Publications

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    ABSTRACT: Abstract Background data: Low back pain is a common, highly debilitating condition, whose severity is variable. This study evaluated the efficacy of treatment with Ga-Al-As diode laser (980 nm) with a large diameter spot (32 cm(2)), in association with exercise therapy, in reducing pain. Objective: The present study aimed to evaluate the pain reduction efficacy of treatment with the Ga-Al-As diode laser (980 nm) in combination with exercise therapy, in patients with chronic low back pain (CLBP). Methods: This study evaluated 100 patients with CLBP (mean age 60 years) who were randomly assigned to two groups. The laser plus exercises group (Laser+EX: 50 patients) received low-level laser therapy (LLLT) with a diode laser, 980 nm, with a specific handpiece [32 cm(2) irradiation spot size, power 20 W in continuous wave (CW), fluence 37.5J/cm(2), total energy per point 1200 J] thrice weekly, and followed a daily exercise schedule for 3 weeks (5 days/week). The exercises group (EX: 50 patients) received placebo laser therapy plus daily exercises. The outcome was evaluated on the visual analogue pain scale (VAS), before and after treatment. Results: At the end of the 3 week period, the Laser+EX group showed a significantly greater decrease in pain than did the EX group. There was a significant difference between the two groups, with average Δ VAS scores of 3.96 (Laser+EX group) and 2.23 (EX group). The Student's t test demonstrated a statistically significant difference between the two groups, at p<0.001. Conclusions: This study demonstrated that the use of diode laser (980 nm) with large diameter spot size, in association with exercise therapy, appears to be effective. Such treatment might be considered a valid therapeutic option within rehabilitation programs for nonspecific CLBP.
    Photomedicine and laser surgery. 09/2014; 32(9):490-494.
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    ABSTRACT: In 2010, one of the authors proposed that lasers could be used to enhance the decontaminating action of sodium hypochlorite (NaOCl). The authors conducted a study to compare the disinfection efficacy of laser-activated irrigation (LAI) by using a photon-induced photoacoustic streaming (PIPS) tip with conventional irrigation and specifically LAI's ability to remove bacterial film formed on root canal walls.
    Journal of the American Dental Association (1939) 08/2014; 145(8):843-8. · 1.82 Impact Factor
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    Tosun Tosun, Stefano Benedicenti
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    ABSTRACT: The Erbium laser (Er:YAG, 2940 nm wavelength) with its high absorption in water and low penetration depth in soft and hard oral tissues, enables a high ablation depth control in bone surgery. This precise control offers a major advantage, especially in lateral approach sinus-grafting procedures, where often a thin bone wall is present. The pulse-duration control offered by erbium lasers dramatically affects clinical results in terms of ablation capability. Temporal profiles of dental Er:YAG lasers reveal that there are two distinct types of pulse profiles: Square Pulse and Gaussian. The aim of the present retrospective study is to make a clinical comparison of Square Pulse Er:YAG versus Gaussian Er:YAG lasers in maxillary sinus surgeries. The study consists of two groups: Square Pulse vs Gaussian. In the Square Pulse group, an articulated-arm-based Er:YAG device (LightWalker, Fotona) that produces a Variable Square Pulse (VSP) beam profile was used. The Square Pulse group consists of 7 cases with 10 sinus lifting procedures. The laser power settings used were 400 mJ x 10 Hz = 4 W, 50 µsec pulse duration, 44% air, 33% water spray. In the Gaussian group, a fiber delivery Er:YAG device (VersaWave, Hoya ConBio), which has not been available commercially since June 2011, was used. In the Gaussian group, there were 6 cases with 9 sinus lifting procedures. The power settings of the Gaussian group were 400 mJ x 15 Hz = 6 W, 300 µsec fixed pulse duration, under copious water/air cooling. The surgeon evaluated the clinical usefulness of the instruments by Visual Analog Scale (VAS) according to the parameters of handling, visibility of the surgical field, irrigation, bone cutting speed, working time duration, scoring each on a scale from "poor" 0 (zero) to "perfect" 10. Membrane rupture rate was registered as either absent or present. The Square Pulse group showed only one membrane rupture and shorter preparation times. According to the data collected during sinus surgeries, the VSP Er:YAG laser was found to be more effective in comparison with a fixed pulse duration Gaussian profile beam laser.
