Publications by authors named "Sergio Caputi"

93 Publications

Mechanical Pull-Out Test of a New Hybrid Fixture-Abutment Connection: An In Vitro Study.

Materials (Basel) 2021 Mar 22;14(6). Epub 2021 Mar 22.

Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy.

Implant abutment connection was described among the main causes of peri-implant bone resorption. The aim of this in vitro study was to test the coupling capacity, the surface modification of a new hybrid connection and the influence of repeated connection activations caused during the main clinical and laboratory phases. A total of 40 implant-abutment screw retained systems with 10°-conical and internal hexagon connection were tested. The connection was screwed, fixed to the universal test machine, removed the screw and a pull-out test was performed. Test was repeated five times in succession. Also Scanning Electron Microscopy (SEM) was used to detect microscopically surface modification. Analysis of variance and Tukey tests were used for the statistical analysis. Pull-out test reveals a mean value of 131.35 ± 16.52 Newton Centimeter (N·cm). For each single activation, results from first to fifth were: 113.9 ± 13.02, 126.1 ± 12.81, 138.11 ± 15.15, 138.8 ± 11.90 and 140 ± 12.99 N·cm. A statistically significant difference between the measurements and an increase in the removal force was shown. The collected data supports the use of this new type of connection, resulting in a very strong interface between implant and abutment. Also, repeated activation of connection can promote a better coupling of the implant-abutment interface.
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http://dx.doi.org/10.3390/ma14061555DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8004755PMC
March 2021

Access to Dental Care-A Survey from Dentists, People with Disabilities and Caregivers.

Int J Environ Res Public Health 2021 02 6;18(4). Epub 2021 Feb 6.

Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy.

The literature highlights differences in the dental conditions of people with disabilities compared with the general population. The aim of this study was to provide an overview of the dental health of people with disabilities in order to understand if their needs are met and to identify their most critical issues as per dentists. A paper and a Google Form platform were used in conducting a survey in Central Italy (the Abruzzo region), by performing an analysis on different points of view as reported by people with disabilities and dentists. The results showed that only 69.2% of dentists treat persons with disabilities. Of these, 73.5% treat less than 10 patients with physical disabilities per year. However, 54% of dentists do not treat people with cognitive impairment and a poor ability to collaborate during treatment. More than 80% of respondent dentists report that people with disabilities do not have good oral hygiene. On the other hand, 49.1% of people with disabilities (or their caregivers in cases where the patient was unable to answer) report that they rarely or never go to the dental office. Moreover, when they do go, it is mainly for emergencies. Despite this, respondents are well aware of their dental problems. However, they have difficulties in communicating their dental problems to their dentist. The 50% of dentists who treat people with cognitive impairment do not include them in follow-up, while only 20% of these patients reported being regularly recalled. This illustrates the importance of the implementation of follow-up. In addition, training courses could help clinicians to reduce this gap and create barrier-free dental offices.
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http://dx.doi.org/10.3390/ijerph18041556DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915372PMC
February 2021

SARS-CoV-2 and Oral Manifestation: An Observational, Human Study.

J Clin Med 2020 Oct 7;9(10). Epub 2020 Oct 7.

Clinica Medica Institute, Department of Medicine and Aging Sciences, University "Gabriele d'Annunzio", Chieti-Pescara, 66100 Chieti, Italy.

The correlation between SARS-CoV-2 and oral manifestations is still controversial. The aim of this observational study was to determine the oral manifestation of the hospitalized patients for COVID-19. A total of 20 patients met the inclusion criteria and gave their signed informed consent. A questionnaire of 32 questions regarding the oral and systemic health condition was administrated to these patients during the convalescence. A descriptive statistic was performed. Data were analysed through the use of χ test, to assess the statistical significance. A statistically significant increase of about 30% of reporting xerostomia during hospitalization was observed ( = 0.02). Meanwhile, a decrease of oral hygiene was observed during the hospitalization, even if a non-statistically significant difference was shown between the two study time points (before and after hospitalization). During the hospitalization period, 25% of patients reported impaired taste, 15% burning sensation, and 20% difficulty in swallowing. An interesting result was that among the systemic conditions, hypertension was observed in 39% of patients and mostly in female patients (62.5%). Further studies are necessary to better understand the symptoms of this new virus in order to faster detect its presence in humans. Probably, a multidisciplinary team following the COVID-19 patients could be of key importance in treating this disease.
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http://dx.doi.org/10.3390/jcm9103218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600761PMC
October 2020

COVID-19 and radiation oncology: the experience of a two-phase plan within a single institution in central Italy.

Radiat Oncol 2020 Sep 29;15(1):226. Epub 2020 Sep 29.

Rector "G. D'Annunzio" University, Chieti, Italy.

Background: COVID-19 in Italy has led to the need to reorganize hospital protocols with a significant risk of interruption to cancer treatment programs. In this report, we will focus on a management model covering the two phases of the COVID-19 emergency, namely lockdown-phase I and post-lockdown-phase II.

Methods: The following steps were taken in the two phases: workload during visits and radiotherapy planning, use of dedicated routes, measures for triage areas, management of suspected and positive COVID-19 cases, personal protective equipment, hospital environments and intra-institutional meetings and tumor board management. Due to the guidelines set out by the Ministry of Health, oncological follow-up visits were interrupted during the lockdown-phase I; consequently, we set about contacting patients by telephone, with laboratory and instrumental exams being viewed via telematics. During the post-lockdown-phase II, the oncological follow-up clinic reopened, with two shifts operating daily.

Results: By comparing our radiotherapy activity from March 9 to May 4 2019 with the same period in 2020 during full phase I of the COVID-19 emergency, similar results were achieved. First radiotherapy visits, Simulation Computed Tomography and Linear Accelerator treatments amounted to 123, 137 and 151 in 2019 compared with 121, 135 and 170 in 2020 respectively. There were no cases of COVID-19 positivity recorded either in patients or in healthcare professionals, who were all negative to the swab tests performed.

