Publications by authors named "E F Gherlone"

212 Publications

Digital Smile Designed Computer-Aided Surgery versus Traditional Workflow in "All on Four" Rehabilitations: A Randomized Clinical Trial with 4-Years Follow-Up.

Int J Environ Res Public Health 2021 Mar 26;18(7). Epub 2021 Mar 26.

Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy.

The aim of the present study was to evaluate and compare the traditional "All on Four" technique with digital smile designed computer-aided "All on Four" rehabilitation; with a 4-years follow-up. The protocol was applied to a total of 50 patients randomly recruited and divided in two groups. Digital protocol allows for a completely virtual planning of the exact position of the fixtures, which allows one to perform a flapless surgery procedure with great accuracy (mini-invasive surgery) and also it is possible to use virtually planned prostheses realized with Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) (methods for an immediate loading of the implants. After 4 years from the treatments 98% of success were obtained for the group of patients treated with the traditional protocol and 100% for the digital protocol. At each time interval a significant difference in peri-implant crestal bone loss between the two groups was detected; with an average Marginal Bone Loss (MBL) at 4 years of 1.12 ± 0.26 mm in the traditional group and 0.83 ± 0.11 mm in the digital group. Patients belonging to the digital group have judged the immediate loading (92%), digital smile preview (93%), the mock-up test (98%) and guided surgery (94%) as very effective. All patients treated with a digital method reported lower values of during-surgery and post-surgery pain compared to patients rehabilitated using traditional treatment. In conclusion, the totally digital protocol described in the present study represents a valid therapeutic alternative to the traditional "All on Four" protocol for implant-supported rehabilitations of edentulous dental arches.
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http://dx.doi.org/10.3390/ijerph18073449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037328PMC
March 2021

Frequent and Persistent Salivary Gland Ectasia and Oral Disease After COVID-19.

J Dent Res 2021 Mar 3:22034521997112. Epub 2021 Mar 3.

Vita-Salute San Raffaele University, Milan, Italy.

The clinical picture of coronavirus disease 2019 (COVID-19) in various target organs has been extensively studied and described. However, relatively little is known about the characteristics of oral cavity involvement. This is surprising, considering that oral mucosal and salivary gland cells are known targets for the direct replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and that the presence of the virus in saliva is a source of transmission of the infection. The aim of our study was to investigate the presence and prevalence of oral manifestations in COVID-19 survivors. We profiled the oral involvement in 122 COVID-19 survivors that were hospitalized and followed up at a single-referral university hospital in Milan, Italy, between July 23, 2020 and September 7, 2020, after a median (interquartile range) time from hospital discharge of 104 (95 to 132) d. We found that oral manifestations, specifically salivary gland ectasia, were unexpectedly common, with oral manifestations being detected in 83.9% while salivary gland ectasia in 43% of COVID-19 survivors. Salivary gland ectasia reflected the hyperinflammatory response to SARS-CoV-2, as demonstrated by the significant relationship with C-reactive protein (CRP) and lactate dehydrogenase (LDH) levels at hospital admission, and with the use of antibiotics during acute disease. Both LDH levels and antibiotic administration survived as independent predictors of salivary gland ectasia at multivariable analysis. Temporomandibular joint abnormalities, facial pain, and masticatory muscle weakness were also common. Overall, this retrospective and prospective cohort study of COVID-19 survivors revealed that residual damage of the oral cavity persists in the vast majority of patients far beyond clinical recovery, and suggests that the oral cavity represents a preferential target for SARS-CoV-2 infection. Further studies are needed to clarify the connection between SARS-CoV-2 infection and oral disorders.
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http://dx.doi.org/10.1177/0022034521997112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930603PMC
March 2021

Effect of Finishing Systems on Surface Roughness and Gloss of Full-Body Bulk-Fill Resin Composites.

Materials (Basel) 2020 Dec 11;13(24). Epub 2020 Dec 11.

Dental Academy, University of Portsmouth, Portsmouth PO1 2QG, UK.

Background: In this study, we assess the effect produced on roughness and gloss of full-body bulk-fill materials by different finishing and polishing systems.

Methods: Four full-body bulk-fill materials were tested: SonicFill2 (SF), Filtek Bulk Fill Posterior Restorative (FB), Tetric EvoCeram bulk-fill (EC), and Fill-Up! (FU). Sixty discs per material (2 mm in thickness and 7 mm in diameter) were obtained and randomly assigned ( = 15) to four finishing and polishing methods: Sof-Lex Spiral Wheels (SW), HiLusterPLUS (HL), Astropol (AP), and Opti1Step (OS). Surface roughness and gloss were then measured.

Results: For roughness, material and surface treatment were significant factors ( < 0.001) with SF = FB = EC < FU and AP < SW < HL = OS. Material and surface treatment had a significant effect also on gloss ( < 0.001), with SF > FB = EC > FU and SW > AP > HL > OS.

Conclusions: The tested combinations of bulk-fill and polishing systems provided clinically acceptable results with regard to roughness, while the outcome was poor for gloss. Multistep finishing/polishing systems were able to produce smoother surfaces on full-body bulk-fill materials compared to simplified ones.
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http://dx.doi.org/10.3390/ma13245657DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763061PMC
December 2020

Stannous Fluoride Preventive Effect on Enamel Erosion: An In Vitro Study.

J Clin Med 2020 Aug 26;9(9). Epub 2020 Aug 26.

Department of Biological, Geological, and Environmental Sciences, University of Bologna, 40126 Bologna, Italy.

The aim of this in vitro study was to evaluate the effects of a single dose application of two daily toothpastes on enamel exposed to acid attack. The research was conducted on human molars enamel fragments ( = 72). The two different toothpastes active ingredients were sodium fluoride (NaF) and stannous fluoride (SnF). They were compared in protecting the surface of the enamel exposed to three acids: citric acid, lactic acid and hydrochloric acid. A spectrophotometer was used to measure the calcium ions and phosphate released in the solutions by the enamel specimens. Afterward, ionic concentrations were analyzed through the t-Student test, in order to estimate the significance level ( < 0.05) of the solubility differences obtained between the treatment and control groups. Finally, sample surfaces were analyzed with scanning electron microscopy and X-ray energy dispersive spectroscopy (SEM/EDX). The two analyzed toothpastes did not reveal any statistically significant variation in the release of calcium and phosphate ( > 0.05). Nevertheless, acid-resistant deposits were detected in samples treated with stannous fluoride and exposed to lactic acid, though the presence of tin ion deposits on samples treated with stannous fluoride was not shown. A single dose of a fluoride-based toothpaste before different acids attack, in simulated oral cavity conditions, did not show a significant preventive effect.
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http://dx.doi.org/10.3390/jcm9092755DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7563875PMC
August 2020

Fourteen-year evaluation of posterior zirconia-based three-unit fixed dental prostheses: A Prospective clinical study of all ceramic prosthesis.

