1,721,038 research outputs found
Hybrid Funnel Technique: A Novel Approach for Implant Site Preparation: A Pilot Study
(1) Background: Different techniques and tools have been developed for implant site preparation. In this clinical scenario, Hybrid Funnel Technique (HFT), a novel osteotomy procedure, has been proposed. (2) Aim: The aim of this retrospective observational study was to consider the different responses to compression of the histological bony compartments (cancellus and cortical). HFT involves the use of multiple drills for the cortical layer preparation and of an osteotome for the osteocompaction of the cancellous bone. (3) Materials and Methods: Following computer-supported implant planning and guided surgery, 10 osteotomies with HFT were performed and 10 implants with the same length and diameter were placed in seven healthy and no daily smoking patients. Periapical X-ray and intraoral photographs were performed at baseline and after 12 months of follow-up to evaluate marginal bone level (MBL) changes and aesthetic results obtained from implant prosthetic rehabilitation. (4) Results: At 1 year of follow-up, 100% of the implants were successfully integrated, MBL change mean value was 0.17 mm ± 0.21. No differences in terms of MBL were noted between thin and thick biotypes. Pink esthetic score (PES) and white esthetic score (WES), assessed one year after definitive restoration placement, were 7.5 ± 2.3 and 8.5 ± 1.1, respectively. (5) Conclusions: Based on the findings of this preliminary clinical study, HFT has led to stability of peri-implant tissues and could represent a reliable technique for surgical preparation of the implant site
Chairside virtual patient protocol. Part 1: Free vs Guided face scan protocol
Objectives: The 3D facial scan technology allows to virtualize the face of the patient, that can be incorporated with other 3D dental images produced by digital scanning of the dental structures. Aim of this study is to investigate the trueness and precision of a low-cost portable face scanner, with two different scan techniques Materials and methods: Ten patients were enrolled for this study and seventeen soft tissue landmarks were selected to perform linear facial measurements, specifically Reference (Ref), Pronasion (Prn), Subnasal (Sn), Exocanthion Left (Ex-L), Exocanthion Right (Ex-R), Pogonion (Pg), Glabella (G), Alar curvature Right (Al-R), Alar curvature Left (Al-L), Zygion Left (Zn-L), Zygion Right (Zn-R), Orbital Left (Or-L), Orbital Right (Or-R), Tragus Right (T-R), Tragus Left (T-L), Chelion Right (Ch-R) and Chelion Left (Ch-L). Interlandmark distances were measured both manually and digitally. For the manual group ten measurements were made using a digital caliper. For digital group measurements were recorded on the patient face scan obtained using an Ipad Pro 3rd Gen. (Apple Store, Cupertino, CA, USA) and Bellus3D Dental Pro-App (Bellus3D, Inc. Campbell, CA, USA) using "face mode" scan with two different scanning techniques, named Free technique (FT) and Slider Technique (ST). Ten measurements were made for each technique. An open-source software (Meshlab; Meshlab) was used to record all the distances. A paired t-test was used to analyze FT and ST results. In order to further evaluate precision and scan repeatability a surface analysis was performed with both scanning techniques using a CAD software (GOM inspect, GOM) and the total differences in absolute 3D deviations were calculated as root mean square. Results: The comparison between manual and digital measurements showed a mean absolute difference of 0.95 +/- 0.25 for FT and 1.00 +/- 0.29 for the ST. Trueness analysis showed statistically significant differences for the Exocanthion L- Exocanthion R measurement with FT having better performance (P<.05). Precision analysis showed statistically significant differences for G-Pg, Ref-Zn-R and Prn-Zn-R with ST having better performance (P<.05). To achieve all the scans required without any signs of deformation, 184 scans were performed using Free technique and 124 scans using Slider technique. Surface analysis revealed a mean distance of 0.12 +/- 0.45 between Free scans and 0.13 +/- 0.46 between Slider scans in accordance with the linear measurement analysis Conclusion: The study showed that accuracy of low-cost portable scanner can be suitable for clinical use. The use of ST is suggested for a reliable clinical use due to the better precision and an effective reduction of motion artifacts and the lower compliance required to the patients during the scan
Innovative Alveolar Ridge Preservation Surgical Technique with Immediate Dental Implant Placement: A Retrospective Case Report of 1-Year Follow-Up