    Journal of the Laser and Health Academy. 01/2014; 2014(2014):29-32.
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    ABSTRACT: Abstract Objective and background: Odontomas are hamartomatous developmental malformations of the dental tissues. We present a retrospective study of recent clinical experience using erbium-doped yttrium aluminum garnet (Er:YAG) (wavelength 2940 nm) and chromium-doped yttrium scandium gallium garnet lasers (Er,Cr:YSSG) (wavelength 2780 nm) for the surgical treatment of these lesions, and score postsurgical pain. Materials and methods: This retrospective study comprised 35 odontomas treated at the Department of Oral Pathology and Laser-Assisted Surgery, San Martino Hospital, University of Genoa, Italy. Of 35 Caucasian patients (23 male, 12 female; ages 8-35; odontomas localized at various oral subsites) those in Group 1 (n=25) had odontomas excised by laser (Er:YAG laser operating at 2940 nm, pulse width 100 msec, curved handpiece, truncated cone HPX tip, 400 μm with energy output 250-400 mJ per pulse, frequency 15 Hz; and Er, Cr: YSGG laser, power 3.5 W, frequency 20 Hz, 55% air/45% water spray, H (hard tissue) mode, pulse width 190-750 μsec variable). In Group 2 (n=10) odontomas were excised by conventional surgery. Pain was assessed using a visual analog scale (VAS). Clinical outcome was determined at 6-12 months. Results: Complete responses were achieved in 100% of the laser-treated odontomas, which compares favorably with reported results of conventional surgery. A statistically significant difference in VAS score was found between patients treated with traditional scalpel surgery (median=4.00) and those who underwent laser surgery (median=3.00). Conclusions: In treating odontomas, a laser surgery protocol effectively minimizes pain, maintains an excellent clinical outcome, and requires minimal additional treatment time compared with conventional surgery.
    Photomedicine and laser surgery 01/2014; 32(1):47-53. · 1.76 Impact Factor
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    ABSTRACT: The aesthetic outcome of an implant-supported restoration is first of all dependent on the soft tissue volume. Because the labial bone plate resorbs in every direction after tooth extraction, even when an implant is placed immediately, most patients end up with compromised aesthetics. In this parallel-designed, randomized clinical trial, participants were randomly assigned to the test group (immediate load post-extractive implant treated with subepithelial connective tissue graft placed using the tunnel technique in the labial area) and control group (immediate load post-extractive implant treated without raising a flap) with an allocation ratio of 1:1. Both groups received deproteinized bovine bone mineral. Patients were observed at baseline, crown insertion, 1-year follow-up, and 2-year follow-up. Clinical, radiological and aesthetic parameters were recorded to assess primary treatment outcomes. A random permuted block system was blindly generated ensuring uniformity of the patient allocation during the trial by randomly distributing three participants to the test and three participants to the control group every six treated patients. At the 2-year examination, all 47 implants were successfully integrated, demonstrating stability and healthy peri-implant soft tissues as documented by standard clinical parameters. The results showed a soft tissue remodeling of -10% in thickness and -18% in highness in the non-grafted group, whereas in the grafted group there was a gain of 35% in thickness and a slight reduction of -11% in highness. Test group reported an increase of aesthetic result (mean pink aesthetic score [PES] 8) compared with control group (mean PES 6.65). This prospective study demonstrates the effectiveness of placing a soft tissue graft at the time of immediate implant placement in the aesthetic zone. At the 2-year follow-up, test group revealed a better aesthetic outcomes and stable facial soft tissues compared with control group.
