170,470 research outputs found
Recensione a «Milano e il suo territorio in età comunale (XI-XII secolo)», XI Congresso Internazionale di Studi, Milano 26-30 ottobre 1987
No full textRecensione ai contributi presentati al Convegno internazionale "Milano e il suo territorio in età comunale (XI-XII secolo)", promosso dal CISAM di Spoleto nel 1987
Recensione a K.Watson, French Romanesque and Islam, Andalusian elements in French architectural decoration c. 1030-1180, BAR International Series 488(i), Oxford 1989, 2 voll.
No full textRecensione a K.Watson, French Romanesque and Islam, Andalusian elements in French architectural decoration c. 1030-1180, BAR International Series 488(i), Oxford 1989, 2 voll
Guided Bone Regeneration with Nonresorbable Membranes in the Rehabilitation of Partially Edentulous Atrophic Arches: A Retrospective Study on 122 Implants with a 3- to 7-Year Follow-up
No full textThe aim of this retrospective study was to evaluate clinical and radiographic outcomes of guided bone regeneration (GBR) procedures in the rehabilitation of partially edentulous atrophic arches. A total of 58 patients were included with a follow-up of 3 to 7 years after loading. Data seem to indicate that GBR with nonresorbable membranes can be a good clinical choice and suggest that it could be used to vertically reconstruct no more than 6 mm of bone in the posterior mandible. However, this technique remains difficult and requires expert surgeons
Minimally invasive fixed rehabilitation of a totally edentulous severely atrophic mandible with 4-mm ultrashort immediately loaded implants: A case report
No full textThis case report describes the minimally invasive full fixed rehabilitation of a totally edentulous severely atrophic mandible. The patient refused to undergo any other treatment, from the reconstructive surgery to the removable prosthesis, and asked for a fixed minimally invasive solution in the shortest possible time. Considering that the posterior mandibular bone was inadequate in height and that the interforaminal bone was only 4.3 to 5 mm in height, the patient received four 4-mm-ultrashort implants in the interforaminal area that were immediately loaded. Within all the limitations of this case report this procedure in this specific case appears successful through 2 years of loading
Pericoronal and well-defined radiolucencies (pt. I)
No full textOBJECTIVES The aim of this Module is to provide the clinician with an in-depth knowledge of the aspects, primarily radio graphic, of the radiolucent lesions that surround the crown of dental elements as well as non-pathological well-de fined radiolucent entities. Similarities and differences among the lesions have been highlighted and the elements of radiographic as well as clinical diversity analyzed, allowing proper differential diagnosis. MATERIALS AND METHODS The authors have included the most recent international literature available on: normal follicular space; den tigerous cysts (also know as follicular cyst); botryoid cyst; eruptive cyst (also know as gengival cyst); osteolysis-related pericoronitis; ameloblastic fibro ma; ameloblastic fibro-odontoma; odontogenic adenomatoid tumor; Pindborg’s tumor; early dental crypts; variants of trabecular medullary structure; Stafne’s lacuna; post-ex traction alveolar socket; focal osteoporotic medullary defect and fibrous healing defect. This literature have been found through the major databases (PubMed, Medline, Scopus, Google Scholar, and Cochrane Library), in addition to decades of aca demic clinical practice of the authors. RESULTS Many lesions have specific features that allow to reduce the diagnostic hypothesis to a smaller pool of cases. The clinician must consider the location, the radiographic appearance, the prevalence among the population divided by age and the elements involved with the radiolucency. These features can guide the clinician trough a correct diagnosis, distinguishing proper lesions from clinical conditions not requiring any treatment. DISCUSSION Based on the involvement or non-involvement of dental elements, the radiolucent lesions examined can be distinguished into peri-coronal and well-defined radiolucency. Radiographies are necessary for a correct diagnosis, but often are not di agnostic alone. They need in fact to be correlated with an accurate anamnesis and knowledge of topography as well as age-distribution. Diagnostic hypothesis guides the treatment approach and the correct follow-up programs, as well as identifying potentially more aggressive lesions and distinguishing them from physiological conditions. CONCLUSIONS Through anamnestic knowledge and an accurate clinical and radiographic investigation, the dental surgeon must be able to discriminate the nature of osteolytic lesions. This diagnostic hypotesis allows to distinguish the cases that require a wait-and-see approach from the cases that require a conservative or aggressive treatment, preceded by a biopsy evaluation when indicated. CLINICAL SIGNIFICANCE This Module provides the clinician with radiographic information useful in formulating a correct diagnostic hypothesis regarding the macro-categories of peri coronal radiolucency lesions and non-pathological well-de fined lesions
Radiolucency with indistinct margins and radiopacity