J Dent 2020 10 30;101:103419. Epub 2020 Jun 30.

Department of Neurosciences, Reproductive and Odontostomatological Sciences, University "Federico II" of Naples, Via Pansini 5, Naples, 80138, Italy.

Objectives: the purpose of the present prospective trial was to evaluate the clinical performance of posterior 3-unit zirconia-based fixed dental prostheses (FDPs) after 14 years of clinical function.

Methods: thirty-seven patients needing to replace either premolars or molars were involved and 48 FDPs were fabricated (Procera Zirconia, Nobel Biocare AB). Frameworks with a9 mm cross section of the connectors and 0.6 mm minimum thickness of the retainers were made by means of Procera Forte CAD-CAM System (Nobel Biocare AB). The patients were recalled after 6 and 12 months and then yearly up to a total follow-up of 14 years. Two independent survival curves for patients wearing 1 or 2 FDPs were calculated by means of Kaplan-Meier analysis and a log-rank test was performed in order to compare these curves. The United States Public Health Service criteria were used to examine technical and esthetic outcomes. The biological examination was performed evaluating plaque control, pocket depth, attachment level, bleeding on probing at both abutments and contralateral teeth and evaluated by means of the Wilcoxon test (p < 0.05) between the baseline and the 14-year follow-up.

Results: descriptive statistics resulted in 91 % and 99 % cumulative survival rates for patients wearing 1 and 2 FDPs, respectively. There were no significant differences in periodontal parameters between control and test teeth. Both function and esthetic results were successful for FDPs over a 14-year follow-up period.

Conclusions: the results of this prospective clinical study confirmed the effectiveness of zirconia as a clinical option to fabricate short-span posterior FDPs.

Clinical Significance: within the limitations of the present prospective clinical study, zirconia-based three-unit fixed dental prostheses perform satisfactorily on long term, in posterior areas and in patients with standard biomechanical conditions.
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http://dx.doi.org/10.1016/j.jdent.2020.103419DOI Listing
October 2020

Developmental Enamel Defects (DDE) and Their Association with Oral Health, Preventive Procedures, and Children's Psychosocial Attitudes towards Home Oral Hygiene: A Cross-Sectional Study.

Int J Environ Res Public Health 2020 06 5;17(11). Epub 2020 Jun 5.

Dental School, Vita-Salute San Raffaele University and Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele, 20132 Milan, Italy.

Background: Developmental enamel defects (DDE) exert significant effects both on esthetics and occlusal function and prevention should be the general clinical approach to DDE. The purpose of this cross-sectional study was, therefore, to detect, within a pediatric sample, any significant association between DDE and children's psychosocial attitudes towards home oral hygiene, as well as potential associations between primary preventive procedures and DDE.

Methods: 394 schoolchildren (197 males and 197 females, 8.9 ± 1.4 years) underwent an intra-oral examination; they were then interviewed with a brief questionnaire.

Results: 5-6% and 12-14% of participants had, respectively at least one molar and one incisor affected by DDE. In general, no associations were observed in the examined clinical categories (caries and other oral health indices). A strong relationship was found between the presence of molar DDE and children's positive vs. negative psychosocial attitudes towards home oral hygiene.

Conclusions: The probability of finding DDE in our sample of examined children was approximately more than doubled for children with negative psychosocial attitudes towards home oral hygiene, than for children with positive attitudes towards home oral hygiene.
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http://dx.doi.org/10.3390/ijerph17114025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311990PMC
June 2020

Prevalence of Caries and Associated Risk Factors in a Representative Group of Preschool Children from an Urban Area with High Income in Milan Province, Italy.

Int J Environ Res Public Health 2020 05 12;17(10). Epub 2020 May 12.

Dental School, Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, 20132 Milan, Italy.

The present survey provides a quantitative assessment of caries prevalence, covering a group of 3-5 year-old children from an urban area generally with a high income in the province of Milan, and a comparison of the obtained results with the data presented by the W.H.O. A cross-sectional study was conducted in the period from March to September 2018 to investigate the prevalence of caries in a sample of 160 children (82 females and 78 males). The absence/presence of caries was defined as a dependent variable. Factors concerning lifestyle, diet, oral habits, oral hygiene, the presence and type of malocclusion and mouth breathing attitude were considered as risk factors. Data were analyzed by Chi-square (χ2) and regression tests using SPSS (version 25.0) software. In total, 84.38% of children (135 out of 160) showed no caries. A regression analysis demonstrated that children who had already received an early first dental visit were mostly those already affected by caries. Furthermore, children who had four meals daily or more were less exposed to the risk of developing caries compared to those who had only 1-3 meals daily. The caries prevalence of preschool children from urban areas with a high income in Milan province is relatively close to that considered acceptable by the W.H.O. in its proposed goals for the year 2020. Therefore, it can be concluded from the obtained results that there is a possibility for further improvement in preventing caries growth at its initial stage: it is necessary for the number of meals daily consumed by children to be controlled by parents, and conducting a dental visit early in childhood must not be neglected.
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http://dx.doi.org/10.3390/ijerph17103372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277466PMC
May 2020

New Application of Osteogenic Differentiation from HiPS Stem Cells for Evaluating the Osteogenic Potential of Nanomaterials in Dentistry.

Int J Environ Res Public Health 2020 03 16;17(6). Epub 2020 Mar 16.

Dental School, Vita-Salute University and IRCCS San Raffaele, 20132 Milan, Italy.

Objective: HiPS stem cells are commonly used for the study of medical disorders. Thelaboratory in which this study was conducted uses these cells for examining the treatment and cureof neurodegenerative diseases. Bone regeneration poses the greatest challenge for an oral surgeonboth in terms of increased implant osseointegration and reducing bone healing times. The aim ofthis study was to validate the protocol in the literature to produce and then test in vitro osteoblastswith different nanomaterials to simulate bone regeneration.

Method: hiPS clones (#2, #4, and #8)were differentiated into an osteoblast cell culture tested for alizarin red staining and for alkalinephosphatase testing at 14, 21 and 28 days, after the cells were plated.

Results: The cells showeddiffuse positivity under alizarin red staining and the alkaline phosphatase (ALP)-test, showingsmall formations of calcium clusters.

Conclusion: Despite the limitations of our study, it is a startingpoint for further protocols, laying a solid foundation for research in the field of bone regenerationthrough the use of stem cells. .
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http://dx.doi.org/10.3390/ijerph17061947DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7142891PMC
March 2020

Postoperative bleeding in patients taking oral anticoagulation therapy after 'All-on-four' rehabilitation: A case-control study.

