Piezoelectric bone surgery appears to be more efficient in the first phases of bone healing; it induced an earlier increase in BMPs, controlled the inflammatory process better, and stimulated bone remodeling as early as 56 days post-treatment.

These data suggest that increased volumes of GCF and PICF could be useful markers of early inflammation in gingival and peri-implant tissues. In the presence of de novo plaque, implants showed lower, and nearly significant, levels of IL-1beta compared with teeth.

Masticatory efficiency, oral function and degree of satisfaction with the treatment received were analysed in a group of fully edentulous patients with severe atrophy of the mandibular bone, rehabilitated with complete removable dentures, before and after anchoring the dentures to osseointegrated implants. Masticatory efficiency increased significantly and chewing cycles increased in amplitude after anchoring the denture. The component of the chewing cycle that most influenced the increase in functional area was the lateral one. A correlation was found between the increase in the lateral component of the chewing cycle and the increased masticatory efficiency achieved with implant-anchored dentures. The degree of satisfaction with their rehabilitation reported by the subjects was correlated neither to increased masticatory efficiency nor to improved oral function.

This is an author version of the contribution published on:Questa è la versione dell 'autore dell'opera: J Oral Maxillofac Surg. 2014 Oct;72(10):1890-7. doi: 10.1016/j.joms.2014 AbstractPurpose: The surgical removal of mandibular third molars is frequently accompanied by significant post-surgical sequelae, and different protocols have been described to improve such adverse events. The aim of this study was to investigate the performance of piezosurgery compared with traditional rotating instruments during mandibular third molar removal. Methods:A single-centre, randomized, split-mouth study was performed using a consecutive series of unrelated healthy Caucasian patients, attending the Oral Surgery Unit of the University of Turin, for surgical removal of bilateral mandibular third molar teeth. Each patient was treated, at the same appointment, using bur removal on one side of the mandible and a piezoelectric device on the contralateral side. The primary outcomes reported were postoperative pain, objective orofacial swelling and the duration of surgical time; secondary outcomes were sex, age and possible adverse events. Anova or paired t-test were used as appropriate to test any significant differences at baseline according to each treatment subgroups and categorical variables were analysed by χ2 test.Results: The study sample consisted of 100 otherwise healthy patients. The mean pain evaluation reported by patients who underwent surgery with the piezosurgery was significantly lower than that experienced after bur (conventional) removal, reaching a statistical difference after 4 days (P=0.043). The clinical value of orofacial swelling at 7th day, normalized to baseline, was lower in the piezosurgery group (P<0.005).The average time of surgery was significantly lower in the bur than piezosurgery group (P<0.05).Three patients having bur removal experienced short-term complications (two dry sockets and one temporary paraesthesia): both totally resolved by 4 weeks. Conclusions:To date, this prospective investigation is the largest reported split-mouth study on piezosurgery for lower third molar tooth removal, also comparing surgeons with different 3 degrees of experience. It is evident that using a piezoelectric device can enhance the patient experience and reduce post-operative pain and swelling.

The most retentive cement was zinc-phosphate, followed by polyurethane, polyurethane plus vaseline, and zinc oxide-eugenol.

Ceramic materials are widely used for biomedical applications because of their remarkable biological and mechanical properties. Composites made of alumina and zirconia are particularly interesting owing to their higher toughness with respect to the monolithic materials. On this basis, the present study is focused on the in vivo behavior of alumina toughened zirconia (ATZ) dental implants treated with a hydrothermal process. A minipig model was implemented to assess the bone healing through histology and mRNA expression at different time points (8, 14, 28, and 56 days). The novel ATZ implant was compared to a titanium clinical standard. The implants were analyzed in terms of microstructure and surface roughness before in vivo tests. The most interesting result deals with a statistically significant higher digital histology index for ATZ implants with respect to titanium standard at 56 days, which is an unprecedented finding, to the authors' knowledge. Even if further investigations are needed before proposing the clinical use in humans, the tested material proved to be a promising candidate among the possible ceramic dental implants.

The study aimed to investigate the connective tissue seal and the spatial organization of collagen fibers around long-term loaded implants in man. Block specimens containing smooth titanium implant abutments and the surrounding supracrestal connective tissue were obtained from patients rehabilitated for at least 1 year with implant-retained overdentures or implant-supported fixed prostheses and were histologically investigated. The histological features of the connective tissue around long-term loaded titanium abutments were specific: the tissue was rich in collagen fibers, organized in bundles, presenting a constant spatial arrangement, similar to that reported in animal studies. Circular fibers, the most numerous, were located externally, and longitudinal fibers internally. Radial fibers inserted on the abutment surface, similar to those of the periodontal system, were not observed in any case. No histological differences were found between tissue sampled around implants supporting a fixed restoration and those anchoring an overdenture.

Cross-talk between cells and cytokines in peri-implant tissue is largely unknown. The immune response in the gingival mucosa appears to favor implant integration over rejection, since titanium-implant-retained overdentures show long-term success. This study evaluates pro-inflammatory (interleukin [IL]-2, interferon [IFN]-gamma, IL-12) and anti-inflammatory (IL-4, IL-10, transforming growth factor [TGF]-beta1) cytokine mRNA expression and tissue morphometry in peri-implant soft tissue from patients before and during treatment with Brånemark titanium implants. Immediately after treatment with endosseous implant and overdenture, TGF-beta1 mRNA increased in peri-implant mucosa specimens; transcript accumulation for IL-10 was elevated at 4 months and decreased dramatically thereafter. Transcripts for IL-2, IFN-gamma, IL-12, and IL-4 were absent. Healthy osseointegrated implants showed no histological inflammation in most patients. These findings suggest that newly classified TGF-beta and/or IL-10 secreting T regulatory (r)/T helper (h)-3 cells may populate implant insertion sites.