The head and neck region is an anatomical heterogeneous area that comprises numerous specialised tissues of all lineages, which can give rise to different malignancies, among which squamous cell carcinomas are the most frequent. For this malignancy, a new staging system based on TNM classification was recently published (Lydiatt et al., 2017). These cancers represent the seventh most common malignancy worldwide, accounting for 750,000 new cases per year and causing approximately 340,000 deaths annually (Bray et al., 2018). Radiotherapy (RT) has gained a fundamental role in the treatment of head and neck cancers, and nearly 75% of all these patients undergo this therapy, either with curative, adjuvant or palliative indication (Ratko, Douglas, de Souza, Belinson, & Aronson, 2014).
Alzheimer’s disease is classified as a neurodegenerative condition, a heterogeneous group of illnesses characterized by the slow and progressive loss of one or more functions of the nervous system. Its incidence tends to increase gradually from 65 years of age, up to a prevalence of 4% at age 75. The loss of dental elements is more prevalent in this population and might negatively affect the masticatory capacity, quality of life, and pathogenesis of Alzheimer’s disease. This study investigated problems related to oral health and the loss of dental elements in elderly patients suffering from Alzheimer’s and considered whether local inflammatory processes could affect the etiopathogenesis of Alzheimer’s disease. The purpose of this systematic review is to identify a link between the causes leading to tooth loss and the onset/progression of Alzheimer’s disease. We also studied whether there is a higher incidence of tooth loss (primary outcome) and edentulism (secondary outcome) among Alzheimer’s patients. We searched records in electronic databases such as PubMed, EBSCO, and Web of Science using the following keywords: Alzheimer’s Disease AND periodontal, Alzheimer’s Disease AND periodontitis, dementia AND (periodontitis OR periodontal) “Alzheimer’s Disease” AND “tooth” OR “dental loss,” “dementia” AND “edentulous,” “Alzheimer’s Disease” AND “edentulous,” “dementia” AND “tooth” OR “dental loss.” The records were screened, and after applying the eligibility and inclusion criteria, nine articles were left, six of which were analyzed for the primary outcome (loss of dental elements) and six for the secondary outcome (tooth loss). Results from this meta-analysis revealed that Alzheimer’s disease patients have an increased risk of dental loss (hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.00–2.30, p = 0.05) and edentulous condition (HR 2.26, 95% CI 1.70–3.01, p < 0.001). A quantitative analysis of the included studies indicated that patients suffering from Alzheimer’s disease are characterized by a greater number of lost dental elements and general edentulism compared to the control groups.
Background
Peri‐implantitis is widely recognized as a major cause of late implant failure, both in pristine and regenerated bone. The present study aims to evaluate the prevalence of peri‐implantitis in implants inserted in augmented maxillary sinuses and to analyze possible risk factors.
Methods
A cross‐sectional study was conducted in four centers including patients who underwent lateral or transcrestal sinus augmentation and received dental implants. Clinical and anamnestic data were collected using a standardized form. Univariate and multivariate logistic regression analyses have been performed for both implant‐level and patient‐level variables. Subsequently, a multilevel logistic mixed‐effect model was built to analyze variables correlated with the occurrence of peri‐implantitis.
Results
A total of 156 patients (61 males and 95 females; mean age: 60.9 ± 11.6 years) with 315 implants inserted into augmented maxillary sinuses with a follow‐up ranging from 1 to 18 years were evaluated. Seven implants in seven patients were previously lost for peri‐implantitis (2.2% and 4.5% at implant‐ and patient‐level, respectively); 250 implants showed no signs of peri‐implant diseases (79.4%), 34 implants presented mucositis (10.8%), and 24 implants exhibited peri‐implantitis (7.6%). Corresponding data evaluated at patient‐level were 125 (80.1%), 17 (10.9%), and 14 (9.0%), respectively. At the multilevel analysis, history of periodontitis, sinus elevation with lateral approach, and one‐stage sinus floor elevation significantly correlated with the occurrence of peri‐implantitis (P <0.001).
Conclusions
History of periodontitis confirmed its well‐known role as a risk factor for peri‐implant pathologies. In addition, both lateral window technique and one‐stage sinus floor elevation seemed to represent significant risk factors for peri‐implantitis.
Endodontic treatment consists of different working procedures, such as the isolation of the operating field, pulp chamber access, and cleaning and shaping phases with at last the need of a three-dimensional filling of the canals. Each step requires a series of single-use or sterilizable instruments. We have performed a systematic review of different sterilization and disinfection procedures aiming at drawing up a disinfection and sterilization procedure to be used on endodontic instruments. A search on PubMed and Scopus was carried out using the following keywords: “endodontic sterilization,” “endodontic autoclave,” “decontamination dental bur,” “sterilization dental burs,” and “gutta-percha points sterilization.” Eligible articles were included in the qualitative and quantitative analysis. Results of the meta-analysis showed that the most effective method in sterilization is autoclaving. The qualitative analysis showed that the use of single-use or first-use instruments requires presterilization or sterilization procedures, and for reusable tools, attention must be paid to the removal of debris deposited on the blades, not easy to remove manually.
An early diagnosis and appropriate orthopedic-orthodontic intervention allow to simplify the management of TS patients and provide satisfactory and stable results.
Sterilization is a fundamental step in the reuse of endodontic instruments. The sterilization procedure involves disinfection, cleaning, washing, drying, packaging, and sterilization by heat. Heat sterilization can lead to changes in the physical and mechanical properties of dental instruments. These changes can affect the external surfaces via micropitting, corrosion, a reduction in cutting capacity, and/or an influence on the resistance to cyclic fatigue or to torsional fatigue. In this study, we examined the modification of the torsional properties of endodontic instruments after hot sterilization, and compared the properties with instruments not subjected to hot sterilization cycles in terms of resistance to torsional fatigue and deflection angle in NiTi and steel instruments. The following work was performed based on the PRISMA indications. Studies were identified through bibliographic research using electronic databases. A total of 725 records were identified in the PubMed and Scopus databases. A total of 685 records remained after exclusion by year of publication (1979 to 2019). With the application of the eligibility criteria (all articles pertaining to the issue of sterilization in endodontics), we found 146 articles, which decreased to 130 articles after elimination of duplications. There were 45 articles that studied the influences of sterilization procedures on the physical and mechanical characteristics of the instruments, and 12 that measured parameters related to resistance to torsional fatigue. Applying the inclusion and exclusion criteria resulted in a total of eight articles for quantitative analysis. The meta-analysis results show a pejorative effect of torsional fatigue for NiTi instruments subjected to heat sterilization compared to the non-sterilized control.
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