Publications by authors named "Lorenzo Azzi"

27 Publications

  • Page 1 of 1

Chronic mechanical trauma/irritation and oral carcinoma: A systematic review showing low evidence to support an association.

Oral Dis 2021 Oct 12. Epub 2021 Oct 12.

Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.

Background: Chronic trauma of oral mucosa, resulting from repeated and persistent mechanical irritative action of an intraoral injury agent, has repeatedly been reported to be possibly implicated in the development of oral squamous cell carcinoma (OSCC).

Objectives: The present systematic review aimed to assess whether chronic mechanical trauma can be considered a risk factor for OSCC.

Data Sources: PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), Scopus; EMBASE, Web of Science.

Study Eligibility Criteria: Cohort studies comparing OSCC incidence among subjects with/without chronic mechanical trauma or case-control or cross-sectional studies comparing chronic mechanical trauma among subjects with/without OSCC.

Results: Only one prospective case-control study fulfilled the inclusion criteria, but the quality of the evidence provided is not enough to define trauma as a risk factor for OSCC. The main limitation is the presence of only one case-control study at high risk of bias. In the absence of strong evidence supporting the role of trauma in OSCC, a thorough discussion on trauma and carcinogenesis has been performed.

Conclusions: Available evidence does not support an active role for chronic trauma in oral carcinogenesis, neither as promoter nor as progressor factor. Prospective cohort studies able to better assess trauma in OSCC are needed.
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http://dx.doi.org/10.1111/odi.14049DOI Listing
October 2021

Symptomatic SARS-CoV-2 infections after full schedule BNT162b2 vaccination in seropositive healthcare workers: a case series from a single institution.

Emerg Microbes Infect 2021 Dec;10(1):1254-1256

Department of Medicine and Surgery, University of Insubria, Varese, Italy.

We report 11 cases of SARS-CoV-2 infection in healthcare workers (HCW) for COVID-19 and seropositive after the second dose of the BNT162b2 mRNA vaccine. Based on voluntary-based surveillance, they tested positive for different strains of SARS-CoV-2, as Spike gene sequencing showed. Five of them reported mild symptoms. Given the risk for SARS-CoV-2 introduction from asymptomatic vaccinees, this case series suggests the need to continue nasopharyngeal screening programmes.
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http://dx.doi.org/10.1080/22221751.2021.1942230DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221119PMC
December 2021

Can transfer type and implant angulation affect impression accuracy? A 3D in vitro evaluation.

Odontology 2021 Oct 1;109(4):884-894. Epub 2021 Jun 1.

Private Practitioner, Milano, Italy.

Impression accuracy is fundamental to achieve a passive fit between implants and the superstructure. Three transfer types were tested to evaluate the differences in impression accuracy and their efficiency in case of different implant angles. A master model with four implant analogues placed at 0°, 15° and 35° was used. 27 impressions were taken with three different types of impression coping: closed tray technique coping (CT), open tray technique coping (COT) and telescopic open tray coping (TOT). The impressions were poured. Analogues were matched with scan bodies to be scanned and exported in STL. An implant bar was designed from each STL and another one from the master model. A comparison between these bars was obtained. Linear and angular measurements for every type of coping were calculated for different angulations. The collected data were analyzed with ANOVA test (95% of confidence). Student's t test showed a significative discrepancy (p ≤ 0.001) on linear and angular measurements on Δx, Δy, Δz with different transfer types as well as diverse implant positioning angles (p ≤ 0.001). Within the limitations of this study, it can be concluded that the coping type and the implants divergence may be significant parameters influencing the impression accuracy.
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http://dx.doi.org/10.1007/s10266-021-00619-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387271PMC
October 2021

Previous Humoral Immunity to the Endemic Seasonal Alphacoronaviruses NL63 and 229E Is Associated with Worse Clinical Outcome in COVID-19 and Suggests Original Antigenic Sin.

Life (Basel) 2021 Apr 1;11(4). Epub 2021 Apr 1.

Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.

Antibody-dependent enhancement (ADE) of severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) infection has been hypothesized. However, to date, there has been no in vitro or in vivo evidence supporting this. Cross-reactivity exists between SARS CoV-2 and other for both cellular and humoral immunity. We show here that IgG against nucleocapsid protein of alphacoronavirus NL63 and 229E correlate with the World Health Organization's (WHO) clinical severity score ≥ 5 (incidence rate ratios was 1.87 and 1.80, respectively, and 1.94 for the combination). These laboratory findings suggest possible ADE of SARS CoV-2 infection by previous alphacoronavirus immunity.
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http://dx.doi.org/10.3390/life11040298DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067214PMC
April 2021

An episode of oral mucositis after the first administration of the ChAdOx1 COVID-19 vaccine.