No full textOBJECTIVES The aim of this Module is to provide the clinician with an in-depth knowledge of the aspects, primarily radiographic, of radiolucent lesions with indistinct margins and radiopaque lesions. It will also compare the similarities between lesions, which allow to exclude certain diagnostic hypotheses in the first instance, and the elements of radiographic-clinical diversity, in order to make a correct differential diagnosis. MATERIALS AND METHODS The most recent international literature available on osteomyelitis, osteoradionecrosis, bisphosphonate osteonecrosis, metastatic and primary intra-alveolar epidermoid carcinoma, Langerhans cell histiocytosis group, plasmacytic myeloma, idiopathic osteosclerosis, condensing osteitis, hypercementosis, bone-cement dysplasia, cementoblastoma, osteoblastoma, central cement-ossifying fibroma, exostosis, enostosis, osteosclerosis, osteoma, chondrosarcoma, osteosarcoma, odontoma, ameloblastic odontoma, and foreign bodies was taken into consideration. This literature was found through the main databases (PubMed, Medline, Scopus, Google Scholar and Cochrane Library), which was combined with the experience derived from several years of clinical activity of the authors. RESULTS The data reported in the literature show that it is possible to identify peculiar identifying features for each type of lesion such that diagnostic suspicion can be ascribed to a few lesion types. The location, radiographic appearance, distribution in the population divided by age, and features related to the elements involved in radiolucency/radiation can guide the clinician in a correct diagnosis. DISCUSSION The lesions examined can be distinguished into pathological radiolucencies with indistinct margins and radiopacity, based on radiographic presentation. Radiographic pictures are indeed fundamental for a correct diagnosis, but often alone they are not diriment if not correlated with an accurate history and knowledge of topography and demographic distribution. Diagnostic framing is ultimately aimed at treatment and the correct follow-up programme, as well as identifying potentially more aggressive lesions and distinguishing them from paraphysiological conditions. CONCLUSIONS The dentist must be able to discriminate, through in-depth anamnestic knowledge and a careful clinical and radiographic investigation, the more or less aggressive forms of osteolytic lesions in order to be able to distinguish cases that require an observational approach and patient maintenance under follow-up from cases that require conservative and more aggressive treatment, preceded by a bioptic evaluation when indicated. Finally, it is important to be able to identify and distinguish oral manifestations of systemic pathologies, sometimes the first manifestations
Osteolytic lesions of the jaws: focus on keratocysts and ameloblastomas
No full textOBJECTIVES The objective of this Module is to pro-vide the clinician with a thorough un-derstanding of the aspects of odonto-genic keratocysts and ameloblasto-mas from a radiographic stand point. The topic of discussion is the compar-ison between a conservative versus a surgical approach. Similarities and dif-ferences among the lesions have been highlighted and the elements of radio-graphic as well as clinical diversity an-alyzed, allowing proper differential di-agnosis. MATERIALS AND METHODS The most recent available international literature about keratocysts and amelo-blastomas has been reviewed. Considering that the lesion to date known as keratocyst has changed name over time, the terms dermoid cyst, cholesteoma, primordial cyst and keratocystic tumor were also consid-ered in the literature search. In line with the latest classification of the World Health Organization, only the cases presenting paracheratinized histology were considered. With regards to ameloblastomas, the five variants by which it is classified as: unicystic, conventional, adenomatoid, metastasizing, and peripheral were ex-amined. The adenomatoid variant has only recently been introduced, so there is not much supporting literature yet. The literature was found through the major databases (PubMed, Medline, Scopus, Google Scholar, and Cochrane Library), in addition to decades of aca-demic clinical practice of the authors. RESULTS The datas reported in the literature re-garding keratocysts are extremely het-erogeneous with regards to both the type of treatment and the lesions, fea-tures in terms of location, extent, in-volvement of dental and/or mucosal el-ements and association with syn-dromes. With regards to ameloblasto-mas there is a broader classification and thus a more focused literature. In both keratocysts and ameloblastomas, unicystic forms are often misinterpret-ed and diagnosed retrospectively be-cause they are less known. On the oth-er hand, clinicians often draw their at-tention towards multilocular lesions that are put into differential diagnosis (including the lesser known ones such as glandular odontogenic cyst). DISCUSSION After an initial skimming, a number of lesions still remains in differential diag-nosis. Literature agrees, that these le-sions require a biopsy examination in order to diagnose their nature with cer-tainty. The goal is to implement the most appropriate treatment plan that aims not only to minimize the recur-rence rate but also to ensure a good standard of quality of life for patients. CONCLUSIONS In cases of keratocysts and ameloblas-tomas, correct identification with re-spect to other lesions turns out to be crucial, as a failure to recognize them may give clinical implications such as more invasive surgeries for the patient. CLINICAL SIGNIFICANCE To focus on the often underestimated unicystic forms of keratocysts and am-eloblastomas. The professional should follow a diagnostic flowchart to make a correct diagnosis by clinical, radio-graphic and biopsy examination wich will guided the management of the le-sions in a conservative or intervention-al approach. In addition, the funda-mental differential diagnosis aspects that allow intercepting these types of lesions are highlighted
Well-defined (pt. II) and multilocular radiolucencies