Int J Oral Implantol (Berl) 2020 ;13(1):77-87

Purpose: The aim of this study was to estimate bleeding prevalence and postoperative peri-oral purpura after full-arch immediate implant rehabilitation according to the 'All-on-four' technique, in patients on different oral anticoagulant therapies (warfarin and rivaroxaban).

Materials And Methods: A total of 120 patients (47 women, 73 men, mean age 66.4 years) presented with edentulous or partially edentulous arches. All patients were treated with immediate full-arch fixed prostheses (28 maxillary, 34 mandibular), each supported by four implants (two vertical, two distally tilted). Participants were divided in three groups: 40 patients under treatment with warfarin formed group A, 40 patients under treatment with rivaroxaban composed group B, and 40 healthy subjects composed the control group. As the primary outcome measure, mild, moderate and severe postoperative bleeding was recorded. As the secondary outcome measure, the presence of postoperative petechiae, ecchymoses and haematomas in oral and peri-oral tissues was recorded.

Results: Patients under treatment with warfarin (group A) showed a higher prevalence of postoperative bleeding (P = 0.002) and purpura (P = 0.012) in comparison with other groups. No severe bleeding took place and no haematomas appeared in any patient. Prefabricated metal-reinforced, screw-retained, acrylic resin provisional restorations were delivered in all patients.

Conclusions: The preliminary results of this prospective case-control study showed how immediate rehabilitation according the 'All-on-four' technique could be a safe and predictable procedure in anticoagulated patients where anticoagulation therapy is not discontinued or modified.
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March 2020

Accuracy of Edentulous Computer-Aided Implant Surgery as Compared to Virtual Planning: A Retrospective Multicenter Study.

J Clin Med 2020 Mar 12;9(3). Epub 2020 Mar 12.

Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy.

Purpose: To evaluate the accuracy of computer-aided dental implant positions obtained with mucosal-supported templates as compared to Three-Dimensional (3D) planning.

Materials And Methods: One-hundred implants were inserted into 14 edentulous patients using the All-on-4/6 protocol after surgical virtual planning with RealGUIDE, 3DIEMME, and Geomagic software. After 6 months, three-dimensional neck (V) and apex (S) spatial coordinates of implants and angle inclination displacements as compared to virtual plans were evaluated.

Results: The S maxilla coordinates revealed a significant discrepancy between clinical and virtual implant positions (-value = 0.091). The V coordinates showed no significant differences (-value = 0.71). The S (-value = 0.017) and V (-value = 0.038) mandible coordinates showed significant discrepancies between the clinical and virtual positions of the screws. Implant evaluation showed a 1-mm of the horizontal deviation in the V point and a 1.6-mm deviation in the S point. A mean 5° angular global deviation was detected. The multivariate permutation test of the S (-value = 0.02) confirmed the difference. Greater errors in the mandible were detected as compared to the maxilla, and a higher S discrepancy was found in the posterior jaw compared to the anterior section of both the mandible and maxilla.

Conclusions: Computer-aided surgery with mucosal-supported templates is a predictable procedure for implant placement. Data showed a discrepancy between the actual dental implant position as compared to the virtual plan, but this was not statistically significant. However, the horizontal and angle deviations detected indicated that flap surgery should be used to prevent implant positioning errors due to poor sensitivity and accuracy in cases of severe jaw atrophy.
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http://dx.doi.org/10.3390/jcm9030774DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141387PMC
March 2020

Dental Implants with Different Neck Design: A Prospective Clinical Comparative Study with 2-Year Follow-Up.

Materials (Basel) 2020 Feb 25;13(5). Epub 2020 Feb 25.

Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy.

The present study was conducted to investigate whether a different implant neck design could affect survival rate and peri-implant tissue health in a cohort of disease-free partially edentulous patients in the molar-premolar region. The investigation was conducted on 122 dental implants inserted in 97 patients divided into two groups: Group A (rough wide-neck implants) vs. Group B (rough reduced-neck implants). All patients were monitored through clinical and radiological checkups. Survival rate, probing depth, and marginal bone loss were assessed at 12- and 24-month follow-ups. Patients assigned to Group A received 59 implants, while patients assigned to Group B 63. Dental implants were placed by following a delayed loading protocol, and cemented metal-ceramic crowns were delivered to the patients. The survival rates for both Group A and B were acceptable and similar at the two-year follow-up (96.61% vs. 95.82%). Probing depth and marginal bone loss tended to increase over time (: t = 12 vs. t = 24 months) in both groups of patients. Probing depth ( = 0.015) and bone loss ( = 0.001) were significantly lower in Group A (3.01 vs. 3.23 mm and .92 vs. 1.06 mm; Group A vs. Group B). Within the limitations of the present study, patients with rough wide-neck implants showed less marginal bone loss and minor probing depth, as compared to rough reduced-neck implants placed in the molar-premolar region. These results might be further replicated through longer-term trials, as well as comparisons between more collar configurations (e.g., straight vs. reduced vs. wide collars).
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http://dx.doi.org/10.3390/ma13051029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084739PMC
February 2020

Evaluation of bradykinin, VEGF, and EGF biomarkers in gingival crevicular fluid and comparison of PhotoBioModulation with conventional techniques in periodontitis: a split-mouth randomized clinical trial.

Lasers Med Sci 2020 Jun 29;35(4):965-970. Epub 2019 Nov 29.

Dental School, Vita-Salute San Raffaele University, Milan, Italy.

Periodontal disease is a chronic progressive inflammatory process leading to damage of tooth-supporting tissues. This comparative study assessed the effect of PhotoBioModulation (PBM) versus conventional therapy, and investigated biomarkers involved in the healing process. The test group comprised twenty systemically-healthy non-smoking subjects with chronic periodontitis with the presence of two matched contro-lateral premolar sites (probing depth > 5 mm); twenty subjects without chronic periodontitis (CP) served as control group. Patients were treated at baseline, either with scaling and root planing (SRP group) or with a procedure entailing SRP supported by PBM (PBM group). The laser used was a diode laser operating at 645 nm wavelength, 10 J/cm2, and 0.5 W/cm2 with a 600 μm fiber optic. Crevicular fluid levels of bradykinin (BK), vascular endothelial growth factor (VEGF), and epidermal growth factor z (EGF) were determined at both sites. Crevicular fluid specimens from both groups were analyzed with the ELISA TEST. Clinical differences in analyzed outcomes were observed in favor of PBM treatment. Taking average values as 100%, the reduction in BK concentration was 47.68% with SRP and 68.43% with PBM on day 3; the VEGF concentration decreased by 35.73% with SRP and 48.59% with PBM on day 7; the EGF concentration increased by 55.58% with SRP and by 58.11% with PBM on day 21.Clinical parameters improved significantly in both groups (pooled mean values of probing depth decreased from 5.6 to 4.5 mm; gingival index from 1.92 to 1.1; and bleeding on probing from 49.67 to 23.23) but did not vary significantly between the PBM and the SRP group. The results confirmed that PBM have beneficial effects in the early phases of the healing process playing a role in modulation of BK, EGF, and VEGF in gingival crevicular fluid levels; both groups had significant clinical improvement over control but there was no significant difference between them, only a trend for PBM group. The overall results of the study suggest a potential benefit of PBM in conjunction with SRP in treating chronic periodontitis.
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http://dx.doi.org/10.1007/s10103-019-02919-wDOI Listing
June 2020

The 'All-on-four' protocol in HIV-positive patients: A prospective, longitudinal 7-year clinical study.

