1,721,024 research outputs found
Quality of life after microscopic periradicular surgery using two different incision techniques : a randomized clinical study
No full textAim: To monitor the quality of life of patients after periradicular surgery when two different flap designs were used. Methodology: Forty patients with teeth having a periradicular lesion of endodontic origin were included according to specific selection criteria. Patients were randomly assigned to two groups. In one group a sulcular incision (SI) with complete papilla mobilization was made, and in the other group a papilla-base incision (PBI) was used. Periradicular surgery was performed using a surgical microscope. Parameters related to life quality were recorded daily in the first week post-surgery using a questionnaire. Pain was evaluated with a 0–100 visual analog scale (VAS). Other symptoms (swelling, bleeding and nausea), plus functions (chewing, speaking, sleeping, daily routine and work) were assessed using a five-point scale. Analgesic intake was recorded. Fisher’s test and unpaired t-test were used to assess the difference between groups. Results: The VAS score for pain, and the scores for swelling, chewing and phonetic impairment, peaked on days 1 and 2 postoperatively. A significant difference in favour of the PBI group was found for chewing and swelling in the first 4 days. Starting from day 3 post-surgery, the PBI group reported a significantly more rapid decrease in pain levels and analgesics use than the SI group (P < 0.05). The other parameters were similar in the two groups.
Conclusions: The papilla-base incision technique may be preferred as reduction of pain levels, swelling and drug intake were more rapid in the first week postoperatively compared with cases in which a sulcular incision was used
Analisi facciale globale : approccio diagnostico-terapeutico multidisciplinare alla riabilitazione implantare complessa
No full textObiettivi
L’obiettivo del presente lavoro è illustrare il percorso diagnostico di analisi facciale globale.
Materiali e metodi
Nel presente lavoro vengono forniti gli elementi per un percorso diagnostico razionale, indispensabile in casi riabilitativi implanto-protesici complessi.
Risultati e conclusioni
Attraverso un approccio facciale globale si riduce il rischio di non diagnosticare importanti alterazioni dento-scheletriche che possono pregiudicare la riabilitazione implanto-protesica.Objectives: To illustrate the diagnostic approach to total face analysis. Materials and methods: The factors for a rational diagnostic evaluation, that is essential in complex implant-prosthetic rehabilitation cases, are provided. Results and conclusions: Total face analysis reduces the risk of not diagnosing dental-skeletal alterations that may affect the outcome of an implant-prosthetic rehabilitation
Interstitial fluid dynamics of gingival tissues in the transition from physiological condition to inflammation
No full textAutologous platelet concentrates in head and neck cancer surgery : Are such bio-adjuvants really safe?
No full textRisk factors Analysis following maxillary sinus augmentation : a retrospective multicenter study
No full textPurpose: Implant-supported rehabilitation of the atrophic posterior maxilla often necessitates maxillary sinus surgery to augment existing bone volumes. Recent systematic reviews have reported implant survival rates above 90% following sinus elevation. However, statistical assessment of the effect of anatomic factors, implant design and surface, individual risk factors, and complications related to sinus floor elevation procedures on implant survival through analyzing patient data has not yet been performed. The aim of this study is to identify risk factors that might affect implant survival following sinus elevation. Materials and Methods: Three centers were involved in this retrospective multicenter study; 106 patients were treated with 144 sinus elevation procedures and received 328 implants. The mean follow-up was 48.4 months, and the longest follow-up period was 72 months. The analysis considered patient age, gender, health status, and smoking habit; implant size, shape, and surface; residual ridge height; timing of implant placement with respect to grafting; graft material; and the occurrence of surgical complications. For quantitative variables, the Pearson correlation was used. The chi-square test and Fisher exact test (for samples smaller than five units) were used for qualitative variables. Results: The cumulative implant survival rate was 93.0% up to 5 years. Complications occurred in 41 patients. Intraoperative sinus membrane perforation occurred in 40 sinuses (28%) and was not a significant risk factor for implant survival. Six patients experienced postoperative infection leading to graft failure, and two patients had considerable intraoperative bleeding. Smoking more than 15 cigarettes/day and a residual ridge height < 4 mm were significantly associated with reduced implant survival. Conclusions: Smoking habits and residual ridge height should be evaluated carefully prior to sinus elevation procedures
