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Purpose: The present systematic review and meta-analysis aimed to investigate the available evidence in the literature to answer the following focused question: In partially edentulous arches with reduced bone width, do implants placed after horizontal bone augmentation exhibit differences in survival and success rate compared to narrow-diameter implants placed in native bone? Materials and methods: A population, intervention, comparison and outcome question was defined and an electronic search was conducted using the MEDLINE (via PubMed) and Cochrane Oral Health Group databases to identify all studies analysing the use of standard-diameter implants inserted in regenerated bone or narrow-diameter implants for the rehabilitation of partially or completely edentulous atrophic maxillae and mandibles. Inclusion criteria and quality assessments were established, and studies were selected on this basis. Results: Twenty-four studies met the inclusion criteria and were analysed cumulatively. A comparative meta-analysis was not possible due to the lack of studies directly comparing the two rehabilitation methods in question. A cumulative implant survival rate of 97.80% (1246/1274; pooled proportion 0.984, 95% confidence interval 0.977–0.991) was reported for the narrow implants placed in atrophic ridges, while similar results were obtained for the standard-diameter implants placed in regenerated bone, with a cumulative implant survival rate of 97.94% (1332/1360; pooled proportion 0.983, 95% confidence interval 0.976–0.990). Conclusions: The present systematic review found high and comparable survival rates between narrow and standard-diameter implants placed in regenerated bone; however, well-designed randomised controlled trials are required to support the hypothesis that both treatment strategies are successful in comparable circumstances.

Type II testicular germ cell tumors (TGCTs) represent the most frequent malignancy in Caucasian males (20-40 years). Even if diagnosed with disseminated disease, > 80% of patients are cured; however, a small percentage of cases progress and result in death. It is commonly accepted that these cancers arise from a disturbed testicular embryonic niche that leads to the block of gonocyte differentiation. The subsequent development of the invasive seminomas and nonseminomas is due to a combination of genetic, epigenetic and microenvironmentbased alterations (genvironment). Hepatocyte growth factor (HGF) is present in the testicular microenvironment, together with its receptor c-MET, from early embryonic development to an adult stage. In addition, c-MET is a well-known proto-oncogene involved in the onset and progression of various human cancers. Herein, we have investigated the expression and availability of HGF and c-MET in TCam-2, NCCIT and NT2D1 cells, which are type II (T)GCT representative cell lines, and the effect of c-MET activation/repression on the regulation of cancerous biological processes. We found that NT2D1 cells increase their proliferation, polarized migration, and invasion in response to HGF administration. NCCIT cells respond to HGF stimulation only partially, whereas TCam-2 cells do not respond to HGF, at least according to the investigated parameters. Interestingly, the immunohistochemical study of c-MET distribution in TGCTs confirm its presence in both seminoma and non-seminoma lesions with different patterns. Notably, we found the highest c-MET immunoreactivity in the epithelial elements of the various components of TGCTs: teratoma, yolk sac tumor and choriocarcinoma. Type II testicular germ cell tumors (TGCTs) represent the most frequent malignancy in Caucasian males (20-40 years). Even if diagnosed with disseminated disease, > 80% of patients are cured; however, a small percentage of cases progress and result in death. It is commonly accepted that these cancers arise from a disturbed testicular embryonic niche that leads to the block of gonocyte differentiation. The subsequent development of the invasive seminomas and nonseminomas is due to a combination of genetic, epigenetic and microenvironmentbased alterations (genvironment). Hepatocyte growth factor (HGF) is present in the testicular microenvironment, together with its receptor c-MET, from early embryonic development to an adult stage. In addition, c-MET is a well-known proto-oncogene involved in the onset and progression of various human cancers. Herein, we have investigated the expression and availability of HGF and c-MET in TCam-2, NCCIT and NT2D1 cells, which are type II (T)GCT representative cell lines, and the effect of c-MET activation/repression on the regulation of cancerous biological processes. We found that NT2D1 cells increase their proliferation, polarized migration, and invasion in response to HGF administration. NCCIT cells respond to HGF stimulation only partially, whereas TCam-2 cells do not respond to HGF, at least according to the investigated parameters. Interestingly, the immunohistochemical study of c-MET distribution in TGCTs confirm its presence in both seminoma and non-seminoma lesions with different patterns. Notably, we found the highest c-MET immunoreactivity in the epithelial elements of the various components of TGCTs: teratoma, yolk sac tumor and choriocarcinoma.

