The history of dentistry, of course, has followed a constant development since the dawn of society. The dental profession, reserved in ancient times to people with special skills and high rank, after the Middle Ages was diminished and practiced by barbers. The pharmacological evolution of oral surgery techniques has led this branch, today as never before, to obtain a level of specialization and preparation comparable to all other specialist medical branches. Some milestones in the history of dentistry will be considered so as to finally understand how the importance of anesthetic drugs was of primary importance, and which drugs are used today.
During the COVID-19 emergency, the medical operating protocols have been largely modified for reducing any type of contamination risk, for working in a safe way and for making the patient feel in a safe environment. Telemedicine, smart phones and apps could represent important devices for the community, in order to prevent virus trasmission and to perform quick diagnosis and management at medical offices. This manuscript could be useful for clinicians with regard to the current state of the effectiveness of the telephone triage in this COVID-19 epidemic period. Therefore, it could be an important starting point for future perspectives about telemedicine and virtual patient management.
This study aims to highlight the latest marine-derived technologies in the biomedical field. The dental field, in particular, uses many marine-derived biomaterials, including chitosan. Chitosan that is used in different fields of medicine, is analyzed in this review with the aim of highlighting its uses and advantages in the dental field. A literature search was conducted in scientific search engines, using keywords in order to achieve the highest possible number of results. A review of randomized controlled trials (RCT) was conducted to evaluate and process all the relevant results for chitosan and oral health. After a screening and a careful analysis of the literature, there were only 12 results highlighted. Chitosan performs different functions and it is used in different fields of dentistry in a safe and effective way. Among the uses of chitosan, we report on the remineralizing property of chitosan which hardens tissues of the tooth, and therefore its role as a desensibilizer used in toothpastes. According to our systematic review, the use of chitosan has shown better surgical healing of post-extraction oral wounds. Furthermore, some studies show a reduction in bacterial biofilm when used in dental cements. In addition, it has antibacterial, antifungal, hemostatic and other systemic properties which aid its use for drug delivering.
The objective of the present investigation was to evaluate how dental implant positioning can influence the masticatory stress distribution over screwed mandibular prosthodontics restoration and over the surrounding bone tissue. Moreover, the dental implant components and overdenture bar strengths under masticatory cycles have been investigated in order to evaluate possible screw and prosthesis breakage. A “virtual jaw” model and 3D dental implant were reproduced to realise finite element analysis in order to underline the parameters and the mechanical characteristics of the bone and of the dental implants connected to the overdenture bar. The distribution of a nonspecific chewing phase, analysing the overall load on the fixtures of the lower jaw, was performed. The study investigating frontal and horizontal planes and vertical directions of occlusal forces showed how position and perspective of fixtures strongly influenced the stress distribution and the consequent jawbone tissue remodelling. Prostheses elements such as cantilever, passing screws, and dental implants are strictly related to the correct selection of dental implant position. This study suggested a virtual method to guide the surgeon in the choice of implant number, position, diameter, and length, and cantilever length and shape, and to evaluate the prospective stress distribution of chewing strengths for a correct prosthesis rehabilitation.
Nowadays the development of diagnostic imaging, surgical techniques, alloplastic materials, and surgical instruments has made possible a more accurate management of orbital fractures. The aim of the present study was the management of orbital fractures and the solution of particular cases. The use of high-resolution computed tomography makes possible to gain a better understanding of the complex orbit anatomical structure. Also endoscopy is a valid alternative for medial orbital wall fractures treatment. It gives high control of the fracture site and its reduction. When this technology is combined with 3-dimensional (3D) reformatted images, it allows us to reconstruct more accurately the orbital defects. The authors present their experience in complex orbital fractures treated with the aim of the 3D navigation using a preformed orbital titanium plate. Endosopical approach was used to control plate positioning.
