Solidarizzazione elettronica su impianti a carico immediato: un caso clinico in chirurgia flapless

Objectives

The author presents a case of rehabilitation using flapless surgery, immediate-load implants, and electronic soldering of the implants as a support for implant osseointegration.

Materials and methods

The surgical and prosthetic techniques are described along with the method used for implant soldering. Implants were inserted and the interim prostheses manufactured on the same day; the procedures lasted about 1 hour.

Results

There were no complications, and all implant were intact at the 18-month follow-up visit. The patient maintains good oral hygiene and is satisfied with the functional and esthetic results of the intervention. There is no radiological evidence of peri-implant bone loss.

Conclusions

In the case described here, this technique proved to be an effective aid for immediately loaded implant osseointegration.     

Implantologia a carico immediato con impianti postestrattivi root-form e contestuale rigenerazione ossea: caso clinico

ObjectivesIn this study, the immediate placement and loading of a fixed bridge implant supported prosthesis is described and discussed in view of the recent advancements in understanding immediate loading techniques and factors affecting their success.Materials and methodsA patient showing residual dental elements all compromised was treated by placing six rootform implants in the extraction sockets located in the upper jaw and by grafting the implant-bone gaps with an equine bone substitute. On the following day the final prosthesis was delivered.ResultsFollow-up controls showed that soft and hard tissue levels were maintained up to 24 months after surgery.ConclusionsThe adopted surgical strategy allowed for primary stability, implant osseointegration and therefore clinical success.     

Il ruolo dei probiotici nella prevenzione delle pigmentazioni del cavo orale

Objectives

The purpose of this study is to verify the efficacy of a probiotic product in the selection of the oral flora and to ascertain if chromogenic bacteria could be eliminated through professional oral hygiene procedures in combination with chlorhexidine.

Materials and Methods

The study is a randomized controlled clinical trial. Ten patients aged between 25 and 35 years were examined (5 males and 5 females).They presented extrinsic pigmentations with a black line presumably to be ascribed to chromogenic bacteria.

Results and Conclusions

The results obtained by splitting the sample into two groups are presented.Probiotics are efficient when combined with a correct professional and home care protocol of oral hygiene.It is assumed, however, that the effect of the probiotic persists until it is administered and wanes when the administration is suspended.     

Le alterazioni del cavo orale negli utenti in carico ai servizi di assistenza domiciliare: un’indagine di prevalenza

Objective

The purpose of this study is to estimate the prevalence of oral mucosal disorders and mouth hygienic conditions of the users in charge of home care services to a Tuscan Health Company.

Materials and methods

Four hundred eight users were included, their mouth has been observed and an oral interview has been performed. Patients were observed by home care nurses, because there is no dental hygienist in home care services. Home care nurses were trained by a dentist, who thought them how to reveal signs of oral mucosal disorders. They were equipped with a LEAD torch, which facilitated the observation.

Results

Twenty-one percent of the patients had inflammatory lesions localized to the oral mucosa and 3.3% had lesions of uncertain nature. 17.6% presented alterations related to teeth. Almost half of the patients had low levels of oral hygiene.

Conclusions

The data of prevalence of oral alterations suggest the need to increase the awareness of health professions about oral care and the need of specific services in mouth hygiene in home care.     

Trauma a carico degli incisivi superiori. Caso clinico

Objectives

The aim of this case report is to illustrate the importance of clinical and radiographic examinations for a correct diagnosis and treatment of dental trauma.

Material and methods

A 27-year-old woman in good health conditions presented to the Emergency Department of the Dental Department of the University of Milan with trauma to the superior maxilla related to a bicycle accident. The clinical examination revealed mobility, extrusive dislocation and uncomplicated crown fracture of the right central upper incisor. A small fracture was also noted in the left upper central incisor, but it was not associated with mobility. The lips presented lacerations and contusions. Endoral X-rays were obtained in the Emergency Department, and the injured incisor was subjected to splinting with an orthodontic wire and temporary reconstruction. After clinical examination, low-dose cone-beam computed tomography was done to exclude the possibility of maxillary fracture.

Results

In the presence of dental trauma, it is important to recall that tooth fragments may be present in the lip or in other soft tissues, giving rise to a foreign body granuloma.

Conclusions

Scrupulous clinical examination of soft tissues is imperative to detect dental fragments or foreign bodies.     

Un ausilio all'igiene orale in pazienti diversamente abili

Objectives

The aim of the study is to prove that the use of a disposable gauze imbued with chlorhexidine 0.12% is a helpful aid to traditional oral hygiene procedures in disabled patients.

