1,721,023 research outputs found
Interpretazione psicosomatica ed antropologica di un caso di alopecia decalcante.
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Management 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
In-vitro comparison of toothbrush bristles penetration into the peri-implant sulcus
No full textBackground: Implant-prosthetic reconstructions present anatomical and structural characteristics different from the dento-periodontal condition. These differences can lead to a problematic hygienic access by toothbrush bristles and a consequently reduced biofilm removal.
Aim/Hypothesis: The aim of this preclinical study was to compare the ability of the conical and cylindrical bristles to penetrate the peri-implant sulcus.
Material and Methods: A mandibular dentition was reproduced using a plaster model: the gingival component was recreated in silicone and a glass cylinder was positioned simulating a 4 mm diameter implant. The penetration of the bristles during brushing was recorded by using an optical fiber placed inside the cylinder. The Bass Technique was performed in a humid environment from the vestibular side. This brushing motion is described as a vibratory movement of the bristles oriented at 45° respect to the long axis of the tooth into the sulcus. The protocol included 5 toothbrushes per group and 10 tests per toothbrush, for a total of 50 assessments for each of the two groups. Each test lasted 1 minute with controlled pressure of approximately 350gr and a stroke length of 25 mm. Five degrees of penetration were identified: grade 0 (<2 mm), grade 1 (2–3 mm), grade 2 (3–4 mm), grade 3 (4–5 mm) and grade 4 (5–8 mm). The highest value was collected for each test.
Results: The conical bristles showed 8 times greater efficacy (P = 0.001) than the cylindrical bristles (multilevel analysis). The percentage of tests reaching depths ≥3 mm was 86% for conical group and 28% for the cylindrical group.
Conclusion and Clinical implications: This preclinical study shows a clear and superior penetration capacity of the conical bristles compared to traditional cylindrical ones. Further studies are required to investigate the correlation between penetrative capacity and cleaning efficacy in implant conditions. If a greater penetrative capacity is correlated with a greater cleaning efficacy, then these newly designed bristles would be preferable
Dental Trauma Epidemiology in Primary Dentition: A Cross-Sectional Retrospective Study
Full text linkOur aim was to investigate the epidemiology of dental trauma (DT) injuries in primary teeth, a health hazard issue that is often neglected by the public health care system. The records of 298 children who attended the Unit of Dental Care for Special Needs Patients and Pediatric Dentistry, University of Bologna, Bologna, Italy and had suffered a DT between January 2011 and December 2021 were examined to assess age, gender, cause and place of the DT, type of lesion and teeth involved. The chi-squared test was used to compare categorical variables. A total of 265 children (89%) suffered a single trauma, and 33 (11%) suffered from repeated DT. A total of 511 teeth (mean 1.7 +/- 0.5) experienced dental trauma. Most of the trauma occurred in the 2-3 years range (153 DT, 30%). The most affected teeth were the upper central incisors (n = 388; 76%). The DT involved periodontal tissue in 316 teeth (62%) and hard dental tissue in 262 cases (51%). DT in primary teeth is commonly caused by accidental falls at home, occurs most frequently to toddlers' upper central incisors, and usually affects tooth-supporting structures. Clinicians should be aware of the most frequent DT and be updated concerning treatment guidelines
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
In vitro comparison of two types of toothbrush bristles in penetration capacity into the peri- implant sulcus.
No full textAim: The aim of this preclinical study was to compare the ability of the conical and cylindrical bristles to penetrate the peri-implant sulcus.
Methods: A mandibular dentition was reproduced using a plaster model. The gingival component was recreated in silicone and a glass cylinder simulating a 4mm diameter implant was positioned by replacing element # 3.6. Using an 1mm diameter optical fiber placed from the lingual side inside the cylinder, the penetration of the bristles was recorded during the brushing. The Bass Technique was performed in a humid environment from the vestibular side. This brushing motion is described as a vibratory movement of the bristles arranged at 45° respect to the long axis of the tooth into the sulcus. The protocol included 5 toothbrushes per group and 10 tests per toothbrush for a total of 50 assessments per group. Each test lasted 1 minute with controlled pressure of approximately 500gr and a stroke length of 15 mm. From the video clips acquired, 4 degrees of penetration were identified: grade 0 (<2mm), grade 1 (2-3mm), grade 2 (3-4mm), grade 3 (4-5mm) and grade 4 (5-8mm). The highest value was collected for each test. At an α level of 0.05 for a one-tailed test with a power of 80% and a margin of superiority of 40%, a sample of 10 toothbrushes was needed. Intraoperative variability was assessed with the Cohen's kappa coefficient. A generalized mixed-effect linear model (multilevel analysis) was used considering the level of bristle penetration as the primary outcome and the type of bristle as fixed effects. The level of significance α was a priori set at 0.05. The null hypothesis affirms that no difference of efficacy (level of penetration) exists between the two types of bristles.
Results: Excellent agreement was obtained between the measurement performed by the examiner (K-statistics =1). The conical bristles showed 8 times greater efficacy (p = 0.001) than the cylindrical bristles; moreover, with respect to the latter, the degree of penetration of the conical bristles proved to be 2 times (p = 0.015), 20 times (p = 0.001) and 76 times (p = 0.001) higher than degrees 1, 2 and 3 respectively. The null hypothesis was therefore rejected.
Conclusion: This preclinical study shows a clear and superior penetration capacity of the conical bristles compared to traditional cylindrical ones. This result suggests a greater hygienic efficacy at the peri- implant level for the newly designed bristles
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
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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