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.

Oral rehabilitation of maxilla: technical consideration.

Oral rehabilitation of edentulous maxilla is particularly difficult because of the lack of bone in correspondence of maxillary sinuses, therefore, the surgeon is forced to place implants in sites where bone is more prevalent. In addition, patients require more frequent oral immediate rehabilitation in order to reduce the discomfort related to wearing a total denture. A viable solution to provide stability and retention of the prosthesis in a short time is represented by the technique of intraoral welding supporting total denture or fixed prosthesis. This goal may be achieved thanks to the technique of welding titanium bars onto implant abutments. In fact, the procedure can be performed directly in the mouth, eliminating the possibility of errors or distortions due to prosthetic procedures. This paper describes a case report and the most recent data regarding long-term success and high predictability of intraorally-welded titanium bar in immediate loading implants.

The role of implant-abutment connection in preventing bacterial leakage: a review.

Osseointegration can be affected by oral conditions; in particular, the micro gap at the implantabutment-connection (IAC) represents a site for dental plaque aggregation favoring bacterial leakage that can increase inflammatory cells at the level of the IAC, causing peri-implantitis. This micro gap, once early colonized, may constitute a bacterial reservoir that could subsequently contaminate fixture's surroundings and interfere with peri-implant tissues health. The aim of this review is to describe, according to the most recent literature, the different kind of implant-abutment connection and their ability to reduce bacterial leakage and thus preventing peri-implantitis. The following database were consulted: Pubmed (n=26), Scopus (n=90), Research gate (n=7) and 123 articles were found. Duplicates were excluded and after reading abstract and titles, those articles that were off topic were also excluded. The remaining ones (n=24) were assessed for full-text eligibility. We excluded 5 articles because they were case reports, 2 because there was no clear reference to the relationship between IAC and bacterial leakage and 2 because they were not pertinent to the argument. Fifteen articles were included in the review. From the review, it is clear that a relationship between the IAC and bacterial leakage exists. All the connections presented an amount of micro-gap and bacterial micro-leakage but conical and mixed connection systems seem to behave better. Moreover, both connections seem to have a better load distribution and the mixed one has anti-rotational properties, very useful during the positioning of the prosthesis.

Phase angle as a nutritional evaluation tool in all stages of chronic liver disease.

INTRODUCTION: Malnutrition is commonly and frequently under-diagnosed in clinical settings in patients with chronic liver disease (CLD) due to the limitations of nutritional evaluation methods in this population. We hypothesized that the bioelectrical impedance analysis derived phase angle (BIA-derived PhA) might be considered as a nutritional indicator in CLD since it represents either cell death or malnutrition characterized by changes in cellular membrane integrity. OBJECTIVE: The aim of this study was to evaluate the BIA-derived PhA as a nutritional evaluation tool in all stages of CLD, including chronic hepatitis, liver cirrhosis and hepatocellular carcinoma (HCC). Liver-related death and survival were evaluated. METHODS: A total of 66 patients were enrolled in a cross-sectional study. For the nutritional diagnosis, mid-arm circumference (MAC), triceps skinfold thickness (TST), mid-arm muscle circumference (MAMC) and Subject Global Assessment (SGA) were evaluated. Biochemical and clinical evaluations were performed. RESULTS: Our results showed that PhA was higher in well-nourished patients, according to SGA and in the patients without hepatic encephalopathy. PhA correlated significantly with MAMC, MAC and albumin and was inversely correlated with age. No correlation was found between PhA values and the Child-Pugh score and ascites. PhA was strongly associated with survival and PhA ≤ 5.18º with relative risk increase of 2.5 for death. CONCLUSIONS: We conclude that the BIA-derived PhA is a relevant nutritional evaluation tool in chronic hepatitis, liver cirrhosis and HCC and the role of PhA in the prediction of survival in CLD should be examined further in a controlled study.