Conclusion: During both phases of the COVID-19 emergency, the planned model used in our own experience guaranteed both continuity in radiotherapy treatments whilst neither reducing workload nor interrupting treatment and, as such, it ensured the safety of cancer patients, hospital environments and staff.
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http://dx.doi.org/10.1186/s13014-020-01670-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522911PMC
September 2020

What Happens at a Dental Surgery When the Patient is a Child with Autism Spectrum Disorder? An Italian Study.

J Autism Dev Disord 2020 Sep 3. Epub 2020 Sep 3.

Department of Neuroscience Imaging and Clinical Sciences, University "G. D'Annunzio" Chieti-Pescara, Via dei Vestini 33, 66100, Chieti, CH, Italy.

Oral health care can be a difficult experience for a child with Autism Spectrum Disorder (ASD), for their family and for the dentist. The purpose of this study is to provide an understanding of the challenges experienced by the three aforementioned figures during oral care treatment. A cohort of 275 parents of typical development children (TD), 57 parents of children with ASD (3-15 years old) and by 61 dentists, completed two different multiple choices questionnaires. The data obtained show a great difficulty in the treatment of children with ASD as seen by the dentists and by the parents. This is due to: caregivers' demographic issues; difficulties encountered before and during the dental examination; scarce presence of experts in ASD treatment.
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http://dx.doi.org/10.1007/s10803-020-04684-0DOI Listing
September 2020

Gingival Response to Dental Implant: Comparison Study on the Effects of New Nanopored Laser-Treated vs. Traditional Healing Abutments.

Int J Mol Sci 2020 Aug 22;21(17). Epub 2020 Aug 22.

Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy.

The health of peri-implant soft tissues is important for the long-term success rate of dental implants and the surface topography is pivotal in influencing it. Thus, the aim of this study was to evaluate, in human patients, the inflammatory mucosal microenvironment in the tissue surrounding a new, nanoscale, laser-treated healing abutment characterized by engineered nanopores versus a standard machined-surface. Analyses of anti- and pro-inflammatory markers, cytokeratins, desmosomal proteins and scanning electron microscopy were performed in 30 soft-tissue biopsies retrieved during second-stage surgery. The results demonstrate that the soft tissue surrounding the laser-treated surface was characterized by a lower grade of inflammation than the one facing the machined-surface, which, in turn, showed a disrupted epithelium and altered desmosomes. Moreover, higher adhesion of the epithelial cells on the laser-treated surface was detected compared to the machined one. In conclusion, the laser-treated surface topography seems to play an important role not only in cell adhesion, but also on the inflammatory makers' expression of the soft tissue microenvironment. Thus, from a clinical point of view, the use of this kind of topography may be of crucial importance not only on healing abutments but also on prosthetic ones
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http://dx.doi.org/10.3390/ijms21176056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7504205PMC
August 2020

The Impact of COVID-19 Related Lockdown on Dental Practice in Central Italy-Outcomes of A Survey.

Int J Environ Res Public Health 2020 08 10;17(16). Epub 2020 Aug 10.

Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy.

The COVID-19 pandemic has affected lives and professions worldwide. We aimed to determine the behavior of dentists during the lockdown in Central Italy through an online survey. We demonstrated that the most frequent of urgencies, not otherwise manageable through telemedicine, was dental pulp inflammation. Although a statistically significant increase in the use of some of the personal protective equipment (PPE) from pre to during lockdown was shown, dentists were afraid of being infected during the dental procedures. Moreover, we showed that digital dentistry, telemedicine, use of the rubber dam, distancing of the appointments and further structural changes at the dental office are necessary to reduce the contagion among dentists and patients. No significant differences were shown between gender.
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http://dx.doi.org/10.3390/ijerph17165780DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459991PMC
August 2020

Artificial Saliva in Diabetic Xerostomia (ASDIX): Double Blind Trial of Aldiamed Versus Placebo.

J Clin Med 2020 Jul 11;9(7). Epub 2020 Jul 11.

Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy.

Xerostomia is a symptom frequently present in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM). In the present trial, the activity of an artificial saliva (aldiamed spray) in comparison to a placebo spray were used to evaluate the xerostomia and the saliva antioxidant capacity (SAT). Sixty patients of both genders with T1DM or T2DM were randomized into two groups of 30 subjects each. The experiment was a double-blind study approved by the Ethics Committee of the "G. d'Annunzio University" of Chieti and Pescara. Moreover, measurements of the stimulated saliva flow rate and the ultrasonography of the submandibular and parotid glands were performed at both the study time points. The results demonstrated statistically significant differences between the treatments in terms of the xerostomia average score. Specifically, the values were at baseline and after 30 days 2.9 ± 1.31 and 3.0 ± 1.44 and 1.4 ± 1.48 and 2.4 ± 0.99 for aldiamed spray and the placebo, respectively. Meanwhile, no statistically significant differences were shown between the two groups for the other variables, such as the salivary flow rate, the antioxidant capacity of the saliva, and the ultrasonography of the major salivary glands.
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http://dx.doi.org/10.3390/jcm9072196DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408818PMC
July 2020

Influence of Dentine Pre-Treatment by Sandblasting with Aluminum Oxide in Adhesive Restorations. An In Vitro Study.

Materials (Basel) 2020 Jul 7;13(13). Epub 2020 Jul 7.

Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy.

Dentine pretreatment through sandblasting procedures has been widely studied but no curve test results are currently available. Thus, the aim herein was to in vitro compare the adhesive strength in sandblasted or not samples using a universal testing machine. Thirty -two bovine teeth were divided into two groups, namely test ( = 16 bars), sandblasting with aluminum oxide particles (50 µm) was performed before the adhesion procedures), and control ( = 16 bars), where no sandblasting procedure was performed. A bi-material curve test was used to evaluate the characteristics of the dentine pretreatment in terms of tensile stress and fracture strength. A scanning electron microscope (SEM) was used to analyze the fracture topography in the composite, bonding, dentin, and at the relative interfaces. The results demonstrated a statistically significant difference between the two groups in terms of tensile stress at maximum load showing values of 84.300 ± 51.342 MPa and 35.071 ± 16.609 MPa, respectively for test and control groups ( = 0.033). Moreover, a fracture strength test showed values of 18.543 ± 8.145 MPa for test and 8.186 ± 2.833 MPa for control group ( = 0.008). In conclusion, the sandblasting treatment of the dentine significantly influenced the mechanical resistance of the adhesion in this in vitro study.
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http://dx.doi.org/10.3390/ma13133026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7372407PMC
July 2020

A 4 Year Human, Randomized, Radiographic Study of Scalloped versus Non-Scalloped Cemented Implants.

