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Oral malignant melanoma (OMM) has a prevalence less than 1% of all melanomas and it commonly develops on the oral mucosa following a slow and unspecific transformation of unstable melanocytic lesions, often resulting in a diagnostic delay. The marker PReferentially Expressed Antigen in MElanoma (PRAME) seems to be a valid tool to investigate the biological and histological nature of cutaneous melanocytic lesions, but to date its use to characterize pigmented lesions in the oral cavity is largely unexplored. The aim of this study was to create preliminary knowledge on the PRAME expression in OMM, and to compare its expression respect to other dysplastic pigmented lesions of the oral cavity. Interestingly, PRAME has been demonstrated to be reliable in the clinical conditions investigated in our pilot study; in fact, it has clearly differentiated the cases of Melanoma, which showed diffuse and intense positivity (score 6+/7+) to PRAME, from the other melanocytic nevi, which resulted to be mainly negative to PRAME. This means a better differential diagnosis, a reliable early diagnosis and a proper clinical/surgical management of the oncological lesions. In conclusion, PRAME can be a valid qualitative marker for differential diagnosis, not only in cutaneous melanomas, but also in malignant melanoma of the entire head and neck area.

Purpose: The aim of this case series study was to evaluate clinical and radiographic changes of soft and hard tissues around tapered, platform-switched, laser-microtextured implants 24 months after crown placement. Materials and Methods: Twenty tapered, platform-switched, laser-microtextured collar implants were placed in 20 patients. Full-mouth plaque score, full-mouth bleeding score, probing depth, and mucosal recession were recorded at the time of crown cementation and after 24 months follow-up. The marginal bone-level changes at the mesial and distal aspects of the implants were calculated by subtracting from baseline and 24-month implant marginal bone level. Results: In terms of the full-mouth plaque score and full-mouth bleeding score, tapered, platform-switched, laser-microtextured implants showed statistically significant improvements at 6 months when compared to baseline (P < .001). Statistically significantly deeper probing depths (P < .001) were found when comparing baseline and at 24 months at mesial, lingual, and distal sites. However, no statistically significant difference was found at the buccal aspects (P = .064). Radiographic marginal bone loss at 2-year follow-up for tapered, platform-switched, laser-microtextured implants was 0.72 ± 0.16 mm and 0.67 ± 0.15 mm at the mesial and distal sites, respectively. Conclusion: Within the limits of this study, tapered, platform-switched, laser-microtextured implants maintained marginal bone level (less than 1 mm radiographic bone loss) as well as limited mucosa recession over a 2-year period.

Background: Titanium dental implants are today widely used with osseointegration mainly dependently on the implant surface properties. Different processing routes lead to different surface characteristics resulting, of course, in different in situ behaviors of the implants. Materials: The effect of different treatments, whether mechanical or chemical, on the surface morphology of titanium implants were investigated. To this aim, various experimental methods, including roughness analysis as well scanning electron microscope (SEM) observations, were applied. Results: The results showed that, in contrast to the mechanical treatments, the chemical ones gave rise to a more irregular surface. SEM observations suggested that where commercial pure titanium was used, the chemical treatments provided implant surfaces without contaminations. In contrast, sandblasted implants could cause potential risks of surface contamination because of the presence of blasting particles remnants. Conclusions: The examined implant surfaces showed different roughness levels in relation to the superficial treatment applied. The acid-etched surfaces were characterized by the presence of deeper valleys and higher peaks than the sandblasted surfaces. For this reason, acid-etched surfaces can be more easily damaged by the stress produced by the peri-implant bone during surgical implant placement.

In oral surgery, the management of patients on anticoagulant therapy is still challenging because of the risks of uncontrolled bleeding and, if the therapy is discontinued, the possibility of undesired thromboembolic complications. The use of local hemostatic agents may be a viable alternative to overcome these issues. Along these lines, the aim of this work was to evaluate the use of newly developed swelling matrices loaded with tranexanic acid in preventing postextractive bleeding in patients with no modification of oral anticoagulant therapy. The matrices are made up of cellulose and are able to fit the tridimensional postextractive alveolar cavity, thus assuring also a mechanical contribution to homeostasis. The potential of this new therapeutic approach in reducing hospitalization, removing the risk of infections, and lowering the number of hemorrhagic complications was demonstrated.

