Medicina e Chirurgia

Some studies have demonstrated that platelet rich fibrin (PRF) is a healing biomaterial with a great potential for bone and soft tissue regeneration, without any inflammatory reactions and may be used alone or in combination with bone grafts, promoting hemostasis, bone growth, and maturation. PRF appears as a natural and satisfactory aid in bone regenerative surgery in elderly patients with favorable results and low risks. This study wants to demonstrate how PRF in association with a new split crest augmentation technique can be a great aid in implant rehabilitation, especially in the elderly patients, when bone regeneration is required. Ten patients were treated in this study, five following the flapless split crest new procedure and other five patients following traditional procedure without split crest as control. Five patients with an average age between 50 and 60 years were selected to be operated with a split crest flapless modified technique in order to optimize the regenerat...

The aim of this study was to assess the skeletal and dentoalveolar changes obtained after 1 year of treatment with elastodontic appliances (EA) in a retrospective cohort of children reporting early signs of malocclusion. Also, a detailed description of the tested EAs was reported. The study sample included 20 subjects, 8 males and 12 females, with a mean age of 8.4 ± 0.6 years, and a control group consisting of 20 subjects, 9 males and 11 females, with a mean age of 8.1 ± 0.8 years. All subjects in the treated group received the AMCOP second class (SC) (Ortho Protec, Bari, Italy) device. Digital impressions were taken along with a digital bite registration in centric relation before treatment (T0) and after 1 year (T1). Lateral cephalograms were also taken at T0 and T1 and cephalometric analysis was performed to assess the skeletal sagittal changes of the maxilla and the mandible (sella, nasion, A point angle, SNA^; sella, nasion, B point angle, SNB^; and A point–nasion–B point angl...

(1) Background: Celiac disease (CD) patients can be affected by mouth and tooth disorders, which are influenced by their gluten-free diet. The aim of our research was to evaluate the pathological conditions of the stomatognathic system observed in celiac patients on a gluten-free diet. (2) Methods: we consecutively recruited celiac patients on a gluten-free diet at our celiac center, as well as healthy volunteers. Two dentists examined all patients/controls and checked them for any mouth disorder. (3) Results: Forty-nine patients affected by celiac disease (age at test 31.8 ± 11.58, time on GFD 8.73 ± 7.7) and 51 healthy volunteers (age at test 30.5 ± 8.7) were included. Recurrent aphthous stomatitis was reported in 26 patients (53.0%) and in 13 (25.5%) controls (p = 0.005). Dental enamel disorders were reported in 7 patients (14.3%) and in 0 controls (p = 0.002), with none having geographic tongue. We found non-specific tooth wear, characterized by loss of the mineralized tissue of the teeth, in 9 patients (18.3%) and in 3 (5.9%) controls (p = 0.05). (4) Conclusion: Recurrent aphthous stomatitis and enamel hypoplasia are "risk indicators" that may suggest that an individual has CD. We detected a high prevalence of non-specific tooth wear that can be caused by several factors such as malocclusion, sleep bruxism, parafunctional activity, and age.

Objective: Metal alloys used in dentistry and in other biomedical fields may release nickel ions in the oral environment. The release of nickel might influence the normal biological and physiological processes, including tissue wound healing, cell growth and proliferation. The aim of this study was to evaluate in vitro the effects of nickel ions on cell cycle, viability and proliferation. Materials and Methods: Human osteosarcoma cells (U2OS) and human keratinocytes (HaCat) were exposed to different nickel chloride (NiCl2) concentrations (0 - 5mM) for various periods exposure. The viability of cultured cells was estimated by flow cytometry using Annexin V-FITC and Propidium Iodide (PI). Cell proliferation was evaluated by using carboxyfluorescein diacetate succinimidyl ester (CFDA-SE) and flow cytometry. Finally, the effects of NiCl2 on cell cycle were assessed and quantified by flow cytometry. Statistical analysis was performed by means of ANOVA followed by Tukey’s test. Results: N...

Several in vitro studies have reported contrasting values for triethylene glycol-dimethacrylate (TEGDMA) concentrations shown to induce cytotoxic effects. The aim of this study was to evaluate the effective concentrations of TEGDMA reached under the routine experimental conditions used in biocompatibility in vitro tests and determines changes in cytotoxicity and the associated production of reactive oxygen species (ROS) based on different TEGDMA solutions. TEGDMA was added to cell culture medium either directly or previously dissolved in dimethyl sulfoxide (DMSO) or ethanol (EtOH), both in the presence and absence of cells. Intracellular and extracellular TEGDMA concentrations were determined by high performance liquid chromatography (HPLC). The cytotoxicity effects of TEGDMA preparations were determined in 3T3-fibroblasts by 3-(4,5 dimethyiazol-2-1)-2-5-diphenyl tetrazolium bromide assay. The production of ROS was measured by flow cytometry. In the absence of cells the effective final TEGDMA concentrations obtained in Dulbecco's Modified Eagle Medium were significantly lower than the nominal one. When 2 mmol/L TEGDMA was first solubilized in DMSO or EtOH, a significant decrease in cell viability, and an increase in ROS production-compared to pure TEGDMAwas observed. After 2 h of incubation, TEGDMA previously dissolved in DMSO or ETOH was reduced by 15% and 20%, respectively, whereas otherwise it remained unaffected. Our results demonstrate that the effective concentration of TEGDMA dissolved in culture medium (in the presence or absence of solvents) does not concur with the nominal one. Therefore, the presence of the utilized solvents does not substantially alter the monomer solubility but eases its entrance into the cells thus improving its cytotoxic potency. V

