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Solitary central osteomas of the jaw seem to be especially rare lesions; since 1955, only 12 cases have been reported and 4 of these were located in the maxilla. Osteomas are benign osteogenic lesions considered as real tumours but without infiltrative or metastatic potential. Their growth potential is usually limited, but certain rare and large cases of peripheral osteoma are described in literature. Although surgery is recommended, there are no reports of malignant transformation. In this study, we describe successful implant rehabilitation in a patient with a central osteoma of the maxilla with immediate loading in a fresh extraction socket.The report concerns a 33-year-old woman with a compromised deciduous first molar in the left premolar region of the maxilla; an asymptomatic bony expansion of the palatal and vestibular sides of the left canine/premolar/molar area of the maxilla and by radiograph revealed a well-defined radiopaque mass. An immediate non-occlusal loading was performed, and complete loading of the implant was completed five months later.The pathogenesis of these osteomas is unclear. Several authors reported a clear history of traumatic events, but others had no history of previous trauma or contributory medical factors. Since in our case no cancer growth happened over a period of more than four years, we decided to perform an immediate loading procedure during the implant rehabilitation. The outcome was successful.

The change in anatomy and physiology resulting from radical mandible surgery is often exacerbated by radiation therapies that make the mucosa atrophic and susceptible to irritation and ulceration rendering the task of areating functional complete dentures for edentulous subjects very challenging to prosthodontists. The aim of this study is to describe an implant supported denture rehabilitation in an edentulous hemimandibulectomized patient with a singular prosthetic design in order to compensate for the lack of a condylar process.The subject of the clinical case, had a history of squamous cell carcinoma of the right tonsillar region for which it was subjected to a hemimandibulectomy and was primarily rehabilitated with an over denture mounted onto a bar furnished by a resin condylar eminence in articulation with the glenoid fossa of the upper denture. The need to provide greater stabilization for the upper prosthesis led to a maxillary implant insertion and to the realization of a new joint connection that was constituted inferiorly by a titanium condyle and superiorly by a teflon acetabulum.The prosthetic balance guaranteed by the second rehabilitation greatly affected the biomechanics of mastication leading to a reduction of eccentric interferences, a stabilization of centric occlusion, and a lowering of intensity contraction by masticatory muscles. This difference is well represented by two and three-dimensional plans obtained from the application of a T-Scan III device.The rehabilitative solution proposed was effective in resolving the lateral deviation, in relieving masticatory and speech discomfort, as well as restoring an aesthetically acceptable appearance in a hemimandibulectomized and not reconstructed patient.

currently, head and neck irradiation is not considered an absolute contraindication for implant placement (1), especially due to the transition from conventional to conformal radiotherapy. However, there is a difference in the success rate of implant placement between irradiated and non-irradiated bones (5). Successful osseointegration is mainly affected by the total dose of radiation (6). The main purpose of this study was to minimize problems related to radiation dose by evaluating in advance the most suitable site for implant insertion on the basis of the mean absorbed dose. Additional aims were: to estimate the appropriate timing for implant insertion in irradiated bones, to analyze the difference in stability between maxilla and mandible, and to evaluate the success of implants with wrinkled microgeometry and increased layer of TiO(2).five patients who had been irradiated for head and neck cancer using intensity-modulated radiotherapy (IMRT) were recruited for our study. Surgical procedures were performed following a pre-surgical evaluation of the correct insertion position of implant fixtures. The latter was based on a scrutiny of dose-volume histograms (DVH) developed by a team of experts in medical physics and radiotherapists after dentists had contoured the volumes of interest. Student's t test and Pearson's correlation test were used for comparison and correlation between the variables considered.the percentage of osseointegration was 100%, which supports the usefulness of the adopted technique. A statistically significant difference in stability and crestal bone resorption emerged in the comparison between maxilla and mandible, but not between times of insertion. Moreover, there was a significant correlation between radiation dose and ISQ values: an increase in radiation dose corresponded to a decrease in primary stability. However, the correlation between ISQ values and implant length was not significant as well as that between primary stability and implant diameter.implantology guided by assessment of absorbed irradiation dose in the site to be rehabilitated can lead both to an increase in implant survival into irradiated tissue bone, and to a reduction in the incidence of ORN. However, both a larger sample size and the development of long-term prospective studies are necessary to validate the described method.