YouTube™ is increasingly being used by patients to obtain health-related information. No studies have evaluated the content of YouTube™ videos on children oral thrush. The aim of this work is to examine the quality of information offered by this platform about oral thrush in children. Searching term “oral thrush in children” (OTC) displayed a total of 2.790 results. Of the top 60 videos analyzed, 27 were excluded. The main source of upload was from generalist information YouTube® channels (GC) followed by healthcare professionals (HP), individual users (IU), and healthcare information channels (HC); usefulness of videos is successfully correlated with the number of visualization, number of likes and viewing rate and was interdependent with the number of visualizations, number of likes and VR. However, videos on the oral thrush do not have satisfactory quality information. HP themselves, along with HC, do not seem to provide more appropriate information on COT, than GC or IU. YouTube™ is increasingly being used by patients to obtain health-related information. No studies have evaluated the content of YouTube™ videos on children oral thrush. The aim of this work is to examine the quality of information offered by this platform about oral thrush in children. Searching term “oral thrush in children” (OTC) displayed a total of 2.790 results. Of the top 60 videos analyzed, 27 were excluded. The main source of upload was from generalist information YouTube® channels (GC) followed by healthcare professionals (HP), individual users (IU), and healthcare information channels (HC); usefulness of videos is successfully correlated with the number of visualization, number of likes and viewing rate and was interdependent with the number of visualizations, number of likes and VR. However, videos on the oral thrush do not have satisfactory quality information. HP themselves, along with HC, do not seem to provide more appropriate information on COT, than GC or IU.

Nowadays, autograft and allograft techniques represent the main solution to improve bone repair. Unfortunately, autograft technique is expensive, invasive and subject to infections and hematoma, frequently affecting both donor sites and surgical sites. A recent advance in tissue engineering is the fabrication of cell-laden hydrogels with custom-made geometry, depending on the clinical case. The use of ECM (Extra-Cellular Matrix)-derived Hydrogels from bone tissue is the new opportunity to obtain good results in bone regeneration. Several micro-engineering techniques and approaches are available to fabricate different cell gradients and zonal structures in hydrogels design, in combination with the advancement in biomaterials selection. In this review, we analyse the stereolithografy, the Bio-patterning, the 3D bioprinting and 3D assembly, the Laser-Induced Forward Transfer Bioprinting (LIFT), the Micro-extrusion bioprinting, the promising Electrospinning technology, the Microfluidics and the Micromolding. Several mechanical properties are taken into account for bone regeneration scaffolds. However, each typology of scaffold presents some advantages and some concerns. The research on biomaterials is the most promising for bone tissue engineering: the new biomimetic materials will allow us to obtain optimal results in the next clinical application of basic research. Nowadays, autograft and allograft techniques represent the main solution to improve bone repair. Unfortunately, autograft technique is expensive, invasive and subject to infections and hematoma, frequently affecting both donor sites and surgical sites. A recent advance in tissue engineering is the fabrication of cell-laden hydrogels with custom-made geometry, depending on the clinical case. The use of ECM (Extra-Cellular Matrix)-derived Hydrogels from bone tissue is the new opportunity to obtain good results in bone regeneration.Several micro-engineering techniques and approaches are available to fabricate different cell gradients and zonal structures in hydrogels design, in combination with the advancement in biomaterials selection. In this review, we analyse the stereolithografy, the Bio-patterning, the 3D bioprinting and 3D assembly, the Laser-Induced Forward Transfer Bioprinting (LIFT), the Micro-extrusion bioprinting, the promising Electrospinning technology, the Microfluidics and the Micromolding. Several mechanical properties are taken into account for bone regeneration scaffolds. However, each typology of scaffold presents some advantages and some concerns. The research on biomaterials is the most promising for bone tissue engineering: the new biomimetic materials will allow us to obtain optimal results in the next clinical application of basic research.

