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Background: Topical applications have long been regarded as precise methods for delivering drugs to soft tissues, such as the periodontal ligament, as well as hard structures, including the alveolar bone and cementum. Recently, the combination of hyaluronic acid (HA) and ozone therapy has gained popularity as a supportive treatment for chronic inflammation, in addition to its established role in enhancing healing after dental procedures. Methods: To gather the necessary research for our study, we conducted a systematic search across several databases, including PubMed, Google Scholar, and Ovid. Our study was registered under Prospero number CRD42024569641. The research, which began in June 2015 and concluded in May 2024, systematically examined the potential benefits of topical HA application in the management of both acute and chronic inflammatory diseases. Using relevant keywords and Medical Subject Headings, we selected 28 pertinent studies: three related to gingivitis, thirteen on chronic periodontitis, seven involving dental surgeries such as implants and sinus lifts, and three on oral ulcers. Results: The risk of bias among the analyzed studies was assessed using the RoB 2 tool. Regarding the randomization process, 75% of the studies exhibited a high risk of bias. However, all studies (100%) had a low risk of bias concerning allocation concealment. Only 25% of the studies adequately addressed performance bias, and another 25% reported all outcome data. Nevertheless, 85% of the included studies showed a low risk of reporting bias. Conclusions: The results indicate that the use of topical HA in combination with ozone therapy is highly effective not only in promoting post-operative healing following dental procedures but also in providing positive outcomes for individuals dealing with chronic gingivitis, periodontal inflammation, and oral ulcers. [ABSTRACT FROM AUTHOR]

Aim: The aim of this systematic review and meta-analysis was to assess possible histomorphometric differences in new bone formation and in remaining graft particles when hyaluronic acid (HA) was added and mixed with graft materials in bone regeneration. Materials and methods: This review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) of the National Institute of Health Research (registration number CRD42024530030). Electronic research was performed, and involved studies published up to 29 February 2024 using a specific word combination. The primary outcome was to assess possible histomorphometric differences in new bone formation and in remaining graft particles when HA was added and mixed with graft materials in bone regeneration. The search resulted in 138 potential studies. Meta-analyses were performed using the fixed and random effects model to identify significant changes in new bone formation and in the remaining graft particles. Results: After screening procedures, only three randomized controlled trials fulfilled the inclusion criteria and were selected for qualitative and quantitative analysis. The effect size of HA in the new bone formation was not statistically significant at 95% CI (Z = 1.734, p-value = 0.083, 95 % CI -,399; 6516). The effect size of HA in the remaining graft particles was not statistically significant at 95% CI (Z = −1.042, p-value = 0.297, CI -,835; 255). Conclusions: Within the limitations of the present systematic review and meta-analysis, the addition of HA to bone graft did not result in significant changes in bone regeneration procedures in terms of new bone formation and residues, even if the included studies showed encouraging and promising results. [ABSTRACT FROM AUTHOR]