Materials and methods

The ability of disabled people during oral hygiene procedures was evaluated with a questionnaire. The patients were given instructions on how to use the gauze for their daily oral hygiene. It was also used a teaching aid set formed by an information brochure and a plastic model of the oral cavity. After 45 days their questionnaire was filled out to evaluate the improvement of oral hygiene performance.

Results

The use of a gauze in addition to correct dental hygiene procedures turned out to be an excellent way to improve the performance of dental hygiene procedures.

Conclusions

The results have shown the need to divulge the basis of dental prevention procedures within rehabilitation facilities.     

Prevenzione e igiene orale in pazienti in terapia ortodontico-chirurgica

Objectives

The aim of this work consists in presenting the results obtained from a qualitative and quantitative analysis of bacterial plaque in patients in orthodontic surgical treatment.

Materials and methods

Seventy-five patients of both sexes (aged 21–41 years) were studied. Samples of plaque were obtained from lingual surfaces of tooth 46 at the first appointment (T1), the day before surgical intervention (T2), during intermaxillary fixation (T3), at the removal of the orthodontic appliance (T4) and after one year from the removal of the fixed appliance (T5). Samples of plaque were evaluated quantitatively and qualitatively, analysing plaque index, total coccoid and bacillary forms and Gram positive and Gram negative forms for each sample.

Results

A slight decrease of the plaque index and total bacillary and coccoid forms between the first sample (T1) and the one taken the day before surgical intervention (T2) was recognised. During intermaxillary fixation (T3), a slight increase of the plaque index was evidenced. Between T3 and T4 another reduction of the plaque index (that reached 8%) was noticed. The plaque index was lower in T4 (8%) than in T2 (14%). From the fourth to the fifth sampling, performed after a year, there was a further general improvement of the plaque index: indeed, in 51 patients out of 75 (68%) the plaque index decreased, while in 24 patients there was a slight increase that did not exceed 10% compared with the previous sampling.

Conclusions

Patients in orthodontic surgical treatment, after a proper training, show a significant reduction of bacterial plaque between the first appointment and the following ones. Bacterial forms diminish. Also during intermaxillary fixation, when mechanical plaque control is compromised, it is possible to plan a plaque control through mouthwashes containing hydrolitic enzymes with destranasic activity.     

Fumo,alcol e salute orale

Objectives

Cigarette smoking, the second cause of death worldwide, and alcohol abuse, a leading cause of mortality and morbidity, are major risk factors for oral diseases. The aim of this paper is to present the effects of cigarette smoking and alcohol abuse on oral health. Specific strategies are also proposed to develop smoking cessation interventions in the office practice of dentists and dental hygienists providing.

Materials and methods

Original papers, reviews and guidelines on this subject, published in English and in Italian from 2006 to the first trimester of 2013, were located in the Medline/Pubmed database. Additional publications were obtained by searching the reference list of retrieved works.

Results and conclusions

Cigarette smoking is the most important risk factor for oral squamous cell carcinoma and potentially malignant oral lesions; alcohol abuse increases oral cancer risk in a synergistic fashion. Moreover, cigarette smoking is the second risk factor for chronic periodontitis, after dental plaque, whereas further studies are needed to assess the role of alcohol consumption on onset and progression of chronic periodontitis. The “Five A's” approach represents an effective protocol for smoking cessation that members of dental team can use with all smoker patients. The patients attempting to quit should use the nicotine replacement therapy, sustained-release bupropion or varenicline in order to significantly increase success rate of quit attempt.     

Alterazioni del cavo orale e strategie preventodontiche in menopausa

Objectives

The aim of this work is to evaluate the effects of menopause on oral health, the most frequent problems and prevention strategies feasible in this particular category of patients.

Materials and methods

A survey was conducted in the electronic database of Medline, using specific inclusion and exclusion criteria, and the following keywords “oral health and menopause”. Some interesting texts for this research were selected among the found articles. Some articles published in not indexed journals were added and some considerations were drawn from related texts.

Results and conclusions

The menopause is a time of great hormonal changes and periodontal tissue is particularly sensitive to it. Some clinical features showed up most frequently in this group of patients: desquamative gingivitis, stomatopirosis, xerostomy, gingivitis and periodontal diseases in general. A strict prevention of all forms of periodontal disease should be implemented to minimize the risk of teeth loss or the onset of infectious and inflammatory issues against gums and oral mucosa.     

La salute del cavo orale nel bambino in sovrappeso

Objectives

To evaluate food habits and oral care level of eleven and twelve years old students with the purpose of preventing obesity and oral diseases. The role of Dental Hygienists in the prevention of such problems was examined as well.