    Clinical Implant Dentistry and Related Research 12/2013; · 3.82 Impact Factor
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    ABSTRACT: Human Severe Combined Immunodeficiency (SCID) is a prenatal disorder of T lymphocyte development that depends on the expression of numerous genes. Juvenile myelomonocytic leukemia (JMML), previously known as juvenile chronic myeloid leukemia (JCML), is a rare, myelodysplastic/myeloproliferative disease typically presenting in early childhood. Two cases are described of immunodeficiency disorders, both treated with chemotherapeutic drugs (Busulfan plus cyclophosphamide) before bone marrow transplantation. After treatment, these two different cases showed several similar oral lesions: microdontia, root alterations, numerous tooth ageneses, incomplete calcification, enamel hypoplasia, premature apexification and hypodontia. Both subjects underwent dental and orthodontic treatment. The first phase comprised orthopaedic treatment using a removable appliance (Interim-G®) followed by rapid palatal expansion; in the second phase patients underwent tooth extraction and were treated using fixed appliances for 19 and 26 months, respectively (mean 2 years) to obtain final alignment and maximum intercuspation. In the third and final phase, reconstruction of malformed teeth was completed, and implant-supported protheses were applied. The difficulties of managing and treating these diseases are discussed, with particular focus on tooth anomalies and malocclusion disorders. Collaboration between dentist and paediatrician in dealing with patients with a variety of oral lesions and tooth anomalies is important in order to prevent any other possible tooth lesions and ensure correct jaw development.
    European Journal of Paediatric Dentistry 12/2013; 14(4):328-32. · 0.52 Impact Factor
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    ABSTRACT: PURPOSE: The aim of this randomized clinical trial was to compare the potential of deproteinized bovine bone added to autologous bone or corticocancellous allograft block with or without the addition of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) to regenerate mandibular atrophic ridges. MATERIALS AND METHODS: Trial design: parallel, allocation ratio of 1:1 using a split-mouth model. Eligibility criteria for patients: adult patients; bilateral atrophic edentulous areas in the posterior area of the mandible; a preoperatory cone beam computed tomography scan; and absence of systemic diseases affecting the bone metabolism. Bone graft intervention for control group consisted of bone chips collected with a scraper mixed with deproteinized bovine bone covered with a resorbable membrane. Bone graft intervention for test group consisted of a corticocancellous allograft block, shaped before surgery, and protected with a collagen membrane. In addition, both groups received rhPDGF-BB or a saline solution as control. As primary outcome quantity, bone variation after a 1-year healing period was considered. A p-value of.05 was considered statistically significant. RESULTS: Sixteen patients were enrolled in this trial. A total of 50 implants and 32 bone grafts were placed. All patients concluded the study (no dropouts). Change at 1 year in bone volume was not significantly different between the two groups (p-value = .25). Effect of treatment in terms of change in bone volume at 1 year was not significant (p-value = .89) when saline solution was used while was at limit of significance when rhPDGF-BB was used (p-value = .052). After 1 year, all the implants were successfully integrated. CONCLUSIONS: The block allograft and the standard regenerative procedure showed similar results in terms of regenerated bone volume after 1 year of functional loading. The rhPDGF-BB positively influenced soft-tissue healing.
    Clinical Implant Dentistry and Related Research 01/2013; · 3.82 Impact Factor
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    ABSTRACT: Diastema closure is a frequently requested, technique-sensitive cosmetic procedure. There are many techniques and materials that can be employed to close diastemas. While direct composite techniques can be economical and successful, they do present challenges in achieving satisfactory clinical and esthetic results. Traditional porcelain veneer placement may offer an excellent esthetic result, but typically requires the removal of tooth structure; as such, this is an irreversible procedure. The present article reports the case of a maxillary midline diastema closure in a healthy dentition by means of sectional porcelain veneers simply cemented onto the natural teeth and without tooth preparation. A step-bystep procedure is proposed for illustrating the proper implementation of an additive-only and noninvasive indirect technique that yields a satisfactory clinical and esthetic outcome for clinician and patient.