Background: The present study analyzes the clinical aspects of the use of small-diameter implants for the fixation of total overdenture-type prostheses on both totally edentulous dental arches. Materials and methods: This is a review of all randomized controlled trials of at least ten patients with a control group in which at least two narrow implants were placed, published between January 2010 and July 2023. Most databases were analyzed, and clinical studies involving the insertion of at least two narrow implants (<3.5 mm in diameter) were analyzed. Results: Studies showed that the survival rate of narrow implants varied from 78% to 100%. Conclusions: The results indicated that narrow-type implants have satisfactory and predictable clinical performance for the long-term stability of overdenture-type prostheses. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to analyze retrospectively the clinical reliability of complete-arch rehabilitations with screw-retained fixed prostheses supported by four dental implants inserted with a fully guided surgical protocol. Materials and Methods: All the implants were placed between December 1, 2015, and April 30, 2019. Digital implant surgical planning was performed for all the complete-arch rehabilitations, and then, fully guided surgery was performed. The fixed provisional prostheses were delivered the day of the surgery and replaced by definitive prostheses after the healing period. Patients were followed up to determine survival of the implants and success of the overall treatment. Results: A total of 160 implants were positioned in 37 patients, with three patients receiving rehabilitations in both arches. A total of 40 complete-arch rehabilitations were performed, 26 in the maxilla and 14 in the mandible. Only five implants failed, resulting in an overall implant survival rate of 96.9%. No definitive prostheses failed, resulting in a 100% prosthetic success rate. The failed implants were successfully replaced before definitive prostheses were made, resulting in an overall treatment success of 100%. Conclusion: Within the limitations of this study, digital planning and guided surgery to perform complete-arch rehabilitations on four dental implants seems to be a valid treatment option. However, several prospective studies with longer follow-up are needed to achieve more predictable results. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the survival rate, marginal bone levels, and prosthetic success of short implants when placed in posterior areas of severely reabsorbed mandibles. Materials and Methods: A systematic review was performed of all randomized controlled trials with at least 10 patients with a control group where bone augmentations were performed that were published between January 2015 and February 2020. From 77 pertinent studies, 14 full-text publications were studied, and 6 studies fulfilled the inclusion criteria. Results: The implant survival rates of short dental implants ranged from 92% to 96.9% with a follow-up from 1 to 5 years, and the prosthetic success rate ranged from 90% to 100% during the same follow-up. The mean marginal bone level values of involved short implants ranged from -0.51 to -2.30 mm. Conclusion: The obtained data showed that short dental implants are a valid therapeutic choice to rehabilitate severe mandibular atrophy in the medium to long term. [ABSTRACT FROM AUTHOR]

Enterococci are commonly found in the environment and humans as a part of the normal microbiota. Among these, Enterococcus faecalis and Enterococcus faecium can convert into opportunistic pathogens, making them a major cause of nosocomial infections. The rapid diffusion of vancomycin-resistant strains and their impact on nosocomial settings is of considerable concern. Approximately one-third of the E. faecium infections in Italy are caused by vancomycin-resistant strains. This study explored the hypothesis that the oral cavity could represent a silent reservoir of virulent enterococci. A sample of 862 oral flora specimens collected from healthy human volunteers in Central Italy was investigated by real-time PCR to detect E. faecalis and E. faecium, as well as the genetic elements that most frequently determine vancomycin resistance. The prevalence of E. faecalis was 19%, a value that was not associated with alcohol consumption, tobacco smoking, or age of the subjects. Less frequently detected, with an overall prevalence of 0.7%, E. faecium was more common among people older than 49 years of age. The genes conferring vancomycin resistance were detected in only one sample. The results indicate that the oral cavity can be considered a reservoir of clinically relevant enterococci; however, our data suggest that healthy individuals rarely carry vancomycin-resistant strains. [ABSTRACT FROM AUTHOR]

Complete edentulous arches have been considered as one of the main limitations of intraoral scanners (IOSs). In these clinical scenarios, the accuracy of IOSs can be reduced because of several anatomical factors. To overcome these limitations, some studies have proposed several techniques to increase the accuracy of the impressions by means of various materials and instruments. The aim of this narrative review was to describe these techniques and to compare the obtained results to understand if it is currently feasible to increase the accuracy of the digital impressions of complete edentulous arches. An accurate analysis of the literature was performed using PubMed (National Library of Medicine) as well as manual searching without time and language restrictions. The results showed that there are few articles in the indexed literature on this topic, and that all are in vitro studies. Although the results of the analyzed studies were encouraging and reported useful in vitro results for artificial landmarks as well as for the use of an auxiliary geometry part related to the splinting of intraoral scan bodies (ISBs), clinical trials are needed to confirm that these techniques are feasible in daily clinical practice. [ABSTRACT FROM AUTHOR]

