contribution to Reviews of Modern Physic