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Special Issue on Dental Materials: Latest Advances and Prospects—Volume II
Full text linkMany fields of dentistry are firmly connected to innovative materials, and the highest clinical improvements frequently come with the development and creation of original and high-performing equipment, instruments, and biomaterials [...
Special Issue on Dental Materials: Latest Advances and Prospects
Full text linkMost fields of dentistry are closely related to newly developed materials, and all clinical improvements often follow or, in any case, go hand in hand with the creation and development of innovative and higher-performing materials, instruments, and equipment [...
Surgical masks vs respirators: properties and indications for use
Full text linkOBIETTIVI. Sono numerose le procedure odontoiatriche in grado di creare un aerosol capace di trasportare batteri, virus e particelle inquinate nell’ambiente circostante. L’utilizzo di una turbina o di uno strumento ultrasonico va a creare una sospensione di particelle di vario diametro che presenta un serio rischio infettivo per le cavità nasali e tracheo-bronchiali. Questa deposizione di particelle avviene su differenti livelli a seconda delle loro dimensioni, dove le più grosse vengono fermate nelle cavità nasali, mentre le più piccole finiscono negli alveoli polmonari. Queste particelle aerosoliche hanno un proprio movimento, anche di alcuni metri, in parte causato dallo spostamento di masse d’aria e dai moti browniani prodotti dall’urto delle particelle gassose contro quelle aerosoliche. Poiché questa nube aerosolica persiste e si alimenta continuativamente in ambienti dove pazienti e procedure si susseguono e si sovrappongono nell’arco di una giornata, è fondamentale da parte degli operatori l’utilizzo di dispositivi di protezione individuale, fra i quali appare preminente la scelta di una mascherina appropriata. L’obiettivo di questo lavoro è di chiarire la terminologia,i criteri di costruzione di una mascherina, di illustrare le differenze tra mascherine e respiratori orali e di fornire un supporto pratico per la protezione propria e dei pazienti, scegliendo il dispositivo adatto a ogni situazione clinica. MATERIALI E METODI. In questo lavoro è stata condotta una revisione della letteratura nazionale e internazionale sull’argomento, sono stati raccolti i dati scientifici pubblicati dall’introduzione delle mascherine fino a oggi
e vengono descritte le caratteristiche, le differenze e le indicazioni cliniche all’uso di mascherine e respiratori orali nel contesto odontoiatrico. CONCLUSIONI. La mascherina chirurgica e il respiratore sono presidi individuali che soddisfano standard specifici e il cui utilizzo va sempre abbinato ad altri DPI quali schermi e occhiali protettivi, copricapo, guanti, camici monouso e naturalmente a un’attenta igiene personale. Va sempre sottolineata l’importanza
di esaminare la scheda tecnica riferita ai dispositivi utilizzati, al fine di controllare la necessaria stretta aderenza ai protocolli di riferimento. Ad oggi vi sono ancora pareri discordanti su quale possa essere l’indicazione corretta sulla tipologia di respiratore da utilizzare per prevenire il contagio da Sars-CoV-2. I respiratori senza filtro-valvola sembrano i dispositivi in grado di fornire la protezione più alta a operatore e paziente, ma proprio per la loro alta capaci-tà di filtraggio rendono difficile la respirazione se portati per lungo tempo continuativamente. Per migliorare la capacità respiratoria e quindi per ricercare un maggior comfort è ipotizzabile l’utilizzo di un respiratore ad alto filtraggio con valvola di esalazione, in associazione a una mascherina chirurgica da applicarvi sopra. Le mascherine chirurgiche rimangono comunque dei validi presidi per tutte quelle prestazioni che non comportano creazione di aerosol altamente
infetti e conseguente dispersione di particelle potenzialmente contaminate nell’aria. Infine, per limitare il più possibile la diffusione del Covid-19, chiunque dovrebbe indossare una mascherina chirurgica, in modo tale che un soggetto infetto non possa contaminare l’ambiente circostante e le persone vicine. SIGNIFICATO CLINICO. Questo contributo mette in evidenza le caratteristiche di mascherine chirurgiche e respiratori orali, fornendo indicazioni pratiche sui dispositivi più idonei alla protezione da infezione da Covid-19.OBJECTIVES. Many dental procedures are responsible for the creation of an aerosol capable of transporting bacteria, virus and infected particles into the surrounding environment. The use of handpieces and/or ultrasonic devices creates an aerosol of particles with different diameters that present a severe risk for nasal and tracheobronchial cavities. This deposition of particles occurs on different levels, depending on their dimensions: particles with larger diameter stops in the nasal cavities, while the smaller ones end up in lung alveoli. These aerosol particles have their own movement, partly caused by the displacement of air masses and by the Brownian motions produced by the impact of the gaseous particles against the aerosol ones. Since these droplets are able to persist continuously for long time in environments where patients and procedures follow and overlap over the course of a day, it is essential for dental clinicians to adopt personal protective equipment, among which the choice of an appropriate mask. The aim of this literature overview is to clarify the terminology, the criteria for the construction of a mask, to illustrate the differences