1,721,083 research outputs found
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
Sharpening of ultrasonic sealers
No full textAbstract Instruments suitable for removing calculus, plaque and necrotic cementum, which hinder normal periodontal reattachment, are extremely important for successful therapy. The test was carried out in order to see if a standard sealer used for ultrasonic tartar removal maintains its physical features when sharpened. 6 sealers, compatible with piezoelectric generators, were tested and 2 diameters, A and B, weights and resonance frequencies were measured. Sealers no. 2, 3, 4, 5, were sharpened with India stone, sealer no. 6 with rotatory instrument; sealer no. 1 was not sharpened and was used as control. All measurements were taken again at the end of the test. Statistical analysis reveals significant variations, after sharpening, of A diameter (t= 4.14 > 3.55, p < 0.01), B diameter (p= 5.34 > 3.355, p < 0.01) and resonance frequency (t= 2.82 > 2.306, p < 0.05); in contrast, there is no significant change of weights (t= 1.17 < 2.306, p > 0.05). These results suggest that sharpening slightly modifies the physical features of ultrasonic tips, so that sharpening ultrasonic sealers, from a physical point of view, can be carried out, paying attention not to damage the water cooling system. Copyright © 1991, Wiley Blackwell. All rights reserve
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
Variables affecting the gingival embrasure space in aesthetically important regions: Differences between central and lateral papillae
Full text linkThis study evaluated different variables to determine their role in the appearance of the central and lateral upper jaw papillae. 292 interdental embrasures were examined. Personal variables were: age, smoke, and use of interproximal hygiene devices. The clinical characteristics were: tooth shape, periodontal biotype and papilla appearance. Radiographic measurements were: root to root distance at the cemento-enamel junction (horizontal distance), and bone crest to interdental contact point distance (vertical distance). The papilla recession increased with patient age. The horizontal distance of the central papilla was always greater (up to 1 mm) than that of the other papillae. The vertical distance of the central papilla was greater (up to 2 mm) than that of the other papillae for each class except for the normal one (Nordland & Tarnow classification). For vertical distances ≤5 mm, papillae were almost always present; for distances up to 6 mm, the lateral papillae belonging to the normal class disappeared, while the central papilla remained in 11% of cases; central papillae of class 1 were present in larger proportions until a vertical distance of 8 mm. The present observational study shows that differences on clinical and radiographic determinants do exist between central and lateral papillae. This variance should be strictly taken in account for a harmonious and stable treatment outcome on this highly aesthetic area. © Montevecchi et al.; Licensee Bentham Open
Retrospective study of tooth loss in 92 treated periodontal patients
No full textBACKGROUND/AIMS: In this retrospective study, the efficacy of periodontal therapy and maintenance in preventing tooth loss was evaluated. METHODS: The study included 92 patients with 2310 teeth diagnosed with chronic adult periodontitis and observed over a mean period of 6.7 years, with each patient receiving surgical therapy in two or more quadrants. The group was divided into two subgroups: those who complied with the recommended maintenance schedule and those whose compliance was erratic. Individual tooth prognosis was assigned according to radiographic parameters. RESULTS: At the completion of active periodontal therapy, 2184 teeth were present. During the maintenance period, 44 teeth were lost due to periodontal reasons. Tooth mortality revealed a mean annual adjusted tooth loss rate of 0.07/year. Molars were the teeth most frequently lost; canines the least. The number of teeth lost in the three prognostic categories was: one (0.07%) for teeth with good prognoses, 21 (3.63%) for questionable prognoses and 22 (11.34%) for hopeless prognoses. Patients complying erratically with supportive periodontal therapy were at a 5.6 times greater risk for tooth loss following active therapy than regularly compliant patients. Conclusions: The results demonstrated a low tooth mortality rate in periodontal patients following active treatment combined with a strict maintenance program
Preservation and reconstructive techniques of interdental papilla
No full textLa papilla interdentale, inizialmente considerata come una semplice parte della gengiva di forma piramidale, è un’entità anatomica dalla morfologia complessa, alla quale si riconoscono oggi sia finalità protettive verso il parodonto profondo e le superfici radicolari, sia funzioni estetiche e fonetiche; la sua perdita quindi deve essere valutata come l’alterazione dell’insieme delle sue specifiche funzioni. Analizzando i versanti papillari rivolti verso le superfici dentali in direzione corono-apicale, si trovano l’epitelio sulculare, l’epitelio giunzionale e l’attacco connettivale. L’attacco connettivale e l’epitelio giunzionale costituiscono un’unità fondamentale definita ampiezza biologica, la cui violazione porta a un’inesorabile e spontanea perdita di supporto di tessuto dentale finalizzata alla ricostruzione del corretto rapporto epitelio-connettivale. Molteplici sono le cause che possono portare alla perdita o al danneggiamento della papilla.
