1,721,022 research outputs found
La gestione dei tessuti molli peri-implantari
No full textObiettivi: l’obiettivo di questo dossier è descrivere, sulla base dei più recenti dati della letteratura, la gestione dei tessuti molli peri-implantari al fine di orientare il clinico nella decisone della tecnica chirurgica da adottare. L'altezza del tessuto molle sopracrestale perimplantare (TSP) è la dimensione verticale del tessuto molle che circonda un impianto dentale dal margine della mucosa all'osso crestale. Il termine tessuto cheratinizzato (TC) definisce la caratteristica esterna della porzione di tessuto molle misurato come distanza verticale dal margine mucoso alla linea mucogengivale. Lo spessore dei tessuti molli peri-implantari non è correlato all'altezza del tessuto cheratinizzato ed è misurato come la dimensione orizzontale dei tessuti molli compresi tra la superficie esterna della mucosa alla superficie dura metallica della componete implanto-protesica. Lo spessore dei tessuti molli è invece strettamente correlato al concetto di fenotipo tissutale in quanto esso dipende primariamente dallo spessore di tessuto connettivo compreso tra l’epitelio orale esterno e l’epitelio sulculare
Materiali e metodi: le tecniche chirurgiche per la gestione dei tessuti molli peri implantari sono state suddivise in tecniche per l’incremento dello spessore e in tecniche per l’incremento del tessuto cheratinizzato.
Risultati: attraverso una serie di casi clinici sono stati descritti step by step i vari approcci terapeutici. Nei settori posteriori è indicato l’innesto gengivale libero per incrementare il tessuto cheratinizzato e quindi migliorare il controllo di placca domiciliare. Nei settori anteriori durante il posizionamento dell’impianto, l’uso aggiuntivo dell’innesto connettivale migliora il risultato estetico della riabilitazione implanto-protesica. Nel trattamento delle complicanze estetiche, la procedura combinata protesico-chirurgica ha mostrato ottimi risultati in termini di copertura completa della deiscenza dei tessuti molli peri-implantari.
Conclusioni: la gestione dei tessuti molli peri-implantari svolge un ruolo primario sia in termini di funzione che di estetica nella riabilitazione implanto-protesica
Significato Clinico: un’ottimale riabilitazione implanto-protesica deve essere eseguita attraverso un’attenta valutazione delle condizioni cliniche dei tessuti duri e dei tessuti molli. L'inserimento implantare in quantità di osso adeguato in altezza e spessore rappresenta il presupposto per l’osteointegrazione e la stabilità funzionale nel tempo. La gestione dei tessuti molli peri-implantari garantisce il mantenimento di un buon controllo igienico domiciliare e permette di garantire un soddisfacente risultato estetico
Full-mouth treatment of gingival recessions and noncarious cervical lesions with coronally advanced flap and xenogeneic collagen matrix: a 2-year case report
No full textIn clinical practice it is common to observe adjacent multiple gingival recessions (MGRs) associated with noncarious cervical lesions (NCCLs). The aim of this 2-year case report was to describe the full-mouth treatment of a patient affected by MGRs and NCCLs, with a combined restorative-surgical approach using a coronally advanced flap (CAF) and a xenogeneic collagen matrix (CM)
In‐vitro comparison of two different toothbrush bristles about peri‐implant sulcus penetration
No full textObjective: The aim of this preclinical study was to compare the ability of tapered and cylindrical bristles to penetrate the peri-implant sulcus. Methods: A full mandibular dental arch was reproduced in plaster cast. In site #3.6 a hollow glass cylinder was positioned simulating a 4 mm diameter implant and the gingival component was recreated by using dedicated silicone. A Bass brushing technique was performed from the vestibular side in humid environment. During it, the penetration of the bristles between the gum and the implant was recorded by mean of an optic fibre fixed inside the cylinder. The protocol included 5 toothbrushes per group and 10 tests per toothbrush, for a total of 50 assessments for each of the two groups. A scale of 5 grades for bristle penetration was defined: 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). From the video recordings the highest value of penetration was identified for each test. Results: The tapered bristles showed an 8 times greater penetration capacity (p = 0.001) in respect to the cylindrical bristles (multilevel analysis). The percentage of tests reaching depths ≥3 mm was 86% for tapered group and 28% for the cylindrical group. Conclusion: This preclinical study shows a clear and superior penetration capacity of the tapered bristles in respect to traditional cylindrical ones. For tapered bristles, a potentially greater hygienic efficacy around dental implants is suggested
Effect on plaque control in children patients with Down syndrome using Digital Brush with or without chlorhexidine: A randomized clinical trial
