International Poster Journal of Dentistry and Oral Medicine, 02/2016

Introduction: Prosthetic implant rehabilitation of single missing maxillary incisors constitutes a clinical challenge in esthetic dentistry. Thus, multiple clinical parameters should be considered, such as bone volume, periodontal tissues quality, esthetic outcome of definitive crown, and most importantly patient satisfaction. This poster describes the case of a multidisciplinary management of a missing 11, in a context of insufficient bone/gingival volumes. Case Report: A healthy 42-year-old Caucasian female consulted for implant-supported rehabilitation of a missing 11. Clinical and radiographic examination revealed the need for bone augmentation prior to implant placement. A ramus bone graft was harvested and placed in the buccal region of 11. Four months later, the implant was successfully placed. After a 3-month healing period, a provisional abutment and resin crown were placed, and a connective tissue graft was carried out at the same time in order to enhance the peri-implant mucosal contour. Afterwards, the contact surfaces were modified as well as the mesial surface of the 21 using an esthetic composite. Six months later, satisfactory gingival contour maturation could be noticed. The final ceramic crown was delivered, and the occlusion was checked. Conclusion: The patient showed full esthetic and functional satisfaction. She was enrolled in a periodontal/implant supportive therapy program. Discussion: In this case report, a multidisciplinary approach combined techniques from oral surgery, periodontology, implantology and prosthetics in order to esthetically and functionally rehabilitate a single maxillary incisor. Mastering all these competences or team work is necessary in order to succeed in the treatment of such complex clinical situations. Keywords: grapht, incisor, implant, esthetic

Guided bone regeneration (GBR) is a surgical procedure used to preserve or increase bone volume, hence permitting optimal placement of dental implants. GBR requires the use of resorbable or non-resorbable membrane. Synthetic, Poly (lactic-co-glycolic acid) (PLGA) membranes have been presented as clinically efficient for periodontal/pre-implant regenerative procedures. We wanted to clinically test a newly commercialiesd PLGA membrane (Tisseos®) in a GBR procedure before implant placement. Keywords: GBR, PLGA, membrane, implant

Literature data attest to the adsorption of salivary glycoproteins on the resin substrate of denture bases. This layer increases the surface energy of the substrate though improving its wettability. An increased wettability associated with the perfect fit principle and the maximum physiological extension of the denture base provide better retention of the dentures. Artificial saliva should represent a mandatory part of the prosthetic treatment in xerostomic patients. Six denture base materials: Acry Pol (x2 thermo-cure cycles), Eco Cryl Hot, Polyan, Biodentaplast, BMS 014, Superacryl, were investigated regarding wettability change following immersion in natural and artificial salivas (Xerostom, Biocosmetics Laboratoires). Natural saliva was collected from a single healthy patient and stored in optimal conditions during the experiment. The resin specimens were fabricated following the manufacturer's indications, and the immersion conditions were standardised. Contact angle measurements (using CAM 101, KSV Instruments) were carried out to evaluate wettability modification. The liquid used for measurements was natural saliva for a more appropriate reproduction of the biological phenomenon. The samples were dried before the contact angle measurement, which were made after 1 and 7 days for immersion in natural saliva and after 1 day for immersion in artificial saliva. Both salivas improve the wettability of the substrate. Artificial saliva has an almost uniform effect on all materials. Natural saliva improves wettability with slight variations depending on the substrate and duration of immersion. Keywords: wettability, denture resin bases, saliva

Nodular fasciitis is a benign proliferative lesion of fibroblasts with pseudosarcomatous histologic features. It is a benign soft tissue lesion, most commonly found in the superficial fascia and was first reported by Konwaler et al in 1955. The lesion usually occurs in the first three decades of life; however, it is more common in children. It usually arises in the subcutaneous tissues, with the most common location being the upper extremities, followed by the head and neck, the lower extremities and trunk. Nodular fasciitis has been considered a reactive process of uncertain etiology. However, recent findings indicate that nodular fasciitis is a self-limited clonal neoplastic process. Clinically, nodular fasciitis presents as a subcutaneous "growth" over a period of 3-6 weeks that eventually regresses. The clinical feature of nodular fasciitis may include a sudden onset of a rapidly growing tumour, which may suggest an aggressive or even malignant process. Because of the alarming histologic characteristics, pathologists have frequently diagnosed the lesion as a malignancy. However, it is now generally agreed that nodular fasciitis is benign and never metastasises. The treatment for it is local excision, and the recurrence as reported in the literature is very rare. This poster highlights a case of nodular fasciitis in a 7-year-old girl. Keywords: nodular fasciitis