: Following tooth extraction, the alveolar ridge undergoes morphological and dimensional changes, including a clot formation that is gradually replaced by granulation tissue. Studies indicate that both horizontal and vertical ridge dimensions decrease after extraction; however, these changes can be mitigated through grafting with biomaterials and barrier membranes. Alveolar ridge preservation (ARP) techniques are employed to counteract bone resorption postextraction, encompassing periosteal inhibition and modified periosteal inhibition (MPI) techniques. The Degidi clot chamber technique offers a means to achieve biomaterial-free extraction sockets, promoting healing and osteointegration. This study aims to present the first rehabilitation of a postextraction dental implant in the maxilla using an innovative ARP procedure via a MPI technique. The technique does not involve autologous or heterologous grafting materials; instead, a cortical lamina and a customized screw are used in conjunction with the blood clot. The primary objective is to protect the vestibular cortical bone from preosteoclastic aggression, which can trigger bone resorption. The technique employs a 0.5-mm cortical lamina to mechanically shield the vestibular cortical bone, preventing vestibular cortical bone resorption and increasing its thickness without the need for biomaterial insertion, relying on the blood clot. The effectiveness of the technique was assessed through a 12-month postimplantation cone-beam computed tomography scan, revealing a 0.5-mm increase. Although based on a single case, the 1-year follow-up results are promising, and further studies are warranted to validate the technique's efficacy
Reactive Soft Tissue Preservation in Maxillary Large Bone Defects
Granulation tissue containing reactive soft tissue with potential multipotent stem cells can help socket healing following extraction. The aim of this study was to assess bone healing of maxillary large bone defects while maintaining reactive soft tissue
Chairside virtual patient protocol. Part 2: Management of multiple face scans and alignment predictability
Objectives: Face scans are currently used in dentistry to obtain a virtual patient. Find stable and repeatable references for their matching is a fundamental step. Aim of this study is to evaluate matching reliability of multiple face scans using frontal adhesives references. Null hypothesis was that no significant discrepancy could be detected between the references position analyzed both with surface analysis and linear analysis. Materials and methods: Nine patients were enrolled for this study and nine soft tissue adhesives landmarks (APLI Paper S.A.U, 4 mm o) placed, equally distributed, on the forehead and glabella. Patients were digitally scanned with a portable scanner (iPad Pro 3rd Gen. Apple Store, Cupertino, CA, USA) using the software Bellus3D (Inc. Campbell, CA, USA) in maximum intercuspation, with a full smile and with a scan reference device. After the scan procedure, a high-definition polygon file format (.ply) was exported, and linear measurements were collected with MeshLab (MeshLab; MeshLab). In order to further evaluate reference accuracy, a surface analysis was performed using a CAD software (GOM inspect, GOM). 3D deviations were calculated as root mean square. Statistical analysis was performed used two repeated-measures ANOVAs. Results: Results showed non-significant differences both for linear measurements (p=.22) and surface analysis (p=.58). Frontal references showed to be clinical reliable landmarks for use during face scans alignment, even with different facial expressions. Conclusion: The proposed technique seems to be suitable for the clinical use when superimposition of several face scans is required. Clinical significance: This study showed the clinical reliability of face scans matching method using adhesives references. These references are cheap and easy to use, allowing for a rapid registration of the patient anatomy
Effect of Toothpaste on the Surface Roughness of the Resin-Contained CAD/CAM Dental Materials: A Systematic Review
Background: The purpose of this review is to describe the possible effect of toothbrushing on surface roughness of resin-contained CAD/CAM materials. Methods: Systematic literature search for articles published in peer-reviewed journals between January 2000 and February 2020 has been conducted, which evaluated the effect of brushing on surface roughness of resin-contained CAD/CAM dental materials. The research was conducted in Scopus, PubMed/Medline, Web of Science, Embase, and Science Direct using a combination of the following MeSH/Emtree terms: “brushing”, “resin-based”, “dental”, “CAD/CAM”, and “surface roughness”. Results: A total of 249 articles were found in the search during initial screening. Fifty-five articles were selected for the full-text evaluation after the steps of reading of abstract/title and remotion of duplicate. Only six articles fulfilled the inclusion criteria. The Cohen’s Kappa agreement test showed an index of 0.91 for full-text. Discussion: Four of five selected articles identified an increase of surface roughness on resin-contained CAD/CAM materials after toothbrushing. Although all the articles examined used different toothpastes with no homogeneous relative dentine abrasivity (RDA) and cycles of brushing, the findings are about the same. The possible reason is attributable to the compositions of the resin-contained CAD/CAM materials. Conclusions: The surface roughness of most resin-contained CAD/CAM materials was affected by artificial toothbrushing. Correct knowledge of the composition of the dental material and toothpastes is fundamental to avoid an increase of surface roughness on prosthetic rehabilitation