Oral Dis 2021 Apr 12. Epub 2021 Apr 12.

Department of Medicine and Surgery, University of Insubria, Varese, Italy.

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http://dx.doi.org/10.1111/odi.13874DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8250649PMC
April 2021

Anti-SARS-CoV-2 RBD IgG responses in convalescent versus naïve BNT162b2 vaccine recipients.

Vaccine 2021 04 30;39(18):2489-2490. Epub 2021 Mar 30.

Department of Medicine and Surgery, University of Insubria, Varese, Italy; Laboratory of Microbiology, ASST dei Sette Laghi, Varese, Italy.

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http://dx.doi.org/10.1016/j.vaccine.2021.03.086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8009041PMC
April 2021

SARS-CoV-2 on Ocular Surfaces in a Cohort of Patients With COVID-19 From the Lombardy Region, Italy.

JAMA Ophthalmol 2021 09;139(9):956-963

Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.

Importance: Since February 2020, coronavirus disease 2019 (COVID-19) has spread rapidly all over the world, with an epidemiological cluster in Lombardy, Italy. The viral communicability may be mediated by various body fluids, but insufficient information is available on the presence of the virus in human tears.

Objectives: To investigate the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in tears collected from patients with COVID-19 by means of real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) assay and to assess the association of virus presence with concomitant clinical conditions.

Design, Setting, And Participants: Cross-sectional study conducted between April 9 and May 5, 2020. The setting was intensive care units at Azienda Socio-Sanitaria Territoriale (ASST) Sette-Laghi Hospital, University of Insubria, in Varese, Lombardy, Italy. A conjunctival swab was performed in 91 patients hospitalized for COVID-19, which was clinically diagnosed by rRT-PCR assay on nasopharyngeal swabs and by radiological imaging. Conjunctival swabs from 17 additional healthy volunteer participants with no symptoms of COVID-19 were examined to evaluate the availability and applicability of the conjunctival swab test.

Exposure: SARS-CoV-2 detection by means of rRT-PCR assay performed on the collected samples obtained by conjunctival swabs.

Main Outcomes And Measures: Conjunctival swab and nasopharyngeal swab results are reported, as well as demographic and clinical data.

Results: A total of 108 participants (mean [SD] age, 58.7 [14.2] years; 55 female and 53 male) were tested for SARS-CoV-2 using rRT-PCR assay, including 91 patients hospitalized with COVID-19 and 17 were healthy volunteers. SARS-CoV-2 was found on the ocular surface in 52 of 91 patients with COVID-19 (57.1%; 95% CI, 46.3%-67.5%), with a wide variability in the mean viral load from both eyes. Among a subset of 41 patients, concordance of 63.0% (95% CI, 41.0%-81.0%) was found between positive conjunctival and nasopharyngeal swab test results when performed within 2 days of each other. In 17 of these patients, nasopharyngeal swab results were negative for SARS-CoV-2. In 10 of these 17 patients, conjunctival swab results were positive for the virus.

Conclusions And Relevance: In this study, SARS-CoV-2 RNA was found on the ocular surface in a large part of this cohort of patients with COVID-19, although the infectivity of this material could not be determined. Because patients may have positive test results with a conjunctival swab and negative results with a nasopharyngeal swab, use of the slightly invasive conjunctival swab may be considered as a supplementary diagnostic test.
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http://dx.doi.org/10.1001/jamaophthalmol.2020.5464DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934077PMC
September 2021

Antibiotics to prevent complications following tooth extractions.

Cochrane Database Syst Rev 2021 02 24;2:CD003811. Epub 2021 Feb 24.

School of Dentistry, University of Parma, Parma, Italy.

Background: The most frequent indications for tooth extractions, generally performed by general dental practitioners, are dental caries and periodontal infections. Systemic antibiotics may be prescribed to patients undergoing extractions to prevent complications due to infection. This is an update of a review first published in 2012.

Objectives: To determine the effect of systemic antibiotic prophylaxis on the prevention of infectious complications following tooth extractions.

