BackgroundThe aim of this retrospective study was to evaluate the survival of dental implants placed after ablative surgery, in patients affected by oral cancer treated with or without radiotherapy.MethodsWe collected data for 34 subjects (22 females, 12 males; mean age: 51 ± 19) with malignant oral tumors who had been treated with ablative surgery and received dental implant rehabilitation between 2007 and 2012. Postoperative radiation therapy (less than 50 Gy) was delivered before implant placement in 12 patients. A total of 144 titanium implants were placed, at a minimum interval of 12 months, in irradiated and non-irradiated residual bone.ResultsImplant loss was dependent on the position and location of the implants (P = 0.05–0.1). Moreover, implant survival was dependent on whether the patient had received radiotherapy. This result was highly statistically significant (P < 0.01). Whether the implant was loaded is another highly significant (P < 0.01) factor determining survival. We observed significantly better outcomes when the implant was not loaded until at least 6 months after placement.ConclusionsAlthough the retrospective design of this study could be affected by selection and information biases, we conclude that a delayed loading protocol will give the best chance of implant osseointegration, stability and, ultimately, effective dental rehabilitation.
The aim of the study is to observe retrospectively the correlation between Oral Squamous Cell Carcinoma (OSCC) and risk factors; including tobacco, alcohol and Family History of Cancer (FHC). A total of 478 patients were included retrospectively from the database of the Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome. A Test Group (TG) consisted of 239 patients with a confirmed diagnosis of OSCC. A Control Group (CG) consisted of 239 patients without history and/or diagnosis of oral cancer. The logistic regression models were used to calculate the adjusted Odd Ratios (ORs) associated with alcohol, tobacco and FHC; including the General Family History of Cancer (GFHC) and Family History of Head and Neck Cancer (FHHNC) and their 95% Confidence Intervals (CI). The high rate of tobacco consumption was associated with an OR of 1.035 (95% CI 1.001–1.070) and a statistical significance (p = 0.041). Drinker patients showed a significant risk of developing OSCC (p = 0.05) and the OR was 1.035 (95% CI 1.010–1.061). The GFHC was associated with a marginal risk of OSCC with an OR of 1.095 (95% CI 0.953–1.259), without significance (p = 0.199). The FHHNC showed a notable risk increase with an OR of 1.871 (95% CI 0.902–3.882), without significance (p = 0.092). Alcohol and tobacco may be associated with an increase in the risk of OSCC.
A tooth preparation technique in fixed prosthodontics for students and neophyte dentists sonal experience with the novel technique. It could helps dental students and neophyte dentists in their learning curve.Key words: tooth preparation, fixed prosthodontics, dental education, prosthodontics.
IntroductionTooth preparation for fixed prosthesis is a common procedure in clinical practice, which all general dentists should perform correctly. However, it could be difficult to obtain always a predictable result, especially for dental students or young doctors: they could make mistakes in their learning curve leading to inadequate results. Unlike other human substance, dental tissues don't have regenerative capacity. Therefore, the removal of dental biological material should be planned and executed with maximum attention (1). The purpose of a fixed prosthodontic therapy may vary from the restoration of a single tooth to the rehabilitation of the complete occlusion. A single tooth can be fully restored both functionally and aesthetically. A missing tooth can be replaced by a fixed prosthesis, increasing patient masticatory competence and maintaining or improving dental arches function, often elevating patient's self-image (2). Tooth preparation should have specific geometrical characteristics to provide necessary retention and resistance to the vertical and lateral forces acting on the restoration. The most important element of retention is the presence of two opposing vertical surfaces. The axial walls of the preparation should taper slightly to allow the cementation of the artificial crown. The more parallel are the axial walls the greater is the retention. However, it is impossible to obtain parallel surfaces without producing undercuts. Goodacre et al. (3) suggest an angle of convergence between 10 and 20°. Moreover, the occlusocervical length is another fundamental factor for both retention and resistance. The longer is the preparation the greater is the retention. Teeth with larger diameter need a greater length to prevent dislodgement (4). Proper occlusal and axial reductions are essentials to provide enough space, allowing a good functional morphology and structural durability. Moreover, no more than necessary dental tissues should be removed in order not to jeopardize tooth structure and retention of the restoration (2). Preston (5) and Miller (6) suggest starting the tooth preparation producing depth-orientation groves on the vestibular and incisal surfaces, with a round-end tapered diamond as reference for removing tooth structure. The occlusal reduction is performed by removing the tooth por-
SummaryPurpose. The aim of this study was to evaluate a novel technique of tooth preparation in fixed prosthodontics suitable for dental students and neophyte dentists. Materials and methods.Twenty-four dental students of the sixth-year class were recruited to verify the predicibility of this technique. Each student prepared two mandibular second premolars on a typodont for a dental crown with a 90° shoulder finishin...
PTTM-enhanced dental implants were clinically effective in the prosthetic rehabilitation of postoncological patients. Larger long-term follow-up studies will help to evaluate clinical efficacy of PTTM dental implants.
Computer aided implantology is the safest way to perform dental implants. The research of high accuracy represents a daily effort. The validated method to assess the accuracy of placed dental implants is the superimposition of a pre-operative and a post-operative cone beam computed tomography (CBCT) with planned and placed implants. This procedure is accountable for a biologic cost for the patient. To investigate alternative procedure for accuracy assessment, fifteen resin casts were printed. For each model, six implants were digitally planned and then placed following three different approaches: (a) template guided free hand, (b) static computer aided implantology (SCAI), and (c) dynamic computer aided implantology (DCAI). The placement accuracy of each implant was performed via two methods: the CBCT comparison described above and a matching between implant positions recovered from the original surgical plan with those obtained with a post-operative intraoral scan (IOS). Statistically significant mean differences between guided groups (SCAI and DCAI) and the free hand group were found at all considered deviations, while no differences resulted between the SCAI and DCAI approaches. Moreover, no mean statistically significant differences were found between CBCT and IOS assessment, confirming the validity of this new method.
Background: Artificial intelligence (AI) has taken hold in public health because more and more people are looking to make a diagnosis using technology that allows them to work faster and more accurately, reducing costs and the number of medical errors. Methods: In the present study, 120 panoramic X-rays (OPGs) were randomly selected from the Department of Oral and Maxillofacial Sciences of Sapienza University of Rome, Italy. The OPGs were acquired and analyzed using Apox, which takes a panoramic X-rayand automatically returns the dental formula, the presence of dental implants, prosthetic crowns, fillings and root remnants. A descriptive analysis was performed presenting the categorical variables as absolute and relative frequencies. Results: In total, the number of true positive (TP) values was 2.195 (19.06%); true negative (TN), 8.908 (77.34%); false positive (FP), 132 (1.15%); and false negative (FN), 283 (2.46%). The overall sensitivity was 0.89, while the overall specificity was 0.98. Conclusions: The present study shows the latest achievements in dentistry, analyzing the application and credibility of a new diagnostic method to improve the work of dentists and the patients’ care.
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