Aim. Tyrosine kinase inhibitors (TKIs) targeting tu- mor angiogenesis and mammalian target of rapamycin inhibitors (mTOR) are indicated for the management of several cancer types, as for renal cell carcinoma (RCC). Oral ulcerations are reported as common adverse drug reactions of mTOR inhibitors and are currently classified as mTOR inhibitor associated stomatitis (mIAS). Interestingly, these lesions appear as aphthous-like stoma- titis rather than the mucositis seen with chemotherapy agent. Case report. A 49 years old male patient underwent to the left radical nephrectomy in May 2014 for clear RCC. From July to October 2014 he was treated with Pazopanib, a tyrosine kinase inhibitor. In December 2014 the patient started the treatment with Zoledronic acid and Everolimus, an amino-bisphosphonates and an mTOR inhibitor, respectively. Everolimus administration was suspended on the 1st of January 2015 and resumed on the 4th of February. In February 2015, the patient referred to our department for acute pain of mouth floor and tongue; the onset of these symptoms was subse- quent to mTOR therapy. This pain compromised his oral functions (chewing, swallowing, phonetic) and quality of life. Intraoral examination showed aphthous-like lesions on both borders of the tongue and on the right side of the mouth floor. Local antiseptic (0.2% chlorhexidine rinse, twice daily for 1 week), 0.050 g clobetasol propionate cream (twice a day for 4 week, and one times a day for the following 4 weeks) and a wound-healing promoter (Mucosamin Spray®, twice a day for 2 weeks) were administered. Since the oncologist decided to not discontinue the target therapy, the patient continued local therapy until the end of the treatment with everolimus. After two weeks from the first visit, a complete healing of the oral mucosa was observed and the patient complained no pain. Conclusion. This case report confirms the recent view that target therapy with everolimus may induce the onset of aphthous-like stomatitis as adverse drug reaction. Therefore, diagnostic algorithms for stomatitis should include a careful drug history, emphasizing the focus also on oral adverse effects the new target cancer therapies.

The aim of this study was to evaluate the use of a new collagen matrix (Mucograft®; Geistlich Pharma AG, Wol- husen, Switzerland) in the soft tissue reconstruction after excisional biopsy. The healing of soft tissues after bioptical excision tends to heal by secondary intention. To avoid this, the soft tissue grafts can be harvested from the palate, retromolar pad, or (if available) edentulous site. Disadvantages of harvesting the graft from the retromolar pad and edentulous site are minimal amount of tissue availability and thinner grafts are obtained. The use of collagen matrix is also reported in literature and could represent an optimal solution in the future. Mucograft® is a pure collagen type I and III matrix of porcine origin without further cross-linking. Mucograft® consists of pure porcine collagen obtained by standardized, controlled manufacturing processes. The product made up of porcine collagen has a bilayer structure. The compact layer consists of compact collagen fibers which has cell occlusive properties and allows tis- sue adherence as a prerequisite for favourable wound healing. This layer protects against bacterial infiltration in open healing situations and has appropriate elastic properties to accommodate suturing. A second layer consists of a thick, porous collagen spongious structure. In this paper, we report about a case of surgical site healing after biopti- cal excision proliferative verrucous leukoplakia of the hard palate.