Search Methods: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health Trials Register (to 16 April 2020), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2020, Issue 3), MEDLINE Ovid (1946 to 16 April 2020), Embase Ovid (1980 to 16 April 2020), and LILACS (1982 to 16 April 2020). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.

Selection Criteria: We included randomised, double-blind, placebo-controlled trials of systemic antibiotic prophylaxis in patients undergoing tooth extraction(s) for any indication.

Data Collection And Analysis: At least two review authors independently performed data extraction and 'Risk of bias' assessment for the included studies. We contacted trial authors for further details where these were unclear. For dichotomous outcomes, we calculated risk ratios (RR) and 95% confidence intervals (CI) using random-effects models. For continuous outcomes, we used mean differences (MD) with 95% CI using random-effects models. We examined potential sources of heterogeneity. We assessed the certainty of the body of evidence for key outcomes as high, moderate, low, or very low, using the GRADE approach.

Main Results: We included 23 trials that randomised approximately 3206 participants (2583 analysed) to prophylactic antibiotics or placebo. Although general dentists perform dental extractions because of severe dental caries or periodontal infection, only one of the trials evaluated the role of antibiotic prophylaxis in groups of patients affected by those clinical conditions. We assessed 16 trials as being at high risk of bias, three at low risk, and four as unclear.  Compared to placebo, antibiotics may reduce the risk of postsurgical infectious complications in patients undergoing third molar extractions by approximately 66% (RR 0.34, 95% CI 0.19 to 0.64; 1728 participants; 12 studies; low-certainty evidence), which means that 19 people (95% CI 15 to 34) need to be treated with antibiotics to prevent one infection following extraction of impacted wisdom teeth. Antibiotics may also reduce the risk of dry socket by 34% (RR 0.66, 95% CI 0.45 to 0.97; 1882 participants; 13 studies; low-certainty evidence), which means that 46 people (95% CI 29 to 62) need to take antibiotics to prevent one case of dry socket following extraction of impacted wisdom teeth. The evidence for our other outcomes is uncertain: pain, whether measured dichotomously as presence or absence (RR 0.59, 95% CI 0.31 to 1.12; 675 participants; 3 studies) or continuously using a visual analogue scale (0-to-10-centimetre scale, where 0 is no pain) (MD -0.26, 95% CI -0.59 to 0.07; 422 participants; 4 studies); fever (RR 0.66, 95% CI 0.24 to 1.79; 475 participants; 4 studies); and adverse effects, which were mild and transient (RR 1.46, 95% CI 0.81 to 2.64; 1277 participants; 8 studies) (very low-certainty evidence).  We found no clear evidence that the timing of antibiotic administration (preoperative, postoperative, or both) was important. The included studies enrolled a subset of patients undergoing dental extractions, that is healthy people who had surgical extraction of third molars. Consequently, the results of this review may not be generalisable to all people undergoing tooth extractions.

Authors' Conclusions: The vast majority (21 out of 23) of the trials included in this review included only healthy patients undergoing extraction of impacted third molars, often performed by oral surgeons. None of the studies evaluated tooth extraction in immunocompromised patients. We found low-certainty evidence that prophylactic antibiotics may reduce the risk of infection and dry socket following third molar extraction when compared to placebo, and very low-certainty evidence of no increase in the risk of adverse effects. On average, treating 19 healthy patients with prophylactic antibiotics may stop one person from getting an infection. It is unclear whether the evidence in this review is generalisable to patients with concomitant illnesses or patients at a higher risk of infection. Due to the increasing prevalence of bacteria that are resistant to antibiotic treatment, clinicians should evaluate if and when to prescribe prophylactic antibiotic therapy before a dental extraction for each patient on the basis of the patient's clinical conditions (healthy or affected by systemic pathology) and level of risk from infective complications. Immunocompromised patients, in particular, need an individualised approach in consultation with their treating medical specialist.
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http://dx.doi.org/10.1002/14651858.CD003811.pub3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094158PMC
February 2021

Imported SARS-CoV-2 Variant P.1 in Traveler Returning from Brazil to Italy.

Emerg Infect Dis 2021 04 10;27(4):1249-1251. Epub 2021 Feb 10.

We report an imported case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant P.1 detected in an asymptomatic traveler who arrived in Italy on an indirect flight from Brazil. This case shows the risk for introduction of SARS-CoV-2 variants from indirect flights and the need for continued SARS-CoV-2 surveillance.
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http://dx.doi.org/10.3201/eid2704.210183DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007292PMC
April 2021

Psychological profile and unexpected pain in oral lichen planus: A case-control multicenter SIPMO study.

