Objective
This randomized, double‐blind, placebo‐controlled crossover study assessed the efficacy of topical tocopherol acetate compared with placebo in easing oral discomfort in patients with ...reticular oral lichen planus (ROLP).
Materials and Methods
Thirty‐four patients with clinically diagnosed and histologically confirmed ROLP were randomly assigned to two groups, which received first one of two treatments (treatment 1 or 2) for a month, then the other (treatment 2 or 1) for another month, with a two‐week washout between them. One treatment contained tocopherol acetate and the other only liquid paraffin. The primary outcome was less discomfort, measured on a visual analog scale (VAS). Secondary outcomes were as follows: length of striae measured and photographed at each follow‐up; surface area of lesions; and a modified Thongprasom score.
Results
No statistically significant differences emerged between the two treatments (1 vs 2) in terms of VAS scores (P > 0.05; 0.8624) or length of striae (P = 0.0883). Significant differences were seen for surface area of lesions (P < 0.05, P = 0.0045) and modified Thongprasom scores (P = 0.0052).
Conclusion
The two treatments differed only in terms of the surface area of the lesions and Thongprasom scores, not in VAS scores for discomfort or the length of patients’ striae. Topical tocopherol proved effective in the treatment of ROLP.
Scissor bite is a rare malocclusion that often leads to minor facial asymmetry. An orthodontic and orthopaedic correction is advisable in young patients to prevent subsequent temporomandibular ...diseases requesting maxillofacial intervention.
In this case report a 8-year-old girl in mixed dentition with unilateral left scissor bite was treated with a modified Rapid Palatal Expander. To modify an overexpanded maxilla (width 39 mm measured between both upper first molars) the device was used to close rather than to expand, without need of patient compliance. Orthodontic correction was then completed with traditional bracketing. Results were tangible (width 36 mm) and remained stable even for at least 2 years after retention. This original device has proved to be useful in this kind of situations and can be easily applied to young patient to correct such malocclusions.
Objectives
The aim of the present review and meta‐analysis was to evaluate the influence of soft tissue thickness on initial bone remodeling after implant installation.
Materials and Methods
A ...literature search was conducted by two independent reviewers on electronic databases up to May 2022. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) performed on human subjects were included. The risk of bias was evaluated using Cochrane Collaboration's tool. Meta‐analysis and Trial Sequential Analysis (TSA) were performed on the selected articles. The primary outcome was marginal bone loss.
Results
After screening, 6 studies were included in the final analysis, with a total of 354 implants, and a follow‐up from 10 to 14 months. 194 implants were placed in a ≥ 2 mm soft tissue thickness, while 160 had <2 mm soft tissue thickness before implant placement. The included studies had a high level of heterogeneity (I2 > 50%). The meta‐analysis indicated a statistically significant difference between the two groups (0.54; p = .027) and the TSA analysis confirmed the results, despite the limited number of dental implants. Additional analysis showed that age and follow‐up parameters were not statistically significant factors influencing the bone loss (p = .22 and p = .16, respectively).
Conclusions
Based on the available RCTS and CCTs, initial soft tissue thickness seems to influence marginal bone loss after a short follow‐up period. Based on TSA analysis, further studies are needed to assess the influence of the soft tissue thickness on marginal bone loss.
PROSPERO registration number: CRD42021235324.
Nanostructured surfaces of dental implants Bressan, Eriberto; Sbricoli, Luca; Guazzo, Riccardo ...
International Journal of Molecular Sciences,
01/2013, Volume:
14, Issue:
1
Journal Article, Book Review
Peer reviewed
Open access
The structural and functional fusion of the surface of the dental implant with the surrounding bone (osseointegration) is crucial for the short and long term outcome of the device. In recent years, ...the enhancement of bone formation at the bone-implant interface has been achieved through the modulation of osteoblasts adhesion and spreading, induced by structural modifications of the implant surface, particularly at the nanoscale level. In this context, traditional chemical and physical processes find new applications to achieve the best dental implant technology. This review provides an overview of the most common manufacture techniques and the related cells-surface interactions and modulation. A Medline and a hand search were conducted to identify studies concerning nanostructuration of implant surface and their related biological interaction. In this paper, we stressed the importance of the modifications on dental implant surfaces at the nanometric level. Nowadays, there is still little evidence of the long-term benefits of nanofeatures, as the promising results achieved in vitro and in animals have still to be confirmed in humans. However, the increasing interest in nanotechnology is undoubted and more research is going to be published in the coming years.