    Quintessence international (Berlin, Germany: 1985) 01/2013; 44(3):201-6. · 0.64 Impact Factor
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    ABSTRACT: Purpose: The aim of this pig model study was to verify whether the use of devices (surgical templates) or procedures (flapless or flap) of guided surgery may cause a potentially pathologic increase of temperature during the bone preparation. Materials and Methods: In this in vitro study, pig ribs with mean cortical thickness of 1.90 mm were used. Open-flap and flapless guided surgery (experimental groups OGS and FGS) and open-flap and flapless conventional technique (control groups OSS and OFS) were performed. Temperature changes were recorded at a distance of 0.5 mm from the final test osteotomy by 2 thermocouples at depths of 1.5 (point A) and 12 mm (point B). Data were collected from 80 measurements, 10 for each group. Results: A statistically significant increase of temperature was reported for the FGS and OGS groups considering the measurement at point A (mean Δt 4.81 degrees and 4.21 degrees, respectively). The measurement at Point B for the FGS group compared to the FSS group did not differ significantly for the 3-mm drill, nor did the OSS group with the 2-mm drill. Conclusions: Site preparation with surgical stents generated higher bone temperature than conventional drilling. However, this heat generation did not reach temperature levels dangerous for the bone.
    The International journal of oral & maxillofacial implants 01/2013; 28(6):1464-9. · 1.91 Impact Factor
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    The European Journal of Orthodontics 09/2012; · 1.08 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate the correlations between bone characteristics, orthodontic miniscrew designs, and primary stability. Four different miniscrews were placed in pig ribs. The miniscrews were first scanned with a scanning electron microscope to obtain measurable images of their threads. Subsequently, the maximum insertion torque of the screws and the maximum load value in the pullout force tests were measured; furthermore, bone specimen characteristics were analyzed by using cone-beam computed tomography. For each bone sample, the insertion site cortical thickness as well as both cortical and marrow bone density were evaluated. The nonparametric Kendall rank correlation (tau) was used to evaluate the strength of the associations among the characteristics measured. The nonparametric Kruskall-Wallis test was used to evaluate the differences among the groups, and post-hoc comparisons were assessed by using the Nemenyi-Damico-Wolfe-Dunn test. A significant dependence was found between pitch and maximum insertion torque (tau, -0.49). Positive correlations were also found between pullout force and maximum insertion torque (tau, 0.64), cortical thickness (tau, 0.36), and marrow bone density (tau, 0.35). In this in-vitro experimental study, strong correlations were observed among miniscrew geometry, bone characteristics, and primary stability.
    American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 08/2012; 142(2):228-34. · 1.33 Impact Factor
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    Tosun Tosun, Giuseppe Iaria, Stefano Benedicenti
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    ABSTRACT: Background: Conventionally, crown lengthening surgery is achieved through an “open” mucoperiosteal flap access procedure and the use of rotary instruments. The introduction of mid-infrared laser wavelengths, e.g., erbium:YAG (2940 nm), has made possible a “flapless” approach to crown lengthening surgery, which has several advantages such as uneventful healing, less edema, and no sutures. Flapless surgery is a blind approach and the outcome of crevicular bony modeling in such a method is uncertain. Aim: The aim of this study is to compare the topographic results of both surgical methods in a sheep model. Material and Methods: Ten fresh sheep mandibles were used. Bilateral crown lengthening was obtained on four molar teeth. Randomly, one side was used as test and the other as control. An Er:YAG laser (15 Hz frequency, 400 mJ energy, 200 μsec pulse duration, 6 W average power) was used on the test sides without raising a mucoperiosteal flap, and buccal crestal bone of 2 mm height was removed around each tooth. After laser application, each alveolar bone site was smoothed with Gracey curettes, and root planing was performed. Control sides underwent conventional open-flap surgery: 2 mm of buccal crestal bone was removed by a round diamond bur, at 800 rpm under saline irrigation, and root planing was performed with Gracey curettes. At the end of the operation, flaps were raised at the test sites. Impressions were taken by high-durometer silicone die material. Impression blocks were rendered uniform in size (10 x 28 mm surface). Stone models were cast and refined to uniform size and then scanned at 15,500 resolution. The data was analyzed using computer software. Macroscopic surface texture was compared by inspection of standardized digital images. Microscopic surface properties were analyzed by “current triangles” and “current vertices.” Results: Both groups revealed similar macroscopic features, but microscopically there were no significant correlations between current triangles and current vertices values of both groups (rcurrent triangles = 0.0207; rcurrent vertices = 0.0289). Conclusion: Macroscopically, both methods have similar effects on bone surface topography. The Er:YAG laser microscopically creates more rough surface on bone tissue. The results of this study confirm that flapless surgery performed by an Er:YAG laser is as effective in contouring crestal bone as conventional surgery and, taking into consideration the advantages of the flapless surgery, it is suggested as preferable to the conventional crown-lengthening procedure.
