The use of ozone therapy for treatment of periodontal disease: a split-mouth, randomized, controlled clinical trial.

Periodontal treatment has the aim to reduce oral infection and prevent the progression of the disease. The potential benefits of new therapy with Ozonline® for periodontal treatment, include improved patient compliance and an easier access to periodontal pocket. The objective of this study was to explore the efficacy of Ozonline® in the treatment of chronic periodontitis in adult patients. A randomized controlled split-mouth study was carried out in ten patients (5 men and 5 women age 42-73 mean 55 ±7) with a diagnosis of chronic periodontitis. None of these patients received any surgical or non-surgical periodontal therapy and demonstrated radiographic evidence of moderate bone loss. The mouth has been divided into upper right and left quadrants. The upper and lower right quadrants were treated with ultrasonic scaler, the left quadrants with ultrasonic scaler with ozonated water (Ozonline®). 10 microbiological samples were collected from upper left quadrants and 10 from upper right quadrants from each patient. Microbiological samples were collected from the sites of the patients at baseline and at the 7th day. 20 localized chronic periodontitis sites were selected (10 in left quadrants and 10 in right quadrants). After the treatment with Ozonline®, a remarkable decrease in bacteria amount, both for some species and for the total count was observed in the left quadrants respect to right ones. Specifically, T. forsythia and T. denticola were eradicated whereas Total Bacteria Loading and Fusobacterium nucleatum showed a reduction of 38% and 55%, respect to right quadrants. Our study demonstrated the efficacy of the Ozonline® in the management of moderate to severe chronic periodontitis. .

Preventive contamination with Lactobacillus reuteri of the implant-abutment connection: an in vivo study.

The aim of this study is to preventively contaminate the abutment-fixture connection (AFC) with Lactobacillus reuteri(L. reuteri), to evaluate the presence of micro leaks in different types of implant-abutment connections, by measuring the concentration of (L. reuteri), in the sulcular fluid over time. This microorganism produces the Reuterine, an antibiotic which counteracts the development of other microbial species. Fourteen biphasic implants were placed on 10 patients (3 women; 7 men; mean age 55.9±16.54y). Eight implants had a flat top connection (internal Hex) while six implants had a tapered connection (conical plus octagonal). At the time of prosthetic finalization, before the healing screw was removed, the sulcular fluid was harvested, on each implant, by means of three sterile paper cones placed into the gingival sulcus and left in place for 20 sec before to be transferred to a sterile tube. Once the healing screw has been removed, first the implant connection has been gently dried with air jet for 10sec and then completely filled with (L. reuteri) DSM 17938 (Reuflor, Italchimici, Italy). Immediately after the prosthetic finalization the sulcular fluid was then harvested again, with the same procedure described before and repeated at 1 week and 1 month of follow up. The samples were then sent for subsequent DNA extraction and real-time PCR. Our results demonstrate that the concentration of (L. reuteri), in the sulcular fluid, does not persist over time in case of preventive contamination of the AFC, demonstrating no significative differences between flat top and tapered connections. Therefore, the use of the latter does not lead to a lower risk of Peri Implant Disease (PID). Long-term studies, involving a larger number of samples, are advisable to confirm these findings.

Mesenchimal stem cells in oral medicine: an overview.

This review aims to address the procedures and indications, required for the application of the mesenchymal stem cells treatment strategy of regenerative dentistry. Mesenchymal stem cells have rarely been used in this field; conversely, experience from other clinical fields and basic research seems to recommend the suitability of this scope of application. We reviewed 31 out of 206 articles on Web of Science, Scopus, PubMed, etc. The main purpose of this paper is a short review of the literature evaluating the application of stem cells in regenerative dentistry, their ability to get a multilineage differentiation and to introduce a safe and useful alternative way of harvesting and selection. The most common derivation of stem cells used for regenerative dentistry is from the adipose tissue. There are conditions in which the levy adipose cannot be easily achieved, or where large amounts of injectables are not needed. For this purpose, the possibility of selecting stromal stem cells directly from the lax subcutaneous connective tissue preferably of the head region would allow a technical simplification and a greater homology in tissues. .