Is platelet concentrate advantageous for the surgical treatment of periodontal diseases? A systematic review and meta-analysis
No full textBackground: The aim of the present review is to systematically evaluate the effects of autogenous platelet concentrates on clinical outcomes of the surgical treatment of periodontal diseases. Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched using a combination of specific search terms. Furthermore, a hand search of relevant journals and bibliographies of reviews was performed. Only randomized clinical trials were included. For periodontal intrabony defects, the primary outcome variable was the clinical attachment level. For gingival recession, outcome variables were root coverage and keratinized tissue increase. Data were adjusted for baseline values. The methodologic quality of the included studies was assessed. The results of studies in which the only difference between test and control groups was the adjunct of platelet concentrates were aggregated using a metaanalysis. For intrabony defects, the influences of guided tissue regeneration (GTR) and study type (split-mouth versus parallel studies) were also evaluated. Results: The initial search yielded 424 studies. Of the 29 eligible studies, 24 studies were included. There were16 studies on the treatment of periodontal intrabony defects, all of which used platelet-rich plasma (PRP); six studies on gingival recession treatment; and two studies on the treatment of furcation defects. A significant positive effect of the adjunct of PRP was found for intrabony defects. Such an effect was magnified in studies in which GTR was not used, whereas in studies using GTR, the use of PRP had no adjunctive effect. No effect of the study type was found. No significant effect of platelet concentrates was found for gingival recession treatment in which only studies with a follow-up ≤6 months displayed positive results. No significant benefit of PRP could be demonstrated for furcation treatment. Conclusions: PRP may exert a positive adjunctive effect when used in combination with graft materials, but not with GTR, for the treatment of intrabony defects. No significant benefit of platelet concentrates was found for the treatment of gingival recession
Microscope versus endoscope in root-end management : a randomized controlled study
No full textThe purpose of this prospective, randomized, clinical study was to monitor the outcome of periradicular surgery, in which either a surgical microscope or an endoscope was used as a magnification device. A total of 113 teeth in 70 patients were included in the study, according to specific selection criteria. The choice of endoscope or surgical microscope was made using a randomized table. One hundred cases were followed for at least 2 years. Of these, 59 root-end management procedures were performed using a microscope and 41 using an endoscope. At the 2-year follow-up they were classified into three groups (success, uncertain healing and failure) according to radiographic and clinical criteria. After a 2-year follow-up, 91 teeth (91%) healed successfully. In the group using an endoscope 90% of successful healing was achieved, while 92% of success was recorded for the group using a microscope. No statistically significant difference was found in the treatment results relating to the type of magnification device. The type of magnification device used did not seem to affect the outcome of endodontic surgery
Proposta di analisi cefalometrica 3D per un'analisi facciale globale in ortodonzia e implantologia
No full textObiettivi
L’analisi facciale globale è un approccio diagnostico che fornisce un quadro ampio e ben strutturato delle problematiche del paziente candidato a complesse riabilitazioni implanto-protesiche, a complessi trattamenti ortodontici o interventi di chirurgia maxillo-facciale. Gli obiettivi di questo articolo sono proporre alla comunità scientifica e clinica un modello di analisi cefalometrica 3D a scopo diagnostico in ortodonzia, chirurgia maxillo-facciale e implantare e illustrare le attuali potenzialità dei nuovi campi di acquisizione delle indagini 3D.
Materiali e metodi
Per sviluppare questo modello cefalometrico sono stati analizzati i rapporti scheletrici cefalometrici di 30 pazienti a cui era stata comunque richiesta una CBCT per formulare una corretta diagnosi e un successivo piano di trattamento. Non è stata richiesta l’approvazione del Comitato Etico dato che il clinico non ha fatto nulla di differente rispetto a un caso clinico di routine in cui viene richiesto un esame CBCT invece di molteplici esami 2D. L’analisi è stata effettuata con il software dedicato Materialise Simplant OMS (Leuven, Belgio).