Materials (Basel) 2020 May 10;13(9). Epub 2020 May 10.

Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy.

Marginal bone loss (MBL) is a key factor in long-term implant success rate. Among the different factors that influence MBL, it is the different implant shoulder designs, such as scalloped or non-scalloped, which have been widely studied on screw retained but not on cemented retained implants. Thus, the aim of the present study was to evaluate the MBL around scalloped and non-scalloped cemented retained dental implants after 4 years of loading, in humans. A total of 15 patients were enrolled in the present study. A radiographic and clinical examination was performed after implant placement (T0) and after 4 years from it (T1). The results demonstrated a differential MBL (T1-T0) of 2.436 ± 1.103 mm and 1.923 ± 1.021 mm, respectively for test (scalloped) and control (non-scalloped) groups with a statistically significant difference between them. On the other hand, no statistically significant differences were found between the groups in terms of prosthetic complication and abutment decementation, whilst ceramic crowns chipping was shown in both groups. In conclusion, the use of a scalloped platform did not provide better results on the maintenance of MBL after 4 years follow-up. In this study, this probably was determined by multiple factors, among which was the subcrestal insertion of scalloped implants.
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http://dx.doi.org/10.3390/ma13092190DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254311PMC
May 2020

Fracture Resistance of Zirconia-Reinforced Lithium Silicate Ceramic Crowns Cemented with Conventional or Adhesive Systems: An In Vitro Study.

Materials (Basel) 2020 04 25;13(9). Epub 2020 Apr 25.

Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy.

In recent years, Zirconia-reinforced Lithium Silicate ceramic (ZLS), combining lithium-silicate and zirconia features, has shown to have excellent mechanical and aesthetic characteristics. Thus, the aim of this study was to compare the fracture strength of ZLS single crowns cemented with two different cementation techniques. Twenty crowns were realised and cemented on teeth replicas achieved from an extracted premolar human tooth. The samples were divided into two groups of 10 specimens each, Glass-ionomeric cement (GIC) group and Self-Adhesive Resin Cement (ARC) group. The mechanical test was performed using a universal testing machine. The specimens were then evaluated with a scanning electron microscope (SEM) to identify for all crowns and related abutments the pattern of fracture after the breaking point. The data obtained were statistically analysed. The mean fracture toughness values and standard deviations (±SD) were 2227 ± 382 N and 3712 ± 319 N respectively for GIC and ARC groups. In fact, -test showed a statistically significant difference between the two groups ( < 0.001). Moreover, the SEM results demonstrated portions of abutments still attached to the crown fragments in the ARC group, whilst these were not present in the GIC group. Within the limitations of this study, these results suggest the use of adhesive cementation for ZLS crowns, which significantly increase the compressive strength of ZLS restorations compared to GIC.
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http://dx.doi.org/10.3390/ma13092012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254201PMC
April 2020

Evaluation of Salivary Cytokines and Vitamin D Levels in Periodontopathic Patients.

Int J Mol Sci 2020 Apr 11;21(8). Epub 2020 Apr 11.

Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy.

Periodontal disease (PD) is an inflammatory condition of the tissues supporting the teeth, which is widespread among the adult population. Evidence shows a relationship between PD and vitamin D levels, which is involved in the regulation of bone metabolism, mineral homeostasis, and inflammatory response. This study aimed to perform a simultaneous evaluation of inflammatory mediators and vitamin D levels in saliva in periodontopathic patients to better understand their role in periodontal disease. In this observational study, clinical periodontal parameter examination was performed for each patient. Moreover, the saliva levels of 25(OH)D, TGFβ, IL-35, IL-17A, and MMP9 were evaluated using an ELISA assay. An increase in TGFβ, IL-35, MMP9, and IL-17A salivary levels and a reduction in 25(OH)D levels were observed in periodontopathic patients with respect to the healthy controls. The present study revealed significant positive correlation between cytokines and highly negative correlation between 25(OH)D and salivary cytokine levels. Further studies are needed to better understand if salivary cytokines and vitamin D evaluation may represent a new approach for detection and prevention of progressive diseases, such as PD.
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http://dx.doi.org/10.3390/ijms21082669DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215766PMC
April 2020

Penetration of Different Impression Materials into Exposed Dentinal Tubules during the Impression Procedure.

Materials (Basel) 2020 Mar 14;13(6). Epub 2020 Mar 14.

Department of Medical Oral and Biotechnological Sciences, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti (CH), Italy.

Adhesive restorations have been shown to guarantee excellent performance and longevity, although this comes with some disadvantages. Among these, the vulnerability of dentine to different agents has been widely evaluated. The aim of this study was to evaluate the possible penetration of impression materials into freshly cut dentine. Dentine from 27 teeth was impressed with polyether (Impregum Penta L) (nine teeth) and with polyvinyl siloxane (Aquasil Ultra LV) (nine teeth). The surface of nine teeth after the impressions were used as the control. Specifically, the extroflections caused by the imprinting of the dentinal tubules on the impression material, the so-called impression tags, were measured. Furthermore, the presence of the material inside the tubules was examined. Scanning electron microscopy analysis showed material tags for all of the experimental groups. The mean lengths (±SD) were 22.6 (±11.0) µm for polyether, 21.8 (±12.8) µm for polyvinyl siloxane and 11.3 (±7.0) µm for the tooth control, with mean diameters (±SD) of 2.8 (±0.5), 2.4 (±0.7) and 3.1 (±0.7) µm, respectively. Fractal analysis showed fractal dimensions of 1.78 (±0.03), 1.77 (±0.03) and 1.71 (±0.03), respectively. These data demonstrated that the impression materials can remain inside the dentinal tubules, which can adversely affect the adhesive procedures.
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http://dx.doi.org/10.3390/ma13061321DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143836PMC
March 2020

AEDG Peptide (Epitalon) Stimulates Gene Expression and Protein Synthesis during Neurogenesis: Possible Epigenetic Mechanism.