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Aim: To show the evolution of the authors' clinical experience in the application of the Straumann Orthosystem method for anterior anchorage in nonextraction patients. Methods: The Straumann Orthosystem has been combined with different traditional distalizing devices, passing from indirect to direct loading methods. Results: The authors prefer the direct loading method, which minimizes coronal tipping of the first maxillary premolars. Among the different appliances examined, a modified version of the Hilgers pendulum provides better handling and easier activation, due to the extractable springs. Conclusion: The Straumann Orthosystem can be used with a direct or indirect load, but the authors suggest its use with the direct loading method to avoid reciprocal forces in the anterior sector and to aid the contemporaneous distalization of intermediate dental elements. The surgical implant insertion is simple and without serious risks, and patient compliance is not required. [ABSTRACT FROM AUTHOR]

Aim: To describe clinical experience with the Straumann Orthosystem method for orthodontic anchorage. Material and Methods: The Straumann Orthosystem consists of a pure titanium implant, a healing cap with screw, and a set of burs and instruments for the insertion and removal of the implant. The elements of the recommended kit also include an octagonal plastic transfer, a laboratory analogue, and an octagonal steel cap for the laboratory phase. The step-by-step procedure is illustrated from diagnostic planning through the surgical phase. Conclusion: The Straumann Orthosystem represents a valid anchorage system for extraction and nonextraction cases, and it has proven to be an easy and noninvasive surgical technique that is comfortable for the patient. [ABSTRACT FROM AUTHOR]

The article describes a case of the tunnel traction procedure for deeply impacted canines and resorbed lateral incisors in a 12-year-old male who presented with a Class II, division I malocclusion, a deep overbite, and missing upper canines.

Purpose: The purpose of this study was to compare serum levels of HCY and Folate with SCCOC, in order to find statistically significant data showing that the correction of these levels might correspond to an improvement in conventional therapies. The Study also aims to highlight the possibility that Hyperhomocysteinemia (HHCY) could be considered as a tumoral marker. Materials and Methods: Serum levels of Folate and HCY were measured in 20 patients with histologically-proven SCCOC, before any treatment, and in 20 healty patients, non-smokers. These patients were subjected to nutritional control, with the supplementation of Folate (4 mg tablets, lx2 for 6 months) aided by consumption of two kiwifruit a day. Checks were made at the beginning of therapy and after 1 month, 3 and six months. Results: At the first check, cancer patiens showed consistently high values, particularly those with low-grade carcinomas. These high values, at the end of the observation period, appeared much improved. Even the healty patients revealed clear improvements. Conclusions: The role of HCY and folates appears to be important in carcinogenesis of SCCOC, but these serum levels are still not a reference value, so they cannot be included among the known tumor markers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the clinical and histological features and treatment of Pheripheral ameloblastoma. Pheripheral Ameloblastoma is a rare benign odontogenic tumor that concerns soft tissue and have a typical extraosseous localization. Material and Methods: Aim of this work is to show its clinical and histological characters, to have, by this way, an useful information for differential diagnosis with other oral neoformations, comparing the data of literature with our data, collected in ten years of clinical activity of Odontostomatologic Unit of Fatebenefratelli Hospital, Isola Tiberina in Rome. Results: Prognosis of PA is certainly favourable, with a restitution ad integrum near to 100%. In the period between July 2001 and July 2010 we reported 5 diagnosis of P.A. Medium age of the group with diagnosis of PA was 71,4 y with a SD: 3,65. P.A.'s incidence in the our sample of patients was 0,24%. Conclusion: It's possible to conclude that PA is a benign odontogenic tumor that requires a careful diagnosis, a complete surgical eradication and adequate follow up, because malignant evolution is rare but possible. Clinical Significance: Ameloblastoma is a benign but locally invasive neoplasia that arises from odontogenic ephitelium, mandible is the most prevalent localization and intraosseous form is the most frequent type. 1. It can be recognized in three subtypes(1): 2. Intraosseous multicystic or solid type; 3. Intraosseous unicystic type; 4. Peripheral or extraosseous type (P.A.). Multicystic type represents 86% of all ameloblastomas, unicystic type 13% and the peripheral form 1% (2). The diagnosis is based on both the clinical and histologic characteristics. Caution is required during their surgical excision to avoid recurrence. Radiografically it appears to be external to cortical bone. In some cases it's possible to point out the cupping or saucerization effect, because the tumour due to its pressure effects a concavity on the osseous surface (1,3,4). P.A. have a non invasive behaviour, but it has however a recurrence rate of 16-19%. [ABSTRACT FROM AUTHOR]