Intraoral vascular tumors are an heterogeneous group of diseases, so many classification have proposed in the past, and an universally shared classification hasn't been accepted yet. The confusion ...about treatment approach reflects this lack. The AccuVein AV400 is a portable instrument, used by many clinicians to locate superficial vessels, so it can be useful in various professional fields (aesthetic, surgical, radiological, cosmetic, cardiological). It provides a map of the vasculature on the surface of the skin, but no attempt has been done as far as oral mucosa is concerned. The aim of the present case presentation is to report on the application of this device in order to detect and treatment chose of intraoral vascular lesions, to quantify the intraoperative bleeding risk and to check the treatment effectiveness. A healthy 82-year-old female patient was referred to our Dental Clinic. At the intraoral examination, the clinicians noted the presence of a roundish red and blue elevation, sized 5x3 mm, charged to the left retrocommissural area of the oral mucosa. The lesion had been present for four years, but it had recently grown in size, so the patient complained about recurrent bleeding episodes secondary to masticatory trauma. Vascular origin of the lesion had been confirmed by compressive contact between a glass slide and the lesion (the lesion disappeared under compression, because there was no more blood supply) and by the use of the AccuVein400 Vein Viewing System®. This tool exploits infrared rays to detect the hemoglobin in the blood vessels and shows a map of these vessels directly on the skin or on the mucosa overlying the veins. After local anesthesia with Mepivacaine Hydroclorate 3% without vasoconstrictor, the treatment consisted in a 830 nm diode laser photocoagulation (1.5-2.5W). Lasers emit a precise beam of concentrated light energy, well-absorbed, depending on the wavelength, by hemoglobin. The treatment effectiveness was checked immediately after the procedure and at the one-month follow-up visit both with the clinical examination and by the AccuVein400 Vein Viewing System®. A one-month follow-up visit was performed after the procedure, in order to confirm the treatment success. Both the intraoral clinical examination and the AccuVein system confirmed a complete healing of the lesion and of the vascular component in particular. No more bleeding episodes had been referred by the patient, who reported an improvement of her masticatory comfort. The AccuVein400 Vein Viewing System® has been designed to perform more effective venipuncture procedures with less patient discomfort, but it could have various applications. One of them could be the diagnosis, the treatment monitoring and the follow-up of intraoral and extraoral vascular lesions. It can be useful also to discriminate between benign vascular lesions and other neoformations, which can be similar at the clinical examination. This tool is easy to use, handheld and lightweight, it doesn't require any contact with the patient's skin nor calibration and it also allows the clinicians to check the deepest part of the lesion, which might not be visible at a clinical examination. It could maybe reduce the reoccurence rate.
Response to Nimisha Bacci, C; Vanzo, V; Frigo, A C ...
Oral diseases,
2018-Apr-24
Journal Article
Peer reviewed
We thank Dr Nimisha for the letter and provide a response to the comments raised.Table 1 shows the characteristics and medians of assessment parameters before the two treatment sequences (AB-BA) so ...it corresponds to the baseline of first period cross-over design (the value before receiving treatment A for patients randomized to AB sequence, the value before receiving treatment B for patients randomized to AB sequence).Table 2 shows the medians of assessment parameters before and after each treatment (A and B), in this case the baseline is the baseline of the period 1 for the patients randomized to AB sequence and the baseline of the period 2 for the patients randomized to BA sequence. This article is protected by copyright. All rights reserved.