Molecules 2020 Jan 30;25(3). Epub 2020 Jan 30.

University "G. d'Annunzio" Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy.

It was shown that AEDG peptide (Ala-Glu-Asp-Gly, Epitalon) regulates the function of the pineal gland, the retina, and the brain. AEDG peptide increases longevity in animals and decreases experimental cancerogenesis. AEDG peptide induces neuronal cell differentiation in retinal and human periodontal ligament stem cells. The aim of the study was to investigate the influence of AEDG peptide on neurogenic differentiation gene expression and protein synthesis in human gingival mesenchymal stem cells, and to suggest the basis for the epigenetic mechanism of this process. AEDG peptide increased the synthesis of neurogenic differentiation markers: Nestin, GAP43, β Tubulin III, Doublecortin in hGMSCs. AEDG peptide increased Nestin, GAP43, β Tubulin III and Doublecortin mRNA expression by 1.6-1.8 times in hGMSCs. Molecular modelling method showed, that AEDG peptide preferably binds with H1/6 and H1/3 histones in His-Pro-Ser-Tyr-Met-Ala-His-Pro-Ala-Arg-Lys and Tyr-Arg-Lys-Thr-Gln sites, which interact with DNA. These results correspond to previous experimental data. AEDG peptide and histones H1/3, H1/6 binding may be one of the mechanisms which provides an increase of Nestin, GAP43, β Tubulin III, and Doublecortin neuronal differentiation gene transcription. AEDG peptide can epigenetically regulate neuronal differentiation gene expression and protein synthesis in human stem cells.
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http://dx.doi.org/10.3390/molecules25030609DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037223PMC
January 2020

Short Peptides Protect Oral Stem Cells from Ageing.

Stem Cell Rev Rep 2020 02;16(1):159-166

Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy.

Primary stem cells, after several cell divisions, enter into a senescence state, that is characterized by alterations to spindle-shape typical morphology. This concern is one of the main problems in the use of human mesenchymal stem cells (hMSCs) in clinical applications which demand cells in large numbers. Short peptides had geroprotective properties and stimulated stem cell differentiation. The aim of the study is to demonstrate the role of AEDG and KED peptides in maintaining oral hMSCs morphology and functions over long-term expansion. 2 types of hMSCs were investigated: human periodontal ligament stem cells (hPLSCs) and human gingival mesenchymal stem cells (hGMSCs). Cells at the 25th passage were divided into 3 groups: 1 - control (without adding peptide), 2 - treated with AEDG peptide, 3 - treated with KED peptide. Cell cultures were analyzed by an immunofluorescence method and RT-PCR on the p16 and p21 senescence markers expression. AEDG peptide decreased p16 and p21 mRNA expression by 1.56-2.44 times in comparison with the control group. KED peptide decreased p16 and p21 mRNA expression by 1.82-3.23 times in comparison with the control group. These results were confirmed by immunofluorescent visualization. AEDG and KED peptides could be used as supplementary substances in a culture medium to delay the expression of senescence markers in long term stem cell cultivation in order to promote the large-scale in vitro expansion necessarily required for stem cell therapy clinical application. The data obtained confirm the geroprotective effect of AEDG and KED peptide, which was shown early in animal and cells models.
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http://dx.doi.org/10.1007/s12015-019-09921-3DOI Listing
February 2020

Avoidance of Interaction between Impression Materials and Tooth Surface Treated for Immediate Dentin Sealing: An In Vitro Study.

Materials (Basel) 2019 Oct 22;12(20). Epub 2019 Oct 22.

Department of Medical Oral and Biotechnological Sciences, University G. d'Annunzio Chieti-Pescara, Via dei Vestini 31, 66100 Chieti (CH), Italy.

Immediate dentin sealing (IDS) is an advantageous approach for realizing adhesive restorations, but it interferes with the polymerization of impression material due to the oxygen-inhibition layer (OIL), which leaves residues of impression material on the teeth. The aim of this study is to identify a clinical surface cleaning protocol after IDS in order to achieve defect-free impressions. Sixty extracted human teeth were cut to expose fresh dentin and the IDS protocol was performed. Samples were divided into six groups where different surface cleaning protocols were made before taking impressions: G1S and G1P groups, IDS and silicone (S) or polyether (P) impressions; G2S and G2P, treatment with prophy paste and impressions; G3S and G3P, final cleaning phase with surfactant agent and impressions. Teeth were evaluated with a scanning electron microscope to identify the areas (expressed in mm) where residual impression material was present. The results demonstrate a reduction of residues in the G2 groups and the total disappearance in G3 groups with statistically significant differences between them. Superficial cleaning protocols with the prophy paste and surfactant agent lead to the elimination of the interaction with impression materials and OIL. These results suggest a safe clinical protocol for obtaining defect-free impressions after IDS.
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http://dx.doi.org/10.3390/ma12203454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829389PMC
October 2019

The Relationship Between Time of Retightening and Preload Loss of Abutment Screws for Two Different Implant Designs: An In Vitro Study.

J Oral Implantol 2020 Feb;46(1):13-17

Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.

The loosening of an abutment screw is one of the most frequent complications in implant-prosthetic rehabilitation, especially for single-crown cemented prostheses. This complication is due to several mechanical factors including type of connection, abutment-screw geometry, settling effects, and cyclical load. The purpose of the present in vitro study was to compare and associate different times of retightening with reductions in preload losses. We evaluated 40 internal hexagon dental implants and 40 external hexagon dental implants, with their related abutment screws. The implants were embedded in acrylic resin in cylindrical polyvinyl chloride tubes (26 mm diameter, 20 mm height). The abutments were fixed to the implants with screws to an initial torque of 35 Ncm using a digital torque meter with decimal precision. Two different types of connection were randomly divided in 4 subgroups of 10 samples each. One subgroup was used as control. The test groups underwent retightening to the same initial torque at increasing times from initial torque application for tightening of the abutment screws, to their retightening at 2 minutes, 5 minutes, and 10 minutes. The retightening time of 2 minutes shows significantly reduced preload loss. Randomized clinical trials are strongly required to provide clinicians with a beneficial standardized protocol of retightening that can be applied in routine clinical practice.
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http://dx.doi.org/10.1563/aaid-joi-D-18-00138DOI Listing
February 2020

A Human Clinical and Histomorphometrical Study on Different Resorbable and Non-Resorbable Bone Substitutes Used in Post-Extractive Sites. Preliminary Results.