Background. Rebuilding atrophied alveolar ridges can present a significant challenge. There is a multitude of treatment options including guided bone regeneration, onlay block grafting, and distraction osteogenesis. Positioning of dental implants can be placed in an immediate or delayed fashion. An advantage of placing implants immediately is that the patient’s treatment course is shortened as well as the potential for maintaining soft tissue is present. Methods. The recent FDA approval of recombinant human bone morphogenic protein (rhBMP-2) has given clinicians an added treatment option for reconstructing localized alveolar defects. Several patients have been treated with dental implant and rhBMP-2 and the results were recorded by clinical and radiological exams. Results. The potential to reconstruct these challenging defects with a growth factor thus limiting or even avoiding a secondary harvest site is exciting. We describe our experience with the use of implants and bone morphogenic protein together. This study presents excellent results about the combination of using dental implants and growth factor for treating substantial bone defects. Conclusion. Our goal was to clinically evaluate the potential of a purpose designed titanium porous-oxide dental implant surface combined with rhBMP-2.

Purpose. Oral Lichen Planus (OLP) is a chronic inflammatory disease of skin and mucous membranes. Approximately 20% of women with oral lichen planus develops lesions in the genital mucosa. In 1982, Pelisse described a special form of lichen planus (LP), which consists of a triad of symptoms: vulval, vaginal and gingival (VVG)-LP lesions. Aim of the present report is to report two new cases and review the international literature. Material and methods. Two cases of VVG-LP are reported and a review of recent literature is performed. Results. The onset of erosive or ulcerative mouth lesions may precede or follow by months or even years the onset of vulvovaginal lesions. Vaginal agglutination is associated with the postmenopausal state in conjunction with a dermatologic condition. Intra-lesional corticosteroids have a role in localized chronic ulceration, while systemic therapies such as corticosteroids, azathioprine, mycophenolate mofetil, hydroxychloroquine, ciclosporin, methotrexate, retinoids, thalidomide and photo chemotherapy have been used in more severe cases with varying success. Conclusions. VVG-LP is rather a rare condition and has been documented in the literature mainly in the form of case reports. Lack of a precise diagnostic criteria of VVG-LP depends on the specialists. Purpose. Oral Lichen Planus (OLP) is a chronic inflammatory disease of skin and mucous membranes. Approximately 20% of women with oral lichen planus develops lesions in the genital mucosa. In 1982, Pelisse described a special form of lichen planus (LP), which consists of a triad of symptoms: vulval, vaginal and gingival (VVG)-LP lesions. Aim of the present report is to report two new cases and review the international literature. Material and methods. Two cases of VVG-LP are reported and a review of recent literature is performed. Results. The onset of erosive or ulcerative mouth lesions may precede or follow by months or even years the onset of vulvovaginal lesions. Vaginal agglutination is associated with the postmenopausal state in conjunction with a dermatologic condition. Intra-lesional corticosteroids have a role in localized chronic ulceration, while systemic therapies such as corticosteroids, azathioprine, mycophenolate mofetil, hydroxychloroquine, ciclosporin, methotrexate, retinoids, thalidomide and photo chemotherapy have been used in more severe cases with varying success. Conclusions. VVG-LP is rather a rare condition and has been documented in the literature mainly in the form of case reports. Lack of a precise diagnostic criteria of VVG-LP depends on the specialists.