Dysphagia is defined as difficulty in swallowing food (semi-solid or solid), liquid, or both. Difficulty in swallowing affects approximately 7% of population, with risk incidence increasing with age. There are many disorder conditions predisposing to dysphagia such as mechanical strokes or esophageal diseases even if neurological diseases represent the principal one. Cerebrovascular pathology is today the leading cause of death in developing countries, and it occurs most frequently in individuals who are at least 60 years old. Swallowing disorders related to a stroke event are common occurrences. The incidence ranging is estimated from 18% to 81% in the acute phase and with a prevalence of 12% among such patients. Cerebral, cerebellar, or brain stem strokes can influence swallowing physiology while cerebral lesions can interrupt voluntary control of mastication and bolus transport during the oral phase. Among the most frequent complications of dysphagia are increased mortality and pulmonary risks such as aspiration pneumonia, dehydration, malnutrition, and long-term hospitalization. This review article discusses the epidemiology of dysphagia, the normal swallowing process, pathophysiology, signs and symptoms, diagnostics, and dental management of patients affected. [ABSTRACT FROM AUTHOR]

The article describes the case of a 25-year-old woman presented with Class II skeletal and dental relationships. The patient has moderate crowding in both arches wherein three treatment options were discussed including extraction of the upper first and lower second molars. The use of a modified Hilgers Pendulum appliance was suggested with the support of an osseo-integrated palatal mini-implant, to gain space in the maxillary arch of an adult patient.

The article presents a case study of a 13-year-old male who was referred to the orthodontic department of the Fatebenefratelli Hospital in Isola Tiberina, Rome, Italy due to a geminated maxillary left central incisor. It says that radiographic examinations revealed that the anomalous incisor had a single pulp. It states that the patient undergoes surgery, in which the anomalous tooth is extracted. It adds that a Maryland bridge was placed as a temporary prosthetic until adulthood.

Background/aims: The aim of the present study was to determine the prevalence of ten periodontopathic bacteria and microbial complexes in Italian patients with GAgP and GCP and establish if their presence allows distinction between chronic and aggressive generalized periodontitis. Methods: Subgingival plaque samples were collected from 47 GCP and 16 GAgP patients. PCR was used for periodontal bacteria identification. Results: The only statistical difference found between GCP and GAgP subjects was Treponema denticola (10.6% GCP versus 37.5% GAgP). Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium nucleatum were detected most frequently with similar percentage in both groups. Aggregatibacter actinomycetemcomitans was isolated less frequently in chronic (4.3%) than in aggressive (18.8%) periodontitis patients. No statistical differences are present between microbial complexes in GCP and GAgP subjects. Analyzing orange complex positive subjects in relation to BOP, there is a statistical difference between subjects with or without presence of red complex (p=0.037)Conclusion: The subgingival microbiota of both GAgP and GCP Italian subjects was characterized by detection of putative periodontal pathogens, however without statistical differences between the two periodontitis groups. Our data suggest that presence of certain subgingival periodontal pathogens cannot be used for distinguishing between GAgP and GCP subjects [ABSTRACT FROM AUTHOR]

The article presents a case study of a 22-year-old female with a Class I malocclusion. It notes that the maxillary permanently canines were impacted in the palatal bone. It adds that mild crowding is obvious in the mandibular arch. It mentions that the planned treatment was to correct the molar relationship by maxillary molar distalization. Moreover, it details the insertion of a Straumann Orthosystem platal implant.