Int J Oral Implantol (Berl) 2019 ;12(4):501-510

Purpose: This prospective study aims to evaluate the clinical outcomes of 'All-on-four' rehabilitations in controlled human immunodeficiency virus (HIV)-positive patients.

Materials And Methods: Edentulous patients requiring an implant prosthetic restoration of one or both jaws were enrolled in the present study. Each patient received at least one fixed full-arch prosthesis. Four implants, immediately loaded, were placed in each jaw using the 'All-on-four' protocol. Marginal bone loss, implant and prosthetic failure, biological and mechanical complications, and serological levels (CD4 cell count, CD4/CD8 ratio, and HIV viral load) were recorded up to 7-year follow-up.

Results: A total of 116 implants were placed in 24 patients, and 29 rehabilitations based on the 'All-on-four' concept were achieved. Implant failures were registered in four patients (10 of 116 implants), and the implant survival rate was 91.37%. At the 7-year radiographic evaluation, peri-implant crestal bone loss averaged 1.91 ± 1.3 mm for upright maxillary implants (n = 30 implants) and 1.79 ± 1.28 mm for tilted maxillary implants (n = 30 implants). In the mandible, mean peri-implant crestal bone loss was 1.54 ± 1.27 mm for upright implants (n = 28) and 1.5 ± 1.3 mm for tilted implants (n = 28). No statistically significant correlation was found between serological parameters and marginal bone levels at 6 months, or through 7 years of annual follow-up (P > 0.05). A statistically significant linear correlation (P < 0.001) was found between early implant failure and HIV viral load. The CD4/CD8 ratio was significantly correlated with late implant failure (P = 0.009).

Conclusions: Within the limitations of this prospective 7-year longitudinal study, HIV-positive patients with a stable immune system can be candidates for the 'All-on-four' treatment concept.
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December 2019

Cross-cultural adaptation, reliability and validity of the Italian version of the craniofacial pain and disability inventory in patients with chronic temporomandibular joint disorders.

BMC Oral Health 2019 11 12;19(1):244. Epub 2019 Nov 12.

Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova - Campus of Savona, Savona, Italy.

Background: To develop an Italian version of the Craniofacial Pain Disability Inventory (CFPDI-I) and investigate its psychometric abilities in patients with temporomandibular disorders (TMD).

Methods: The CFPDI was translated following international standards. The psychometric analyses included reliability by internal consistency (Cronbach's alpha) and test/retest stability (intraclass correlation coefficient, ICC); construct validity was investigated by matching (a priori hypotheses) the CFPDI-I with the Italian Neck Disability Index (NDI-I), a pain intensity numerical rating scale (NRS), the Italian Pain Catastrophising Scale (PCS-I), the Italian Tampa Scale of Kinesiophobia (TSK-I), and the Italian Migraine Disability Assessment Score Questionnaire (MIDAS) (Pearson's correlation). Alpha was set at 0.05.

Results: Two hundred and twelve patients with chronic TMD completed the tool. The questionnaire was internally consistent (α = 0.95) and its stability was good (ICCs = 0.91). As hypothesised, validity figures showed CFPDI-I strongly correlated with the NDI-I (r = 0.66, p < 0.05) and moderately correlated with the NRS (r = 0.48, p < 0.05), PCS (r = 0.37, p < 0.05), TSKI (r = 0.35, p < 0.05) and MIDAS (r = 0.47, p < 0.05). Similar estimates were shown by CFPDI-I subscales.

Conclusions: The cross-culturally adapted version of the Craniofacial Pain and Disability Inventory (CFPDI-I) showed satisfactory psychometric properties that replicate those of the original version and, therefore, can be implemented in the clinical assessment of Italian people affected by TMD.
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http://dx.doi.org/10.1186/s12903-019-0927-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852744PMC
November 2019

Clinical efficacy of Lactobacillus reuteri-containing lozenges in the supportive therapy of generalized periodontitis stage III and IV, grade C: 1-year results of a double-blind randomized placebo-controlled pilot study.

Clin Oral Investig 2020 Jun 16;24(6):2015-2024. Epub 2019 Oct 16.

Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy.

Objective: The aim of this 12-month mono-centre double-blind randomized placebo-controlled clinical study was to evaluate the efficacy of Lactobacillus reuteri-containing lozenges during the supportive therapy of generalized periodontitis stage III and IV, grade C (GPIII-IVC) patients.

Material And Methods: Twenty treated GPIII-IVC patients were randomly divided into 2 groups. The test group received two 3-month-long administrations of L. reuteri (2 lozenges/day after brushing) with a 3-month washout period, while the control one received a placebo. Outcome measures were tooth survival, complications and adverse events, change in probing pockets depth (PPD), change in probing attachment level (PAL), presence of bleeding on probing (BOP) and patient's evaluation of treatment. Measurements were collected at 3, 6, 9 and 12 months.

Results: At 1 year, no dropout, tooth loss, complications or adverse event were recorded. Mean PPD and mean PAL and percentages of sites with BOP were statistically improved (p < 0.05) compared with baseline in both groups, while more PPD reduction at all time points (p < 0.05) and more PAL gain at 6 months and more BOP reduction at 6 and 9 months were found in the probiotic group (p < 0.05).

Conclusions: Within the limitation of the study, the use of L. reuteri probiotics lozenges improved some clinical outcomes in treated GPIII-IVC patients during maintenance therapy. Studies with a larger number of patients are needed to confirm these data.

Clinical Relevance: The use of L. reuteri probiotic lozenges could be considered as an adjunct in the maintenance therapy of GPIII-IVC patients.
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http://dx.doi.org/10.1007/s00784-019-03065-xDOI Listing
June 2020

A Preshaped Titanium Mesh for Guided Bone Regeneration with an Equine-Derived Bone Graft in a Posterior Mandibular Bone Defect: A Case Report.

Dent J (Basel) 2019 Aug 1;7(3). Epub 2019 Aug 1.

Dental School, Vita e Salute University and IRCCS San Raffaele, 20132 Milan, Italy.