    Journal of Laser Dentistry. 01/2012; 2020(1):10-15.
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    ABSTRACT: The thread shape factor (TSF) to evaluate the relationships between geometrical characteristics and mechanical properties of the temporary anchorage devices (TADs) has recently been introduced. This in vitro experimental study evaluated in 30 different tests with three TADs: ORTHOImplant (1.8 mm diameter and 10 mm length; 3M Unitek), Tomas (1.6 mm diameter and 10 mm length; Dentaurum), and Orthoeasy (1.7 mm diameter and 10 mm length; Forestadent). Scanning electron microscopy images were acquired for each TAD to measure the TSF; afterwards, the maximum insertion torque (MIT) was evaluated and thereafter pull-out tests on two differently designed organic bone analogs were carried out using a testing machine with a crosshead speed of 2 mm/minute being applied. One-way analysis of variance with group as factor was performed. Post hoc multiple comparisons Bonferroni test was used. Rank-transformed data were used when asymmetry of data was shown. To assess correlation between characteristics, load, and MIT, Spearman's rank correlation coefficient was used. A P-value of 0.05 was considered statistically significant. Significant direct correlations were found between TSF and depth and both load and MIT. Particularly, a correlation of 0.90 (P < 0.001) was found between depth and MIT for 2.2 mm cortical thickness. The authors conclude that MIT and maximum load values of pull-out test are statistically related to depth of the thread of the screw and to TSF.
    The European Journal of Orthodontics 01/2012; · 1.08 Impact Factor
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    ABSTRACT: The burden of osteoporosis is increasing in all societies. In comparison with other organs or apparatuses fewer studies have focused on incorrect lifestyles and bone. This article reviews clinical and experimental studies on the effects of obesity, alcohol abuse and smoking on bone. Overweight and obesity protect bone, thus reducing the fracture risk and the development of osteoporosis in older adults. However, extreme obesity (body mass index more than 40 kilogram/meter squared) seems to be a risk factor for osteoporosis. Moderate alcohol consumption may have a protective effect, whereas excessive consumption is an important risk factor. Cytokines are the main mediators of the detrimental effects of obesity and alcohol. Smoking contributes to bone loss and fracture probably by interfering with estrogens, calcium and vitamin D. Health information campaigns against these harmful lifestyles should be strengthened by using available scientific information to increase awareness about their consequences on the bone.
    Frontiers in bioscience (Elite edition) 01/2012; 4:2686-706.