Oral Dis 2021 Jan 29. Epub 2021 Jan 29.

Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Turin, Italy.

Objectives: To analyze psychological profiles, pain, and oral symptoms in patients with oral lichen planus (OLP).

Materials And Methods: 300 patients with keratotic OLP (K-OLP; reticular, papular, plaque-like subtypes), 300 patients with predominant non-keratotic OLP (nK-OLP; erythematosus atrophic, erosive, ulcerative, bullous subtypes), and 300 controls were recruited in 15 universities. The number of oral sites involved and oral symptoms were recorded. The Numeric Rating Scale (NRS), Total Pain Rating Index (T-PRI), Hamilton Rating Scales for Depression and for Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) were administered.

Results: The OLP patients, especially the nK-OLP, showed higher scores in the NRS, T-PRI, HAM-D, HAM-A and PSQI compared with the controls (p-value < .001 ). A positive correlation between the NRS, T-PRI, HAM-A, HAM-D, and PSQI was found with the number of oral symptoms and number of oral sites involved. Pain was reported in 67.3% of nK-OLP and 49.7% of K-OLP cases with poor correspondence between the site of lesions and the site of the symptoms.

Conclusions: Mood disorders are frequently associated with OLP with an unexpected symptomatology correlated with the number of oral symptoms and with the extension of disease suggesting a peripheral neuropathy.
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http://dx.doi.org/10.1111/odi.13787DOI Listing
January 2021

Pilot Study: Long-Term Shedding of SARS-CoV-2 in Urine: A Threat for Dispersal in Wastewater.

Front Public Health 2020;8:569209. Epub 2020 Nov 23.

Pathology Unit, Azienda Socio Sanitaria Territoriale (ASST) Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.

Only 4 months after the beginning of SARS-CoV-2 epidemic, the world is facing a global pandemic due to a complex and insidious virus that today constantly poses new challenges. In this study, we highlight a persistent shedding of SARS-CoV-2 RNA into the urine, even in patients with a negative nasopharyngeal swab and in patients considered recovered. What does it mean? Besides the fact that the kidney is a probable site of viral replication, the prolonged viral excretion is a matter of great concern for our drainage system contamination.
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http://dx.doi.org/10.3389/fpubh.2020.569209DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719751PMC
January 2021

Saliva is the Key Element for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Mass Screening.

Authors:
Lorenzo Azzi

Clin Infect Dis 2021 08;73(3):e566-e568

Unit of Oral Medicine and Pathology, Azienda Socio Sanitaria Territoriale dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.

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http://dx.doi.org/10.1093/cid/ciaa1440DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7665330PMC
August 2021

Influence of Bone Quality, Drilling Protocol, Implant Diameter/Length on Primary Stability: An In Vitro Comparative Study on Insertion Torque and Resonance Frequency Analysis.

J Oral Implantol 2020 Jun;46(3):182-189

IRCCS Fondazione Cà Granda, University of Milan, Milan, Italy.

The aim of this study was to evaluate the influence of bone quality, drilling technique, implant diameter, and implant length on insertion torque (IT) and resonance frequency analysis (RFA) of a prototype-tapered implant with knife-edge threads. The investigators hypothesized that IT would be affected by variations in bone quality and drilling protocol, whereas RFA would be less influenced by such variables. The investigators implemented an in vitro experiment in which a prototype implant was inserted with different testing conditions into rigid polyurethane foam blocks. The independent variables were: bone quality, drilling protocol, implant diameter, and implant length. Group A implants were inserted with a conventional drilling protocol, whereas Group B implants were inserted with an undersized drilling protocol. Values of IT and RFA were measured at implant installation. IT and RFA values were significantly correlated (Pearson correlation coefficient: 0.54). A multivariable analysis showed a strong model. Higher IT values were associated with drilling protocol B vs A (mean difference: 71.7 Ncm), implant length (3.6 Ncm increase per mm in length), and substrate density (0.199 Ncm increase per mg/cm3 in density). Higher RFA values were associated with drilling protocol B vs A (mean difference: 3.9), implant length (1.0 increase per mm in length), and substrate density (0.032 increase per mg/cm3 in density). Implant diameter was not associated with RFA or IT. Within the limitations of an in vitro study, the results of this study suggest that the studied implant can achieve good level of primary stability in terms of IT and RFA. A strong correlation was found between values of IT and RFA. Both parameters are influenced by the drilling protocol, implant length, and substrate density. Further studies are required to investigate the clinical response in primary stability and marginal bone response.
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http://dx.doi.org/10.1563/aaid-joi-D-19-00145DOI Listing
June 2020

Two cases of COVID-19 with positive salivary and negative pharyngeal or respiratory swabs at hospital discharge: A rising concern.