Objective: Aim of the study was to determined by microcomputed tomography (µCT) the horizontal distance between the main (MB1) and the second mesiobuccal canal (MB2) orifices, the vertical distance between the MB1 and MB2 orifices planes, and the distance between the anatomic apex and major apical foramen (AF). Furthermore, we characterized the entire internal and external anatomy of the MB, distalbuccal (DB) and palatal (P) maxillary first molars roots. Materials and Methods: Twenty-two intact extracted first maxillary molars were scanned by X-ray computed transaxial µCT and then 2D and 3D images were processed and analyzed. Results: The results showed that 77.27% of the mesiobuccal (MB) roots presented a second MB canal, and 29.41% of the MB2 were independent from the MB1 canals. In 15 teeth, there were three root canal orifices on the chamber floor, and 10 of these teeth presented MB2 canals. The mean vertical distance between the MB1 and MB2 planes was 1.68 ± 0.83 mm. Seven teet...

Introduction: Cheilitis granulomatosa causes persistent idiopathic lip swelling and ulceration and it can sometimes be recognized as a unique or early manifestation of Crohn's disease. Spontaneous remission is rare and with the lack of controlled trials, different therapeutic approaches have been used. Some cases have been treated with an exclusion diet in the attempt to rule out diet allergens, while the most popular treatments include antibiotics such as tetracycline and clofazimine tranilast, benzocaine topical or intralesional steroids, and cheiloplasty, with different outcomes. Case presentation: We describe the case of a 23-year-old Caucasian man, primarily diagnosed with cheilitis granulomatosa for a severe lower lip swelling, and then with Crohn's disease of the terminal ileum and anus. Treatment of Crohn's disease with an anti-tumor necrosis factor alpha agent (infliximab) successfully induced remission of both the gastrointestinal disease and the oral lesion. Conclusions: Our recommendation is that physicians should be able to recognize cheilitis granulomatosa as a possible marker of a more complex systemic disease and proceed first with an accurate physical examination, and further suggest investigations of the bowel. In cases of Crohn's disease, a therapy with biological agents can be successful.

Primary mandibular non-Hodgkin lymphoma (NHL) and soft tissues NHL of the maxillofacial are extremely rare representing a minimal percentage of the head and neck tumors. Two cases of bone and soft tissue maxillofacial NHL are reported. Clinical, radiological and pathological features are described and the therapeutic procedures are discussed accordingly. Mandibular radiologic features have been carefully analyzed and discussed to achieve an early and accurate diagnosis avoiding improper dental therapies.

Abrikossoffov tumor rijetka je dobroćudna neoplazma mekih tkiva i može se pojaviti na bilo kojem dijelu tijela, uključujući i orofacijalno područje. Obično je benigan, ali postoje podatci da je lokalno bio agresivan i maligan s udaljenim metastazama. Etiologija je nepoznata jer je u nekoliko istraživanja dokazano da zahvaća različite stanice. U prikazanom slučaju riječ je o Dominikanki u dobi od 36 godina koja je upućena na Odjel oralne i maksilofacijalne kirurgije poliklinike Federico Drugi u Napulju zbog ograničene i na opip čvoraste lezije od 17 milimetara na dorzumu jezika. Terapija se sastojala od ekscizijske biopsije na temelju dijagnostičke hipoteze o Abrikossoffovu tumoru, što je potvrđeno histopatološkom analizom te histokemijskom i imunokemijskom procjenom. Abrikossoffov tumor rijetka je neoplazma koja se mora oprezno dijagnosticirati nakon što se uzmu u obzir svi histološki i klinički parametri radi pravilnoga odabira terapije. Ključne riječi tumor granularnih stanica; tumori mekih tkiva; jezik 1 Odjel za neurologiju i odontološku stomatologiju Sveučilišta

The computer-based method allows the computerized planning of a surgical implantology procedure, using computed tomography (CT) of the maxillary bones and prosthesis. This procedure, however, is not error-free, unless the operator has been well trained and strictly follows the protocol. A 70-year-old woman whom was edentulous asked for a lower jaw implant-supported prosthesis. A computer-guided surgery was planned with an immediate loading according to the NobelGuide technique. However, prior to surgery, new dentures were constructed to adjust the vertical dimension. An interim screwed metal-resin prosthesis was delivered just after the surgery; however, after only two weeks, it was removed because of a complication. Finally, a screwed implant bridge was delivered. The computer guided surgery is a useful procedure when based on an accurate 3D CT-based image data and an implant planning software which minimizes errors.