Background: Following an episode of hereditary angioedema (HAE), dental anxiety commonly arises, and many patients find it challenging to access proper care. While the use of virtual reality (VR) for pain and anxiety management in dentistry is on the rise, its application in individuals with angioedema remains largely unexplored. In a case series conducted at a specialized dental clinic, three patients with a history of acute angioedema attacks and dental anxiety engaged with 360° VR videos while seated in the dental chair, utilizing a virtual reality device., Methods: Three patients with hereditary angioedema were treated by subjecting them to virtual immersion using VR glasses. Intraoperative reactions were analyzed using VAS scales in order to report the patients' level of anxiety and pain., Results: The outcomes, evaluated through a standard observation tool, surveys, and interviews, encompass the assessment of patient anxiety and pain, responses to VR, and the evaluation of system usability along with its impact on the dental team's workflow Three individuals underwent examination, from which three reliable questionnaires were obtained, demonstrating a success rate of 99.9%. The group included one male and two females, with their ages spanning from 6 to 58 years. The findings revealed an average anxiety score of 1.80 with a standard deviation of 0.6 points, and an average pain score of 1.98 with a standard deviation of 0.3, thus validating full immersion in distraction. Statistical analysis using independent-sample t-tests and ANOVA indicated no significant differences in anxiety levels among the patients based on gender. Both patients wore the VR device throughout the procedure, expressing that it was comfortable, diverting, and held the potential to alleviate anxiety and pain. The dentist noted a positive influence on patient anxiety levels and procedure completion times, expressing an intention to continue employing VR with other angioedema patients and across diverse clinical populations., Conclusions: Virtual reality can be an excellent distraction tool in patients with hereditary angioedema who present at least one acute attack per year.

Dental anxiety, linked to avoiding dental treatment and heightened medical and surgical risks, prompted this systematic review. The objective is to synthesize existing evidence on conscious sedation techniques employed for managing dental anxiety in patients scheduled for third molar extraction surgery, aiming to identify optimal approaches and address knowledge gaps. This systematic review followed the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" checklist and the population, investigation, comparation, outcome framework. The protocol still needs to be registered. A thorough search was conducted, incorporating MEDLINE/PubMed, EMBASE, SCOPUS, clinicaltrials.gov, and the Cochrane Database of Systematic Reviews until February 2024. Only randomized controlled trials were considered, following "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines. The risk of bias was evaluated following the Cochrane Handbook for Systematic Reviews of Interventions. Eighteen randomized controlled trials involving 2081 patients were included. Certain factors limited the feasibility of a meaningful meta-analysis, leading to a narrative synthesis. Conscious sedation with virtual reality showed an association with improved dental anxiety in 4 studies. One study reported reduced cortisol levels with midazolam compared with a placebo, whereas another noted significant variations in perioperative renin levels with remifentanil versus placebo. This review reveals inconclusive and conflicting findings regarding the role of conscious sedation in managing dental anxiety during third molar extraction surgery. Persistent uncertainties arise due to a need for consistent, standardized outcome measures. Addressing these limitations in study design is crucial for future research., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Background: Lichen planus (LP) is a mucocutaneous disease of chronic inflammatory nature. Although many therapeutic options are available, none are curative. The aim of this article was to describe a therapeutic algorithm that take into consideration the clinical futures of oral LP (OLP)., Methods: Patients affected by symptomatic OLP were enrolled into three groups to receive cyclosporine mouthwash, retinoic acid lotion 0.05%, and autologous platelet-rich plasma (PRP) gel in the treatment of reticular, plaque-like, and erosive-type respectively. The products were applied as follows: retinoic acid BID for 8 weeks, cyclosporine mouthwash OD for 8 weeks, PRP once a week for 8 weeks. Patients were assessed at 2, 4, 8, and 12 weeks. Improvement was evaluated as complete response, partial response and no response., Results: A total of 20 Caucasian patients, 8 male and 12 female, mean age 56 years (range 40-74) concluded the study. Seven patients showed a complete response, 7 patients a partial response, and 6 patients no response., Conclusions: We propose a therapeutic algorithm that take into consideration the clinical features and symptoms of OLP. Long-term experience on larger series of cases are necessary to confirm our data.