The objective of this investigation was to analyze the mechanical features of two different prosthetic retention devices. By applying engineering tools like the finite element method (FEM) and Von Mises analyses, we investigated how dental implant devices hold out against masticatory strength during chewing cycles. Two common dental implant overdenture retention systems were analyzed and then compared with a universal—common dental abutment. The Equator® attachment system and the Locator® arrangement were processed using the FEM Ansys® Workbench. The elastic features of the materials used in the study were taken from recent literature. Results revealed different responses for both the devices, and both systems guaranteed a perfect fit over the axial load. However, the different design and shape involves the customized use of each device for a typical clinical condition of applying overdenture systems over dental implants. The data from this virtual model showed different features and mechanical behaviors of the overdenture prosthodontics attachments. A three-dimensional system involved the fixture, abutment, and passant screws of three different dental implants that were created and analyzed. Clinicians should find the best prosthetic balance to better distribute the stress over the component, and to guarantee the patients clinical long-term results.
The purpose of this study was to evaluate the impact of a treatment with electro-neuro-feedback (ENF), a portable transcutaneous electrical nerve stimulation (TENS) device, on the clinical outcome and inflammatory biochemical parameters related to the impacted lower third molar surgery.
DOI : 10.4103/ejd.ejd_296_17 Anahtar Kelimeler :
Edema, electro-neuro-feedback, pain, third molar surgery, transcutaneous nerve stimulation
The field of dental implantology has made progress in recent years, allowing safer and predictable oral rehabilitations. Surely the rehabilitation times have also been reduced, thanks to the advent of the new implant surfaces, which favour the osseointegration phases and allow the clinician to rehabilitate their patients earlier. To carry out this study, a search was conducted in the Pubmed, Embase and Elsevier databases; the articles initially obtained according to the keywords used numbered 283, and then subsequently reduced to 10 once the inclusion and exclusion criteria were applied. The review that has been carried out on this type of surface allows us to fully understand the features and above all to evaluate all the advantages or not related. The study materials also are supported by a manufacturing company, which provided all the indications regarding surface treatment and confocal microscopy scans. In conclusion, we can say that, thanks to these new surfaces, it has been possible to shorten the time necessary to obtain osseointegration and, therefore, secondary stability on the part of implants. The surfaces, therefore, guarantee an improved cellular adhesion and thanks to the excellent wettability all the biological processes that derive from it, such as increases in the exposed implant surface, resulting in an increase in bone-implant contact (BIC).
Acute Myeloid Leukemia (AML) in pediatric patients is a serious disease, although, for the subgroup of patients who receive proper treatment, a long-term survival rate above 50% is typical. The cycles of chemo- and radiotherapy used to treat AML can impair dental development.
DOI : 10.2174/1874210601812010230 Anahtar Kelimeler :
Acute myeloid leukemia, Bone marrow transplantation, Children teeth, Dental anomalies, Dental implants, Long-term effects
Breakthroughs in technology have not been possible without influencing the medical sciences. Dentistry and dental materials have been fully involved in the technological and information technology evolution, so much so that they have revolutionized dental techniques. In this study, we want to create the first collection of articles on the use of digital techniques and software, such as Digital Smile Design. The aim is to collect all of the results regarding the use of this software, and to highlight the fields of use. Twenty-four articles have been included in the review, and the latter describes the use of Digital Smile Design and, in particular, the field of use. The study intends to be present which dental fields use “digitization„. Progress in this field is constant, and will be of increasing interest to dentistry by proposing a speed of treatment planning and a reliability of results. The digital workflow allows for rehabilitations that are reliable both from an aesthetic and functional point of view, as demonstrated in the review. From this study, the current field of use of Digital Smile Design techniques in the various branches of medicine and dentistry have emerged, as well as information about its reliability.