One of the most often used bone augmentation techniques is the guided bone regeneration procedure. The authors report the case of a 75-year-old man with an atrophic right posterior mandible who underwent bone augmentation through guided bone regeneration with a preshaped titanium mesh adapted on a stereolithographic model of the patient's jaw. The graft volume was simulated with a light-curing resin. The actual site was grafted with a mixture of autogenous and equine-derived bone. Five months later, the mesh was retrieved, three cylindrical implants were positioned, and a bone biopsy was collected for histomorphometric analysis. A provisional prosthesis was delivered three and a half months later. Definitive rehabilitation was accomplished after one additional month. The graft allowed for effective bone formation (newly formed bone, residual biomaterial, and medullar spaces were, respectively, 39%, 10%, and 51% of the core volume). The patient has functioned successfully throughout six and a half years of follow-up. Using the preshaped titanium mesh in association with the enzyme-treated equine bone substitute provided effective bone regeneration.
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http://dx.doi.org/10.3390/dj7030077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784736PMC
August 2019

Point-of-care testing for hepatitis C virus infection at an Italian dental clinic: portrait of the pilot study population.

New Microbiol 2019 Jul 3;42(3):133-138. Epub 2019 Jun 3.

Department of Dentistry IRCCS San Raffaele Scientific Institute, Milan, Italy and Dental School, Vita-Salute University, Milan, Italy.

The dental clinic is an appropriate place to promote the prevention of hepatitis C virus (HCV) infection and fast access for care of HCV-positive subjects with new-generation anti-HCV drugs. This study aimed to determine the socio-demographic profile of subjects screened for HCV virus in a dental clinic to acquire useful information for future campaigns of prevention. An easy, free-of-charge, screen salivary test was offered to patients referred to the dental clinic of San Raffaele Scientific Research Hospital in Milan, Italy for dental procedures. These patients were also asked to complete an anonymous questionnaire on demographics and risk behaviours. A total of 1388 of 2097 (66.19%) questionnaires were evaluable. The demographics of the population responding to this initiative was primarily Italians citizen (96.47%), homogeneous gender distribution (55.55%), age over 50 (609 subjects; 43.88%), with high-level education and stable professional positions. 905 subjects (65.20%) were never tested for HCV before. The test showed positive reactivity in 22 cases (1.05%); of these, 21 subjects were known to be HCV-positive, and the test confirmed their status. One subject was newly diagnosed as HCV-positive. The percentage of subjects who were never tested for HCV infection appears too high (905 subjects, i.e., 65.20%), especially among subjects with high level of education and professions, and among adults over 40 or young people (18-25). The easy screening test in dental clinic can help raise awareness, promote early diagnosis and prevention, and provide a fast link to care for HCV infection.
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July 2019

Implant survival rate in calvarial bone grafts: A retrospective clinical study with 10 year follow-up.

Clin Implant Dent Relat Res 2019 Aug 28;21(4):662-668. Epub 2019 May 28.

Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita Salute University, Milan, Italy.

Background: In this study, we present medium- and long-term data on implant survival in a cohort of patients with severe maxillary atrophy rehabilitated using reconstructive implant site development with calvarial bone grafts.

Materials And Methods: We obtained clinical records from patients treated with implant rehabilitation supported by calvaria bone grafts in the Oral Surgery Department of IRCSS San Raffaele (Milan, Italy). Implant and prosthetic survival and success rates were retrospectively evaluated. Graft survival and postoperative complications were also assessed.

Results: A total of 207 implants placed in 32 patients were evaluated for a mean period of 10.0 years from loading. After 10 years, the cumulative survival rate was 97.10%, the implant success rate was 92.75%, and the prosthetic complication rate was 9.76%. A graft survival percentage of 96.88% was observed, and postoperative complications occurred in 28.13% of cases.

Conclusions: The 10-year survival rate and prosthetic complications for patients treated with implant rehabilitation supported by calvarial bone grafts are excellent, as implant loss was relatively rare, although limited subjects were available for the 10-year follow-up.
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http://dx.doi.org/10.1111/cid.12799DOI Listing
August 2019

Distribution of Trabecular Bone Density in the Maxilla and Mandible.

Implant Dent 2019 Aug;28(4):340-348

Dental School Director, Full Professor and Rector Vita-Salute University IRCCS San Raffaele, Milan, Italy.

Introduction: Implant osseointegration is strongly influenced by the bone quality at the implant insertion site. The present work aims to create distribution diagrams showing the average bone density at each position within the jaws.

Materials And Methods: Data were retrospectively collected from 4 oral surgeons who sought bone-density measurements during implant placement using a torque-measuring implant micromotor. Statistical analyses were performed to investigate whether bone density correlated with the patients' sex and age and whether the bone-density values at different positions within each arch correlated to each other.

Results: Records of 2408 patients and 6060 bone-density readings were retrieved, and density distribution diagrams were created. Density values showed a significant variation within subjects. Within the same jaw, density between adjacent positions showed significant differences. Density at a given position correlated significantly with that at the other positions in most cases. Bone density was significantly lower in women than in men; no significant correlation was found between bone density and the patient age.

Conclusions: Bone density of patients displays significant interindividual variation, thus meaningful assessment must be conducted on a patient-by-patient basis.
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http://dx.doi.org/10.1097/ID.0000000000000893DOI Listing
August 2019

Laser versus LED polymerization: Comparison of in vitro preventive sealing procedures.

J Appl Biomater Funct Mater 2019 Jan-Mar;17(1):2280800018816013

1 Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.

Introduction:: The technique of sealing is a widely accepted procedure for prevention of caries. The aim of our in vitro study was to compare the effect of two different curing units (traditional LED source and innovative laser diode lamp) on the integrity of fissure sealant material and its interface with tooth enamel.

Materials And Methods:: Sixty healthy third molars were randomly assigned to two groups. In group A were teeth intended for polymerization by LED B lamp, and group B comprised teeth to be polymerized by an innovative laser diode. Both groups were treated with the traditional sealing technique, subjected to a metallization process, and analyzed by scanning electron microscope.

Results:: Micro-gaps between the sealant and the enamel were found in specimens in both A (43%) and B (40%) groups ( p=0.793), and sealant shrinkage was seen. Significant differences between the groups emerged in the percentage of perimetric micro-erosion sites (80% vs. 100%, p=0.010) and the presence of holes and micro-bubbles on the sealant surface (21% vs. 63%, p=0.001).

Conclusions:: Although macroscopic clinical polymerization occurred with both instruments, the microscopic evaluation showed significant differences between the studied groups in terms of perimetric micro-erosion sites and micro-bubbles, which were higher in laser-cured samples.
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http://dx.doi.org/10.1177/2280800018816013DOI Listing
June 2019

Influence of Intra-Oral Scanner (I.O.S.) on The Marginal Accuracy of CAD/CAM Single Crowns.

Int J Environ Res Public Health 2019 02 14;16(4). Epub 2019 Feb 14.

Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita Salute University, 20123 Milan, Italy.

The aim of this in vitro study was to compare the quality of digital workflows generated by different scanners (Intra-oral digital scanners (I.O.S.s)) focusing on marginal fit analysis. A customized chrome-cobalt (Cr-Co) implant abutment simulating a maxillary right first molar was fixed in hemi-maxillary stone model and scanned by eight different I.O.S.s: Omnicam (Denstply Sirona, Verona, Italy) CS3500, CS3600, (Carestream Dental, Atlanta, GA, USA), True Definition Scanner (3M, St. Paul, MN, USA), DWIO (Dental Wings, Montreal, Quebec, Canada), PlanScan (Planmeca Oy, Helsinki, Finland), 3D PROGRESS Plus (MHT, Verona, Italy), TRIOS 3 (3Shape, Copenhagen, Denmark). Nine scans were performed by each tested I.O.S. and 72 copings were designed using a dental computer-assisted-design/computer-assisted-manufacturing (CAD/CAM) software (exocad GmbH, Darmstadt, Germany). According to CAD data, zirconium dioxide (ZrO₂) copings were digitally milled (Roland DWX-50, Irvine, CA, USA). Scanning electron microscope (SEM) direct vision allowed for marginal gap measurements in eight points for each specimen. Descriptive analysis was performed using mean, standard deviation, and median, while the Kruskal⁻Wallis test was performed to determine whether the marginal discrepancies were significantly different between each group (significance level < 0.05). The overall mean marginal gap value and standard deviation were 53.45 ± 30.52 μm. The minimum mean value (40.04 ± 18.90 μm) was recorded by PlanScan, then 3D PROGRESS Plus (40.20 ± 21.91 μm), True Definition Scanner (40.82 ± 26.19 μm), CS3500 (54.82 ± 28.86 μm) CS3600 (59,67 ± 28.72 μm), Omnicam (61.57 ± 38.59 μm), DWIO (62.49 ± 31.54 μm), while the maximum mean value (67.95 ± 30.41 μm) was recorded by TRIOS 3. The Kruskal⁻Wallis tests revealed a statistically significant difference (-value < 0.5) in the mean marginal gaps between copings produced by 3D PROGRESS Plus, PlanScan, True Definition Scanner, and the other evaluated I.O.S.s. The use of an I.O.S. for digital impressions may be a viable alternative to analog techniques. Although in this in vitro study PlanScan, 3D PROGRESS Plus and True Definition Scanner may have showed the best performances, all I.O.S.s tested could provide clinically encouraging results especially in terms of marginal accuracy, since mean marginal gap values were all within the clinically acceptable threshold of 120 μm.
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http://dx.doi.org/10.3390/ijerph16040544DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406818PMC
February 2019

Digital versus Traditional Workflow for Posterior Maxillary Rehabilitations Supported by One Straight and One Tilted Implant: A 3-Year Prospective Comparative Study.

Biomed Res Int 2018 11;2018:4149107. Epub 2018 Nov 11.

Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita Salute University, Via Olgettina N. 48, Zip Code 20123 Milan, Italy.

Objectives: The aim of the study was to evaluate and compare digital and traditional prosthetic workflow for posterior maxillary restorations supported by an upright and a distally tilted implant at 3-year follow-up.

Materials And Methods: Twenty-four patients were treated in the posterior maxilla with 24 immediately loaded axial and 24 distally tilted implants supporting 3-unit or 4-unit screw-retained prostheses. Three months after initial loading patients were randomly stratified into two groups: definitive traditional impressions were carried out in the control group, while digital impressions were performed in the test group. The framework-implant connection accuracy was evaluated by means intraoral digital radiographs at 3, 6, 12, and 36 months of follow-up examinations. Outcome considerations comprised implant and prosthetic survival and success rates, marginal bone level changes, and required clinical time to take impressions.

Results: A total of 24 patients received immediately loaded screw-retained prostheses supported by an upright and a distally tilted implant (total 48 implants). No implant dropouts occurred, showing an overall survival rate of 100% for both groups. None of the 24 fixed prostheses were lost during the observation period (prosthetic survival rate of 100%). No statistically significant differences in marginal bone loss were found between control and test groups. The digital impression procedure required on average less clinical time than the conventional procedure.

Conclusions: Clinical and radiologic results suggest that digital impression is a predictable procedure for posterior maxillary restorations supported by an upright and a distally tilted implant.
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http://dx.doi.org/10.1155/2018/4149107DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252190PMC
March 2019

Immediate Postextractive Implants With and Without Bone Graft: 3-year Follow-up Results From a Multicenter Controlled Randomized Trial.

Implant Dent 2018 Dec;27(6):638-645

Professor and Chairman, Department of Clinical and Experimental Medicine, University of Foggia, Italy.

Purpose: To evaluate the outcome of single postextraction immediate implants placed with and without bone grafts in the esthetic maxillary premolar area for 3-year follow-up after loading.

Material And Methods: After tooth extraction, 102 patients received 115 immediate dental implants. Patients were randomly allocated to immediate implant placement with (group A: 51) or without (group B: 51) anorganic bovine bone and resorbable collagen barrier.

Results: After 3 years (T36), 1 implant failed in each group. Thirty-seven patients showed inflammation and bleeding, 19 mucositis, and 2 periimplantitis. Statistical significant association was found between BOP and mucositis at T12 (P < 0.0005) and T36 (P < 0.0005). The mesial bone level was -0.61 mm in group B and -1.01 mm in group A (P < 0.001). The group B distal bone level was -0.71 mm and -1.12 mm in group A (P < 0.005). Group B's buccal mean probing was increased (+0.40 mm) than group A (+0.36 mm). Group B's palatal mean value was higher (+0.54 mm) than group A (+0.38 mm). No statistically significant differences were found between the 2 groups. However, the Pink Esthetic Score and patient satisfaction were higher in group B than A (P < 0.001).

Conclusions: The use of anorganic bovine bone substitute with a resorbable collagen barrier in immediate postextractive implants seems to improve the esthetic outcomes after a 3-year follow-up.
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http://dx.doi.org/10.1097/ID.0000000000000816DOI Listing
December 2018

Relationship Between Crestal Bone Levels and Crown-to-Implant Ratio of Ultra-Short Implants With a Microrough Surface: A Prospective Study With 48 Months of Follow-Up.

J Oral Implantol 2019 Feb 24;45(1):18-28. Epub 2018 Jul 24.

4   Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy.