This controlled, randomized, crossover, double-blind study was performed to evaluate the efficacy of tocopherol acetate in terms of improvement of the clinical aspect and the discomfort level in ...patients with oral reticular Oral Lichen Planus comparing the results a Placebo. The authors recruited 26 patients with clinical and histological diagnosis of OLP. Patients were divided in two groups (A and B) according to a randomization list generated by a specifical software (SAS 9.2 for Windows, SAS Institute Inc., Cary, NC, USA). This study exploits the role of antioxidant tocopherol as a factor in preventing the oxidation of polyunsaturated fatty acids, in the development of the process of lipid peroxidation. Tocopherol has proven to be a valuable support in the management of OLP reticular, although asymptomatic. Surprisingly, we noticed significant differences between two treatment sequences for two periods, limited the extent of lesions and the scale of Thongprasom; while there has been no statistical significance in the comparison of VAS, nor between the lengths.
To evaluate the influence of at least three abutment changes in conventionally loaded implants against placement of a definitive abutment in immediately non-occlusal loaded implants on hard and soft ...tissue changes.
Eighty patients requiring one single crown or one fixed partial prosthesis supported by a maximum of three implants were randomised, after implants were placed with more than 35 Ncm, according to a parallel group design to receive definitive abutments which were loaded immediately (definitive abutment or immediate loading group) or transmucosal abutments. These were delayed loaded after 3 months and were removed at least three times: 1) at impression taking (3 months after implant placement); 2) when checking the zirconium core on titanium abutments at single crowns or the fitting the metal structure at prostheses supported by multiple implants; 3) at delivery of the definitive prostheses (repeated disconnection or conventional loading group). Patients were treated in four centres and each patient contributed to the study with only one prosthesis followed for 1 year after initial loading. Outcome measures were: prosthesis failures, implant failures, complications, pink esthetic score (PES), buccal recessions, patient satisfaction, peri-implant marginal bone level changes and height of the keratinised mucosa.
Forty patients were randomly allocated to each group according to a parallel group design. Two patients dropped out from the definitive abutment group but no implant failed. Four provisional and one definitive single crowns had to be remade (due of misfitting) and one definitive crown (due to ceramic fracture) in the repeated disconnection group versus one provisional prosthesis of the immediate loading group due to frequent debondings (difference = 12%; CI95%: 0%, 25%; P = 0.109). Eight patients were affected by complications: four patients from each group (difference = 1%; CI95%: -13%, 14%; P = 1). PES scores assessed at 1 year post-loading were 11.4 (1.5) mm for the definitive abutment group and 11.0 (2.0) mm for the repeated abutment changes group (difference = 0.4; CI95%: -0.4, 1.2; P = 0.289). Buccal recessions at 1 year post-loading amounted to 0.07 (0.35) mm for the definitive abutment group and 0.12 (0.65) mm for the repeated abutment changes group (actually it was a soft tissue gain; difference = 0.05 CI 95%: -0.19, 0.29; P = 0.659). All patients declared to be very satisfied or satisfied with the function and aesthetics of the prostheses and would undergo the same procedure again. Mean peri-implant marginal bone loss at 1 year after loading was 0.06 (0.12) mm for the definitive abutment group and 0.23 (0.49) mm for the repeated abutment changes group (difference = -0.16; CI95%: -0.33,-0.00; P = 0.046). The height of the keratinised mucosa at 1 year post-loading was 2.8 (1.5) mm for the definitive abutment group and 2.8 (1.7) mm for the repeated abutment changes group (difference = -0.0; CI 95%: -0.8, 0.7); P = 0.966. Up to 1 year after initial loading, there were no statistically significant differences between the two procedures, with the exception of 0.16 mm more marginal bone loss at implants subjected to three abutment removals.
One-year post-loading data showed that repeated abutment changes significantly increased bone loss of 0.16, but this difference cannot be considered clinically relevant, therefore clinicians can use the procedure they find more convenient for their specific patient. In addition, immediately non-occlusally loaded dental implants are a viable alternative to conventional loading. Conflict-of-interest statement: This trial was partially funded by Dentsply Sirona Implants, the manufacturer of the implants and other products evaluated in this investigation. However, data belonged to the authors and by no means did the manufacturer interfere with the conduct of the trial or the publication of the results with exception of rejecting the proposal of changing the protocol, after the trial was started, allowing the use of indexed abutments.
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