Clinical Outcome of Fully Digital Workflow for Single-Implant-Supported Crowns: A Retrospective Clinical Study
A digital workflow by means of intraoral scanners and computer tomography has been used in dental implantology, allowing clinicians to be potentially more accurate and precise. Computer-Aided Design and Computer-Aided Manufacturing (CAD-CAM) and 3D models facilitate the process from treatment planning to the surgical procedure, up to the implant placement and final prosthesis. The aim of the present retrospective study was to evaluate a fully digital workflow for single-tooth implant rehabilitation. A total of 19 patients (22 implants) were included in the present study, with a mean follow-up time of 2 years. A fully digital workflow was performed on each patient through the planning, design and printing of a surgical guide, following a digital impression made with an intraoral scanner, computer-tomography-guided implant placement and, finally, with the delivery of a CAD-CAM crown. The two-year follow-up results were satisfactory in terms of the aesthetic yield and precision of the prosthesis. In single-implant-supported restorations, due to digital protocols and digital planning, a reduced number of clinical sessions was registered and the treatment plan results were more predictable. Future studies are needed to understand the application of fully digital protocols in cases of partially or totally edentulous patients
The Effects of Ultrasonic Scaling and Air-Abrasive Powders on the Decontamination of 9 Implant-Abutment Surfaces: Scanning Electron Analysis and In Vitro Study
(1) Background: The aim of this study is to understand from a microscopic point of view whether bicarbonate air-abrasive powders associated with ultrasonic instruments can decontaminate nine different surfaces used for the abutment/implant junction. Fibroblast growth was carried out on decontaminated surface in order to understand if there are significative differences in terms of biocompatibility. (2) Methods: After taking samples of patient plaque, nine different surfaces were contaminated and analyzed by SEM, then their wettability was evaluated. Fibroblasts were cultured on the decontaminated surfaces to understand their ability to establish a connective tissue seal after decontamination. The results were analyzed from a statistical point of view to hypothesize a mathematical model capable of explaining the properties of the surfaces. (3) Results: A negative correlation between roughness and contamination has been demonstrated, whereas a weak correlation was observed between wettability and decontamination capacity. All surfaces were topographically damaged after the decontamination treatment. Grade 5 titanium surfaces appear tougher, whereas anodized surfaces tend to lose the anodizing layer. (4) Conclusions: further studies will be needed to fully understand how these decontaminated surfaces affect the adhesion, proliferation and differentiation of fibroblasts and osteoblasts
Oral Health and Use of Novel Transbuccal Drug Delivery Systems in Patients with Alzheimer’s and Parkinson’s Disease: A Review
Neurodegenerative disorders, such as Alzheimer’s disease (AD) and Parkinson’s disease (PD), are common age-related diseases responsible for high disability. Disease-modifying treatments for AD and PD are still lacking, but symptomatic therapies are available, although limited by difficult administration and patients’ scarce compliance at later disease stages. Transbuccal Drug Delivery Systems (TDDSs) include chemical-physics biotechnologies and mechatronic approaches, allowing drug delivery via the transbuccal route, a strategy that may theoretically overcome the limitations imposed by conventional oral administration. In this review, we provided a snapshot of TDDSs, their mechanism of action, the existing subtypes, and their potential application in PD and AD patients. We found a variety of TDDSs, including tablets, solutions, sprays, patches, and the more sophisticated “mechatronic” IntelliDrug and OraFuse devices using a system of pumps and valves for continuous drug release. Several trials have been conducted either on models or patients to test the safety and efficacy of the antidementia and antiparkinsonian agents delivered by TDDSs, which produced encouraging results that suggest future application on a larger scale. Moreover, oral health has emerged as a fundamental prerequisite for the successful use of TDDSs. Accordingly, greater attention to oral hygiene is now due in patients with neurodegenerative disease
- …
