Search

Introduction: Within the field of periodontology, there has been a proposal for the utilization of noninvasive laser therapy as a potential treatment for persistent periodontitis. The Laser-Assisted New Attachment Procedure (LANAP) employs an Nd:YAG laser as a specific technique. Through its interaction with endogenous chromophores, the Nd: YAG laser exhibits a selective effect on the evaporation of granulation tissue, therefore establishing a correlation with reduced bleeding. The study also examined Oxygen High-Level Laser Therapy (OHLLT). The OHLLT technique employs a high-power diode laser in combination with hydrogen peroxide solutions to facilitate the liberation of singlet oxygen, which possesses antibacterial attributes, within the periodontal pockets. The existing literature indicates their potential to promote the regeneration of tooth support tissues. Objective: The aim of this study is to assess the subjective pain levels reported by patients who have undergone surgery using the OHLLT protocol versus those who have undergone surgery using the LANAP technique. Methods: A total of 20 individuals with a stage III-IV periodontitis diagnosis were recruited for the study. The participants were randomly divided into two groups, each consisting of 10 individuals: Group 1, comprising patients treated according to the LANAP protocol, and Group 2, comprising patients treated according to the OHLLT protocol. After their initial session of nonsurgical periodontal therapy, individuals provided feedback regarding their level of pain, utilizing a Numerical Rating Scale (NRS) comprising time intervals of 0 h (T0), 6 h (T1), 12 h (T2), 24 h (T3), 48 h (T4), and 7 days (T5). The Wilcoxon-Mann-Whitney statistical test was employed to assess the variations in NRS scores between Group 1 and Group 2 at each recording period. (p <= 0.05). In addition, a microbiological assessment of the bacterial load in the periodontal region was conducted on all subjects using real-time PC

A case of home care is proposed on a frail non-ambulatory patient who presents an old lower total prosthesis in resin broken in several parts. The various pieces of the prosthesis were joined by the patient, as if it were a puzzle, using a glue for plastics and wood. The union of the parts attached with glue was the consequence of the lockdown in the COVID-19 period and of the economic hardship experienced by the elderly disabled patient during the pandemic period. The procedure for preserving the glued parts was carried out carefully, trying not to modify the edges of the glued pieces, to join them correctly, thereby restoring the correct occlusion to subsequently perform the relining. The old lower total prosthesis obtained after the repair and relining operations allowed for the restoration of the patient’s chewing and smile. The procedure presented is easily repeatable, risk-free and achievable even in a short time, satisfying elderly non-self-sufficient patients who need interventions for prosthetic emergencies during a period of confinement.

Objective: To assess if photobiomodulation (PBM) improves the efficiency of orthodontic treatment with fixed appliance during the alignment stage. Methods: Eighty-nine subjects were included in this trial and randomly assigned for treatment with fixed appliance and PBM group or with fixed appliance only (control group). Inclusion criteria were as follows: (1) age between 13 and 30 years, (2) permanent dentition, (3) class I malocclusion, (4) lower 6-6 mild crowding measured on dental cast, (5) no spaces or diastema in the lower arch, (6) no ectopic teeth, (7) nonextractive treatment plan, and (8) no previous orthodontic treatment. PBM was administered in the PBM group every 14 days using the ATP38® (Biotech Dental, Allée de Craponne, Salon de Provence, France) (72 J/cm2 of fluency for each session). Dental alignment was assessed by visual inspection, and treatment time was defined in days as T2 (date of assessment of complete dental alignment)-T1 (date of brackets bonding). The number of monthly scheduled appointments was also recorded. All the data underwent statistical analysis for comparison between groups. Results: Treatment time was significantly shorter (p < 0.001) in the PBM group (203 days) compared with the control (260 days). Consequently, control visits (p < 0.001) were lower in the PBM group (7) compared with the control group (9). Conclusions: The present findings would confirm that PBM can be used to enhance the efficiency of orthodontic treatment during dental decrowding.

Aim: Osteoradionecrosis of the jaws (ORNJs) is aseptic bone necrosis that develops in post-irradiated bone tissue of patients who underwent radiotherapy for head-neck tumors. The present study aims to clinically assess the regenerative ability of the ozone in the form of oil-based gel applied to the exposed bone area in the treatment of ORNJ. Materials and methods: Eight patients who underwent radiotherapy for the treatment of cervical or neck cancer were diagnosed with ORN of the jaws at our Department, for a total of 11 sites of necrotic bone exposure (3 patients were diagnosed with more than one site of osteoradionecrosis). In the therapeutic protocol, the exposed bone lesion and osteomucosal margin were cleaned with manual debridement. Then the ORN lesion was treated with topical applications of ozone delivered as oil suspension (Ozosan® - Sanipan, Clivio, Italy) on the exposed bone for 10 minutes. The application was repeated each week until movement of the necrotic fragment was noted Results: In six patients on 8 (75%) lesions resolved with complete mucosal healing with 3 to 19 ozone applications. Total sequestration of the necrotic bone with spontaneous expulsion was observed. One patient improved his conditions shifting from a stage B2S1 to B1S1 according to He et al. classification. A patient only worsened his conditions with treatment. No toxicity was reported or observed. Conclusion: These results showed the efficacy of ozone oil suspensions in the non-invasive treatment of ORN, probably related to its properties of stimulation of local revascularization and antibacterial activity, and the good tolerability of the related protocol used.

