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This study aims to describe pathologic fractures of the jaws due to cystic bone lesions. Their daily clinical practice findings are not very common, so their treatment can be challenging. In addition, endosseous benign lesions like a radicular, residual, solitary, aneurysmal cyst, and odontogenic keratocyst, might weaken the bone so that trauma, or usual chewing, could break it. We follow from the first clinical examination to the X-ray or CBCT examination and surgical management of our patients, reporting all procedures and results to explain our approach to these cases. We also reviewed the literature briefly to determine if our operative management is in line with the scientific community. Mandibular angle and body are common locations, while symphysis and condyle are less so. Young men are the most affected, and trauma is the most triggering event. Cyst enucleation, followed by fracture reduction and fixation, is the treatment of choice for our clinical team and the scientific community. We observe how impactful it is to approach the cavity of the cystic lesion from the fracture line as the surgical gold standard

IDEHA (Innovation for Data Elaboration in Heritage Areas), is a PON project coordinated by CNR, aimed to an open platform for real-time aggregation of Cultural Heritage elements (sites, monuments, etc.) data, and their "packaging" in sets of informations for different targets of outlined public. The main tool conceived for displaying data (spread from different sources: news, digital libraries, IoT, etc.) is an immersive viewer capable of displaying 360° images and videos, all multimedia inserts html5-compatible, and multi-language audio-synthesized messages. Such a tool is presented here. It has been planned thanks to the effort of CNR and Engineering, and will be released in order to become a trigger of further initiatives both commercial and free.

Aim: to assess the fracture resistance of maxillary molars restored using lithium disilicate glass-ceramic (LDG) table-top restorations fabricated with two different production protocols. Methods: sixteen maxillary molars were randomly assigned to two groups (n = 8). The teeth received a preparation for a full-coverage table-top restoration with a 90° rounded shoulder margin. Restorations were fabricated using monolithic LDG blocks milled via Cerec 3 CAD/CAM System in group 1 (G1) and heat-pressed LDG in group 2 (G2). All table-tops were luted with Variolink II cement. The specimens were loaded to fracture after thermomechanical aging (1 250 000 cycles). A qualitative analysis on the type of fracture was conducted. Collected data were statistically analyzed with non-parametric test (Mann Whitney U-test). Results: the mean load to fracture was 2395.01 ± 150.96 N in G1 and 1796.58 ± 307.27 N in G2; the difference was statistically significant (p < 0.05). The majority of the specimens showed restorable fractures (6 specimens in G1 and 6 specimens in G2). Conclusion: the milled CAD/CAM LDG table-top restorations withstood higher load before fracturing than the restorations made with the heat-pressed LDG production protocol.

Aim: the following work assessed the behavior of human Dental Pulp Stem Cells (hDPSC) on PEEK and Titanium samples, in particular their ability to adhere, proliferate and differentiate into osteoblasts. Methods: surface modifications were made to the samples by pre-established protocols of sandblasting and laser micropatterning, to modulate surface roughness. After roughening treatments, samples were divided into two groups: nontreated and treated with air-plasma cleaning process to modulate surface wettability. The hDPSCs were harvested from dental elements and, after expansion in the proper medium, were seeded on the samples to study their behavior. The analyses for the adhesion and the proliferation were performed by Scanning Electron Microscopy and Alamar Blue test, while the differentiation in osteoblasts was evaluated by measuring AlkalinePhosphatase activity. Results: all the samples tested are able to support hDPSCs adhesion, proliferation and differentiation in osteoblasts with differences depending on the material nature and surface. Laser micropatterned titanium samples, in particular, were the best performing in terms of cell differentiation. Air-plasma treatment does not affect cell adhesion and proliferation but improves cell differentiation, in particular on Titanium samples. Conclusion: PEEK and Titanium are confirmed as excellent materials to support the adhesion, the proliferation and the differentiation of the hDPSCs. The biological behavior is strong