Materials (Basel) 2019 Jul 28;12(15). Epub 2019 Jul 28.

Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy.

Background: The healing of sockets following teeth extraction results in a marked reduction of the height and width of the ridge. This in vivo study aims to assess and compare the efficacy of calcium sulphate (CS) and sintered nano-hydroxyapatite (NHA) in postextraction sockets.

Materials And Methods: 10 subjects were enrolled for single or multiple tooth extraction and implant placement. Each site was randomly assigned to one of four groups and filled with CS, NHA, a combination of CS and NHA, or left to normal healing. After five months tissue samples were harvested from the extraction sites and prepared for histological investigations.

Results: Histomorphometric analysis showed that the average percentages of vital bone was 13.56% ± 13.08% for CS, 17.84% ± 7.32% for NHA, 58.72% ± 8.77% for CS + NHA%, and 80.68% ± 21.8% for the controls; for the connective tissue the results were 33.25% ± 35.75% for CS, 55.88% ± 21.86% for NHA, 17.34% ± 8.51% for CS + NHA, and 22.62% ± 0.52% for the controls; for residual biomaterial the results were 0.56% ± 0.52% for CS group, 21.97% ± 0.79% for NHA, and 47.54% ± 20.13% for CS + NHA. : Both biomaterials led to bone tissue formation after five months of healing. The combination of the biomaterials presented a better behavior when compared to the individual application.
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http://dx.doi.org/10.3390/ma12152408DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695925PMC
July 2019

Human Gingival Fibroblasts Exposed to Extremely Low-Frequency Electromagnetic Fields: In Vitro Model of Wound-Healing Improvement.

Int J Mol Sci 2019 Apr 29;20(9). Epub 2019 Apr 29.

Department of Medical, Oral and Biotechnological Science, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy.

Several clinical studies have suggested the impact of sinusoidal and pulsed electromagnetic fields in quickening wound repair processes and tissue regeneration. The clinical use of extremely low-frequency electromagnetic fields could represent a novel frontier in tissue repair and oral health, with an interesting clinical perspective. The present study aimed to evaluate the effect of an extremely low-frequency sinusoidal electromagnetic field (SEMF) and an extremely low-frequency pulsed electromagnetic field (PEMF) with flux densities of 1 mT on a model of oral healing process using gingival fibroblasts. An in vitro mechanical injury was produced to evaluate wound healing, migration, viability, metabolism, and the expression of selected cytokines and protease genes in fibroblasts exposed to or not exposed to the SEMF and the PEMF. Interleukin 6 (IL-6), transforming growth factor beta 1 (TGF-β), metalloproteinase 2 (MMP-2), monocyte chemoattractant protein 1 (MCP-1), inducible nitric oxide synthase (iNOS), and heme oxygenase 1 (HO-1) are involved in wound healing and tissue regeneration, favoring fibroblast proliferation, chemotaxis, and activation. Our results show that the exposure to each type of electromagnetic field increases the early expression of IL-6, TGF-β, and iNOS, driving a shift from an inflammatory to a proliferative phase of wound repair. Additionally, a later induction of MMP-2, MCP-1, and HO-1 was observed after electromagnetic field exposure, which quickened the wound-healing process. Moreover, electromagnetic field exposure influenced the proliferation, migration, and metabolism of human gingival fibroblasts compared to sham-exposed cells. This study suggests that exposure to SEMF and PEMF could be an interesting new non-invasive treatment option for wound healing. However, additional studies are needed to elucidate the best exposure conditions to provide the desired in vivo treatment efficacy.
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http://dx.doi.org/10.3390/ijms20092108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6540598PMC
April 2019

Periodontal Ligament Stem Cells: Current Knowledge and Future Perspectives.

Stem Cells Dev 2019 08 20;28(15):995-1003. Epub 2019 May 20.

1Department of Medical, Oral and Biotechnological Sciences and Stem Tech Group, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy.

Teeth represent a fascinating area of study in regenerative medicine, because of their unique and complex developmental origin. Several types of mesenchymal stem cells (MSCs) have been characterized in the oral cavity, and those derived from the periodontal ligament (PDL) first isolated by our group in 2005, can be expanded in a xeno-free medium preserving morphological features and markers associated with pluripotency. These postnatal MSCs can be easily recovered by noninvasive procedures and cultured. This could facilitate the use of adult stem cells in human clinical regeneration therapy. In this review we summarize the results of our studies describing morphofunctional features, surface markers, and multilineage differentiation capacity in vitro of PDL MSCs obtained in our laboratories. In vivo characterization of PDL stem cell (PDLSC) location and heterogeneity are still lacking. However, we describe studies exploring the potential use of PDLSC to treat both periodontal diseases and regeneration of other tissues. These MSCs may have an advantage in possessing also angiogenetic, immunoregulatory, and anti-inflammatory properties. The secretome of such cells contains several interesting molecules mimicking the effects of the producer cells. We describe some recent studies from our group on the use of conditioned medium from PDL MSCs, and purified extracellular vesicles therein contained, in animal models of experimental autoimmune encephalomyelitis and their potential application to human disease.
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http://dx.doi.org/10.1089/scd.2019.0025DOI Listing
August 2019

Effect of short peptides on neuronal differentiation of stem cells.

