151 research outputs found
Mario Rigone, un referente barrial
No full textFil: Caggiano, María Amanda. Instituto Municipal de Investigaciones Antropológicas de Chivilcoy. Universidad Nacional de La Plata; Argentin
I percorsi giuridici per l’integrazione. Migranti e titolari di protezione internazionale tra diritto dell’Unione e ordinamento italiano
No full textMedication-Related Osteonecrosis of the Jaw: A Case Report of an Unusual Side Effect of Adalimumab
No full textBackground. Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse drug reaction characterized by progressive bone destruction and necrosis of mandibular and/or maxillary jaw bone that occurs in patients undergoing treatments with antiresorptive drugs such as bisphosphonates or denosumab, antiangiogenic agents such as bevacizumab, or other kinds of monoclonal antibodies such as rituximab and ipilimumab, for different oncologic and nononcologic diseases. The aim of this study was to report a case of MRONJ in a patient affected by rheumatoid arthritis disease in treatment with adalimumab. Case Presentation. A 70-year-old female patient affected by rheumatoid arthritis (RA), who had been undergoing adalimumab (40 mg subcutaneous injection) every two weeks for 5 years, with no history of antiresorptive or antiangiogenic agent administration, came to our attention for intraoral necrotic bone exposures of the anterior mandible. After drug withdrawal and antibiotic cycles, the patient underwent surgical treatment with bone resection and debridement of necrotic tissues. After an observation period of 8 months, a complete healing without signs of recurrence was detected.Conclusions. Based on this study, a correlation between adalimumab and MRONJ is possible. Therefore, we believe that an oral cavity examination should be done in every patients, before starting therapy with adalimumab, to possibly avoid MRONJ onset. Further studies are required to confirm the role of adalimumab in MRONJ
Palatal Graft Harvesting Site Healing and Pain Management: What Is the Best Choice? An Umbrella Review
No full textThe use of free gingival graft (FGG) and connective tissue graft (CTG) from the palate are among the most predictable periodontal and peri-implant plastic surgery procedures. However, palatal harvesting causes severe discomfort in the palatal area in patients undergoing harvesting. The aim of this umbrella review is to evaluate which products or techniques can result in fewer side effects and less morbidity in patients. Systematic reviews, with meta-analysis or not, about postoperative pain and wound healing in patients undergoing surgery to remove a free gingival graft or connective tissue graft from the palatal region, published only in the English language, were electronically searched for on BioMed Central, Scopus, MEDLINE/PubMed, the Cochrane library databases, and PROSPERO register. Of 1153 titles, only 7 articles were included in this review. The reviews included suggest that the more effective interventions for patient-reported outcomes, particularly for pain management, are cyanoacrylate adhesives, platelet-rich fibrin, hyaluronic acid, and the use of palatal stents. Low-level laser therapy also demonstrated good results in palatal wound healing speed after FGG procedures. Also, topical agents were also described. Future studies and more high-quality randomized clinical trials are needed to provide clear descriptions and standardized procedures of interventions to obtain clear results
PRF and PRP in Dentistry: An Umbrella Review
No full textIntroduction: Platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) utilize autologous blood and share the objective of leveraging blood-derived growth factors to enhance the body’s natural healing process. A large extensive use has been made in various branches of dentistry. Methods: A total of 4175 records were identified from the electronic search, specifically 291 from BioMed Central, 3406 from MEDLINE/PubMed, 304 from the Cochrane library databases, and 174 from the PROSPERO register. This review was performed in relation to the PRISMA flow chart and was annotated in the PROSPERO register. Results: In total, 3416 title abstracts were screened, and a total of 40 systematic reviews were finally included in the present umbrella review. Conclusions: Research supports the use of PRF and PRP in different fields of dentistry. This is a huge potential for the patient but also for the doctor as these products are from the patient and have zero cost. However, further studies are needed, especially RCTs, to have clearer evidence on the role of PRF and PRP
Biomechanical Implications of Mandibular Flexion on Implant-Supported Full-Arch Rehabilitations: A Systematic Literature Review
No full textBackground: Mandibular flexion (MF) is a complex biomechanical phenomenon, which involves a deformation of the mandible, due mainly to the contraction of the masticatory muscles, and it can have numerous clinical effects. The deformation of the lower jaw caused by mandibular flexion is generally very small, and it is often overlooked and considered irrelevant from a clinical point of view by many authors; however, it should be important to remember that median mandibular flexure (MMF) has a multifactorial aetiology. The main aim of the current systematic review is to highlight the different factors that can increase MF in order to help clinicians identify patients to whom they should pay more attention. As a secondary outcome, we wanted to analyse the preventive measures and suitable techniques to be adopted to minimise the negative effects of this phenomenon on oral fixed rehabilitations. Methods: The review, which was carried out in accordance with the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) flowchart, was recorded in the “International Prospective Register of Systematic Reviews” (PROSPERO). As research questions, “Patient/Population, Intervention, Comparison