OBJECTIVES: Stem cells have the ability to rescue and/or repair injured tissue. In humans, it is possible to isolate different types of stem cells from the body. Among these, dental pulp stem cells (DPSCs) are relatively easily obtainable and exhibit high plasticity and multipotential capabilities. In particular they represent a gold standard for neural-crest-derived bone reconstruction in humans and can be used for the repair of body defects in low-risk autologous therapeutic strategies. SOURCES: An electronic search was conducted on PubMed databases and supplemented with a manual study of relevant references. RESULTS: All research described in this review highlight that DPSCs are mesenchymal stem cells that could be used in clinical applications. Unfortunately, very few clinical trials have been reported. Major obstacles imposed on researchers are hindering the translation of potentially effective therapies to the clinic. Both researchers and regulatory institutions need to develop a new approach to this problem, drawing up a new policy for good manufacturing practice (GMP) procedures. We strongly suggest that only general rules be standardized rather than everything. Importantly, this would not have an effect on the safety of patients, but may very well affect the results, which cannot be identical for all patients, due to physiological diversity in the biology of each patient. Alternatively, it would be important to study the role of specific molecules that recruit endogenous stem cells for tissue regeneration. In this way, the clinical use of stem cells could be successfully developed. CONCLUSIONS: DPSCs are mesenchymal stem cells that differentiate into different tissues, maintain their characteristics after cryopreservation, differentiate into bone-like tissues when loaded on scaffolds in animal models, and regenerate bone in human grafts. In summary, all data reported up to now should encourage the development of clinical procedures using DPSCs. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved Objectives: Stem cells have the ability to rescue and/or repair injured tissue. In humans, it is possible to isolate different types of stem cells from the body. Among these, dental pulp stem cells (DPSCs) are relatively easily obtainable and exhibit high plasticity and multipotential capabilities. In particular they represent a gold standard for neural-crest-derived bone reconstruction in humans and can be used for the repair of body defects in low-risk autologous therapeutic strategies. Sources: An electronic search was conducted on PubMed databases and supplemented with a manual study of relevant references. Results: All research described in this review highlight that DPSCs are mesenchymal stem cells that could be used in clinical applications. Unfortunately, very few clinical trials have been reported. Major obstacles imposed on researchers are hindering the translation of potentially effective therapies to the clinic. Both researchers and regulatory institutions need to develop a new approach to this problem, drawing up a new policy for good manufacturing practice (GMP) procedures. We strongly suggest that only general rules be standardized rather than everything. Importantly, this would not have an effect on the safety of patients, but may very well affect the results, which cannot be identical for all patients, due to physiological diversity in the biology of each patient. Alternatively, it would be important to study the role of specific molecules that recruit endogenous stem cells for tissue regeneration. In this way, the clinical use of stem cells could be successfully developed. Conclusions: DPSCs are mesenchymal stem cells that differentiate into different tissues, maintain their characteristics after cryopreservation, differentiate into bone-like tissues when loaded on scaffolds in animal models, and regenerate bone in human grafts. In summary, all data reported up to now should encourage the development of clinical procedures using DPSCs.

Objectives. The purpose of this study was addressed at the understanding and management in the ameloblastoma treatment, performing a segmental surgical resection. Ameloblastoma represents nearly 1% of all neoplasm located  Annali di Stomatologia 2014; Suppl. 3 to n. 2: 1-41 15 in the oral cavity. In 80% of cases it could be found in the mandible, of these lesions 70% are located in the molar re- gion or the ascending ramus, 20% in the premolar region and 10% in the anterior part. It is considered as a benign neoplasm with slow growing-pattern and locally aggressive behaviour. Methods. On the basis of clinicoradiological findings, ameloblastoma is divided into 3 groups: solid or multicystic, unicystic and peripheral. The solid ameloblastoma represents nearly 86% of all lesions; it has a tendency to be more aggressive than the other types with a higher incidence of recurrence. The high tax of recurrence represents a dan- ger for patients. The prognosis for ameloblastoma is more dependent on the method of surgical treatment rather the histologic type of tumour. Resection with some safe margin is considered the best primary method for treating sol- id/multicystic ameloblastomas because it results in a lower recurrence rates compared with a conservative approach. Results. In this study we report the treatment of two multicystic ameloblastomas located in the anterior part of the mandible with a surgical segmental resection. Challenges, in this two cases, were related to extension and position of the lesions, which required a careful isolation of the mental foramen. Conclusions. After a follow-up period of two years no recurrence have been detected. These two cases support the evidence of literature, that considers the surgical resection as the best approach to reduce recurrence in patients with multicystic ameloblastoma. References • Dandriyal R, Gupta A, Pant S, Baweja HH. Surgical management of ameloblastoma: Conservative or radical approach. Natl J Maxillofac Surg. 2011; 2:22-27. • Rastogi V, Pandilwar PK, Maitra S. Ameloblastoma: an evidence based study. J Maxillofac Oral Surg. 2010;9:173-177. • Shi S, Liu Y, Shan Y, Fu T, Zhao S. Enucleation combined with peripheral ostectomy: Its role in the management of large cystic ameloblastomas of the mandible. J Craniomaxillofac Surg. 2014.