Aim: the aim of this study is to evaluate the efficacy of two different dosages of dexamethasone, i.e. 2 and 4 mg injected submucosally to reduce postoperative discomfort after mandibular third molar surgery. Methods: the study was conducted on 150 patients subjected to surgical removal of an impacted third molar. Patients were randomly divided into three groups: G1 (n = 50) received 4 mg/1 ml dexamethasone submucosally; G2 (n = 50) received 2 mg/0,5 ml dexamethasone submucosally; G3 (n = 50) received saline submucosally. The drug was administered after wound closure through silk sutures. Pain, swelling, trismus, analgesic consumption and operation time were comparatively evaluated at three different time point: T0 before surgery, T1 on 3rd and T2 on 7th day after surgery. The sutures were removed on the 7th day. Results: G2 showed statistically significant reduction in swelling considering male gender. The differences between the time points where statistically significant in G2 under 25 years old when trismus was analyzed. Difference between G2 and G3 was statistically significant at T1 when compared in painkillers assumption. Conclusion: it can be concluded that better post-operative values were obtained with 2 mg dexamethasone infiltration in order to reduce trismus in subjects under 25 years old. The statistical analysis showed positive effects in female patients with 4 mg dose of dexamethasone in the aperture evaluation and oedema.

The thesis starts from the observation that a significant number of novels from the 1990s and early 2000s present two salient stylistic features. First, they are sprawling with characters; second, these fictional renditions often read as ‘flat’, in that they are endowed with little psychological specificity. I contend that the sub-genre I identify as the ‘neoliberal novel’ originates at the intersection of these two traits, and that its specimens can be said to be ‘neoliberal’ inasmuch as they respond to the challenges posed by their historical juncture. Through their deployment of characters, these novels delineate the problematic nature of the idea of ‘person’ in the age of neoliberalism and elaborate varieties of perception and experience that can be said to be ‘impersonal’. Often, in the neoliberal novel, flatness of character represents impersonality, and the latter is consistently associated with the specifically biopolitical aspects of neoliberal ideology. In order to explore these issues, I read four novels from the United States and Latin America: David Foster Wallace’s Infinite Jest (1996), Don DeLillo’s Underworld (1997), Salvador Benesdra’s El traductor (1998) and Roberto Bolaño’s 2666 (2004). I contend that the American hemisphere is particularly productive as a point of observation of the general workings of the ‘neoliberal novel’ in that the historical facts surrounding the spread of neoliberal policies and practices in the region makes the continent a compendium of its stratified social and anthropological effects. Finally, I conclude that impersonality per se, while offering an escape route from the traps of liberal individualism, does not stand in any definite relationship to either authority or social change. Rather, it represents the plane of contrast in which the two constantly made and re-made each other.

Aim: The aim of this clinical study is to evaluate and compare the relative ef cacy of two different dosages of dexamethasone, i.e. 2 and 4 mg injected submucosally to reduce postoperative discomfort, e.g. trismus and oedema after mandibular third molar surgery. Methods: A prospective randomized double blind study is still being conducted on 150 patients requiring surgical removal of an impacted third molar. Selected patients are divided randomly into three groups of 50 patients each: group I (literature’s gold standard) patients received one regimen single dose of 4 mg dexamethasone submucosally, group II (test) received one regimen single dose of 2 mg dexamethasone submucosally, and group III (control group), no dexamethasone was given but only received injection of normal saline submucosally. The drug was administered after the wound closure through silk sutures. Baseline measures were done pre-operatively as inter-incisal mouth opening width and three linear measurements for facial swelling. Each patient was instructed to assume 1 gr paracetamol exclusively. For pain assessing patients were required to take note on a survey form through an VAS scale and the paracetamol capsules amount. The postoperative sequelae were assessed using the same linear measurements on the second and seventh postoperative day. The sutures were removed on the seventh day post-surgery. Results: As compared to group III, group I showed statistically signi cant reduction in trismus and swelling whereas no statistically signi cant difference were found between the group II and group III. The statistical analysis showed that the dexamethasone treatment is more effective on the male gender. Conclusions: It can be concluded that dexamethasone is effective in curtailing the postoperative oedema and trismus of lower third molar surgery but have negligible analgesic effect, though keeping in mind that is still a work in progress because the sample size is yet to be reached. As no statistically signi cant di- erence is found between both the group II (2 mg) and control group, so within the con nes of our study, it may be concluded that 4 mg dexamethasone can be given safely to reduce the postoperative edema after the third molar surgery. Due to the gender pattern that has emerged from our statistical analysis, further high-quality study are needed to con rm this findings.