Int J Immunopathol Pharmacol 2019 Jan-Dec;33:2058738419828613

2 Department of Biogerontology, Saint Petersburg Institute of Bioregulation and Gerontology, Saint Petersburg, Russia.

It has been demonstrated that short peptides play an important role in the transmission of biological information, modulation of transcription, and restoring genetically conditioned alterations occurring with age. Peptidergic regulation of homeostasis occupies an important place in physiological processes, which lead to the aging of cells, tissues, and organs, consisting in the involution of major regulatory systems-the nervous, the endocrine, and the immune. The effect of AED (Ala-Glu-Asp), KED (Lys-Glu-Asp), KE (Lys-Glu), AEDG (Ala-Glu-Asp-Gly) peptides and their compound on neuronal differentiation of human periodontal ligament stem cells (hPDLSCs) was studied by immunofluorescence and western blot analysis. Growth-Associated Protein 43 (GAP43), which implements neurotransmission mechanisms and neuroplasticity, demonstrated an increased expression in hPDLSCs cultured with a compound of all studied peptides and with KED alone. The peptide compound and KED, increase the expression of Nestin (neurofilament protein), expressed in early neuronal precursors in hPDLSCs cultures. Thus, the compound of peptides AEDG, KE, AED, and KED could promote the neuronal differentiation of hPDLSCs and be a promising tool for the study of peptides as a modulator of neurogenesis in neurodegenerative diseases studied in animal models.
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http://dx.doi.org/10.1177/2058738419828613DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376556PMC
June 2019

Comparison of a Novel Ultrasonic Scaler Tip vs. Conventional Design on a Titanium Surface.

Materials (Basel) 2018 Nov 22;11(12). Epub 2018 Nov 22.

Department of Medical Oral and Biotechnological Sciences, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti (CH), Italy.

The aim of this in vitro study was to evaluate the alterations of a titanium surface after treatment with two different types of ultrasonic tips: conventional steel versus an innovative copper alloy silver-plated one. Twenty smooth-surface, grade IV unalloyed titanium discs were divided into two groups. The discs were ultrasonically instrumented and the scaler was connected with a loading machine. The surface morphology was examined using scanning electron microscopy (SEM) and fractal analysis of lacunarity was calculated to highlight the alteration of the surface using the two different tips. The SEM analysis showed different degrees of surface roughness between the two types of scaler tips. Moreover, these observations demonstrated that the new tip showed fewer irregularities on the disc's surface than the conventional steel tip. The statistical and fractal analysis showed a statistically significant difference between the two groups. Surface alterations of titanium induced by the conventional ultrasonic tips were much greater than those made by copper alloy silver plated tips. The presented results suggest that the use of this new ultrasonic tip may reduce the alterations on the implant surface during its use in dental practice.
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http://dx.doi.org/10.3390/ma11122345DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6316870PMC
November 2018

Peri-Implant Bone Resorption during Healing Abutment Placement: The Effect of a 0.20% Chlorhexidine Gel vs. Placebo-A Randomized Double Blind Controlled Human Study.

Biomed Res Int 2018 16;2018:5326340. Epub 2018 Oct 16.

University G. d'Annunzio Chieti-Pescara, Department of Medical Oral and Biotechnological Sciences, Via dei Vestini 31, 66100 Chieti (CH), Italy.

Introduction: Peri-implant marginal bone loss (MBL) seems to be more pronounced in the first year of loading despite all the studies and changes implemented to reduce it. Among the different causes, the presence of a microgap makes the interface between fixture and abutment colonizable by bacteria, causing an inflammatory response and consequent bone resorption. To reduce this several local antiseptics like chlorhexidine digluconate (CHX) were used after surgical procedures.

Aim: The objective was to radiologically compare the MBL when a 0.20% CHX gel or a placebo gel was applied to the implant-abutment interface during all surgical and prosthetic phases and for a follow-up period up to 12 months.

Method: 32 patients (16 for each Group A and B) were enrolled and rehabilitated with a single implant (Cortex classic, Cortex, Shalomi, Israel). During each of the clinical stages a gel containing 0.20% CHX (Plak ®Gel; Polifarma Wellness Srl, Rome, Italy) or a placebo gel (Placebo, Polifarma Wellness Srl, Rome, Italy) was used as indicated by the randomization chart. In order to compare radiographic modification intraoral radiographs was taken. Also, clinical data regarding implant or prosthetic failure and gingival index were recorded. Data were presented as means and standard deviations (SD) and used for the statistical analysis.

Results: All implants showed no bleeding on probing and a very small plaque score at the 1 year of follow-up. MBL was statistically significantly different between the groups in every stage.

Conclusion: Results obtained showed that the use of CHX gel inside the connection significantly reduces MBL during the first year. A rigid disinfection protocol with 0.20% CHX from the time of implant insertion to crown delivery is recommended to reduce host inflammatory response and consequently MBL. This trial is registered with ClinicalTrials.gov Identifier: (Registration Number: NCT03431766).
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http://dx.doi.org/10.1155/2018/5326340DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206572PMC
February 2019

Three-dimensional printed PLA scaffold and human gingival stem cell-derived extracellular vesicles: a new tool for bone defect repair.

Stem Cell Res Ther 2018 04 13;9(1):104. Epub 2018 Apr 13.

Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio", Via dei Vestini, 66100, Chieti, Italy.

Background: The role of bone tissue engineering in the field of regenerative medicine has been a main research topic over the past few years. There has been much interest in the use of three-dimensional (3D) engineered scaffolds (PLA) complexed with human gingival mesenchymal stem cells (hGMSCs) as a new therapeutic strategy to improve bone tissue regeneration. These devices can mimic a more favorable endogenous microenvironment for cells in vivo by providing 3D substrates which are able to support cell survival, proliferation and differentiation. The present study evaluated the in vitro and in vivo capability of bone defect regeneration of 3D PLA, hGMSCs, extracellular vesicles (EVs), or polyethyleneimine (PEI)-engineered EVs (PEI-EVs) in the following experimental groups: 3D-PLA, 3D-PLA + hGMSCs, 3D-PLA + EVs, 3D-PLA + EVs + hGMSCs, 3D-PLA + PEI-EVs, 3D-PLA + PEI-EVs + hGMSCs.

Methods: The structural parameters of the scaffold were evaluated using both scanning electron microscopy and nondestructive microcomputed tomography. Nanotopographic surface features were investigated by means of atomic force microscopy. Scaffolds showed a statistically significant mass loss along the 112-day evaluation.