"More than in any other human relationship, motherhood means being instantly interruptible, responsive and responsible." Pregnancy, being a unique time in a woman's life, is characterised by complex physiological changes that can adversely affect her oral health and the child as well. It's an opportune time to educate women about preventing dental diseases in children. Objective: To co-relate and evaluate the attitude, practice and awareness of oral health and its outcome on the newborn amongst the expecting mothers in Pune city. Material and methods: A cross-sectional questionnaire-based survey was conducted among pregnant women, randomly selected attending various private nursing homes/clinics/hospitals in Pune (Maharashtra) city of Central India. After giving consent, patients were interviewed after regarding their demographic details, dental visits and oral hygiene habits. Data collected were then analysed statistically. Results: The responses to questions pertaining to awareness regarding oral hygiene during pregnancy and its adverse outcome on the newborn were co-related to different educational levels, showing significant values (p 0.017). Conclusion: The current study emphasises the role of oral health care during pregnancy, which can be incorporated as an integral part of pre-natal care to eliminate adverse pregnancy outcomes. Keywords: pregnancy, adverse outcomes, oral health, knowledge, attitude, oral health practices

Aim: The purpose of this in vitro study is to assess the passive fit of prosthetic metal frameworks obtained through a novel digital impression system, for full-arch rehabilitations on multiple implants. Materials and methods: Five master casts, reproducing edentulous jaws with 4 tilted implants, were poured (Groups: MC #1, MC #2, MC #3, MC #4, MC #5). An intraoral scanner system [True Definition Scanner, 3M ESPE, St. Paul, MN, USA] was used to perform five digital impressions (DI) of each master cast (n=25). The implant position was detected with 4 special scan bodies [Toothless, Simbiosi srl, Empoli Firenze, Italy]. A single DI, presenting mean values compared to the others, was selected from each group in order to fabricate a metal framework with CAD-CAM technology (n=5). Passive fit was assessed with the Sheffield Test, screwing each framework on the corresponding master cast. A stereomicroscope [Wild M3Z, Wild Heerbrugg, Heerbrugg, Switzerland] (40x magnification) was used to record maximum gap values at the framework-implant analog interface. Results: Sheffield test reported the following mean values of gap: MC #1 = 0.024 ± 0.019 mm (range: 0.003-0.044 mm), MC #2 = 0.022 ± 0.014 mm (range: 0.003-0.047 mm), MC #3 = 0.027 ± 0.015 mm (range: 0.003-0.045 mm), MC #4 = 0.021 ± 0.012 mm (range: 0.003-0.037 mm), MC #5 = 0.021 ± 0.016 mm (range: 0.002-0.046 mm). No statistically significant differences were found among the groups (p>0.05). Conclusion: Within the limits of this study, digital impression represents a reliable method to fabricate full-arch implant frameworks provided with passive fit. Keywords: intraoral scanner, digital impression, impression accuracy, implant, passive fit, prosthetic framework