Since its introduction, piezoelectric bone surgery has established an important role in oral surgery and dental implantology. Piezoelectric surgery is efficient at preparing implant site osteotomies due to its selective cut, micro-streaming and cavitational effects, which preserve and maintain the soft tissue. Several advantages have been outlined in patient’s symptoms, both in terms of improved intraoperative comfort and postoperative course. The aim of this study was to compare implant insertion procedures using piezoelectric surgery or conventional drilling. Intra- and postoperative pain, implant site preparation time and learning curve were evaluated. Methods: A total of 13 (7 women/6 men, aged between 45 and 75 years) partially edentulous patients were rehabilitated with 40 titanium implants (n=20). Implant therapy consisted in the inclusion of at least two conical implants between 3.8 and 4.5 mm diameter with a maximum torque of 35 Ncm in randomised bilateral edentulous areas. First sites were prepared with piezodevice (test sites) and the contralateral ones with conventional drilling (control sites). Surgery was always performed by the same operator. Implant site preparation timing was measured from flap elevation until implant inclusion. Patients recorded their subjective intraoperative and postoperative pain daily for 7 days and at 15th day after surgery using a Visual Analog Scale (VAS). Results: Patients treated with piezoelectric technique presented a lower VAS, minor swelling and less recovery time compared to the conventional technique. No operative complications were reported and the implant survival rate at 1 year was 100% for both the techniques. VAS significant differences were found for the test sites as intraoperative symptoms (p = 0.009), after 1 day (p = 0.010), 2 days (p = 0.016), 3 days (p = 0.017), 5 days (p = 0.015), 6 days (p = 0.018) and 7 days (p = 0.039). The average surgical times of implant sites preparation were: 10 (± 1.4) minutes for the test sites, and 7.00 (± 1.7) minutes for the control sites. In 69.2% of cases (9 of 13 patients) the operator has found advantages in terms of better access to the posterior sites, enhanced intraoperative visibility and insertion axis maintenance using the piezoelectric technique. The learning curve with piezodevice has seen a decrease in timing (rho = -0827, p = 0.001) from the first to the last intervention; whereas no significant difference was evaluated with the traditional method. Conclusion: Compared to traditional methods, piezoelectric technique enables optimal healing because it reduces the postsurgery swelling and discomfort. The average time necessary for the piezoelectric implant site osteotomy was approximately 3 minutes more than conventional technique.

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Aim: The objectives of this study were three: 1) obtaining electronic microscopy images before and after a PRF pretreatment from three different implant surfaces, 2) evaluating the angle contact obtained wetting, with a blood drop, three different implant surfaces and 3) evaluating if the PRF pretreatment of the same implant surfaces, modifies their wettability. Methods: Six implant surface’s samples were selected: two machined, two blasted and two with laser treatment. Four images for implant surface were acquired by SEM (Scanning Electron Microscope) before and after a PRF pretreatment, respectively with 200x, 500x, 1000x and 2000x magnification. Afterwards the angle contact formed between three different implant surfaces and 10μl blood drop was calculated by optical microscope with 10x magnification. With other three samples, that were pretreated with PRF, the angle contact formed between the different implant surfaces and 10μl blood drop was evaluated by the same microscope. The pretreatment of the implant surfaces was made soaking the samples in the PRF and after drying them with sterile gauze. The entire procedure was performed five times in five different days to obtain five measurements for implant surface with and without the PRF pretreatment. The human blood, for the drops and for the PRF production, was drawn from the same volunteer for all the time. Results: The results obtained with SEM were poorly relevant. It was possible to observe only a few fibrin deposits on implant surfaces with PRF pretreatment. The results obtained with optical microscopy, evaluating different surfaces between them, were relevant: by using “non parametric” tests with software SPSS for Mac OS X (SPSS inc. Chicago, IL, USA) a significant wettability difference from different implant surfaces was observed. The average angle contact of the different surfaces were: for the machined surface 56.58 ± 12.83, for the sandblasted surface 76.45 ± 6.93 and for laser treated surface 51.02 ± 3.49. The results obtained, calculating the angle contact after PRF pretreatment of implant surfaces, were very interesting and satisfying. It was possible to observe an important wettability improvement of implant surfaces: machined surface had 33.67 ± 3.06, sandblasted surface had 38.84 ± 8.49 and laser treated surface had 32.88 ± 1.59. The statistical analysis highlighted a significant wettability difference from the same implant surface before and after PRF pretreatment but there was not significant angle contact difference between the different surfaces after PRF pretreatment; in fact the angle contact values were very similar Conclusions: Compelling evidence from our study lead us to suggest, according to scientific literature, that the machined surfaces have more wettability than sandblasted surfaces and a similar one compare to the laser treated surfaces. The PRF pretreatment have a positive effect on wettability of implant surfaces. This effect is independent from the kind of surface, probably because the wettability improvement is directly related to PRF proprieties and not to the characteristics of the implant surface even if the results with SEM were not significant; perhaps due to chemical changes on implant surfaces (not visible by microscopy) thanks to PRF pretreatment. So the PRF could be used as a helper to make the osseointegration process faster by using a rough surface, which stimulates the cell differentiation, with an optimal wettability, which allows to improve the cell adhesion.