Oral Dis 2021 Apr 11;27 Suppl 3:707-709. Epub 2020 May 11.

Laboratory of Clinical Microbiology, ASST dei Sette Laghi - Ospedale di Circolo, Department of Medicine and Surgery, University of Insubria, Varese, Italy.

We report two cases of COVID-19 showing negative respiratory swabs but positive salivary samples at the same time. These findings rise the concern about how to manage these patients before hospital discharging, thus avoiding contagion among their family members or a second coronavirus wave once the lockdown is over.
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http://dx.doi.org/10.1111/odi.13368DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267504PMC
April 2021

Saliva is a reliable tool to detect SARS-CoV-2.

J Infect 2020 07 14;81(1):e45-e50. Epub 2020 Apr 14.

Laboratory of Clinical Microbiology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.

Objectives: This study analyzed salivary samples of COVID-19 patients and compared the results with their clinical and laboratory data.

Methods: Salivary samples of 25 COVID-19 patients were analyzed by rRT-PCR. The following data were collected: age, sex, comorbidities, drugs. Lactate dehydrogenase (LDH) and ultrasensitive reactive C protein (usRCP) values were registered on the same day when a salivary swab was collected. Prevalence of positivity in saliva and association between clinical data and the cycle threshold as a semiquantitative indicator of viral load were considered.

Results: Twenty-five subjects were recruited into this study, 17 males and 8 females. The mean age was 61.5 +/- 11.2 years. Cardiovascular and/or dysmetabolic disorders were observed in 65.22% of cases. All the samples tested positive for the presence of SARS-CoV-2, while there was an inverse association between LDH and Ct values. Two patients showed positive salivary results on the same days when their pharyngeal or respiratory swabs showed conversion.

Conclusions: Saliva is a reliable tool to detect SARS-CoV-2. The role of saliva in COVID-19 diagnosis could not be limited to a qualitative detection of the virus, but it may also provide information about the clinical evolution of the disease.
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http://dx.doi.org/10.1016/j.jinf.2020.04.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194805PMC
July 2020

Correlation between Buccal Bone Thickness at Implant Placement in Healed Sites and Buccal Soft Tissue Maturation Pattern: A Prospective Three-Year Study.

Materials (Basel) 2020 Jan 21;13(3). Epub 2020 Jan 21.

IRCCS Fondazione Cà Granda, University of Milan, Via Francesco Sforza 28, 20122 Milan, Italy.

Background: Optimal aesthetic implant restoration is a combination of a visually pleasing prosthesis and adequate surrounding peri-implant soft tissue architecture. This study describes the influence of the residual buccal bone thickness (BBT), measured at the time of implant placement, on the soft tissue maturation during three years of follow-up.

Methods: Seventy-eight implants were enrolled in the present study. The BBT was assessed at the surgical stage and each case assigned to Group 1 (BBT values ≤0.5 mm), Group 2 (BBT values >0.5 and <1.5 mm), or Group 3 (BBT values ≥1.5 mm). Only native bone and healed sites were included. The tooth height (TH), based on the distance between the buccal free gingival margin at the zenith level and the crown incisal edge, according to the main axis of the tooth, was monitored at one, two, and three years from the final prosthodontic rehabilitation to determine any occurrence of recession or coronal repositioning of the gums over time. A Pearson Two-Tailed test was applied and the significance level set at ≤ 0.05.

Results: For BBT values ≤0.5 mm, the buccal gum at three years showed an average recession of 1.22 ± 0.41 mm. For BBT values >0.5 and <1.5 mm, the buccal gum also showed recession of 0.64 ± 0.29 mm. In contrast, for BBT values ≥1.5 mm, the buccal gum showed coronal growth of 0.77 ± 0.22 mm. The differences between the groups were significant ( ≤ 0.01) at all times.

Conclusion: The BBT at the time of implant placement was found to affect the buccal gingival margin stability over three years of observation.
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http://dx.doi.org/10.3390/ma13030511DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040578PMC
January 2020

A Comparative 3D Finite Element Computational Study of Three Connections.