and Outcomes” (PICO) questions were employed. Using the ROBINS-I technique, the risk of bias in non-randomised clinical studies was evaluated. Results: The initial electronic search identified over 1300 potential articles, of which 54 studies were included in this systematic review. Information regarding the relationship between MF and individual factors, mandibular movements, impression taking, and fixed rehabilitations were obtained. Conclusions: The studies included in this systematic review showed that MF is greater during protrusive movements, in the posterior areas of the lower jaw, and in patients with brachial facial type, greater jaw length; small gonial angle; and less density, length, and bone surface of the symphysis. The biomechanical effects of mandibular flexion on fixed restorations are debated. Prospective clinical and radiological observational studies should be conducted to evaluate the potential short-, medium-, and long-term consequences of MF
Infection Control in Dental Practice During the COVID-19 Pandemic
No full textCOVID-19 is the disease supported by SARS-CoV-2 infection, which causes a severe form of
pneumonia. Due to the pathophysiological characteristics of the COVID-19 syndrome, the particular
transmissibility of SARS-CoV-2, and the high globalization of our era, the epidemic emergency
from China has spread rapidly all over the world. Human-to-human transmission seems to occur
mainly through close contact with symptomatic people aected by COVID-19, and the main way
of contagion is via the inhalation of respiratory droplets, for example when patients talk, sneeze or
cough. The ability of the virus to survive outside living organisms, in aerosol or on fomites has also
been recognized. The dental practitioners are particularly exposed to a high risk of SARS-CoV-2
infection because they cannot always respect the interpersonal distance of more than a meter and are
exposed to saliva, blood, and other body fluids during surgical procedures. Moreover, many dental
surgeries can generate aerosol, and the risk of airborne infection is to be considered higher. The aim
of this paper is to provide practical advice for dentists based on the recent literature, which may be
useful in reducing the risk of spreading COVID-19 during clinical practice
Platelet-rich fibrin (PRF) in implant dentistry in combination with new bone regenerative technique in elderly patients
No full textIntroduction 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. Aim 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. Materials and methods 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 regenerative conditions with a bone augmentation and implant insertion in one single stage procedure. For all the patients autologous PRF has been used to fill the split crest gap or simply as regenerative material. Orthopantomography, intraoral radiography and CT DentaScan/CT Cone beam were performed for every patient before the treatment and at follow-up time exeption made for CT. Results All cases were successful, there were no problems at surgery time, at post-operative and at osteointegration periods. All implants achieved osteointegration. These results were obtained by accurately managing immediate and late post operative period in all of the operated cases. Mean difference for height bone loss between the two groups of patients was 2.4 mm at T1 and 2.2 mm at T3. Discussion The rationale of this split crest flapless modified technique is to obtain a proper buccal cortex expansion preserving its vascular supply avoiding periosteal elevation for better cortical bone nourishing. Moreover, advantages are reported related to the use of PRF. The effectiveness of PRF is shown in promoting the healing of surgical wounds, it has, in fact, platelet growth factors that can improve the vascularisation of the surgical site, promoting neoangiogenesis. Furthermore, by simply changing the settings of the centrifuge, it is possible to obtain a normal gelling if it has to be used as regenerative and stimulating material, or more consistent substance to be used as a filler in the split crest gap. Conclusions The main advantages in using the platelet-rich fibrin are healing and bone regenerative properties in combination with its complete resorption after surgery, thus avoiding a second surgery time, important factor in the elderly patients. Currently, it is a minimally invasive technique with low risks and satisfactory clinical results such preventing complications or implant failure particularly in elderly patients for age related conditions
Infection Control in Dental Practice during the COVID-19 Pandemic: What Is Changed?
No full textThe COVID-19 pandemic has profoundly changed our lives. Since the SARS-CoV-2 was discovered, many studies have been done on the transmission mode, its replication within humans, and its survival even in the outside environment and on inanimate surfaces. Undoubtedly, health care workers have faced the greatest risks because of their close contact with potentially infected patients. Of these, dental health care professionals are certainly among the most vulnerable categories, precisely because infection occurs with the airborne virus. The treatment of patients within the dental office has changed profoundly, respecting all preventive measures towards the patient and the practitioners themselves. The aim of this paper is to understand whether the protocols changed for the prevention of SARS-CoV-2 infection among dentists remained even after the most acute phase of the pandemic. In particular, this study analyzed habits, protocols, preventive measures, and any costs incurred in the COVID-19 era for the prevention of SARS-CoV-2 infection among dental workers and patients
Zygomatic fractures: Technical modifications for better aesthetic and functional results in older patients.
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