The use of laser in oral surgery and periodontology is a matter of debate, mainly because of the lack of consensual therapeutic protocols. The aim of this study was to evaluate the surgical advantages of diode laser versus traditional surgery with a cold blade for the surgical excision of pyogenic granuloma (PG). Twenty-one patients (10 males, 11 females, aged 19-66 years; mean age: 46.5 years), requiring PG excision, were enrolled in the study. Through a randomized clinical trial design, all patients were randomly subjected to PG surgical excision with either diode laser or cold blade. Parameters analyzed were the speed of incision, time of intervention, intraoperative bleeding, number of stitches, and patient compliance. Histologic examination was performed before and after surgical excision of the lesions. Patients compiled a subjective evaluation questionnaire. Both treatments were successful in surgical excision of PG. However, the mean speed of incision was significantly reduced in diode laser group (0.61 ± 0.29 mm/s) compared with cold blade group (1.47 ± 1.23 mm/s) (P < 0.05). The mean lengths of time for the whole surgical intervention were significantly lower in diode laser group (221.15 ± 220.89 s) compared with cold blade group (316.10 ± 248.69 s) (P < 0.05). Moreover, diode laser induced a reduced intrasurgical bleeding, and a better gingival healing compared with cold blade surgical treatment. This study demonstrated that the use of diode laser showed additional advantages compared with cold blade in terms of less postoperative discomfort and pain for surgical removal of PG.
In the dental field, the study of materials has always been the basis of the clinical practice. Over the years, with the evolution of materials, it has been possible to produce safe and predictable prosthetic devices, with ever better aesthetic features, biocompatibility and patient satisfaction. This review briefly analyzes the features of dental resin materials to underline the biological, microbiological and chemo-physical characteristics. The main aim of prosthodontics is to rehabilitate patients and therefore improve their quality of life. Dental resins are the main materials used for the production of dentures. Once solidified, these polymers have different mechanical or surface characteristics. The results of the literature on these characteristics were analyzed and some new brand dental resins, known as modern resin, were subsequently evaluated. The new materials are undoubtedly a step forward in the creation of dental prostheses, and also in all subsequent maintenance phases. This review shows how changing the chemical structure of the resins could have microbiological influences on the growth and management of the biofilm, and also physical influences in terms of its mechanical characteristics. The development of new materials is a constant goal in dentistry in order to obtain increasingly predictable rehabilitations.
Cases of correlations between posture and the temporomandibular joint have long been reported in the literature. In particular, occlusal anomalies, and therefore malocclusion, could have negative implications for the spine. The objective of this study was to review the literature and bring to light any correlations between temporomandibular joints (TMJ) and posturology. The literature search was conducted in the PubMed and Embase scientific search engines with the aim of obtaining the most possible results in the initial search, the number of results initially obtained was 263. Subsequently, the inclusion and exclusion criteria were reduced first to 83 and subsequently to manual analysis of the articles, those included remained only 11. The results show a correlation between anomalies of the TMJ and dysfunctions of the vertebral column. Not all the articles considered are in agreement with each other regarding epidemiological data, but surely this study can represent an important starting point for a much more careful evaluation of the dental patient and at the same time for the request for counseling by a dentist in case of postural abnormalities.
The aim of this retrospective analysis is to describe and to evaluate the middle third horizontal root fractures, long term clinical management results and to estimate the effect of treatments factors upon healing and survival rate.
In recent years there has been a lot of talk about toothpastes with a particular chemical compound: stannous fluoride (SnF2). Its presence is currently still highly controversial, as the latter could have negative health effects. The different companies that produce toothpastes express its dosage in ppm. The purpose of this systematic literature review is to analyze all randomized clinical trials in the literature over the last 10 years and to draw clear results on the function of stannous fluoride, for this purpose the authors performed a Mann–Whitney U Test. Materials: The first analysis of the literature produced a number greater than 800 results, subsequently applying the inclusion and exclusion criteria, and following a manual analysis of the results, 26 manuscripts have been obtained. Results: From the results analyzed in this review, it could be shown that stannous fluoride does not present important contraindications, if not those commonly reported for fluorine. A meta-analysis on enamel loss has been conducted, it shows that SnF2 products provide better results with a p < 0.05 value. Conclusion: This compound could have significant effects in favor of erosion and recalcification of the enamel, on the biofilm formation, gingival inflammation, and in addition, it could be an important aid in the removal of tooth stains and halitosis.
