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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.

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The findings of this prospective study indicate that both suggested protocols for tooth extraction in patients treated with oral BPs can provide a predictable treatment outcome (100 % success). Therefore, because atraumatic surgery is more comfortable for patients, we suggest the adoption of Protocol B, which limits trauma to both the soft and hard tissues.

Background: To date, only few studies have reported on the clinical outcomes of immediate postextraction implant placement and immediate loading. Purpose:The purpose of this retrospective study was to report the results of immediately loading of four implants placed in fresh extraction sockets in the mandible after a follow-up of 24 months. Materials and Methods:Between January 2001 and January 2009, 50 patients (28 women and 22 men, average age 54 years) had 347 teeth extracted and a total of 200 dental implants placed in the mandible. The patients received a provisional fixed bridge the same day and a permanent one 3 months later. Clinical check-ups were performed after 1, 2, 3, 6, 12 and 24 months. Marginal bone measurements were made in intraoral radiographs taken one day after surgery and after one year. A questionnaire was used to evaluate self-perceived factors related to comfort, aesthetics and function.Results: All bridges were stable and no implant failures were recorded during the follow-up, giving a survival rate of 100%, at two years. The marginal bone loss amounted to 1.33 + 0.36 mm after one year and 1.48+ 0.39 mm after two years. Ten patients showed prosthetic complications with the provisional bridge, but all the definitive prostheses remained stable throughout the study period without any complications. The patients reported satisfaction with the treatment. Conclusions:The present retrospective study showed that immediate loading of four implants immediately placed in extraction sockets is a valid treatment modality for the totally edentulous mandible. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 Page 2 of 27 Clinical Implant Dentistry and Related Research INTRODUCTIONDue to a better understanding of biological and biomechanical features together with the notable progress in dental implant morphology and surface characteristics, immediate loading has become an attractive alternative to conventionally loaded implants 1 . Despite the fact that numerous studies on immediate, or early loading have been published 1,2,3, over the last few years 4,5,6,7 , scientific literature contains several different definitions and evaluation criteria as to the immediate loading concept. Indeed, authors refer to immediate loading even when dealing with a 20 8 or even 30-day period 9 between surgery and actual loading. In the fourth ITI Consensus Conference, immediate loading was defined as a prosthesis that is placed in occlusion with the opposing dentition within 48 hours of implant placement 10 .The concept of immediate loading was first applied to the loading of multiple implants in both the maxilla and mandible 11 for full arch restorations 11,12,13,14 , with predictable results.Currently, the survival rates for implants subjected to immediate loading in mature mandible bone vary between 80% and 100% 15,16,17,18,19 . Howeve...

The adjunctive use of PRF in combination with barrier membrane is more effective in the treatment of intrabony defects in chronic periodontitis as compared with barrier membrane alone.