Materials (Basel) 2019 Sep 26;12(19). Epub 2019 Sep 26.

IRCCS Fondazione Cà Granda, University of Milan, Via francesco Sforza 28, 20122 Milan, Italy.

Masticatory overload on dental implants is one of the causes of marginal bone resorption. The implant-abutment connection (IAC) design plays a critical role in the quality of the stress distribution, and, over the years, different designs were proposed. This study aimed to assess the mechanical behavior of three different types of IAC using a finite element model (FEM) analysis. Three types of two-piece implants were designed: two internal conical connection designs (models A and B) and one internal flat-to-flat connection design (model C). This three-dimensional analysis evaluated the response to static forces on the three models. The strain map, stress analysis, and safety factor were assessed by means of the FEM examination. The FEM analysis indicated that forces are transmitted on the abutment and implant's neck in model B. In models A and C, forces were distributed along the internal screw, abutment areas, and implant's neck. The stress distribution in model B showed a more homogeneous pattern, such that the peak forces were reduced. The conical shape of the head of the internal screw in model B seems to have a keystone role in transferring the forces at the surrounding structures. Further experiments should be carried out in order to confirm the present suppositions.
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http://dx.doi.org/10.3390/ma12193135DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6803952PMC
September 2019

Is there an association between drugs and burning mouth syndrome? A case-control study.

Oral Dis 2019 Sep 28;25(6):1634-1644. Epub 2019 May 28.

Unit of Oral Pathology and Medicine, Maxillo-facial and Dental Unit, Fondazione Ca' Granda Ospedale Maggiore Policlinico, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.

Objective: The purpose of this case-control study was to compare the pharmacological anamnesis collected from a group of 150 burning mouth syndrome (BMS) patients with that of a control group of 150 patients matched for age and sex.

Materials And Methods: The patients' medical histories were reviewed, and data on drug therapy were collected. Drugs were classified on the basis of pharmacological effects; the classes were antihypertensives (i.e., ACE inhibitors/ARBs, calcium antagonists, diuretics and beta-blockers), antiaggregants, anticoagulants, antidiabetics, vitamin D integrators, bisphosphonates, psychotropics (i.e., anxiolytics and antidepressants), gastroprotectors, statins, thyroid hormone substitutes, corticosteroids and immunosuppressants.

Results: The BMS patients and the controls were matched for age (mean age: 69 years) and sex (128 females and 22 males). Antihypertensives, especially ACE inhibitors/ARBs (OR = 0.37, CI: 0.22-0.63, p = 0.0002) and beta-blockers (OR = 0.36, CI: 0.19-0.68 p = 002), revealed an inverse association with the presence of BMS, whereas anxiolytics (OR = 3.78, CI: 2.12-6.75 p < 0.0001), but neither antidepressants nor antipsychotics, were significantly associated with BMS. There were no correlations with other drug classes.

Conclusion: Our study highlighted that ACE inhibitors, ARBs and beta-blockers were in inverse relation to BMS and found that anxiolytics, but neither antidepressants nor antipsychotics, were linked to the presence of the syndrome.
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http://dx.doi.org/10.1111/odi.13116DOI Listing
September 2019

Poly D,L-Lactide-Co-Glycolic Acid Grafting Material in Sinus Lift.

J Craniofac Surg 2019 Jun;30(4):1073-1077

Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

The poly D,L-lactide-co-glycolic acid (PLGA) is a copolymer used in many therapeutic devices for its high rates of biodegradability and biocompatibility. The principal aim of the research was to evaluate the new bone formation, after 16 (T1) and 28 weeks (T2), in sheep maxillary sinus lift in vivo model using PLGA.Computerized tomography analysis, X-ray microanalysis, and scanning electron microscope analysis of secondary electrons (SE) and the backscattered electrons (BSE) of the samples were detected.After 28 weeks, the computed tomography analysis showed a 22% increase of UH density in the grafting areas. The X-ray microanalysis of the samples showed calcium and phosphorus increase at T1 and T2 follow-up period and the carbon and oxygen concentration decrease. The SE evaluation showed a rapid superficial resorption of the biomaterials at T1 and a completely bone reorganization of biomaterial at T2. The BSE analysis confirmed the SE data and showed the direct and intimate contact between bone and PLGA with a higher calcification in T2 compared to T1.Certainly, still other experiments and a larger number of samples will be necessary to be analyzed to determine the behavior of the PLGA in the bone regeneration; however, the PLGA used in maxillary sinus lift animal model, seem to promote new bone formation that continues increase at 28 weeks after grafting.
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http://dx.doi.org/10.1097/SCS.0000000000005067DOI Listing
June 2019

Chronic ulcerative stomatitis: A comprehensive review and proposal for diagnostic criteria.