Dysphagia is defined as difficulty in swallowing food (semi-solid or solid), liquid, or both. Difficulty in swallowing affects approximately 7% of population, with risk incidence increasing with age. There are many disorder conditions predisposing to dysphagia such as mechanical strokes or esophageal diseases even if neurological diseases represent the principal one. Cerebrovascular pathology is today the leading cause of death in developing countries, and it occurs most frequently in individuals who are at least 60 years old. Swallowing disorders related to a stroke event are common occurrences. The incidence ranging is estimated from 18% to 81% in the acute phase and with a prevalence of 12% among such patients. Cerebral, cerebellar, or brain stem strokes can influence swallowing physiology while cerebral lesions can interrupt voluntary control of mastication and bolus transport during the oral phase. Among the most frequent complications of dysphagia are increased mortality and pulmonary risks such as aspiration pneumonia, dehydration, malnutrition, and long-term hospitalization. This review article discusses the epidemiology of dysphagia, the normal swallowing process, pathophysiology, signs and symptoms, diagnostics, and dental management of patients affected.
Tooth transplantation can be considered a valid and predictable treatment option for rehabilitating young patients with permanent teeth loss. This study presents several cases of successful autogenous tooth transplantation with a 6-9 months follow-up. Tooth auto-transplantation can be considered a reasonable option for replacing missing teeth when a donor tooth is available. The auto-transplantation of a right mandibular third molar with compromised function and esthetics to replace the residual roots resulting from coronal destruction due to extensive carious lesion of the second molar in the same quadrant as shown in the presented cases can result a viable treatment alternative especially in a young patient that cannot undergo dental implant therapy. Transplantation of mature third molar seems to be a promising method for replacing a lost permanent molar tooth and restoring esthetics and function. This clinical procedure showed excellent functional and esthetical long-term results in the analyzed cases.
Elastics are the simplest device that can be used during a class correction in orthodontics, and despite the simplicity of a latex band, they are very effective and powerful. The resultant inter-maxillary force affects not only the teeth, but even the mandibular position, and consequently the temporomandibular joints (TMJ). The purpose of our work is to simplify the use of elastics, and to reduce the amount of inventory for orthodontists, because there is a lot of merceology available on the market, and different ways of using the elastics. The use of elastics in clinical practice is based on the force extension values, which are given by the manufacturer for the different sizes of the elastics, generally when they are stretched to three times their lumen size. Various configurations allow for the correction of different malocclusions. We propose a new classification and a new device, the elastic selector gauge, in order to allow clinicians to quickly and easily choose the right elastic in all conditions.
DOI : 10.3390/jfmk4030063 Anahtar Kelimeler :
elastics, inter-maxillary traction, class II correction, orthodontics, selector gauge
ISSN: 2411-5142 Cilt: 4 Sayı: 3 Sayfa: 63
Pseudoaneurysm is an abnormal dilation of an artery that could be caused either by iatrogenic or traumatic events and it is associated with high rupture risk. Pseudoaneurysm rarely involves internal maxillary artery. Computed tomography angiography and digital subtraction angiography are essential tools to perform a proper diagnosis and treatment of pseudoaneurysms. The authors described 2 different cases of internal maxillary artery pseudoaneurysm, treated by different embolization approaches. The first case was treated by a well-known arterial catheterism technique, whereas the second one was performed by an uncommon approach with a direct percutaneous puncture.
The aesthetic treatment for anterior teeth requires a series of clinical and technical evaluations to obtain a predictable result, following a well-defined operating sequence. Today, the clinical–technical team can use different digital tools in the different steps of the workflow. A preventive assessment, the knowledge of limits, and the possibilities of surgical and prosthetic procedures allow to use these devices. Sharing goals of the treatment with the patient according to their expectations and needs is the key point of the treatment plan. Setting a defined treatment plan avoids invasive procedures. In this clinical case report, a 27-year-old patient affected by Class II div 2 malocclusion with deep bite was treated with a full digital workflow. Previewing the aesthetics was through dedicated software, which shows operators and patients the objectives of the therapy and guides the dental technician in the first phase of the work. The use of digital flows in the prosthetic phases reduces the working time. In this case, it shows the impact of a digital workflow on peri-prosthetic therapy for the aesthetic rehabilitation of the upper central incisors in a young adult.