In the field of maxillofacial reconstructive surgery, the authors take into consideration the autogenous calvarial bone graft harvest technique for the correction of maxilla bone defects and examine some salient aspects such as technical problems and possible surgical complications.

PURPOSE To assess soft and hard tissues healing at immediate transmucosal implants placed into maxillary molar region with collagen membranes uncovered. MATERIALS AND METHODS Twenty subjects received 20 immediate transmucosal implants placed in maxillary molar extraction sockets. Periimplant marginal defects were treated according to the principles of guided bone regeneration by means of deproteinized bovine bone mineral particles in conjunction with collagen membrane. Flaps were repositioned and sutured, allowing nonsubmerged, transmucosal soft tissues healing. The collagen membranes adapted around implant neck were uncovered. RESULTS No implants were lost during the 1-year observation period yielding a survival rate of 100%. No postsurgical wound healing complications were observed. No degranulation of grafting material was reported. CONCLUSIONS The results of this 12-month prospective study showed that the exposure of collagen membrane at time of the flap suturing does not represent a limitation for the soft and hard tissues healing at immediate transmucosal implants placed into maxillary molar extraction sites.

Objectives The aim of this study was to identify a correct clinical, surgical, and prosthetic management of endosseous implants replacing missing teeth in the anterior maxilla, achieving predictable aesthetic outcomes. Placement of immediate post-extraction implants without incisions or flap elevation is one of the surgical treatment options able to improve the healing and regenerative potentials of the fresh socket. Materials Fifty-five patients (33 men, 22 women), ranging in age from 19 to 57 years (mean 29), were selected for this study. All the patients were not smokers, no bruxers, presented stable soft tissue conditions, an acceptable occlusion, and the absence of pathologies that would contraindicate bone healing. Patients were treated with implants made by 2 manufacturers: Institute Straumann, Walderburg, Switzerland and Friadent, Mannheim, Germany. A total of 87 implants were placed immediately after each failing tooth had been removed. The temporary restoration was placed 3 months after implant placement, and the final restoration was placed 4 months from the surgical procedure. The patients were evaluated clinically and radiographically at implant placement, and 2, 4, 18, and 24 months post-insertion. Results At 24 months, only 3 implants were lost (2 in male patients;1 in female patient). All of these failed implants did not achieve osseointegration. The overall success rate was 96.6%, with an implant failure rate of 3.4%, all prior to restoration. Conclusions The immediate placement in the anterior maxilla fresh extraction sockets without incisions or flaps elevation is a surgical option that can ensure ideal peri-implant tissues healing, preserving the presurgical gingival and bone aspects. For a predictable aesthetic result, the most important aspect seems to be the height and thickness of the buccal bone wall, which remain after immediate placement of the fixture.

The aim of this report is to demonstrate the outcome of implant rehabilitation in the anterior maxilla. Aesthetics in implantology results from the correct execution of many rehabilitation phases: presurgical planning, surgical and prosthetic phases, and case management. In the presurgical phase, preexisting anatomical conditions and prosthetic evaluations influence the choice of regenerative techniques. Correct presurgical planning, in order to realize surgical and prosthetic procedures, is the most important phase to obtain an aesthetic result. Only a successful anatomical correction of hard and soft tissues is able to assure a satisfying therapeutic achievement involving many operative steps and the rigorous observance of recovery timing. A guided bone regeneration technique with a staged approach was used in conjunction with implant replacement.