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    ABSTRACT: It has been suggested that stem/progenitor cells exist in dental tissue. This study identified adult mesenchymal stem/stromal cell-like populations in the dental follicle of human impacted third molars.The immunohistochemical analysis, of dental follicle using known stem-cell markers: Cytokeratins (AE1-AE3), Smooth Muscle Actin, Ki-67, CD34, CD44, CD45, CD56, and CD133. A positive reaction for at least one of the markers typical of stromal phenotype (CD56, CD44 and CD271) was observed in seven cases . Interestingly, all positive cases showed coexpression of CD44 and CD56, except for one case which was CD56 positive and CD44 negative. Immunohistochemical reaction was negative in all 27 cases for Ki-67, Cytokeratins, Smooth Muscle Actin, CD34, CD133 and CD45. The association: negative for CD34, CD45, CD133, and positive for CD44, CD56 (markers of a subpopulation of stem cells from bone marrow) suggests these may be quiescent mesenchymal stem cells, a hypothesis supported by the negativity of Ki-67 (proliferative index). Our results are compatible with the identification of immature fibroblast cells with phenotypic features of stromal stem cells in the dental follicle.
    Frontiers in bioscience (Elite edition) 01/2012; 4:1009-14.
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    ABSTRACT: To evaluate the effects on bone of forced insertion of self-tapping orthodontic mini-implants and thus obtain biomechanical data to develop insertion protocols and optimize drills for implant site preparation. After implant site preparation, 39 orthodontic mini-implants (OMI), 1.6 x 7.5 mm each, were inserted into the hard bone of sheep mandible; 24 were placed with a 1-mm bone drill and 15 were placed with a standard-diameter (1.2-mm) drill. Removal torque was measured immediately (group A) and 8 weeks after insertion (group B). Eight OMIs (group C) were removed from the mandible in block sections of appropriate size for microcomputed tomographic morphometric and morphologic analyses. All OMIs were placed without complications, with mean insertion torque of 17.625 (± 1.71) Ncm (test groups) and 17.70 (± 1.41) (control groups) and were stable at reentry. Group A implants showed a reduction in removal torque of 5.66%, while in group B, removal torque was reduced by 43.25%. In the control groups (ie, OMIs placed with a 1.2-mm drill), removal torque immediately after placement was reduced by 5.64%, and 8 weeks after insertion, removal torque had declined by 18.2%. Microcomputed tomographic bone morphometric analysis for both test and control groups showed that bone-implant contact was lower than expected in cortical bone 8 weeks after insertion. Morphologic analysis revealed cavities in the cortical bone close to the surface and microcalli in soft bone. Cavities in the cortical bone may have been caused by bone trauma during insertion. The use of a narrow drill for site preparation increased orthodontic screw insertion torque, but it also damaged the bone and decreased removal torque. Standard histologic examination may clarify whether cavities in hard bone are actually signs of bone resorption that results from the activation of remodeling.
    The International journal of oral & maxillofacial implants 11/2011; 26(6):1233-40. · 1.91 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate the efficacy of erbium lasers for retrograde endodontic treatment, in terms of clinical outcome and therapeutic success. Apicoectomy with retrograde filling is a well-established surgical procedure to treat teeth affected by persistent periapical lesions. The apical root end is generally removed with burs, and the adjacent periapical tissue curetted, or alternatively treated with ultrasound or laser. Between 2000 and 2010, 65 apicoectomies were performed on necrotic teeth that presented apical lesions (29 men, 36 women). The lasers used in the study were the erbium:yttrium-aluminum-garnet (Er:YAG) laser, wavelength 2940 nm, and the erbium,chromium-doped:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser, wavelength 2780 nm. Of the 65 teeth in the study, failure only occurred in 9 CASES, MANIFESTING AFTER DIFFERENT TIMES. THE REMAINING PATIENTS, 86.15%, experienced no complications, and their treatment followed a positive course. Laser-assisted surgery increases the range of therapeutic approaches in the sphere of retrograde endodontic treatment. The results of this study show that the erbium laser, used for apicoectomy, results in a high success rate with considerable benefit in terms of clinical outcome and therapeutic success.