the present case report aims at illustrating how implant-prosthetic rehabilitation in patients with oral cancer resection aids to improve their quality of life.a patient with verrucous squamous cell carcinoma of the mandible was treated with surgery and rehabilitation with three interforaminal dental implants and Toronto bridge. Three years after treatment, because of cancer recurrence, a segment of jaw and one of the three mandibular implants were removed. The histological examination showed healthy bone contact to implant surface, despite proximity to the neoplastic area.the case shows the maintainance of the osseointegration implants despite the cancer recurrence in the same area.endosseous implants represent a useful and valid tool for the prosthetic rehabilitation of cancer patients. Long-term effects of implant-prosthetic rehabilitation in patients with cancer still need to be verified. It would be interesting to confirm the data obtained by numerical studies of representative samples.

the treatment of oral cancer requires different surgical approaches such as marginal or segmental mandibular resection in order to allow a safe removal of the neoplastic lesion. The aim of this work is to evaluate the efficacy of an implant-supported denture rehabilitation for restoring oral function and facial appearance on a hemimandibulectomized patient.the patient was a 64 years old man, hard smoker and moderate drinker. Due to a jaw neoplastic lesion, he underwent a hemimandibulectomy, followed by the insertion of 4 implant fixtures at the chin cap symphysis site. The denture rehabilitation consisted in an over-denture mounted onto a bar furnished by a condylar eminence in articulation with the glenoid fossa of the upper denture.this type of implant-supported denture rehabilitation allows the recovery of the masticatory function and the mandibular reposition with a satisfactory restoration of the proper facial symmetry and appearance.in the edentulous patient implant-supported denture with artificial condyle allows the recovery of the masticatory function without the need of additional operations to re-establish the temporomandibular joint anatomy. It is currently considered as a low invasive technique with very low risk of side effects.

Background: Impacted lower third molars often require surgical extraction. The management of post-operative complications such as pain and inflammation is a crucial stage during healing. Objectives: To compare anti-inflammatory and analgesic efficacy of naproxen sodium 550 mg (Synflex forte®, Recordati SpA) versus diclofenac sodium 50 mg (Voltaren®, Novartis Farma SpA) after surgical extraction of impacted lower third molars. Materials and methods: A sample of 25 patients requiring extraction of bilaterally impacted mandibular molars was selected. The sample was divided into two groups: in the first right molars were extracted and naproxen was used to control pain; in the second group left molars were extracted and diclofenac was used as analgesic drug. Patients scored perceived pain on a 0-100 mm visual analogue scale during postoperative period in accord to a precise timing. Data collected were statistically analysed and processed by Wilcoxon test. Results: Mean pain scores were similar at any time; at time 1 mean score was 61.76 and 62.84 and at time 10 it was 18.28 and 18.04 for naproxen and diclofenac respectively. According to the ANOVA model the variable "group" is not statistically significant (p value = 0.2410); this means that in both groups the drugs tested have effectively controlled pain in the days following surgery. Conclusions: According to our trial, both naproxen sodium 550 mg (Synflex forte®, Recordati SpA) and diclofenac sodium 50 mg (Voltaren ®, Novartis Farma SpA) showed similar efficacy in controlling pain and acute postoperative events after surgical extraction of impacted lower third molars.

INTRODUCTION. Ageing of population has recently revealed the necessity of dedicated health centres for elderly patients. Researching a correct management of this kind of patients, based on an adequate psychological approach, appears to be of paramount importance both for oral and general health. AIM OF WORK. The Authors report their experience at the Dental Clinic of the University of MilanoBicocca together with Don Gnocchi Foundation. MATERIALS AND METHODS. This study includes two groups of patients, the first one from institutionalized geriatric people, the second one from all sufficient people. Systemic and oral pathologies incidence is considered. RESULTS. The odontostomatological pathologies are serious in institutionalized subjects than in all sufficients subjects. CONCLUSIONS. Their work started in 2004 with a screening of elderly people (whether self-sufficient or not) living in the Don Gnocchi Foundation's area.

In Summer 2002, a patient with frequent epistaxis was admitted to the San Gerardo Hospital. Local examination showed a big mass in the nasal fossa. TC and RMN revealed a diffuse erosion of the palatal bone and infiltration of the maxilla. The tumor was removed and histological examination showed a gland carcinoma. The young age of the patient and the need of an adequate bone reconstruction led to use osteoperiosteal calf bone graft. Subsequently, using local anesthesia, 6 implants were positioned. After normal healing and the period of osteointegration, a Toronto bridge was made on implants that the patient wears with no problem.