Risultati
La dose radiogena somministrata e il tempo di esposizione influenzano la qualità dell’immagine. Confrontando le indagini radiografiche CBCT con le convenzionali TC-multislice si può rilevare come la CBCT sia l’esame di scelta per la ridotta esposizione alle radiazioni, l’accessibilità e il vantaggioso rapporto costi-benefici. L’analisi dei piani e l’analisi delle distanze fra i diversi piani forniscono utili indicazioni diagnostiche per individuare importanti alterazioni ossee e dentali.
Conclusioni
Si può quindi concludere che la proposta di analisi cefalometrica 3D può essere un utile strumento in fase diagnostica terapeutica nei casi ortodontici, di chirurgia maxillo-facciale e implantare in cui è richiesta una più approfondita valutazione di parametri scheletrici di tutto il distretto maxillo-facciale.Objectives: The Total Face Approach is a diagnostic evaluation that gives a comprehensive vision of the patient's parameters candidate to complex treatments in implant dentistry, orthodontics or maxillo-facial surgery. Such assessment needs a cephalometric 3D evaluation whose interpretation allows to formulate a correct diagnosis and an adequate treatment plan. The aim of this paper is to introduce the scientific community with a 3D cephalometric model for diagnostic purposes in orthodontics, maxillo-facial and implant surgery and to illustrate the potential of the latest 3D technologies. Materials and methods: To develop this cephalometric analysis, the intermaxillary skeletal relationships of 30 patients to whom a CBCT examination was prescribed for diagnostic purposes are presented. An approval of the Ethical Committee was not requested since the clinicians did not do anything different from a normal routine case in which a CBCT examination is requested instead of multiple 2D radiologic examinations. The analyses have been studied using a dedicated software (Materialise Simplant OMS, Leuven, Belgium). Results: The radiation dose and the exposure time influence the quality of the examination. Comparing CBCT to conventional CT scans, CBCT could become the examination of choice to lower the radiation dose. It is easily accessible and has an advantageous cost-benefit ratio. Conclusions: It can thus be concluded that our proposal of 3D cephalometric analysis can be defined a useful diagnostic tool. In all clinical cases of orthodontic surgery, maxillo-facial and implant surgery which request a more detailed evaluation of skeletal parameters regarding the entire maxillo-facial area. © 2012 Elsevier Srl. All rights reserved
Periodontal microsurgery : report of 16 cases consecutively treated by the free rotated papilla autograft technique combined with the coronally advanced flap
No full textThe coronally advanced flap combined with a free connective tissue graft is a predictable method for achieving root coverage in buccal gingival recession. Nevertheless, this procedure conventionally requires involvement of a second surgical site; the latter is avoided by the proposed technique. Sixteen isolated gingival recessions (2.5 to 4.0 mm deep) were surgically treated with a coronally advanced flap associated with a connective tissue graft harvested from one adjacent papilla whose dimensions matched those of the exposed root area. Procedures were performed with the aid of a surgical microscope. Recession depth, probing depth, periodontal attachment level, and keratinized tissue width were recorded at baseline and 12 months after surgery. Mean recession moved from 3.38 +/- 0.72 mm at baseline to 0.13 +/- 0.29 mm at 12 months, a gain of 97.03%. In 13 of the 16 cases 12 months after surgery, the gingival margin was located at the CEJ or coronal to it, while in two cases the residual recession was less than 1.0 mm and in another case it was 1.0 mm. Mean periodontal attachment level was 4.72 +/- 1.00 mm at baseline and 1.03 +/- 0.59 mm at follow-up. Mean keratinized tissue increased from 1.25 +/- 0.75 mm to 3.47 +/- 0.87 mm. All differences between 12 months and baseline were statistically significant. No pockets were present at baseline, and this situation remained stable during the observation period. All 16 isolated recessions treated showed an excellent gain in root coverage without requiring a second surgical site and thus reducing patient morbidity
- …