Aim To assess the effectiveness of two integrated shaping and filling techniques for the treatment of maxillary central incisors affected by chronic apical periodontitis. Methodology The trial enrolled 60 patients with a maxillary central incisors needing root canal treatment affected by chronic apical periodontitis with periapical radiolucency smaller than 5 mm in diameter. Block-randomization was undertaken to allocate the patients to two treatment groups with different canal shaping and filling protocols: group 1 (G1, n = 30), Revo-S/One Step Obturator; group 2 (G2, n = 30) GTX/GTX Obturator. An independent examiner evaluated the patients at baseline, after 6, 12, 24 and 36 months by performing percussion and palpation tests. At the same time points, standardized periapical radiographs were taken to score the radiographic healing according to a previously published scale. For this analysis, the level of agreement with regard to the scores assigned by two blind evaluators was tested by weighted kappa statistics. Comparability of baseline clinical data, as well as the differences between the two groups and among time points concerning clinical and radiographic data were evaluated with non-parametric tests (p < 0.05). Results All the patients were re-evaluated after 3 years. One patient per group complained of mild symptoms at the end of the observation period. Radiographic healing was progressive during the follow-up. The lesions were classified as totally healed, partially healed and not healed in 93.3%, 3.3% and 3.3% of cases in G1 and in 93.3%, 0% and 6.7% of cases in G2. The differences between groups were not significant (p > 0.05). Conclusions The two integrated endodontic systems were equally effective in achieving high three-year success rates in the treatment of maxillary central incisors with chronic apical periodontitis.

Aim: From the literature we infer that efficient peri- implant debridment cleaning result is obteined using metal tips rather than plastic material tips. Plastic tips allow to alter, the least possible, fixture superficial properties or analized specimens. Aim of this study was to evaluate in vitro effects of ultrasonic instrumentation using Acteon Implant Protect® ultrasonic grade IV titanium tips on implant surface micro- and macro-topography. Methods: Nine 6 mm diameter and 2,6 mm height titanium disks were used in this study, with 3 different kinds of surface: machined, laser-treated and sandblasted. Four 500x500 μm areas were selected on each surface. Each area was equidistant from the disk center and from the disk border. Each area was analized using a Talysurf CLI 1000® profilometer and captured with an optical microscope at 3x enlargement and with a scanning electron microscope at 100x and 300x enlargement. Successively thesurface of each titanium disk was instrumented for a total of 40 strokes by a single operator using Implant Protect® (Acteon®) ultrasonic tianium tip. The tip was angulated tangentially. Calibrations were performed with scales before the experiment, and the average pressure applied in this study was 30g. Back and forth movements were performed in the same direction for 40 times. For the Satelec® scaler a power setting 3/10 was set at 25 to 32 kHz. Instrumentation was achieved with a continuos water irrigation. Pictures were acquired again by optical microscope and scanning electron microscope. After instrumentation any contaminants were searched with SEM-EDX (Scanning Electron Microscope – Energy Dispersive X-ray spectrometry). All reserched values were subjected to statistical analysis. Results: Each image acquired with optical microscope and with Scanning Electron Microscope reveals instrumentation signs with tested tips. Machined and sandblasted surfaces showed a significant Ra reduction (p value < 0,05). Only laser-treated surface showed scratch signs without substantial Ra reduction. Contaminants were not found with EDX analysis before specimen instrumentation and after instrumentation neither. Before instrumentation and after instrumentation sandblasted surface presented a considerable quantity of Al and O. Conclusion: To be effective implant surface ultrasonic instrumentation has to be done with titanium tips, not whith plastic material tips. Nevertheless titanium tips instrumentation causes alterations of implant surface microtopography; in addition different implant surfaces undergo different kinds of structural alteration non-clinically definable.