Oral rehabilitation of edentulous jaws with one-piece implants: a case series.

The popularity of one piece implants has increased considerably between patients and dentists. The advantages of one-piece immediate loading for rehabilitation of edentulous mandibles is to reduce the number of interventions and timing of prosthetic. These parameters can be better controlled with a one-piece implant. Twenty-one patients with one-piece implants inserted in totally edentulous mandibles were considered for this retrospective study. Inclusion criteria were: Good oral hygiene, absence of lesions of the oral mucosa, no smoking or smoking less than 20 cigarettes a day, drinking less than 2 glasses of wine a day, good general health no pregnancy. Twenty-one (12 females 9 males) patients were enrolled in this retrospective study. The mean follow-up was 1 years. A total 84 one-piece implants (Biohorizon, Italy) were inserted in edentulous mandible. Implants diameter was 3.0 mm in all fixtures. Implants length was equal and longer than 12 mm in 44 and 40 fixtures respectively. 48 were inserted in females 36 in males (range 33-67; mean age 58.3). One-piece immediate loading implants has no difference in survival rate respect to two-piece implant and delayed loading for rehabilitation of totally edentulous mandibles. In conclusion one-piece immediate loading implant is a reliable device for mandible rehabilitation.

Technical note: surgical guide for computer-aided endodontic surgery.

INTRODUCTION: CBCT combined to intra-oral scansion are the means to build an endodontic surgical guide to perform an easier and safer access to the apex in endodontic micro-surgery. . METHODS: A 38-year-old woman presented chronic apical periodontitis, which involved the three roots of 16 that was treated by endodontic therapy several years ago elsewhere. The palatine channel was retreated, the mesio- and disto- buccal roots were instead treated with apicoectomy. A surgical template was printed by a 3D printer to obtain greater precision in the surgical access. CONCLUSIONS: Endodontic microsurgery has evolved over the years. New tools have been introduced to improve therapy, even if the basic principles have not changed. In fact, according to the literature, it is necessary to cut at least 3 mm of root to be sure of eliminating the anatomical variations and the accessory channels. Several Authors have devoted themselves to creating an endodontic surgical template, some in vitro and others in vivo. The present paper introduces a new method that allows a more conservative osteotomy and greater precision the surgical access. Further investigation are needed to test and improve the effectiveness of the treatment but this technique seems very promising because it is less invasive for the patient and simplifies the work for the dentist who can perform micro-surgery in an easier and faster way.

Bone strain measurements and implant micro-surface analysis of drill-less self-threading dental implants - preliminary in-vitro results.

Innovative implant thread design enables timesaving one-stage insertion, with no need for prior osteotomy. This technique may impair bone and implant surface. The aim of this study was to investigate the strain levels produced in surrounding bone by this new treatment approach during and after implant placement and the effect of high insertion torque on the surface microstructure of the implants. Fresh bovine bone was collected and prepared to receive 2 types of drill-less self-threading dental implants differing in their thread design. Prior to implant insertion, two strain-gauges were cemented onto the bovine bone at each of the implant's neck recipient sites, one horizontally and one vertically. 5 Type 1 and 5 Type 2 implants were inserted into the bone with insertion torque of 80 Ncm. Strain was measured during implant insertion, and residual strain was recorded for 1 hour after implant placement. Implants micro-structure were analyzed by SEM. These results were compared to osteotomy and implant insertion strain data of conventional dental implants. A clear pattern of higher vertical compared to horizontal strain levels can be seen in the drill-less implants, compared to the opposite in drilling and insertion of conventional implants. Type 2 drill-less implant showed the lowest strain levels of all groups. Highest horizontal strain levels were measured for insertion of standard implants. Strain recovery was least prominent in the insertion stage of standard implants. Significant more cervical compression zones were detected in type 1 implant. However, SA and Rx. Surface roughness measurements didn't show any differences. Favorable horizontal stress distribution was noted in the 2 types of the novel drill-less implants, and comparable or lower vertical strains compared to regular protocol was also noted. Residual strain was low within all dimensions of bone. Conventional implant insertion protocol delivers strain to the frequently vulnerable bone around the implant neck. Horizontal residual strain, both in drilling and inserting conventional implants, was higher than the insertion strain of the drill-less implants. Implant surface roughness was not impaired by high insertion torque. High torque implant insertion may induce positive strain distribution within coronal part of the supporting bone. Implant surface were not impaired by high torque insertion methods.