Results: Our in vitro results revealed that both 3D-PLA + EVs + hGMSCs and 3D-PLA + PEI-EVs + hGMSCs showed no cytotoxicity. However, 3D-PLA + PEI-EVs + hGMSCs exhibited greater osteogenic inductivity as revealed by morphological evaluation and transcriptomic analysis performed by next-generation sequencing (NGS). In addition, in vivo results showed that 3D-PLA + PEI-EVs + hGMSCs and 3D-PLA + PEI-EVs scaffolds implanted in rats subjected to cortical calvaria bone tissue damage were able to improve bone healing by showing better osteogenic properties. These results were supported also by computed tomography evaluation that revealed the repair of bone calvaria damage.

Conclusion: The re-establishing of the integrity of the bone lesions could be a promising strategy in the treatment of accidental or surgery trauma, especially for cranial bones.
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http://dx.doi.org/10.1186/s13287-018-0850-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5899396PMC
April 2018

Endothelial committed oral stem cells as modelling in the relationship between periodontal and cardiovascular disease.

J Cell Physiol 2018 10 30;233(10):6734-6747. Epub 2018 Mar 30.

Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio", Chieti and Pescara, Chieti, Italy.

In the present study we have mimicked, in vitro, an inflammatory process using Lipopolysaccharide derived from Porphyromonas Gingivalis (LPS-G) and human Periodontal Ligament Stem Cells induced to endothelial differentiation (e-hPDLSCs). The research project has been organized into the three following steps: i) induction of hPDLSCs toward endothelial differentiation; ii) evaluation of the molecular signaling pathway involved in the response to the LPS-G, and iii) functional response evaluation of the living construct constituted by porcine decellularized valve/e-hPDLSCs treated with LPS-G. Obtained results showed that 5 μg/ml LPS-G stimulus provokes: a slowdown of cell growth starting from 24 hr and the release of IL6, IL8, and MCP1 molecules. Signaling network analyzed showed the activation of TLR4/ NFkB/ERK1/2/p-ERK1/2 signaling mediated by MyD88 in LPS-G stimulated e-hPDLSCs, moreover a time course put in evidence a nuclear traslocation of ERK1/2 and p-ERK1/2 in differentiated samples. Following, the ability of e-hPDLSCs to expand and colonize the decellularized porcine heart valves was appraised at ultrastructural level. Considering that, the Reactive Oxygen Species (ROS) play an important role in the progression and development of cardiovascular disease (CVD), in LPS-G living construct model e-hPDLSCs/decellularized porcine heart valves (dPHV), ROS production was assessed. Time lapse experiments evidenced that LPS-G provokes in e-hPDLSCs a rapid and sustained increase in ROS generation, negligible on undifferentiated cells. From obtained data, by multiparametric analyses, a reasonable conclusion may be that the inflammation process activated by LPS-G can affect endothelial cells and could represent in vivo a possible pathological and predictor state of CVD.
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http://dx.doi.org/10.1002/jcp.26515DOI Listing
October 2018

Evaluation of Fibrin Clot Attachment on Titanium Laser-Conditioned Surface Using Scanning Electron Microscopy.

J Craniofac Surg 2018 Nov;29(8):2277-2281

Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT University "G D'Annunzio" of Chieti-Pescara, Chieti, Italy.

Objectives: The study aimed to evaluate the effects of different titanium surface treatments on blood clot extension (bce).

Methods: A total of 54 titanium disks with machined surface (M), laser-conditioned surface (L), and grit-blasted surface (S) were used in the present study. The surface characteristics such as contact angles and the microroughness were determined on each group (n = 4). To evaluate the bce, 0.1 mL of human blood was dropped onto the surface of each specimen and left for 7 minutes at room temperature. After fixation, dehydration, and gold sputtering treatments, the specimens were observed under scanning electron microscope. The bce values were expressed as percentage of specimen surface covered by blood clot.

Results: The surface roughness (Ra ± standard deviation [SD]) was 0.75 ± 0.02 μm for M, 0.25 ± 0.02 μm for L, and 1.30 ± 0.03 μm for S. The contact angles measured in static conditions (WCA ± SD) were 71 ± 5.4° for M, 107 ± 6.6° for L, and 91 ± 7.2° for S. Regarding the bce (bce ± SD) of M samples (65.5 ± 4.3%) was statistically lower compared with both L (83.4 ± 5.1%) and S samples (72.4 ± 4.7%) (P < 0.05). Meanwhile, the L group showed the higher bce value.

Conclusion: The present results suggest that the laser-conditioned surface may increase the wettability and bce.
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http://dx.doi.org/10.1097/SCS.0000000000004519DOI Listing
November 2018

MyD88/ERK/NFkB pathways and pro-inflammatory cytokines release in periodontal ligament stem cells stimulated by Porphyromonas gingivalis.

Eur J Histochem 2017 May 24;61(2):2791. Epub 2017 May 24.

University "G. d'Annunzio" Chieti-Pescara, Department of Medical, Oral and Biotechnological Sciences.

The present study was aimed at investigating whether human Periodontal Ligament Stem Cells (hPDLSCs) were capable of sensing and reacting to lipopolysaccharide from Porphyromonas gingivalis (LPS-G) which is widely recognized as a major pathogen in the development and progression of periodontitis. At this purpose hPDLCs were stimulated with 5 μg/mL LPS-G various times and the expression of toll-like receptor 4 (TLR4) was evaluated. Toll-like receptors (TLRs) play an essential role in innate immune signaling in response to microbial infections, and in particular TLR4, type-I transmembrane proteins, has been shown recognizing LPS-G. Our results put in evidence, in treated samples, an overexpression of TLR4 indicating that, hPDLSCs express a functional TLR4 receptor. In addition, LPS-G challenge induces a significant cell growth decrease starting from 24 h until 72 h of treatment. LPS-G leads the activation of the TLR4/MyD88 complex, triggering the secretion of proinflammatory cytokines cascade as: IL-1α, IL-8, TNF-α and β and EOTAXIN. Moreover, the upregulation of pERK/ERK signaling pathways and NFkB nuclear translocation was evident. On the basis of these observations, we conclude that hPDLSCs could represent an appropriate stem cells niche modeling leading to understand and evaluate the biological mechanisms of periodontal stem cells in response to LPS-G, mimicking in vitro an inflammatory process occurring in vivo in periodontal disease.
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http://dx.doi.org/10.4081/ejh.2017.2791DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452629PMC
May 2017

Stemness Maintenance Properties in Human Oral Stem Cells after Long-Term Passage.