Virtual surgical planning (VSP) has recently been introduced in craniomaxillofacial surgery with the goal of improving efficiency and precision for complex surgical operations. Among many indications, VSP can also be applied for the treatment of congenital and acquired craniofacial defects, including orbital fractures. VSP permits the surgeon to visualize the complex anatomy of craniofacial region, showing the relationship between bone and neurovascular structures. It can be used to design and print using three-dimensional (3D) printing technology and customized surgical models. Additionally, intraoperative navigation may be useful as an aid in performing the surgery. Navigation is useful for both the surgical dissection as well as to confirm the placement of the implant. Navigation has been found to be especially useful for orbit and sinus surgery. The present paper reports a case describing the use of VSP and computerized navigation for the reconstruction of a large orbital floor defect with a custom implant.
DOI : 10.1016/j.cjtee.2016.11.002 Anahtar Kelimeler :
Neuronavigation, Orbital trauma, Orbital implants, Virtual surgical planning
ISSN: 1008-1275 Cilt: 20 Sayı: 1 Sayfa: 9 - 13
Aim. To evaluate the correlation between insertion torque (IT) and implant stability quotient (ISQ) in tapered implants with knife-edge threads. Methods. Seventy-five identical implants (Anyridge, Megagen) were inserted by using a surgical drilling unit with torque control and an integrated resonance frequency analysis module (Implantmed, W&H). IT (N/cm) and ISQ were recorded and implants were divided into three groups (n=25) according to the IT: low (<30), medium (30 < IT < 50), and high torque (>50). ISQ difference among groups was assessed by Kruskal-Wallis test, followed by Bonferroni-corrected Mann–Whitney U-test for pairwise comparisons. The strength of the association between IT and ISQ was assessed by Spearman Rho correlation coefficient (α=0.05). Results. At the pairwise comparisons, a significant difference of ISQ values was demonstrated only between low torque and high torque groups. The strength of the association between IT and ISQ value was significant for both the entire sample and the medium torque group, while it was not significant in low and high torque groups. Conclusions. For the investigated implant, ISQ and IT showed a positive correlation up to values around 50 N/cm: higher torques subject the bone-implant system to unnecessary biological and mechanical stress without additional benefits in terms of implant stability. This trial is registered with NCT03222219.
Colon cancer is the third leading cause of cancer-related mortality worldwide and colon cancer metastases in rare sites, such as the oral cavity, lead to a worse prognosis. Oral metastasis is a rare clinical condition and it represents only the 1% among all oral cavity neoplasms. A multidisciplinary approach is recommended to carry out a correct diagnostic procedure that allows distinguishing between metastatic and primitive lesions of the oral cavity. Quick diagnosis and management are fundamental to take an appropriate action as early as possible, as usually the prognosis in patients with oral metastases of colon carcinoma is poor. Aim of this brief clinical report is to underline how the quick diagnosis and management of gingival lesions can be crucial for the correct management of those uncommon oral diseases and for having a better prognosis of the primary cancer.
Rehabilitation of atrophic maxilla still remains a challenge. Fixed implant-supported restorations have become more predictable in the last years; nevertheless, technical and biological complications still occur. Removable overdenture fully supported by a CAD/CAM titanium bar seems to be a viable treatment option for the rehabilitation of completely edentulous patients with a high degree of bone resorption. In these clinical cases, the soft tissues of the lower third of the face need to be respected, and a fixed-removable solution is the only option to have good hygiene control. Nevertheless, there is no consensus about the optimal number and position of the implants. A total of six adult patients were recruited and treated with an overdenture fully supported by a CAD/CAM titanium bar and low-profile attachment, screwed on four or six implants. A detailed step-by-step description of the procedures was presented. Overall, all the patients were successful treated with no relevant complications. With the limitations of this case series, maxillary implant overdenture fully supported by four or six implants seems to be a safer treatment option for the minimally invasive rehabilitation of atrophic maxillae, regardless of the number of implants.