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Purpose: There is uncertainty in the literature on whether the presence of keratinized tissue (KT) ameliorates the state of peri-implant tissue health. A systematic review and meta-analysis was performed to synthesize evidence on the association between peri-implant keratinization, defined as adequate (≥ 2 mm) or inadequate (0 to 2 mm), and peri-implant health and stability, measured as tissue inflammation, plaque accumulation, tendency to bleeding, and probing depth (PD). Materials and Methods: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and was registered on PROSPERO. According to predefined inclusion criteria, full papers for potentially eligible studies resulted from electronic databases (PubMed, Cochrane, and OpenGrey) and screening of titles/abstracts. Publication bias and risk of bias in primary studies were assessed. The primary outcome was gingival inflammation, measured with Gingival Index (GI) and modified Gingival Index (mGI). Additional outcomes were plaque accumulation (mPI/PI), bleeding (bleeding on probing/modified Bleeding Index), and PD. For each outcome, a random-effects meta-analysis was performed comparing the adequate group (≥ 2 mm, KT1) and the inadequate group (< 2 mm, KT0) KT width. The mean number of implants and proportion of mandibular implants were investigated as potential causes of heterogeneity using meta-regression. Sensitivity analysis was performed excluding low-quality studies. Results: From 362 screened studies, a total of 15 papers were included in the systematic review, and 8 articles were finally included in the meta-analysis. Heterogeneity was found for all outcomes. The main analysis showed a statistically significant association between adequate KT level and a lower mGI-GI (standard mean difference [SMD] KT1 vs KT0 = –1.25, 95% CI = –2.12 to 0.37, P = .01). For plaque accumulation (SMD = –1.18, 95% CI = –2.36 to 0.00, P = .05), bleeding (SD = –1.99, 95% CI = –4.60 to 0.61, P = .13), and PD (MD = –0.06, 95% CI = –0.13 to 0.01, P = .10), no statistically significant difference was detected; however, the trend of results was in favor of the KT1 group. The sensitivity analysis supported the main analysis conclusions. Conclusion: The importance of having an adequate KT width around implants was confirmed by this review; adequate KT was significantly associated with less peri-implant inflammation evaluated qualitatively with mGI/GI. No difference was found for plaque accumulation and bleeding, but a positive trend was found favoring implants with adequate KT. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the current clinical trial was to evaluate if the oral supplementation of melatonin after nonsurgical periodontal therapy (NSPT) determined a better periodontal healing than NSPT alone, in patients affected by untreated severe periodontitis. Background: Melatonin's anti‐inflammatory, antioxidant and immunomodulatory capacities, together with its pharmacokinetic and pharmacodynamic profiles are key characteristics that justify the therapeutic use for the treatment of periodontitis. Methods: This is a randomized, triple‐blind, placebo‐controlled study. Twenty patients were blindly randomized either to melatonin or placebo group. The melatonin group received NSPT and melatonin capsules 1 mg per day for 1 month, while the placebo, NSPT, and placebo capsules for 1 month. The patients were evaluated at baseline and 6 months after. Mean change from baseline probing depth (PD) was the primary outcome; site of probing was used as unit of analysis; FMBS (%) and FMPS (%) were also calculated. Mann‐Whitney test was used to evaluate statistical significance (α = 0.05). Results: Melatonin was well tolerated by all patients. Both treatments were effective in reducing PD, but no statistical difference was found when comparing posttreatment PD (probing all sites), P =.62. When considering the primary outcome, melatonin administration resulted in greater mean PD change at 6 months if compared to control group: for 4‐5 mm sites 1.86 (0.81) vs 1.04 (0.69), P =.00001 and for sites >5 mm 3.33 (1.43) vs 2.11 (0.96), P =.00012. No difference was found for FMBS and FMPS. Conclusion: Current study, within its limitations, concluded that oral administration of melatonin (1 mg per day for 30 days) after one‐stage full mouth NSPT determined a greater change from baseline PD if compared to NSPT alone, in untreated stage III periodontitis. This could provide a non‐pharmacological support to improve periodontal healing of periodontal sites after NSPT. [ABSTRACT FROM AUTHOR]

Many studies have shown success with immediate loading of dental implants. The purpose of this paper is to report on a procedure that places implants with a sandblasted and acid-etched surface and loads them with a fixed, provisional, immediately loaded mandibular complete denture, all in a single day. The various surgical, prosthetic, and laboratory phases are explained, with particular attention paid to a luting technique that is able to reduce prosthetic misfit. A series of 14 patients was treated with this protocol and followed for a mean of 28.2 months. A 100% implant survival rate was achieved, and all prostheses were in place and functioning at the most recent follow-up. [ABSTRACT FROM AUTHOR]

This article presents the case report of the bilateral 3-dimensional reconstruction of a posterior mandible in a 48-year-old woman. Titanium meshes and Regena form demineralized freeze-dried bone allograft were used for bone regeneration. After 5 months the titanium mesh was removed, and after another 4 months, 4 Straumann sandblasted, large-grit, acid-etched implants were placed, 2 on each side of the mandible. During implantation a bone specimen was collected and sent for histologic examination. The definitive fixed prosthesis was fabricated after an additional 4 months. The clinical and histologic results are shown. The implants were followed for 18 months after implant loading; no signs of bone loss or infection were observed. [ABSTRACT FROM AUTHOR]

In some periodontal cases, biomechanical, esthetic, medical, or economic concerns make it difficult for clinicians to employ either traditional therapy or restoration with an implant-supported prosthesis. To avoid any compromise and ensure a good result in such cases, we chose a removable telescopic prosthesis on natural teeth. In this paper we present a new clinical and technical method for the telescopic prosthesis, and we show that this is a predictable, reliable solution that is easy to realize, inexpensive, and comfortable for patients. [ABSTRACT FROM AUTHOR]

Aim of the Study: The odontogenic sinusitis has an incidence between 38 and 40.6%. Increased risk of maxillary sinusitis has been reported with the presence of periapical abscesses, periodontal disease, dental trauma, tooth extraction and implant placement when the sinusal membrane is perforated., Materials and Methods: A patient with odontogenic maxillary sinusitis associated with oro-nasal fistula was treated., Results: The follow-up at six months showed the complete resolution of maxillary sinusitis, palatal fistula got closed and pain symptoms disappeared., Conclusion: This case report describes a rare complication of odontogenic maxillary sinusitis: the oro-nasal fistula.

Aim of the Study: 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., Materials and Methods: 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., Discussion: 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., Conclusions: 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.

Aim of the Study: Reconstruction of segmental defects and the atrophic maxilla and mandible is performed using various techniques. Bone substitutes have received a wealth of reports in the literature demonstrating a long-term success when used in alveolar bone augmentation procedures., Materials and Methods: We reviewed articles comparing TiMesh GBR technique with different percentage of bone: autogenous bone alone (AB); anorganic bovine bone alone (ABB); 50:50 or 70:30. From an initial pool of 122, we selected 14 studies. ANOVA followed by Tukey HSD test was used for statistical analysis., Results: We present a table analysing fundamental parameters to value a successful GBR therapy. Autogenous bone remains the gold standard in GBR technique with TiMesh; however, the combination between AB/ABB in relation 50:50 and 70:30 allows reducing surgical cost exploiting properties of eterologous bone., Conclusion: The use of autologous bone is associated with a height and width gain of bone, which are greater compared to other techniques, with a lower exposure of the mesh and a lower bone resorption. The use of heterologous graft leads to a lower bone earn and to percentage of resorption greater than autologous graft but does not differ from the gain and resorption of the bone of AB/ABB in percentage 50:50 and 70:30.