Aim: Cone beam computed tomography (CBCT) is the most refined and affordable method available today for the examination of an incoming patient for different dental pathologies. The aim of this paper is to evaluate the significance of some factors influencing the prevalence of apical periodontitis. Materials and methods: An ortopantomography (OPT) and CBCT scan of the dental arches were examined for each of the selected 45 patients. The presence of apical periodontitis (AP) was compared for CBCT and OPT examination. Sensitivity, specificity, predictive values, and accuracy were calculated for CBCT, using OPT as a reference. The impact of protective/risk factors on the development of AP was examined. Results: CBCT showed higher sensitivity (250%), predictive values (111%), accuracy (111%), and specificity (101%) than OPT. It was found to have higher sensitivity in all the dentition areas, especially where empty anatomical spaces or more radiotransparent structures have a strict relationship with the tooth apex and periapical structures like upper front area, premolar areas, and, especially, in the upper molar area. The prevalence of AP increased from 16 to 17% in the case of insufficient conservative restoration or 25% in the case of microleakage, 35-42% in the case of prosthetic restoration, 56-67% for posts, and 60 and 85%, respectively, for inadequate endodontic treatment and missed canals. Conclusion: CBCT plays a decisive role in the evaluation of molar areas and in the endodontic treatment planning, when a close relationship between the apex and important anatomical structures exists. Different risk factors with different relevance are identified. Clinical significance: As CBCT-examined results show, coronal restorations are moderate-risk factors, while insufficient endodontic treatments and posts are high-risk factors for the development of AP.

Aim: Digital orthopantomography (OPT) is usually the first examination step in supervising an incoming patient. Cone beam computed tomography (CBCT) is the most refined and affordable method to search for different dental lesions. The aim of this paper is to evaluate the effectiveness of OPT and CBCT in detecting periapical lesions in different dental groups. Materials and methods: An OPT and a CBCT scan of the dental arches of 45 patients were examined. The presence of AP was pointed out for OPT and CBCT. Sensitivity, specificity, predictive values, and accuracy were calculated for OPT, using CBCT as the reference standard. Results: OPT showed low sensitivity (40.0), positive predictive value (90.4), negative predictive value (90.0), accuracy (90.0), and high specificity (99.2). It was found to have higher sensitivity in the lower front and premolar areas, while the lowest was found in the upper molar area. Conclusions: OPT can be used for endodontic diagnosis in the lower central and premolar sections, but CBCT plays a decisive role in the evaluation of molar areas and in the endodontic treatment planning, when a close relationship between apex and important anatomical structures exists. Clinical significance: CBCT exposes the patient to higher doses of radiations when compared with OPT, but CBCT, with its more selective sensitivity and the possibility to offer a three-dimensional (3D) rendering of dental and periodontal structures, is an elective choice for uncertain cases and for specific dental areas.

Aim. Endosseous implants are widely used to replace missing teeth but mucositis and peri-implantitis are the most frequent long-term complications related with dental implants. Removing all bacterial deposits on contaminated implant surface is very difficult due to implant surface morphology. The aim of this study was to evaluate the bactericidal potential of photodynamic therapy by using a new high level laser irradiation protocol associated with hydrogen peroxide in peri-implantitis. Materials and Methods. 10 patients affected by peri-implantitis were selected for this study. Medical history, photographic documentation, periodontal examination, and periapical radiographs were collected at baseline and 6 months after surgery. Microbiological analysis was performed with PCR Real Time. Each patient underwent nonsurgical periodontal therapy and surgery combined with photodynamic therapy according to High Level Laser Therapy protocol. Results. All peri-implant pockets were treated successfully, without having any complication and not showing significant differences in results. All clinical parameters showed an improvement, with a decrease of Plaque Index (average decrease of 65%, range 23-86%), bleeding on probing (average decrease of 66%, range 26-80%), and probing depth (average decrease of 1,6 mm, range 0,46-2,6 mm). Periapical radiographs at 6 months after surgery showed a complete radiographic filling of peri-implant defect around implants treated. Results showed a decrease of total bacterial count and of all bacterial species, except for Eikenella corrodens, 6 months after surgery. Conclusion. Photodynamic therapy using HLLT appears to be a good adjunct to surgical treatment of peri-implantitis.

Gingival augmentation techniques proposed in the international literature do not exclude a surgical component, which determines consequent post-surgical discomfort and results are not always predictable. In recent years, the introduction of laser biostimulation has led to a less invasive approach, particularly in the treatment of periodontally compromised patients, limiting the surgical phase to seriously compromised cases, with regeneration techniques for the restoration of a correct periodontal tissue anatomy. The aim of this in vitro study is to establish the validity of laser biostimulation in order to develop the epithelial keratinized layer of the tissue by stimulating fibroblasts-keratinocytes organotypic cultures and fibroblasts and keratinocytes mono-cultures. We created two groups (test and control), each one composed of 3 fibroblast cultures, 3 keratinocyte cultures and 3 organotypic cultures. We performed laser irradiation of test group with Wiser Doctor Smile Lambda, Flat Top Handpiece, at 50 J/cm2 of fluency with one application every 40 h for a total of 5 applications. Forty-eight h after the last laser application, we investigated the presence and amount of keratins 5 and 8 with citofluorymetric and western blotting analyses. Analyses showed an increase in keratin synthesis in test group cultures, showing a remarkable increase in production of keratin 8 in co-cultures test. Laser biostimulation can considerably enhance keratin synthesis when applied with high energy doses and repeated applications to keratinocytes-fibroblasts co-cultures.