Stem Cells Int 2017 2;2017:5651287. Epub 2017 Apr 2.

Stem Cells and Regenerative Medicine Laboratory, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio", Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.

. Neural crest-derived mesenchymal stem cells (MSCs) from human oral tissues possess immunomodulatory and regenerative properties and are emerging as a potential therapeutic tool to treat diverse diseases, such as multiple sclerosis, myocardial infarction, and connective tissue damages. In addition to cell-surface antigens, dental MSCs express embryonic stem cell markers as neural crest cells originate from the ectoderm layer. In vitro passages may eventually modify these embryonic marker expressions and other stemness properties, including proliferation. In the present study, we have investigated the expression of proteins involved in cell proliferation/senescence and embryonic stem cell markers during early (passage 2) and late passages (passage 15) in MSCs obtained from human gingiva, periodontal, and dental pulp tissues. . Cell proliferation assay, beta galactosidase staining, immunocytochemistry, and real-time PCR techniques were applied. . Cell proliferation assay showed no difference between early and late passages while senescence markers p16 and p21 were considerably increased in late passage. Embryonic stem cell markers including SKIL, MEIS1, and JARID2 were differentially modulated between P2 and P15 cells. . Our results suggest that the presence of embryonic and proliferation markers even in late passage may potentially endorse the application of dental-derived MSCs in stem cell therapy-based clinical trials.
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http://dx.doi.org/10.1155/2017/5651287DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392399PMC
April 2017

Cone beam computed tomography for dental and maxillofacial imaging: technique improvement and low-dose protocols.

Radiol Med 2017 Aug 1;122(8):581-588. Epub 2017 Apr 1.

Department of Radiology, University of Foggia, Viale Luigi Pinto 1, 71100, Foggia, Italy.

Objective: The aim of this study was to evaluate images quality and radiation doses of Cone Beam Computed Tomography (CBCT) for dental and maxillofacial imaging testing five different acquisition protocols.

Methods: Dose measurements of different acquisition protocols were calculated for Pax Zenith three-dimensional (3D) Cone Beam (Vatech, Korea) and for conventional orthopantomography (OPT) and cephalometric skull imaging Ortophos (Sirona Dental Systems, Bernsheim, Germany). The absorbed organ doses were measured using an anthropomorphic phantom loaded with thermoluminescent dosimeters at 58 sites related to sensitive organs. Five different CBCT protocols were evaluated for image quality and radiation doses. They differed in FOV, image resolution, kVp, mA, acquisition time in seconds and radiation dose. Measurements were then carried out with the orthopantomograph. Equivalent and effective doses were calculated.

Results: The reference protocol with large FOV, high resolution quality images, 95 kVp, 5 mA and acquisition time of 24 s resulted in a DAP value of 1556 mGy cm instead the protocol with reduced kVp from 95 to 80 kVp translated into a value of DAP inferior to 35% (from 1556 to 1013 mGy cm). Going from a high resolution to a normal resolution, there was a reduction of the acquisition time to 15 s which allowed further dose reduction of approximately 40% (628 mGy cm); this protocol resulted in a value of effective dose of 35 microSievert (μSv). Moreover, the effect of changing FOV has been evaluated, considering two scans with a reduced FOV (160 × 140  and 120 × 90 mm, respectively).

Conclusions: CBCT low-dose protocol with large FOV, normal resolution quality images, 80 kVp, 5 mA and acquisition time of 15 s resulted in a value of effective dose of 35 microSievert (μSv). This protocol allows the study of maxillofacial region with high quality of images and a very low radiation dose and, therefore, could be proposed in selected case where a complete assessment of dental and maxillofacial region is useful for treatment planning.
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http://dx.doi.org/10.1007/s11547-017-0758-2DOI Listing
August 2017

Impact of Second Stage Surgery on Bone Remodeling Around New Hybrid Titanium Implants: A Prospective Clinical Study in Humans.

Implant Dent 2017 Feb;26(1):121-128

*Senior Researcher, Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University Chieti-Pescara, Chieti, Italy. †Fellow Research, Biomaterial Clinical and Histological Research Association, Pescara, Italy. ‡Fellow Research, Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University Chieti-Pescara, Chieti, Italy. §Scientific Director, Biomaterial Clinical and Histological Research Association, Pescara, Italy. ¶Dean, Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University Chieti-Pescara, Chieti, Italy.

Objective: The present prospective study aimed to more precisely identify the time points of bone changes around hybrid titanium implants up to 30 months of follow-up.

Materials And Methods: Twelve hybrid T3 implants (Biomet 3i) were placed in 9 healthy patients with the 2-stage surgical approach. Standardized digital Rx were taken at implant insertion (T0); healing-abutment connection after 3.1 ± 0.2 weeks (TX); loading stage after 7.5 ± 0.6 weeks (T1); after 12 months (T2); and after 30 months (T3) of functional loading. The marginal bone loss was digitally measured.

Results: The mean marginal bone loss was 0.76 ± 0.37 mm after 30 months. More than 60% (0.42 ± 0.29 mm) of the bone loss took place at healing-abutment connection (TX-T1). No statistically significant bone loss was found between T1-T2 and T2-T3, after 12 and 30 months, respectively. Approximately 40% of bone loss (0.34 mm) was noted between T1 and T3 (P < 0.05), which corresponds to the loading period.

Conclusions: The implant-oral environment connection represents a critical step point in crestal bone loss. The amount of marginal bone loss, measured after 30 months of loading (T1-T3), was much less than that reported in the literature, showing that correct loading has a minor impact on the periimplant bone remodeling as compared to surgical implant reopening.
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http://dx.doi.org/10.1097/ID.0000000000000525DOI Listing
February 2017