Objectives. The purpose of this study was the review of 50 ameloblastoma in Nigerian patients observed in the Hos- pital of Ibadan. Ameloblastoma represents nearly 1% of all neoplasm located in the oral cavity. In 80% of cases it could be found in the mandible: 70% of these involving the molar region or the ascending ramus, 20% the premolar region and 10% the anterior part. Ameloblastoma is considered a benign neoplasm with slow growing-pattern and lo- cally aggressive behaviour. Methods. We collected the clinicopathologic data of 50 ameloblastoma from the files of the Hospital of Ibadan. Results. The 50 ameloblastoma occurred in patients from 8 years to 64 years, 25 cases (50%) were in their 3rd decade of life (20-29 years). Males were more frequently affected than females (27 to 23). On the basis of clinicora- diological findings, ameloblastoma were divided into 3 groups: solid or multicystic, unicystic and peripheral. The solid ameloblastoma represents nearly 60% of all cases (29 cases); it has a tendency to be more aggressive than the oth- er types with a higher incidence of recurrence; there were also 20 cases of unicystic and 1 of peripheral. After the surgical treatment we reported 7 recurrences. Conclusions. This review confirms the evidence of literature about amelobastoma: the prognosis for ameloblastoma is more dependent on the method of surgical treatment rather the histologic type of tumour.

Tooth transplantation can be considered a valid and predictable treatment option for rehabilitating young patients with permanent teeth loss. This study presents several cases of successful autogenous tooth transplantation with a 6-9 months follow-up. Tooth auto-transplantation can be considered a reasonable option for replacing missing teeth when a donor tooth is available. The auto-transplantation of a right mandibular third molar with compromised function and esthetics to replace the residual roots resulting from coronal destruction due to extensive carious lesion of the second molar in the same quadrant as shown in the presented cases can result a viable treatment alternative especially in a young patient that cannot undergo dental implant therapy. Transplantation of mature third molar seems to be a promising method for replacing a lost permanent molar tooth and restoring esthetics and function. This clinical procedure showed excellent functional and esthetical long-term results in the analyzed cases.

Stem cell migration is a critical step during the repair of damaged tissues. In order to achieve appropriate cell-based therapies for tooth and periodontal ligament repair it is necessary first to understand the dynamics of tissue-specific stem cell populations such as dental pulp stem cells (DPSC) and dental follicle stem cells (DFSC). Using time-lapse imaging, we analysed migratory and proliferative capabilities of these two human stem cell lines in vitro. When cultured alone, both DPSC and DFSC exhibited low and irregular migration profiles. In co-cultures, DFSC, but not DPSC, spectacularly increased their migration activity and velocity. DFSC rapidly surrounded the DPSC, thus resembling the in vivo developmental process, where follicle cells encircle both dental epithelium and pulp. Cell morphology was dependent on the culture conditions (mono-culture or co-culture) and changed over time. Regulatory genes involved in dental cell migration and differentiation such as TWIST1, MSX1, RUNX2, SFRP1 and ADAM28, were also evaluated in co-cultures. MSX1 up-regulation indicates that DPSC and DFSC retain their odontogenic potential. However, DPSC lose their capacity to differentiate into odontoblasts in the presence of DFSC, as suggested by RUNX2 up-regulation and TWIST1 down-regulation. In contrast, the unchanged levels of SFRP1 expression suggest that DFSC retain their potential to form periodontal tissues even in the presence of DPSC. These findings demonstrate that stem cells behave differently according to their environment, retain their genetic memory, and compete with each other to acquire the appropriate territory. Understanding the mechanisms involved in stem cell migration may lead to new therapeutic approaches for tooth repair.