    Photomedicine and laser surgery 10/2011; 29(12):845-9. · 1.76 Impact Factor
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    ABSTRACT: The aim of the present report is to describe a procedure for zygomatic implant placement using image-guided implant surgery. This is an innovative technique and includes a new clinical approach to provide the direction to guide drilling. The ethical committee of the University of Genoa approved the study. All patients had clinical indications of severe maxillary atrophy (Class 4 Cadwood-Howell). A total of 25 implants were placed, of which 17 were in the premaxilla, 7 in the zygomatic area, and 1 in the pterygoid bone. The treatment was performed in 2 phases. The first phase included cone-beam acquisition to exclude sinus disease and evaluate the anatomy of the residual premaxillary bone in 3 dimensions. The success of osseointegration achieved by the primary implants (PIs) was confirmed after temporary loading and before proceeding with the second phase, in which all patients were scheduled for zygomatic implants. A total of 3 or 4 regular platform MK III implants (17 in all) were placed in the premaxilla using conventional implant surgery. A model within the analogs of the PIs was prepared (master model), taking a conventional impression. Next, a radiologic template was prepared on the same master model and stabilized on the PIs, using dedicated prosthetic components. The guide was screwed onto the PIs during computed tomography acquisition to determine a fixed and repeatable position of the guide. In the second phase, after routine planning, a mucosa-supported stereolithographic SurgiGuide with sleeves for the zygomatic implants and the corresponding stereolithographic model, including the mucosa, were received from the manufacturers. The guide was repositioned on the master model to replace the sleeves for the PIs in the same position. With an original customized surgical kit, including an innovative intrasinus device, we next simulated surgery on the stereolithographic model to determine and control the direction of the osteotomies and the final depth of drilling. The SurgiGuide was anchored onto the PIs before the zygomatic osteotomy, after which flapless surgery was performed to place the zygomatic implants according to the plan. Two PIs in the premaxillary area failed (and were replaced before the zygomatic step). No zygomatic implants failed. The follow-up examinations at 4 to 39 months showed good esthetic, phonetic, and functional results. The results of the proposed surgical procedure appear to be encouraging. Although it is difficult to achieve the correct driven angle of osteotomies for zygomatic implants, in all patients we achieved correct zygomatic positioning, in agreement with previous planning. Additional research and randomized clinical trials are needed to assess the predictability of the procedure.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 08/2011; 69(12):2979-89. · 1.58 Impact Factor
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    ABSTRACT: The aim of this study was to analyse, in vitro, the chemical and mechanical properties of a new fibre retainer, Everstick, comparing its characteristics with the requirements for an orthodontic retainer. Chemical analysis was used to examine seven fibre bundles exposed to a photocuring lamp and then to different acids and resistance to corrosion by artificial saliva fortified with plaque acids. The mechanical properties examined were tensile strength and resistance to flexural force. Ten fibre samples were tested for each mechanical analysis and the mean value and standard deviation were calculated. Wilcoxon signed rank test was used to evaluate change in weight after treatment in each group. To determine changes over time between the groups for each acid considered separately, both repeated measures analysis of variance (ANOVA) on original data and on rank transformed data were used. If the results were different, ANOVA on rank-transformed data was considered. Acetic acid was found to be the most corrosive and caused the most substance loss: both pure and at the salivary pH value. Hydrofluoric acid was the most damaging. For all acids analysed in both groups (lactic, formic, acetic, propionic), changes after treatment were statistically different between two groups (P < 0.001 for lactic, acetic, propionic; P = 0.004 for formic acid).The mean Young's modulus value was 68 510 MPa. Deformation before the fibre separated into its constituent elements (glass fibre and composite) was 3.9 per cent, stress to rupture was 1546 MPa, and resistance to bending was 534 MPa. The deflection produced over a length of 12 mm was 1.4 mm. The fibre bundle was attacked by acids potentially present in the oral cavity; the degree of aggressiveness depending on the acid concentration. To preserve fibre bundles long term, careful plaque control is necessary, especially in the interproximal spaces, to avoid acid formation. The tested product was found to be sufficiently strong to oppose flexural and occlusal forces.
    The European Journal of Orthodontics 08/2011; · 1.08 Impact Factor

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