Survival and success rate of spiral implants inserted mandible.

The rehabilitation of the edentulous mandible is a relatively common clinical problem and dentatl implants are popular medical device routinely use in daily practice. Recently a new type of two-piece spiral implants has been introduced in the market. Here a retrospective study is reported. A total of 54 two-piece implants were inserted in mandible in the period between June and December 2017, 30 in female and 24 in males. The median age was 53 ± 8. Implants replaced 11 incisors, 6 cuspids, 23 premolars and 14 molars. Implant' length was 10 mm, 11,50 mm and 13 mm in 16, 19 and 19 cases, respectively. Implant' diameter was 3.3 mm, 3.75 mm and 4.2 mm in 22, 13, 19 cases, respectively. Twenty two fixtures were placed in totally edentulous patient and 32 in partially edentulous subjects. There were 4 single crowns, 28 implants bearing two or greater bridges, 4 removable dentures and 18 supporting Toronto bridge. The overall mean follow-up was 13 ± 2 months. One implant was lost so that survival rate (SVR) was 98.15%. Then peri-implant bone resorption (success rate, SCR) was used to investigate peri-implant bone stability. No implant have a crestal bone resorption greater than 1.5 mm so that the implants studied are reliable devices for oral rehabilitation with a very high SCR and SVR.

Implants outcome inserted in different sites.

Oral rehabilitation by means dental implants has high standards of success. Recently, a new type of two-pieces spiral implants has been introduced in the market. Since few reports focus of the efficacy of this medical device as a reliable tool for oral rehabilitation, here a retrospective study is reported. In the period June-December 2017 one hundred and two spiral fixtures were inserted, half in females and 51 in males. The median age was 56 ± 8 (min-max 36-73 years). Forty-eight implants were inserted in upper jawbone and 54 in mandible. Two implants were lost and thus survival rate (SVR) is 99.9%. Then peri-implant bone resorption was used to investigate the clinical success (success rate, SCR) over time. No implants have a crestal bone resorption greater than 1.5 mm in the first year follow up. No studied variable has an effect on clinical outcome. In conclusion the studied implants have high SCR and SVR so that they are good tools for oral rehabilitation.

Screening of periodontopathic bacteria in Italian patients affected by periodontitis.

Periodontal disease (PD) is among the most common infectious diseases in the world, caused by pathogenic bacteria that trigger innate, inflammatory, and adaptive immune responses, leading to the destruction of supporting periodontal tissues and, if untreated, tooth loss. This study included 3593 patients, of them 1963 had a complete dataset and thus were analysed: 1088 (55%) were from Northern Italy, 749 (38%) from Central and 126 (7%) from Southern. Aggregatibacter actinomycetemcomitans, Porphyromonas gengivalis, Treponema denticola, and Tannerella forsythia, Campylobacter rectus, Fusobacterium nucleatum, and total bacterial load were investigated. There was a significant difference in geographic distribution as regard A. actinomycetemcomitans (p<0.001), C. rectus (p<0.001), F. nucleatum (p<0.001) and total bacterial load (p<0.001). No differences were detected as regard gender, whereas a significant higher F. nucleatum load was observed in younger patients.

Replica-guided trauma surgery.

The aim of this study is to present a new approach to the surgical treatment of fractures of the middle third of the face, based on the use of resorbable materials and stereolithographic models. From 2009 to 2014, we treated 10 cases of orbitozygomatic trauma mostly as secondary surgery. For each case, an anatomical replica had been produced simulating the expected result and was then used to contour the resorbable plates on its surface, even before the beginning of the surgical procedure itself. The plates and meshes already bended act as a guide to bony reduction procedure. No complications occurred: all patients healed well, without inflammatory reactions. The results obtained corresponded to the expected results. This technique has been employed for primary or secondary treatment of fracturesof the middle third facial, where it is not always easy to understand the displacement of bony segments and where the use of resorbables plates could be particularly beneficial, as they do not interfere with the maxillofacial skeleton physiology and avoid the necessity to remove plates and screws. Combined use of stereolithographic model and resorbable materials allow a new surgical approach based on the realization of the surgical procedure on the model, then transferred from the patient to the model, thanks to plates and meshes. This technique helps to overcome many of the limits of the conventional technique: the need of minimal surgical access, in order to minimize facial scarring and the vasculo-nervous structures that cross the head and neck district and the obligation to restore not only the morphology but also the biological functions.

Vascularized fibula free flap for implant rehabilitation in the case of extreme atrophy.

The skeletal reconstruction in cases of extreme atrophy like a class VI Cawood classification can be carried out using free bone flaps. They represent a valid option for preprosthetic rehabilitation of atrophic maxillas. Over the last 5 years, the use of vascularized bone transplants, aimed at implant-prosthetic rehabilitation, has become a practice, which has gradually found the right indications and the range of applications, which are now widely acknowledged. The key to success in the use of free flaps lies in the identification of the correct indications for use, in meticulous programming and the particular motivation that this type of patient has for reacquiring optimum masticatory functions. The final prosthetic implant rehabilitation must be prosthetically guided and an accurate preoperative planning is of fundamental importance for restoring masticatory functions and esthetic harmony to the patient through a fixed prosthesis. The authors present a case of a rehabilitation of an extreme maxillary and mandibular atrophy.

Amputation trauma of the face: surgical techniques and microsurgical replantations.

The reconstruction of facial parts after traumatic amputation is of special interest because of the psychological and functional implications such accidents have on the patient. Most amputations result from dog bites or knife wounds and are often sustained by children and young adults. The amputated part may be an anatomic structure of functional importance (e.g. , the lips) or a static structure of primarily aesthetic importance (e.g. , the ear or nose). Here, the Authors present results in 6 cases of facial amputation reconstructed using microsurgical replantation for upper lip amputation, with use of the facial artery musculomucosal flap to fill labial defects, and the Mladick method for ear replantation.

Iliac crest free flap in oromandibular reconstruction. 13 cases study.

Oromandibular reconstruction following oncological resection is particularly challenging. In this past decade, great improvements have been made, in functional and aesthetic terms, following the introduction of composite free flaps. By means of this reconstructive technique, it is, in fact, possible to restore mandibular continuity, and, consequently, the morphology of the lower third of the face; rehabilitate mastication through osteointegrated implants, and optimise the reconstruction of soft tissue, employing the fascio-cutaneous or muscular portion of these flaps. Between January 1995 and January 2001, 70 oromandibular reconstructions employing osseous free flaps were performed in the Department of Maxillo-Facial Surgery of the Ospedale Maggiore in Parma, and in 13 of these the iliac crest free flap was used. Personal experience is described regarding the indications and use of this flap.

Nondermatophytes. Pathogen or distracter in onychomycosis.

Fungal infections have risen steadily in the past decade. Podiatrists probably encounter the highest population of patients affected by this condition. Current treatment regimens do not appear to be able to address all of these dermatophytic infections. Nondermatophytes, which have been studied and discovered to be either contaminants or etiologic factors, must now be a consideration in evaluating and treating fungal infections.

Podiatric pathology of lupus erythematosus.

Lupus erythematosus is an enigmatic disease. Its podiatric manifestations are largely cutaneous, but vasculitic involvements may produce complications. The authors review much of the histopathology of lupus erythematosus that is relevant to the podiatric physician and surgeon. Awareness of the serious systemic implications of lupus erythematosus and the internal medications used in treatment is part of the physician's responsibility in understanding the whole patient.