between masks and oral respirators. and to provide practical support for personal and patient protection, choosing the device suitable for each clinical situation. MATERIALS AND METHODS. This work is a literature review of the national and international literature on this topic: the scientific data published since mask introduction to date have been collected, and the characteristics, differences and clinical indications for the use of masks and oral respirators in dentistry have been analyzed. CONCLUSIONS. The surgical mask and the respirator are individual devices that meet specific standards and whose use must always be combined with other PPE such as screens and protective glasses, headgear, gloves, disposable gowns and of course a careful personal hygiene. The importance of examining the technical data sheet referring to the devices used, in order to check the necessary strict adherence to the reference protocols, must always be underlined. To date there are still conflicting opinions on what the correct indication may be on the type of respirator to be used to prevent contagion from Sars-CoV-2. Respirators without a filter-valve seem to be the devices capable of providing the highest protection to the operator and patient but, precisely because of their high filtering capacity, they make breathing difficult if worn for a long time continuously. To improve respiratory capacity and therefore to seek greater comfort, the use of a high filter respirator with exhalation valve, in association with a surgical mask to be applied on it, is conceivable. However, surgical masks remain valid devices for all those services that do not involve the creation of highly infected aerosols and the consequent dispersion of potentially contaminated particles in the air. Finally, to limit the spread of Covid-19 as much as possible, anyone should wear a surgical mask, so that an infected person cannot contaminate the surrounding environment and people nearby. CLINICAL SIGNIFICANCE. This work highlights the characteristics of surgical masks and oral respirators, providing practical indications on the most suitable devices for protection from Covid-19 infection
SISTEMA DI DECONTAMINAZIONE DI CIRCUITI IDRICI
Full text linkLa presente invenzione si riferisce ad un sistema per la decontaminazione di un circuito idrico costituito da un condotto di alimentazione di acqua, in particolare proveniente dalla rete di fornitura o da serbatoio interno al riunito o allo studio, ed almeno un condotto di scarico dell'acqua circolante nel circuito; il sistema comprende mezzi di apertura e chiusura del condotto di alimentazione di acqua, mezzi di apertura e chiusura del condotto di scarico dell'acqua circolante nel circuito e mezzi di immissione di aria in pressione nel circuito idrico
Autologous versus xenogeneic inlay bone graft for augmentation of atrophic posterior mandible: a histological analysis.
No full textManagement of a deeply impacted mandibular third molar and associated large dentigerous cyst to avoid nerve injury and improve periodontal healing: Case report
No full textAs dentigerous cysts increase in size, the risk of postsurgical complications increases as well. Emphasis is usually placed on the risk of neurologic damage caused by trauma during and after surgical removal and of mandibular fracture resulting from the large residual bone defect. However, influence on the periodontal status of neighbouring teeth should also be taken into account. In this article, we present an interdisciplinary, safe, minimally invasive approach to treating large dentigerous cysts associated with deeply impacted third molars. A dentigerous cyst is an epithelial-lined pathologic cavity that develops in association with the crown of an unerupted tooth and appears radiographically as a well-circumscribed pericoronal radiolucency. 1 The cyst not only inhibits the eruption of the associated tooth (usually, a mandibular third molar),2 but can also carry it to unusual positions in the jaw.3-5 Dentigerous cysts may enlarge causing extensive bone resorption and even pathologic fracture.6 The greater the size of the cyst, the higher the risk of neurologic damage caused by trauma during and after surgical removal and of mandibular fracture resulting from the postoperative bone defect.7,8 Moreover, the removal of large cysts can lead to a severe infrabony defect at the root surface of adjacent teeth, jeopardizing their long-term periodontal health. "Orthodontic extraction" is a combined orthodontic-surgical approach that decreases the risk of neurologic complications and facilitates the surgical extraction of impacted mandibular third molars that are in close contact with the mandibular canal,9-12 even when associated with cystic lesions.13 This case report shows that the interdisciplinary approach is also effective in preventing periodontal breakdown on the distal surface of the adjacent second molar
Surgical field isolation through rubber dam to prevent covid-19 exposure during tooth extraction: Case report