Implant position for supporting maxillary over-denture: a clinical study.

The objective of this study was to compare the efficacy of supportive periodontal therapy (i.e. scaling and root planning, SRP) alone, versus a chemical device silica dioxide (SiO2) colloidal solutions (SDCS) used in association with SRP in the treatment of chronic periodontitis in adult patients.A total of 20 patients with a diagnosis of chronic periodontitis (40 localized chronic periodontitis sites) in the age group of 35 to 55 were selected. None of these patients have previously received any surgical or non-surgical periodontal therapy and demonstrated radiographic evidence of moderate bone loss. Two non-adjacent sites in separate quadrants were selected in each patient to monitor treatment efficacy (split mouth design). Clinical pocket depth (PD) and microbial analysis (MA) were analyzed at baseline day 15. SPSS program and paired simple statistic T-test were used to detect significant differences.Total bacteria loading, Tannerella forsitia and Treponema denticola loading were statistically reduced when SiO2 is locally delivered. SDCS gel is an adjuvant therapy which should be added to SRP in the management of moderate to severe chronic periodontitis.

Pharyngeal spasticity due to dantrolene.

WHAT IS KNOWN AND OBJECTIVE: Dantrolene can be combined with baclofen to better treat spasticity, but may cause muscular weakness and dysphagia. We instead describe a pharyngeal spasm due to dantrolene. CASE SUMMARY: A 12-year-old male received dantrolene 3 mg/kg/day in adjunct to baclofen 2 mg/kg/day, to improve spasticity. After 5 days of full-dose dantrolene, his dysphagia worsened and he developed pharyngeal spasm. Dantrolene was suspected for an adverse reaction and removed. The patient subsequently improved. WHAT IS NEW AND CONCLUSION: Causality analysis determined a probable relationship between dantrolene and pharyngeal spasm. This may be due to direct muscle contraction by dantrolene, an effect seen previously in vitro.

Are vascular disorders more prevalent in the relatives of children and adolescents with migraine?

The objective of the study was to assess whether a family history of vascular disorders is more common in children and adolescents with migraine than in the general population. Family history of stroke, arterial hypertension, myocardial infarction and diabetes was investigated by history taking in relatives of ambulatory children and young adults with migraine and in a control group. The odds ratios (ORs) with 95% confidence intervals (95% CI) were used as a risk measure. Using univariate and multivariate (logistic regression) analysis, family history was assessed in the whole sample and in subgroups by sex and age, degree of relationship (parents and grandparents vs. relatives), disease type (migraine with and without aura), and type of vascular disorder. The sample included 143 cases (migraine with aura 35, migraine without aura 108) and 164 controls aged 3-24 years (mean 12 +/- 3.8 years). Patients with migraine were at increased risk of vascular disorders in parents and grandparents but not in all relatives. Multivariate analysis indicated family history of stroke as most common only in boys. In conclusion, our study provides some clues to the assumption that migraine and vascular disorders have common pathogenic mechanisms and that genetic susceptibility plays a role in increasing the risk of migraine in the offspring of families with one or more cerebrovascular or cardiovascular conditions.