Oral Dis 2019 Sep 6;25(6):1465-1491. Epub 2019 Jan 6.

Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.

Chronic ulcerative stomatitis (CUS) is an immune-mediated disorder characterized by oral erosions and ulcers usually refractory to conventional treatments. The disease often involves middle-aged and older women with painful lesions sometimes resembling those of erosive oral lichen planus (OLP). The most affected sites are the buccal mucosa, the gingiva and the tongue, but the skin is involved in 22.5% of cases. Histopathologic features in CUS are non-specific and indistinguishable from those of OLP, with the exception of the presence of a mixed infiltrate composed of lymphocytes and plasma cells. Direct immunofluorescence (DIF) analysis reveals the presence of stratified epithelium-specific antinuclear antibodies (SES-ANA) in the lower third of the epithelium. The IgG antibodies detected on DIF are directed against the ∆Np63α isoform of p63 expressed in the nuclei of the epithelial basal cells. A distinguishing feature of CUS is the low response to conventional corticosteroid therapy and the good outcome with hydroxychloroquine at the dosage of 200 mg/day or higher dosages. This paper presents a comprehensive review of CUS and is accompanied by a new case report (the 73rd case) and a proposal for updated diagnostic criteria.
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http://dx.doi.org/10.1111/odi.13001DOI Listing
September 2019

A Giant-Cell Lesion with Cellular Cannibalism in the Mandible: Case Report and Review of Brown Tumors in Hyperparathyroidism.

Case Rep Dent 2017 9;2017:9604570. Epub 2017 Feb 9.

Department of Surgical and Morphological Sciences, University of Insubria, ASST dei Sette Laghi, Unit of Oral Pathology, Dental Clinic, Varese, Italy.

A small radiolucent area in the mandible was discovered in a 58-year-old woman with no oral complaints. The patient's history included only hypertension. The lesion was considered as an inflammatory cyst and was enucleated. Three months later, a CT revealed the presence of a cyst-like lesion in the mandible with thin expanded buccal cortical plate, localized erosion, and a polylobate appearance on the lingual aspect of the cortical plate. The histological diagnosis of the lesion was central giant-cell granuloma (CGCG). The lesion was thoroughly enucleated. Nevertheless, another X-ray carried out six months later revealed multiple bilateral osteolytic areas throughout the jaw. In addition, widespread cortical plate erosion was observed, as well as signs of root resorption and periodontal enlargement. There was no sign of neurological involvement, although the nerves appeared to be dislocated. After full blood chemistry analysis and detailed collection of radiographs, the final diagnosis was brown tumors in primary hyperparathyroidism. This case report demonstrates how dental clinicians may be the first-line specialists who identify a complex systemic disease before other clinicians. Finally, it highlights the role of cellular cannibalism in predicting the clinical aggressiveness of brown tumors as well as in other giant-cell lesions.
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http://dx.doi.org/10.1155/2017/9604570DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5322443PMC
February 2017

[Burning oral sensation: when is really BMS?].

Fogorv Sz 2015 Dec;108(4):137-43

The aims and purposes of this systematic review of the international literature are to discuss and clarify some considerations on Burning Mouth Syndrome (BMS). Over the last 40 years, many researchers have addressed this disease clinically or experimentally. Thus, the etiology and pathogenesis of BMS remain unclear. We analyzed the etiopathogenesis of Burning Mouth Syndrome and of the burning oral sensation and currently, we could not find a consensus on the diagnosis and classification of BMS. Further studies are required to better understand the pathogenesis of BMS, and a "Gold Standard" classification is required because not every burning sensation in the mouth is BMS.
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December 2015

Survival of post-treatment canine-to-canine lingual retainers with fiber-reinforced composite resin: a retrospective study.

Ann Stomatol (Roma) 2014 Jul 20;5(3):81-6. Epub 2014 Nov 20.

Department of Experimental Sciences and Dentistry Specialist Medical-Surgical, University of Messina, Italy.