The aim of this cohort study was to investigate the relationship between crestal bone levels and crown-to-implant ratio of ultra-short implants, after functional loading. Sixty patients with single or partial edentulism and alveolar bone atrophy were enrolled and treated between December 2009 and January 2016. Without using bone-grafting procedures, patients were rehabilitated with ultra-short implants characterized by a microrough surface and a 6-mm length. Clinical and anatomical crown-to-implant (C/I) ratios and crestal bone levels (CBL) were measured after a follow-up period ranging from 12 to 72 months; all peri-implant and prosthetic parameters were recorded. The data collected were statistically analyzed ( P = .05). A total of 47 patients with 66 ultra-short implants were completely followed up according to described protocol. The mean follow-up was 48.5 ± 19.1 months. The mean anatomical C/I ratio was 2.2, while the mean clinical C/I ratio was 2.6 ± 0.6 at baseline and 2.8 ± 0.6 at the last follow-up appointment. Mean CBL as calculated at the baseline was 0.7 ± 0.5 mm, while at the last appointment it measured 1.0 ± 0.5 mm. The overall implant-based success rate was 96.9%, and the mean peri-implant bone loss (PBL) was 0.3 ± 0.3 mm. No statistically significant relationship was found between anatomical or clinical C/I ratio and PBL. Ultra-short implants appear to offer a predictable solution for implant-prosthetic rehabilitation in patients with edentulism and bone atrophy. A high percentage of implants were successful, with minimal crestal bone loss. The high C/I ratio did not appear to influence either peri-implant bone loss or prosthetic complication rates.
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http://dx.doi.org/10.1563/aaid-joi-D-17-00204DOI Listing
February 2019

Midfacial Tissue Assessment of the Effect of Amount of Keratinized Mucosa on Immediate Temporarization of Fresh Socket Implants: 8-Year Follow-up.

Int J Periodontics Restorative Dent 2019 March/April;39(2):227–232. Epub 2018 Jun 12.

The aim of the present study was to consider the long-term midfacial mucosal outcome around final prosthetic restorations on dental implants placed and loaded immediately after tooth extractions. A total of 42 patients requiring tooth extractions were recruited, and 142 teeth were extracted. Based on the amount of keratinized mucosa (KM), implants were categorized into group A (KM ≥ 2 mm; n = 61) or group B (KM < 2 mm; n = 62). In both groups, all patients received temporary prosthetic restorations immediately after the surgical procedure. Baseline levels were measured at placement of the final prosthetic restoration and patients were followed for 8 years. After the 8-year follow-up, a survival rate of 98.37% was reported. Two implants were lost due to peri-implantitis after 6 and 7 years of function, respectively. Peri-implantitis occurred at 9 implants (3 from group A and 6 from group B) in 8 patients (7.32%). At the 8-year follow-up for group A, an increase in midfacial tissue level of 0.14 ± 0.13 mm (screwed restorations) and 0.16 ± 0.09 mm (cemented restorations) was measured. For group B, a decrease in midfacial tissue level of 0.15 ± 0.09 mm (screwed restorations) and 0.17 ± 0.12 mm (cemented restorations) was reported. Statistically significant differences between groups were measured at 2, 5, and 8 years of follow-up (P < .01). The results demonstrated that the presence of KM is significantly associated with less mucosal inflammation and less gingival recession, regardless of the type of prosthetic restoration (screwed vs cemented).
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http://dx.doi.org/10.11607/prd.3292DOI Listing
August 2019

Thermal Changes During Guided Flapless Implant Site Preparation: A Comparative Study.

Int J Oral Maxillofac Implants 2018 May/Jun;33(3):671-677

Purpose: To compare intrabony thermal changes induced by two different protocols for guided implant surgery during the whole drilling procedure.

Materials And Methods: Two protocols for guided implant placement were evaluated in vitro using artificial bone cylinders. The control protocol provided traditional metal sleeves and a standard drilling sequence composed of four cylindrical triflute drills (cutting surface length = 16 mm). The test protocol provided a three-slot polyurethane sleeve and two cylindrical drills (second drill cutting surface length = 4 mm). Forty automated intermittent and graduated osteotomies (depth = 14 mm) were performed under external irrigation. Temperatures were measured in real time by three sensors at different depths (2, 8, and 13 mm). The temperature changes generated by the final drill of each protocol during the shearing and withdrawing processes were recorded as experimental results and subjected to the Student t test.

Results: Maximum temperature increases were recorded during the process of withdrawing in both protocols. In the control group, the mean thermal changes were 10.18°C, 8.61°C, and 5.78°C at depths of 2, 8, and 13 mm, respectively. In the test group, the mean thermal changes were 1.44°C, 4.46°C, and 3.58°C at depths of 2, 8, and 13 mm, respectively. The control group revealed statistically significantly (P < .0001) higher thermal changes than the test group, both in the superficial and deeper bone areas.

Conclusion: An appropriate irrigation system could be crucial for thermal lowering during a guided implant osteotomy mainly in the coronal and middle third of the implant site. Copious irrigation should be provided during the withdrawing process since greater thermal increases could be expected. Lower temperature increases could be achieved, reducing drill-to-bone contact, ie, cutting surface length, due to short frictional force exposure.
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http://dx.doi.org/10.11607/jomi.6029DOI Listing
August 2018

Prefabricated Bar System for Immediate Loading in Edentulous Patients: A 5-Year Follow-Up Prospective Longitudinal Study.

Biomed Res Int 2018 27;2018:7352125. Epub 2018 Feb 27.

Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita Salute University, Via Olgettina, No. 48, 20123 Milan, Italy.

Objectives: The aim of this clinical study was to evaluate a new type of prefabricated bar system, supported by axial and tilted implants at 5-year follow-up.

Materials And Methods: Twenty-nine consecutive participants (19 females, 10 males) (mean age 61.4 years), edentulous in one or both jaws, with severe atrophy of the posterior regions, were treated according to the All-on-four® protocol with immediately loaded axial (64) and tilted (64) implants supporting complete-arch screw-retained prostheses (12 maxillary, 20 mandibular) featuring a prefabricated bar as framework. Follow-up visits were performed at 3, 6, 12, 24, 48, and 60 months after implant insertion. Radiographic assessments were made using panoramic radiographs obtained immediately after surgery and at each follow-up visit. Bone level measurements around the axial and tilted implants were compared by means of the Student's -test.

Results: One axial implant failed in the lower jaw and did not compromise prosthetic function. The 60-month overall implant survival rate was 100% for axially positioned implants and 98.44% for tilted implants. The implant survival rates were 100% in the maxilla and 98.75% in the mandible. None of the 32 fixed prostheses were lost during the observation period, representing a prosthetic survival rate of 100%. No statistically significant differences ( > 0.05) in marginal bone loss between tilted and axial implants were detected in either jaw over time.

Conclusions: The use of the evaluated prefabricated bar for immediately loaded implants placed according to the All-on-four concept may significantly reduce implant failures; however, more long-term prospective clinical trials are needed to affirm the effectiveness of the surgical-prosthetic protocol.
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http://dx.doi.org/10.1155/2018/7352125DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5848148PMC
September 2018

The association between minor recurrent aphthous stomatitis (RAS), children's poor oral condition, and underlying negative psychosocial habits and attitudes towards oral hygiene.