New polymeric composite materials containing a nanohybrid to be used for the controlled release of an antibiotic molecule, chloramphenicol succinate, have been formulated, prepared and characterised. The nanohybrid consists of a layered double hydroxide of Mg-Al hydrotalcite-type, in which the nitrate anions present in the host galleries were replaced with chloramphenicol succinate anions (CFS(-)) by a simple ion-exchange reaction. Different amounts of the hybrid material were incorporated in polycaprolactone and processed as films of 0.15mm thickness. The composite materials were analysed by X-ray diffractometry and thermogravimetry and their mechanical properties were determined. They showed properties even better than those of the pristine polymer. The release process of the antibiotic molecules was found to be very interesting and promising for tuneable drug delivery. It consists of two stages: an initial stage of a very rapid burst, in which a small fraction of drug is released; and a second stage that is much slower, extending for a longer and longer time. This behaviour is profoundly different and much slower than that of a sample in which the antibiotic molecule is directly incorporated into the polymeric matrix. The parameters influencing drug release have been individuated and discussed.

Background: Gorham’s disease is a rare disorder characterized by spontaneous and progressive osteolysis of one or more skeletal bones. The radiographic findings associated with Gorham’s disease are particularly dramatic, as in some cases a complete resorption of the involved bone can occur, leading to the definition of phantom bone, vanishing bone, or disappearing bone disease. Material and methods: A 24-year-old female patient with a previous diagnosis of periodontal disease and progressive mandibular alveolar bone loss was referred to our Oral Medicine section. The initial radiographic picture showed infrabony defects and horizontal bone loss. Results: After further extensive local and systemic evaluation, including histopathological, laboratory and imagine techniques investigations, the patient was diagnosed to be affected by Gorham’s diease. Meanwhile the progression of the osteolytic process had caused the loosening of all the left mandibular teeth and a pathologic fracture. Appropriate medical therapy was successful in stabilizating the resorptive process, with no evidence of further progressive disease. Conclusions: When Gorham’s disease involves the mandible, the role of the periodontologist is extremely important in diagnosing promptly the disorder and preventing the functional and aesthetic consequences of advanced and extensive bone loss. Gorham’s disease should be included among the pathologic entities mimicking periodontal disease on radiograph, such as inflammatory disease (e.g. osteomyelitis), endocrine disease (e.g. hyperparathyroidism), intra-osseous malignancies or metastases, lymphoma, histiocytosis X, mainly eosinophilic granuloma, infective process (e.g. tuberculosis and actinomycosis), odontogenic tumours.