Full text linkBackground: At the beginning of 2020, a new pathogen named SARS-CoV-2 spread from China to the globe, becoming responsible for a potentially lethal acute respiratory syndrome: COVID-19. Direct contact and airborne contamination are the most frequent infection ways of SARS-CoV-2. During routine dental practice, SARS-CoV-2 transmission can occur through direct contact with mucous membranes, oral fluids, and contaminated instruments or inhalation of aerosol from infected patients. Introduction: Tooth extraction often involves exposure to blood and oral fluids, and the use of a rubber dam could be indicated to minimize direct contact and to decrease the amount of potentially infected droplets around the operatory field. The aim of this clinical case is to show how the use of a rubber dam could help in preventing or minimizing COVID-19 exposure during dental extraction. Materials and Methods: A 32-year-old patient reported severe pain and discomfort to an upper first molar due to a deep carious lesion and vertical tooth fracture. Under local anaesthesia, a rubber dam was placed, isolating the whole upper right sextant, and an atraumatic extraction was performed. Results: All three roots were intact, the bone septum was stable, and no oro-antral communication was present. A gauze swab was placed onto the socket and compressed slightly. After 5 minutes, the socket stopped bleeding, and both clamp and rubber dam, were removed. Conclusion: Within the limits of this single case report, the use rubber dam prior to tooth extraction could be a useful device to decrease aerosol spread and exposure to blood
Vertical bone augmentation versus 7-mm long implants in posterior atrophic mandibles: results up to 4 months after loading
No full textAim of this work was to evaluate whether 7-mm long implants
could be a suitable alternative to longer implants placed in verti-
cally augmented bone for the treatment of atrophic posterior
mandibles. Sixty partially edentulous patients having 7–8 mm of
residual crestal height measured on a CT scan above the mandib-
ular canal received either two to three submerged 7-mm long
implants (30 patients) or 10 mm or longer implants (30 patients)
placed in vertically augmented bone. Three implants in three
patients failed in the augmented group versus one implant in the
short implant group up to the placement of the final prostheses.
Consequently three prostheses versus one prosthesis could not be
placed at the planned time. Four complications (dehiscence)
occurred in four patients of the autogenous bone group versus
none in the short implant group (no significant statistical differ-
ence). In two cases a partial loss of the graft occurred. No per-
manent paraesthesia of the alveolar inferior nerve occurred.
Patients subjected to vertical augmentation recovered their full
mental nerve sensitivity significantly later than those treated with
short implants. Within the limits of this study, the early results
suggest that, when the residual bone height over the mandibular
canal is between 7–8 mm, 7-mm short implants might be a pref-
erable choice since the treatment is faster, cheaper and associated
with less morbidity than vertical bone augmentation
Bilaminar connective tissue graft as an alternative treatment of leukoplakia: case report.
No full textOral leukoplakia is a predominantly white lesion of the oral mucosa that cannot be clinicopathologically characterized as any other definable lesion. Any oral site may be affected by leukoplakia, the most common sites being buccal and alveolar mucosa, floor of the mouth, tongue, lips, and palate. To date there is no evidence of effective treatment of oral leukoplakia that may prevent recurrence. This case report describes a new surgical technique using a bilaminar connective tissue graft in the treatment of oral leukoplakia. During the regular periodontal recall visit, the clinical diagnosis of gingival leukoplakia at the maxillary left sextant was established in a 45-year-old patient. Histopathologic analysis suggested reactive hyperkeratosis. The patient agreed to a new surgical treatment of the lesion. Under local anesthesia a 20-mm-long bilaminar connective tissue graft was interposed between the affected tissue and the bone. Healing was followed by the disappearance of the white lesion within the borders of the underlying graft. Five years after therapy, the treated area remained intact, with no clinical sign of recurrence
Clinical Classification of Bone Augmentation Procedure Failures in the Atrophic Anterior Maxillae: Esthetic Consequences and Treatment Options
Full text linkAlthough the number of complications and failures in bone augmentation procedures is still relatively high, these problems remain poorly documented. Moreover, the literature concerning reconstructive techniques and the treatment of their complications in the anterior areas rarely considers the final esthetic result. The aim of this paper is to propose a new classification of bone augmentation complications in the esthetic area, providing treatment guidelines useful for the management of these cases. Failures of bony regeneration procedures can be mainly divided into partial failures and complete failures. A partial failure can be solved with a corrective surgical intervention: this second surgery can have success or may not be able to provide the desired esthetic result. When the bone reconstructive procedure fails totally, a complete failure occurs and the whole procedure has to be repeated. This new intervention can have success but also this new reconstructive surgery can fail in the same way as the first, causing important damage and a compromise solution that will hardly be acceptable from an esthetic point of view. Bone augmentation techniques are not completely predictable and are not always able to guarantee the expected result, especially in the atrophic anterior maxilla. Complications and failures can often occur and this possibility must always be clearly explained to those patients with high esthetic demands and expectations
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