BMC Pediatr 2018 04 13;18(1):136. Epub 2018 Apr 13.

Dental School, Vita-Salute San Raffaele University and IRCCS San Raffaele, Via Olgettina 58, I-20132, Milan, Italy.

Background: Minor Recurrent Aphthous Stomatitis (RAS) represents a disease which is very difficult to prevent. This case-control study focused on possible associations between minor Recurrent Aphthous Stomatitis in children, their oral health, and underlying behavioral indexes of children's attitudes and habits pertaining to (home) oral hygiene, with the further goal of enabling the dentist to prevent these specific kind of lesions, both from a clinical and a broader psychosocial perspective.

Methods: Four hundred one school-children (5-10 years old) in Milan (Italy) were submitted to an intra-oral examination, and interviewed with the aid of a brief psychosocial questionnaire.

Results: At the clinical level, statistically significant associations were observed between the presence of decayed teeth and minor Recurrent Aphthous Stomatitis (Odds Ratio: 3.15; 95% CI: lower limit 1.06; upper limit: 9.36; Z-test: 2.07, p = 0.039; Chi-square = 4.71, p = 0.030), and between the Decayed Missing or Filled Teeth (DMFT) index and minor aphthous stomatitis (Odds Ratio: 3.30; 95% CI: lower limit 1.13; upper limit: 9.67; Z-test = 2.18, p = 0.029; Chi-square = 5.27; p = 0.022), both results pointing to a significant increase-by circa 3 times-in the risk of developing minor Recurrent Aphthous Stomatitis in children exposed to the two above-identified factors (i.e., the presence of decayed teeth and a clearly compromised oral condition, as signaled by the DMFT index), if compared with the risk run by their non-exposed counterparts. At the psychosocial level of analysis, statistically significant associations were observed (1) between children's practice of spontaneously brushing teeth when not at home and a comparatively lower (i.e. better) Decayed Missing or Filled Teeth index (Chi-square: 8.95; p = 0.011), and (2) between receiving parental aid (e.g., proper brushing instructions) while practicing home oral hygiene and a significantly reduced presence of decayed teeth (Chi-square = 5.40; p = .067; Spearman's Rho, p = .038). Further, significant associations were also observed between children's reported severity of dental pain and both (a) the presence of decayed teeth (Chi-square = 10.80; p = 0.011), and (b) children's (poor) oral health condition as expressed by the Decayed Missing or Filled Teeth index (Chi-square = 6.29; p = 0.043). Interestingly, specific lifestyles and social status, showed no systematic association to other clinical or psychological/psychosocial indices.

Conclusions: These systematic relations suggest that, in the presence of Recurrent Aphthous Stomatitis in pediatric patients, the dentist should carefully monitor children for potential carious lesions, implement protocols of prevention to control Recurrent Aphthous Stomatitis disease in children affected by caries, and also be particularly aware of the right or wrong habits children may acquire in the course of continued social exchange with their caregivers and peers.
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http://dx.doi.org/10.1186/s12887-018-1094-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5897994PMC
April 2018

Etiological periodontal treatment with and without low-level laser therapy on IL-1β level in gingival crevicular fluid: an in vivo multicentric pilot study.

J Biol Regul Homeost Agents 2018 Mar-Apr;32(2):425-431

Department of Clinical and Experimental Medicine, University of Foggia, Italy

Cytokine proteins may have important roles during different human physiological and pathological processes. In the oral cavity, the bone loss and periodontal tissue pathology was related to inflammatory process activation. The aim of the present study was to assess the effects of etiological periodontal therapy with and without the use of Low Level Laser Therapy (LLLT) on clinical periodontal parameters and interleukin (IL)-1β level in gingival crevicular fluid (GCF) from chronic periodontitis (CP) patients. Thirty non-smoker CP patients were selected from the Foggia University Dental Clinic and other 2 private dental clinics. All patients were divided into two homogeneous randomized groups: 15 patients were treated with only scaling and root planing (group 1) and 15 patients with scaling and root planing etiological treatment and LLLT (group 2). In all sites, at baseline before treatment, the periodontal pocket depth (PPD) and bleeding on probing (BOP) were measured. In the PPD sites, the GCF samples were collected from 30 deep (≥5 mm) and shallow (≤3 mm) sites and IL-1β were evaluated at baseline, after 10 days and 1 month. In all the samples at baseline, the IL-1β concentration in GCF and BOP rate were significantly higher at deep PPD sites than at the shallow ones. After 10 days in all samples no PPD improvement was observed in the BOP rate but the IL-1 β level was statistically significantly improved (p<0.005) in group 2 compared to group 1. At 10 days and 1 month, in all deep PPD sites, PPD and BOP improvements were observed. At same time, IL-1β levels were lower and statistically significantly (p<0.005) improved in group 2 compared to group 1. The results confirmed that the periodontal etiology treatment of deep PPD sites with or with-out associated LLLT promotes periodontal health. Etiological treatment associated with LLLT, improves BOP and inflammation in periodontal disease. Moreover, the IL-1β concentration changes in GCF suggest these cytokines as a predictable marker of gingival inflammation in chronic periodontitis patients.
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June 2018

Comparison between fiber-reinforced polymers and stainless steel orthodontic retainers.

Korean J Orthod 2018 Mar 6;48(2):107-112. Epub 2018 Feb 6.

Department of Orthodontics, Seconda Università degli Studi di Napoli, Caserta, Italy.

Objective: The aim of this study was to examine the properties of fiber-reinforced composite and stainless steel twisted retainers for orthodontic retention.

Methods: Three different span lengths (5.0, 8.0, and 14.0 mm) of fiber-reinforced composite were investigated. The three fiber-reinforced composite retainer groups were subdivided according to the storage condition (dry and wet), resulting in a total of six groups. Each stainless steel and fiber-reinforced composite group was comprised of six specimens. The three-point bending flexural test was conducted using a universal testing machine. ANOVA was used to assess differences in the maximum load and maximum stress according to the span length, material, and storage condition. comparisons were performed if necessary.

Results: The maximum stress and maximum load were significantly ( < 0.001) associated with the span length, material, and storage condition. The significant interaction between the material and span length ( < 0.001) indicated the differential effects of the material for each span length on the maximum stress and maximum load, with the difference between materials being the highest for the maximum span length.

Conclusions: Our findings suggest that fiber-reinforced composite retainers may be an effective alternative for orthodontic retention in patients with esthetic concerns or allergy to conventional stainless steel wires.
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http://dx.doi.org/10.4041/kjod.2018.48.2.107DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5854880PMC
March 2018