No full textObjectives The aim of this study was to evaluate efficacy in children affected by Down syndrome of "Digital Brush" in terms of Plaque Index reduction added to the daily oral hygiene procedures. Methods A total of 56 patients with Down syndrome were recruited and randomly assigned in two groups: both control and test groups underwent standard hygiene procedures of tooth brushing twice a day followed by the intervention of Digital Brush, TNT gauze impregnated with chlorhexidine 0.12%, for the test group and by sterile gauze soaked in water for the control group. Initial plaque index was measured for all patients (T0), subsequently were instructed to use either Digital Brush or gauze soaked with water for 2 weeks. At last, patients were reevaluated (T1) and the plaque index measured. Results Plaque index improvement from T0 to T1 in control group was 11.7%, while in test group was 24.1%. The mean differences between test and control group was statistically significant (p < 0.001). Conclusions This study demonstrates how the Digital Brush, added to the daily oral hygiene procedures, obtains significant improvements in supragingival plaque control in children with Down syndrome
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
Coronally Advanced Flap with Site-Specific Application of Connective Tissue Graft for the Treatment of Multiple Adjacent Gingival Recessions: A 3-Year Follow-Up Case Series
No full textThe aim of this study was to evaluate the short- (1 year) and longer-term (3 years) effectiveness of a surgical procedure combining coronally advanced flap (CAF) with site-specific application of connective tissue graft (CTG) in the treatment of multiple gingival recessions (MGR). A total of 60 periodontally healthy subjects with esthetic complaints due to excessive tooth length presenting multiple (at least three) Miller Class I and II gingival recession defects (≥ 1 mm) affecting adjacent teeth in the maxilla and mandible were enrolled in the study. All recessions were treated with CAF. The CTG was applied in gingival defects with a baseline keratinized tissue height (KTH) < 1 mm or with KTH between 1 and 2 mm and gingival thickness < 1 mm. Complete root coverage (CRC) was obtained in 98.5% (263 of 267 recessions) and in 94.7% (256 of 267 recessions) of the sites at the 1- and 3-year follow-up visits, respectively. No statistically significant differences were found at 1 and 3 years in terms of CRC between sites with or without CTG and between sites belonging to the maxilla or mandible. A greater increase in KTH at 3 years was demonstrated in sites treated with CTG. This was ascribed to the tendency of the mucogingival line to regain its genetically determined position and not to graft exposure. The present study demonstrated that the proposed surgical technique combining CAF with site-specific application of CTG was an effective treatment modality for the management of MGR, obtaining 93% CRC in the CAF-treated sites and 100% CRC in the sites treated with CAF + CTG at 3 years
A Minimally Invasive Approach Using a 4-mm Implant Without Extraction of Impacted Maxillary Canine: Four-Year Postloading Results
No full textThe aim of this case report was to suggest an alternative minimally invasive surgical approach to an impacted maxillary canine using a 4-mm-long implant for a fixed prosthetic rehabilitation, avoiding tooth extraction or surgically forced extrusion and exploiting the 6 mm of coronal bone availability. At 4 years postloading, the implant was healthy and well integrated with stable marginal bone levels. The 4-mm length of the implant reduced operative times, postsurgical morbidity, possible complications, and costs. Short implants might be an alternative to traditional, more invasive surgical procedures used in the rehabilitative treatment of impacted maxillary canines
Avoiding errors and complications related to immediate implant placement in the esthetic area with a mucogingival approach
Full text linkImmediate implant placement is considered the treatment of choice for single tooth replacement in the esthetic area. However, this treatment is associated with several critical drawbacks related to the inadequate assessment/management of the soft and hard peri-implant tissues and their subsequent remodeling, resulting in peri-implant soft-tissue defects that can lead to impaired esthetic outcomes in time. We describe in detail how the mucogingival approach to immediate implant placement ensures a standard result regardless of the baseline soft-hard tissue situation. Fully guided implant placement guarantees an adequate three-dimensional implant placement, the flap design makes it possible to perform bone augmentation with complete visibility of the area being treated, allows soft tissue augmentation with proper fixation of the connective tissue graft, and the placement of an immediate provisional ensures stabilization of the peri-implant tissues throughout the healing period
Long-Term Stability of Root Coverage by Coronally Advanced Flap Procedures
No full textTo compare 6 months and 3-year outcomes for root coverage by coronally advanced flap (CAF) procedures in localized gingival recessions
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