Tali fattori possono essere distinti in infettivi, come gengiviti e parodontiti, e traumatici, come l’uso scorretto dei dispositivi igienici domiciliari e la chirurgia parodontale. Dagli anni Sessanta in poi sono state elaborate numerose tecniche chirurgiche finalizzate a preservare i tessuti molli, compresi quelli interprossimali; particolare impulso a questa impostazione va attribuito non solamente a una cre- scente sensibilità estetica del parodontologo, ma anche all’introduzione di conoscenze di tipo rigenerativo/ricostruttivo.
Quando la perdita dei tessuti interdentali è già avvenuta possono essere attuate molteplici tecniche con finalità ricostruttive, che possono essere distinte in due categorie: chirurgiche e non chirurgiche. Le tecniche ricostruttive non chirurgiche mirano fondamentalmente a modificare le determinanti anatomiche non gengivali correlate con la presenza dei tessuti interdentali. Tra queste strategie si riconoscono trattamenti restaurativi, protesici e ortodontici; molto recente la proposta d’iniezione di fibroblasti.
Molteplici stratagemmi chirurgici sono stati descritti in letteratura, con finalità correttive verso deficit di tessuti interdentali; purtroppo nessuna ricerca specifica ha per ora verificato l’effettivo risultato e/o comparato tra loro tali tecnicismi. La conoscenza delle molteplici variabili che influenzano lo stato di salute e l’equilibrio dei tessuti compresi nell’area interdentale è alla base di una corretta gestione clinica dell’area; la rassegna del percorso scientifico che ha portato sino alle più recenti tecniche preservative e ricostruttive della papilla interdentale permette al clinico un razionale approccio terapeutico
Histologic analysis of two dental implants extracted after osseointegration
No full textPurpose. The aim of this case report is to analyze and observe the bone tissue formation around two dental implants after their osseointegration. Methods and Materials. A 58 y.o. woman was referred to the Division of Periodontology and Implantology (University of Bologna, Italy) due to severe pain and discomfort caused by two of the four dental implants placed in the upper jaw (sites #13 and #23) in a private practice 8 months before. Implants were made of titanium, sandblasted with zirconium oxide and etched with mineral acids (Sweden&Martina, Due Carrare, Italy). At clinical and radiographic analysis, implants appeared properly osseointegrated but placed tilted way too buccaly, with their emergence profile in non-keratinized oral mucosa. For the above-mentioned reasons, the patient started having discomfort immediately after the prosthetic load occurred four months after implants placement. The patient was rehabilitated with an implant supported removable prosthesis. The patient explained difficulties to perform adequate oral hygiene and declared pain every time she was wearing the implant-supported removable prosthesis. The implants were removed, preserving the bone around implant threads, and replaced with two new dental implants, placed in a prosthetic-guided correct inclination. The removed implants were processed for histological analysis in accordance with Checchi V. & al, 2015.
Results. The histological analysis revealed proper osseointegration of the implant fixture after eight months (4x figures). Histological views of biopsies show good bone-implant contact recorded from the coronal side to the apical implant section (4x figures). Presence of direct connecting bridges between the peri-implant bone trabeculae and the implant surface were recorded (10x figures). Conclusions.
This case report clearly shows how after 8 months from implant placement, the fixtures coated with a rough surface were properly osseointegrated with good bone-implant contact recorded along their entire surface
A modified papilla preservation technique, 22 years later
No full textThe contour of the interdental tissues, as well as the color and texture of the keratinized tissues, are essential elements of anterior esthetics. Tissue loss in the interproximal regions, with related esthetic concerns, phonetic difficulties, and food impaction, can occur for a variety of reasons, including treatment of periodontal diseases. In periodontal surgical procedures, the soft tissues require elevation and resection to gain access to the root surfaces and osseous supporting structures. Compromised esthetics in the anterior region of the mouth could be a serious consequence of periodontal surgical procedures. Several articles have been devoted to flap designs and surgical techniques to maintain full papillary form and preserve the soft tissues during surgical access. Unfortunately, very little evidence of long-term results is available. The aims of the present article are to report a 22-year follow-up case of surgical interdental papilla preservation, discuss the anatomic variables that conditioned the outcome, and review and compare existing surgical techniques for maintaining the interproximal soft tissues. © 2009 by Quintessence Publishing Co Inc
A coronally positioned single flap approach in periodontal reconstructive surgery
No full textAim of work. The goal of this article is to describe an innovative surgical technique for the treatment of periodontal bony defects that combines the characteristics of both reconstructive and mucogingival techniques. Method. The special features of this technique, named Coronally Positioned Single Flap Approach (CP-SFA), consist in a surgical flap elevated just on one side (buccal or lingual/palatal), and in its coronal reposition that is stabilized thanks to interdental papillae whose epithelium has been removed. Clinical implications. This surgical technique has many advantages, for instance the improvement of periodontal aesthetics due to reduced post surgical contraction and discomfort for the patient because of a smaller surgical field. The site selected for this technique must meet several demands: intrabony defects localized only on buccal or lingual/patatal side, healthy and intact interproximal areas close to bony defect and the possibility of adequately cleansing of bone defects and root surfaces. Conclusions. Short term results confirm the utility of the CP-SFA; further and meticulous investigations are however needed
- …