Translations [German, Spanish, Portugese, Japanese] AUTOR(EN): Gilberto Sammartino, MS,DDS*, Antonio Della Valle, DMD**, GaetanoMarenzi, DMD, PhD***, Salvatore Gerbino,PhD#, Massimo Martorelli, PhD##, Alessan-dro Espedito Di Lauro, DMD, PhD###, Fran-scesco Di Lauro, MD, DDS###. * A.O. Pro-fessor, ‘Federico II‘ Universitat von Neapel,medizinische Fakultat, wissenschaftlicheAbteilung Zahnheilkunde und Gesichts- undKieferchirurgie, Neapel, Italien. ** Privatpraktizierender Arzt, Caserta, Italien. *** Stu-dent der Oralchirurgie, ‘Federico II‘ Univer-sitat von Neapel, medizinische Fakultat, wis-senschaftliche Abteilung Zahnheilkunde undGesichts- und Kieferchirurgie, Neapel, Italien.# Assistenzprofessor, ‘Federico II‘ Universitatvon Neapel, technische Fakultat, Abteilung furIndustrieentwicklung und -management,Neapel, Italien. ## Assistenzprofessor, Univer-sitat von Cassino, technische Fakultat, Abtei-lung fur Mechanik-, Struktur-, Territori-alkunde. ### Assistenzprofessor, ‘Federico II‘Universitat von Neapel, medizinischeFakultat, wissenschaftliche AbteilungZahnheilkunde und Gesichts- und Kieferchiru-rgie, Neapel, Italien. #### Professor, ‘Fed-erico II‘ Universitat von Neapel, medizinischeFakultat, wissenschaftliche AbteilungZahnheilkunde und Gesichts- und Kieferchiru-rgie, Neapel, Italien. Schriftverkehr:GaetanoMarenzi, DMD, Via Lepanto 46, 80125Neapel, Italien. Telefon: 39 - 081 5930107.eMail: gaetano.marenzi@tiscali.itStereolithographie in der Oralimplantologie: ein Vergleich chirurgischer FuhrungenZUSAMMENFASSUNG: Zielsetzung: Die vorliegende Abhandlung stellt die Stereo-lithographie als Einsatzmittel in der Oralimplantologie vor. Die Stereolithographie ist eineneue Methode, bei der durch gezielte Erhartung eines UV-sensitiven Flussigharzes ge-genstandliche Modelle entstehen, so dass die tatsachlichen anatomischen Gegebenheitenvon Ober- und Unterkiefer nachgeahmt werden. Mit Hilfe dieser Modelle konnen Fuhrun-gen geschaffen werden, die eine exakt gleiche Setzung der Implantate beim Patienten wiebei der Planungscomputersimulation ermoglichen. Materialien und Methoden: Einer 70Jahre alten Patientin mit gutem Allgemeingesundheitszustand und schwerer Unterkiefer-knochenatrophie wurde mit einer Deckprothese unter Verwendung von zwei BranemarkImplantaten als Stutzen behandelt. Fur diese Wiederherstellungsbehandlung wurden zweiunterschiedliche operative Planungsmethoden in Erwagung gezogen: a) Herstellung einerchirurgischen Fuhrung unter Auswertung der klinischen Aspekte. b) Die chirurgischeFuhrung als Ergebnis einer stereolithographischen Studie. Ergebnisse: Eine exakte Pla-nung des Chirurgieablaufs kann mit der Knochendichte und den Ausmessungen inVerbindung stehende eventuelle Probleme verringern. Auserdem ist anzumerken, dass diebehandelnden Arzte durch Anwendung der sterolithographischen Studie die Befestigun-gen ideal im Knochen verankern konnten. Schlussfolgerungen: Basiert man die Opera-tionsvorbereitungen auf stereolithographische Erkenntnisse, kann von einem sicherenAblauf ausgegangen werden, was viele Vorteile erbringt. Der biologische und therapeu-tische Vorteil dieses technologischen Behandlungsansatzes liegt in der Vereinfachung deranatomischen Behandlungsvorbereitungen bei gleichzeitig verbesserterImplantierungssicherheit.SCHLUSSELWORTER: Chirurgieplanung, Kieferatrophie, schnelle Prototyperstellung,anatomische Modelle

Purpose: To analyse and compare the dimensional changes of unassisted extraction sockets with alveolar ridge preservation (ARP) techniques and investigate any factors that impact the resorption of the alveolar bone. Materials and methods: A systematic search was conducted to identify randomised clinical trials (RCTs). All data were extracted, and a meta-analysis was performed for the changes in all buccolingual ridge width, midbuccal and midlingual ridge height, and mesial and distal ridge height, and horizontal width at reference points apical to the crestal area. Results: Based on 14 RCTs, the effectiveness of ARP in reducing the dimensions of the postextraction alveolar socket was confirmed. The clinical magnitude of this effect was 1.95 mm in the buccolingual ridge width, 1.62 mm in the midbuccal ridge height, and 1.26 mm on the midlingual ridge height. Additionally, 0.45 mm and 0.34 mm for mesial and distal ridge height, and 1.21 mm, and 0.76 mm for ridge width changes at points 3 and 5 mm apical to the crest were noted. Meta-regression analyses revealed that the reflection of flaps and primary wound coverage during ARP may have detrimental effects on bone remodelling, while no statistical significance was observed for any of the bone graft substitutes or the percentage of molar sockets. Conclusions: Regardless of the protocol, ARP can only minimise ridge resorption. ARP is most effective on horizontal ridge width, providing the most benefit coronally (approximating the crest), followed by the midbuccal ridge height.