determination of tooth color. Consequently, the removal of pulp tissues due to endodontic treatment may often lead to intrinsic staining. In such cases, cleaning procedures utilized to remove surface pigmentations are not effective and chemical bleaching is required to recover the original color. Nowadays, dental bleaching has been recognized as the most conservative treatment for discolored teeth. 1, 2 In recent years, several products and techniques have been developed to achieve reliable dental bleaching. Different studies have demonstrated the effectiveness and safety of carbamide peroxide in removing intrinsic staining. 1-5 Furthermore, if properly used, carbamide peroxide was proved to contribute to smooth enamel, leading to reduced plaque accumulation and improved periodontal tissue health. 2, 4-6 Home bleaching by means of individual trays containing

Administration of ineffective anticancer therapy is associated with unnecessary toxicity and development of resistant clones. Cancer stem cells (CSCs) resist chemotherapy, thereby causing relapse of the disease. Thus, development of a test that identifies the most effective chemotherapy management offers great promise for individualized anticancer treatments. We have developed an ex vivo chemotherapy drug response assay (ChemoID(®)), which measures the sensitivity of CSCs as well as the bulk of tumor cells to a variety of chemotherapy agents to assist an oncologist in making treatment decisions. Three patients affected by oral cancer were referred. Biopsy showed a well-differentiated squamous cell carcinoma (G1) in case 1, a G2 adenocarcinoma in case 2 and a G3 squamous cell carcinoma in case 3. In all of the three cases, after clinical inspection and suspicion of a diagnosis of cancer, a double biopsy was performed. One specimen was sent to the ChemoID laboratory for chemosensitivi...

Aim: Today, thanks to modern technologies as operative microscope, ultrasonic tips, devices to activate irrigation and tridimensional obturation performed with thermo plasticized guttapercha, excellent results could be obtained. Materials and methods: In this study, we present 5 patients with the presence of periapical lesions in molars and incisors with history of pain. Modern endodontic technologies were used. The rationale of using these technologies was to obtain a chemo-mechanical cleansing and obturation of the entire endodontic system and to gain the lesion resolution with a non-surgical approach. Results: A success rate of 100% was obtained. Radiographs and clinical examinations were done until 10 years. All the cases highlighted the success achieved in the short and long term through the complete resolution of the lesions and therefore the reconstitution of the lamina dura. Peer review under responsibility of Società Italiana di Endodonzia.

Vascular lesions of the maxillofacial area are even more challenging than in other different body district, because of the high aesthetic and functional relevance of this area for the sense organs presence like eye, brain, tongue, ear and nose. For these reasons, we propose an accurate classification based on hemodynamic and histologic aspects usefulthat is for diagnostic and therapeutic planning. A female, 60 years old patient came to our observation showing a vascular lesion of the lower left lip, and complaining for aesthetical and functional impairment. To confirm the diagnosis of vascular malformation and to detect lesion flow rate or other possible localization, a Tc red blood cell scintigraphy was carried out. Result was a venous low flow lesion; hence, sclerotherapy by a 3% Polidocanol solution (Atossisclerol) followed by surgery was planned. The aim of this work was to propose a diagnostic and therapeutic scheme with an integration of ISSVA and a flow rate classifications f...

Most common techniques for alveolar bone augmentation are guided bone regeneration (GBR) and autologous bone grafting. GBR studies demonstrated long-term reabsorption using heterologous bone graft. A general consensus has been achieved in implant surgery for a minimal amount of 2 mm of healthy bone around the implant. A current height loss of about 3-4 mm will result in proper deeper implant insertion when alveolar bone expansion is not planned because of the dome shape of the alveolar crest. To manage this situation a split crest technique has been proposed for alveolar bone expansion and the implants' insertion in one stage surgery. Platelet-rich fibrin (PRF) is a healing biomaterial with a great potential for bone and soft tissue regeneration without inflammatory reactions, and may be used alone or in combination with bone grafts, promoting hemostasis, bone growth, and maturation. The aim of this study was to demonstrate the clinical effectiveness of PRF combined with a new s...

Background: There are a lot of techniques to obturate the root canals, but lateral condensation of gutta-percha is the most used one. An important aspect of thermafil is the error margin tolerated by the manufacturer in the production of plastic carriers. In literature, there is no evidence about discrepancy percentage between different carriers. It is demonstrated that the error margin of gutta-percha is 0.5% and is 0.2% for metal files (ISO standards). Objective: The aim of this study was to evaluate the real dimensions of thermafil plastic carriers observed by the stereo microscope measuring the dimensional discrepancy between them. Methods: For this study, 80 new thermafil (Dentsply Maillefer) have been selected. 40 thermafil 0.25 and 40 thermafil 0.30. Through 60X stereo microscope, the dimensions of the plastic carrier tips have been measured. The dimensions of the plastic carrier were also measured after a heating cycle. ZL GAL 11TUSM (Zetaline stereo evolution) microscope wa...