No full textOBJECTIVES The aim of this Module is to provide the clinician with an in-depth knowledge of the features, primarily radiographic, of the pathological well-defined radiolucency and multilocular radiolucency. The second group includes keratocysts and ameloblastomas that will be treated in the next Module. Similarities and differences among the lesions have been highlighted and the elements of radiographic as well as clinical diversity analyzed, allowing proper differential diagnosis. MATERIALS AND METHODS The most recent international literature available on the collateral cyst, naso- palatine cyst, naso-labial cyst, surgical ciliated cyst, radicular cyst, residual cyst, odontogenic glandular cyst, odontogenic myxoma, aneurysmal bone cyst, central bone hemangioma, and kerubismus has been reviewed. This literature was found through the major databases (PubMed, Medline, Scopus, and Cochrane Library), in addition to decades of academic clinical practice of the authors. RESULTS The datas show that it is possible to identify specific features for each type of lesion. This allows to ascribed a diagnostic hypothesis to a few lesions. The clinician must consider the location, the radiographic appearance, the distribution in the population divided by age and the elements involved in radiolucency. These features can guide the clinician trough a correct diagnosis, distinguishing lesions proper from clinical conditions not requiring any treatment. DISCUSSION The radiolucent lesions examined can be distinguished into pathologic well-defined and multilocular radiolucent lesions based on the radiographic presentation. Radiographics are essential for a correct diagnosis, but often alone are not diriment if not correlated with an accurate anamnesis and knowledge of topography and demographic distribution. Diagnostic hypothesis guides the treatment approach and the correct follow- up programs, as well as identifying potentially more aggressive lesions and distinguishing them from paraphysiological conditions. CONCLUSIONS The dental surgeon must be able to discriminate by a thorough anamnestic knowledge and an accurate clinical and radiographic investigation the nature of osteolytic lesions. This diagnostic hypotesis allows to distinguish the cases that require a wait and see approach from the cases that require a conservative or aggressive treatment, preceded by a bioptic evaluation when indicated. CLINICAL SIGNIFICANCE This Module provides the clinician with radiographic information useful in formulating a correct diagnostic hypothesis regarding the macrocategories of pathological well-defined lesions and multilocular ones
Clinical approach to osteolytic lesions
No full textOBJECTIVES The objective of this Module is to in-troduce the clinician to the correct ap-proach for the diagnostic manage-ment of osteolytic lesions both of the maxilla and mandible. It is true that only histologic examination provides a certain diagnosis. However, the clini-cian must always have in mind a diag-nostic hypothesis based on the clinical and radiographic exam. Therefore, in order to guide therapeutic decisions, caution must be taken during the ex-tra-oral and intra-oral examination that will be carried out pre-operatively. To aid the diagnostic process, the cli-nician will follow a specific list of ra-diographic criteria in order to identify the benign or malignant nature of the lesion. MATERIALS AND METHODS The most recent available international literature, has been taken into consid-eration. Articles have been found through the main research databases (PubMed, Medline, Scopus, Google Scholar and Cochrane Library), all combined with decades of academic clinical experience of the authors. RESULTS Exclusion criteria are based on a com-prehensive patient anamnesis com-bined with clinical and radiographic data. These three selection methods have been staged to establish when a surgery is preferred to a monitor ap-proach. Firstly, the anamnesis allows the iden-tification of osteolytic lesions related to Gorlin-Goltz or Marfan syndrome as well as analysis of past dental surger-ies (i.e. apicectomy or history of ex-tractions). Secondly, clinical informa-tion about signs and symptoms, a full perio chart including bleeding on prob-ing, suppuration and/or mobility allow the clinician to direct the diagnosis to-wards a more or less aggressive le-sion. Finally, radiographic information allows to assess the extension of the lesion and its relation to adjacent structures (i.e. dental elements, corti-cal bone, adjacent vascular-nervous bundles, etc). DISCUSSION Osteolytic non-cancerous lesions do not cause symptoms unless they are large expansive lesions. These are generally late diagnosis cases that result in pain and sense of tension on the soft tissues. Radiographically, to note that large non-cancerous le-sions may lead to cortical erosion without causing dysesthesia and/or parestesia. In contrast, when cancer lesions en-croach adjacent structures, they can become symptomatic with possible involvement of nerve bundles. From a radiographic point of view, cancer le-sions show a rapid expansive growth and can erode the cortical bone. It is also possible that they are associated with rhizolysis of the dental elements involved in the lesion. CONCLUSIONS Among the osteolytic lesions, the den-tal surgeon must be able to discrimi-nate the benign from the malignant ones through an in-depth anamnestic knowledge and careful clinical and ra-diographic investigation. This approach allows to determine the lesions that re-quire an observational approach versus an interventional one on the base of the histo-pathologic outcome. CLINICAL SIGNIFICANCE Adequate anamnestic clinical and ra-diographic evaluation of an osteolytic lesion becomes critical for diagnostic purposes to ensure predictable thera-peutic management and to establish prognosis
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