The aim of the study is to evaluate the long term results of ribbond retainer after orthodontic treatment. One hundred and thirty patients who were orthodontically treated satisfied the inclusion criteria of having received a semipermanent retention were treated with FRC lingual retainers (Ribbond (®)). It was performed a follow up evaluation after 2 years average from the retainer application and any complication or failure was recorded. Data from 119 remaining patients that met the inclusion criteria were analyzed and no instances of loosening were observed. It may be concluded that orthodontic canine-to-canine FRC retainers provide aneffective means of retaining realigned anterior teeth for at least two years.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252858PMC
July 2014

Low basal salivary flow and burning mouth syndrome: new evidence in this enigmatic pathology.

J Oral Pathol Med 2015 Mar 26;44(3):229-33. Epub 2014 Aug 26.

Unit of Oral Pathology and Medicine, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Ospedale Maggiore Policlinico IRCCS Ca'Granda Foundation, Milan, Italy.

Background: Burning mouth syndrome remains a puzzling condition. One symptom commonly associated with the burning sensation is xerostomia. The current study measured basal and stimulated salivary flow in a group of burning mouth syndrome patients.

Methods: Three groups of patients were recruited: 44 burning mouth syndrome patients, 27 oral lichen planus patients and 40 healthy patients. We chose to measure basal salivary flow and stimulated salivary flow in the three groups of patients using the 'spitting' method. Thus, the patients were asked to spit every minute for 5 min. Afterwards, they were asked to repeat the procedure a second time, but a drop of citric acid was positioned on their tongue every minute to stimulate salivary secretion. After 14 days, the same procedure was repeated for 15 min.

Results: Although there was no significant difference between the burning mouth syndrome group and the other two groups regarding the stimulated volumes, an important difference was found in the basal volumes, with the burning mouth syndrome patients showing lower values.

Conclusions: The outcomes of our research demonstrate the presence of very low basal salivary flow in burning mouth syndrome patients compared with the other two groups, but the stimulated salivary flow was equal, if not higher, in the burning mouth syndrome patients. This study contributes new topics for further investigation of a solution to the very mysterious pathology represented by burning mouth syndrome.
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http://dx.doi.org/10.1111/jop.12240DOI Listing
March 2015

An unusual green macular lesion of the gingiva: a foreign-body granulomatous reaction.

Oral Surg Oral Med Oral Pathol Oral Radiol 2014 Jan 7;117(1):e65-9. Epub 2013 Jun 7.

Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy.

The current clinical case highlights the diagnostic process in characterizing an unusual green macular lesion of the maxillary gingiva. A review of the history revealed that the patient had suffered trauma to the oral tissues during a soccer match 2 years prior. An incisional biopsy was performed and microscopic analysis demonstrated the presence of a granulomatous reaction to a needle-shaped, birefringent foreign material. Comparative analysis of a specimen collected from the soccer field confirmed that the foreign material was artificial grass. Foreign material was also found inside the gingival epithelial cells.
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http://dx.doi.org/10.1016/j.oooo.2013.04.003DOI Listing
January 2014

Maxillary sinus augmentation with adult mesenchymal stem cells: a review of the current literature.

Oral Surg Oral Med Oral Pathol Oral Radiol 2013 Jun 10;115(6):717-23. Epub 2013 Jan 10.

Dental School, University of Insubria, Varese, Italy.

Purpose: Mesenchymal stem cells (MSCs) have been applied in maxillary sinus augmentation (MSA) with clinically successful results. The purpose of this article was to evaluate the systematically acquired evidence for the effectiveness of cell-based approaches in MSA with various scaffolds, and to narratively assess evidence from additional articles that report effectiveness of cell-based approaches in MSA.

Materials And Methods: Electronic database searches were performed. Inclusion criteria were studies of cell-based approaches in MSA with various scaffolds, in humans, with at least 3 to 4 months of follow-up. Meta-analysis was performed for randomized controlled trials (RCTs) with histologic/histomorphometric evaluation.

Results: Fifteen studies (4 RCTs) were considered to be eligible for inclusion in the review. The meta-analysis suggested a marginal, nonstatistically significant positive effect of MSCs on the bone regrowth.

Conclusions: A number of studies have demonstrated the potential for cell-based approaches in MSA; further RCTs that clearly demonstrate benefits of cell-based approach are needed.
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http://dx.doi.org/10.1016/j.oooo.2012.09.087DOI Listing
June 2013
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