Aim: Determine the capability of a new nasal cannula system (Silhouette, Parker Instrument, Hatfield, PA) to reliably deliver predictable concentrations of nitrous oxide for dental sedation and deliver 100% O2 following the procedure as required by the ADA and AAPD. Methods: 24 volunteers, 12 male, 12 female, 26-61 y/o, took part. Body weight and actual corresponding resting respiratory minute volume (MV) were recorded for each subject. As per manufacturer's instructions, the system was properly fitted, nasal cannula in the right nostril, hood over nose, sealed with attached adhesive and flowmeter set to 6 LPM, which is the maximum safe flow rate [1]. N2O was set at 70% for 10 minutes followed by 100% O2 for 5 minutes. Max N2O concentration was measured during the N2O application and max O2 concentration following the washout of N2O. Results: Females showed significantly lower respiratory minute volumes (MV) and significantly higher max N2O and max O2. Spearman's rank correlation coefficients (rho) were as follows: Total (n=24) MV/N2O: rho -0.93, p0.001, MV/02: rho -0.60, p=0.002. Male (n=12) MV/N2O: rho -0.83, p0.001, MV/O2: rho -0.55, p=0.064. Female (n=12) MV/N2O: rho -0.86, p0.001, MV/O2: rho -0.58 p=0.047. Conclusion: Nasal cannulas have been used to administer low concentrations of oxygen for many years but are known to deliver unpredictable gas concentrations [2]. This study shows similarly unpredictable results for nitrous oxide using a new nasal cannula system. Lower MV causes an unpredictable increase in inhaled N2O and the system is not capable of delivering 100% O2 at the conclusion of N2O sedation. 1. Ward, J.J., High-flow oxygen administration by nasal cannula for adult and perinatal patients. Respir Care, 2013. 58(1): p. 98-122. 2. O'Reilly Nugent, A., et al., Measurement of oxygen concentration delivered via nasal cannulae by tracheal sampling. Respirology, 2014. 19(4): p. 538-43. Keywords: porter silhouette, nitrous oxide, sedation, complications

Background: One of the largest disadvantages of cement-retained restorations on implants is retrievability. Case Report: In this case report a simple, novel approach for locating the screw hole of the abutment and then unscrewing both the abutment and the cement-retained bridge as one unit is described. The position of the screw hole was identified by using acrylic resin index with impression post on the patient's cast. The impression post was removed, and the acrylic resin index was transferred to the patient's mouth. The access hole position was marked with a soft marker to locate the screw position. Finally, drilling with a high speed bur was performed until reaching the abutment screw to retrieve the cemented bridge. Conclusion: This simple method could provide a predictable method for retrieving cement-retained implant bridges, especially after permanent cementation, while maintaining the integrity of both the implant fixture and the superstructure prosthesis on the condition that a patient cast is present. Keywords: cement retained implant bridge, screw loosening and retrievability

To compare the evidence of adjunctive antimicrobial photodynamic therapy in patients suffering from periodontitis and peri-implantitis. After a comprehensive literature search, studies were identified for treatment of aggressive and chronic periodontitis and peri-implantitis. The number of identified RCT's, comparisons, outcomes and length of follow-up were assessed. Meta-analyses are showen in forest-plots for probing depth reduction. There are great differences in the clinical evidence available concerning adjunctive aPDT in the treatment of periodontitis and peri-implantitis. Keywords: antimicrobial photodynamic therapy, periodontitis, peri-implantitis, meta-analyses

Objective: To determine psychological aspects influencing patients' choice between Oraqix® anesthesia gel (AG) and injected Ultracain® D-S forte (LA) during non-surgical periodontal therapy (SRP). Primary endpoints were dental anxiety (DA) and injection fear (IF). Secondary endpoint was the assessment of pain during periodontal probing and SRP. Methods: Thirty-eight patients with periodontitis were included in a randomised, single-blind, split-mouth, and cross-over clinical trial. Periodontal probing pain was recorded at baseline by a visual analogue scale (VAS) and verbal-rating-scale (VRS). Additionally, DA and IF were recorded at baseline. SRP was performed in two appointments; once with the use of AG and once with LA. Patients completed questionnaires as to the current and future preferences for local anesthesia. Results: Twenty-two patients (58%) preferred gel, and 14 patients (36%) preferred injection. One patient was indecisive, and 1 patient missed the recall appointment. DA and IF (P = 0.096, P = 0.254, Mann-Whitney) had no influence on anesthesia choice. Pain perception in AG treatment correlated with choice for injection (VAS P = 0.000, VRS P = 0.000, Mann-Whitney). Conclusion: No psychological aspect showed an influence on anesthesia choice. Assessed pain during treatment was found as the only predictor for patients' preference for future local anesthesia use. Keywords: local anesthesia, non-surgical periodontal therapy, SRP, dental anxiety, injection fear, lidocain, prilocain, anesthesia gel