Materials and methods

A questionnaire was distributed to a sample of 90 secondary school students (41 males and 49 females).

Results

The answers point out that some improper food habits are particularly common, such as the excessive consumption of sweets and fizzy drinks, and the low consumption of fruit and vegetables.

Conclusions

Since not all children have a good oral care and follow a correct diet, the role of Dental Hygienists is paramount.     

Prevenzione orale in alunni del primo anno della scuola primaria

Objectives

To evaluate the oral health of children enrolled in the first grade of a primary school in L’Aquila (Italy) during the years 2008-2009 and 2009-2010 and to provide them with free-of-charge dental care.

Materials and methods

The study included 105 children, aged 6 ± 1 years (64 males and 41 females). Each child had a dental examination that included (as needed) the application of a plaque revealer, plaque and tartar removal, the application of fluoride, saliva testing, and sealing of fissures. Children were also educated about the importance of oral hygiene.

Results

In 2009, 74 of the 105 pupils enrolled (42 males and 32 females) received treatment, consisting in the application of a plaque revealer (n = 49), tartar and pigment removal (n = 47), application of fluoride gel (n = 42), fissure sealing (n = 36), measurement of salivary pH (n = 66), and salivary bacterial counts (n = 63). In 2010, 36 of the children were retreated. During the first year of the study, the difference between the numbers of enrolled and treated children was linked to the poor cooperation of families; during the second year, the difference was related to logistic and strategic difficulties caused by the earthquake that struck the region on April 6, 2009. The results showed a decrease in the dental plaque index from 58% (2009) to 31% (2010). In addition, the 2009 examination (total no. of children = 74) revealed two filled permanent teeth and 12 permanent teeth that were decayed; in 2010, in 36 children, there were two filled permanent teeth and 9 with caries. In 2010, sealants were reapplied in five cases.

Conclusion

The Dental Department of the University of L’Aquila plans to extend this study to other schools in the same geographic area to decrease the incidence of the most frequent oral diseases, thereby warranting children's right to good health.     

Il trattamento chirurgico delle III Classi

Objectives

Aim of the study is to identify the basic criteria to choose a surgical treatment for Class III malocclusions together with the fundamental principles of surgical-orthodontic treatment.

Materials and methods

In planning the treatment, the clinician must consider the type and severity of the malocclusion, the age of the patient, aesthetic demands and/or functional needs. The choice of osteotomy must be based on aesthetical and morphological considerations, rather than cephalometric measurements. The orthodontic treatment before surgery has to be functional and fit the scheduled ostetomy.

Results

The authors report some cases treated with different surgical options, with a follow-up of 2, 5, and 15 years.

Conclusions

Surgical treatment is indicated in a very high number of patients affected by Class III malocclusions. A comprehensive surgical-orthodontic approach allows to obtain very satisfactory long-term results from both an aesthetical and functional point of view.     

Le anomalie vascolari dei tessuti molli del cavo orale

Objectives

To examine the vascular anomalies most frequently found in dental practice. Vascular anomalies are diseases characterized by functional and/or morpho-structural alterations of various nature, severity and extension which can affect every type of vessel (arterial, venous or lymphatic) of any caliber or anatomical region. Generally they are congenital and benign though they may cause complications such as ulceration, bleeding, superinfection, functional, and/or aesthetic deficit.

Materials and methods

Currently, the reference classification is the one adopted by the International Society for the Study of Vascular Anomalies (ISSVA), which distinguishes vascular or vasoproliferative neoplasms, including hemangiomas, from vascular malformations, these latter being further subdivided into low-flow and high bloodstream malformations. The diagnosis of vascular anomalies can not be separated by pathological history and clinical examination of the patient, even if for a certain diagnosis it is necessary to perform instrumental examinations including the echo color doppler ultrasound, a rapid examination, which is repeatable and devoid of ionizing radiation. The treatment involves different techniques, depending on the type of vascular lesion diagnosed; in particular, laser therapy is the most suitable for low-flow anomalies. This technique presents three different approaches: the excisional biopsy being indicated for suspicious lesions which need a histological examination; the transmucousal thermophotocoagulation (TMT) which involves the use of laser in “no contact” mode; and the intralesional photocoagulation (ILP) which uses the laser fiber inside the lesion and is suitable for deepest vascular anomalies.

Results and conclusions

. According to recent literature and clinical experience, we can say that vascular anomalies are a heterogeneous group of diseases for which treatment is necessary to perform a correct diagnostic clinical-instrumental approach; laser devices, with a wavelength similar to the oxidized hemoglobin, are the gold standard for the treatment of low flow blood abnormalities, both for ease of use and the excellent haemostatic effects.