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Assessing bone density in prospective dental implant sites is crucial both for choosing the implant type and for planning a drilling procedure that will ensure the implant’s primary stability and osseointegration. This study aimed to investigate possible differences between the bone densities of various edentulous sites in the maxilla and mandible. The study was conducted on a group of forty partly edentulous patients who underwent radiological examination by scanning the areas of interest using cone beam computed tomography (CBCT). Hounsfield units (HU) were analyzed using dedicated software. Higher HU were observed at the site of mandibular central incisors compared to the site of maxillary central incisors. The HU values in the mandibular first molars region were higher than those of the maxillary first molars. Buccal vs. lingual or palatal cortical HU values did not differ significantly. Within the limitations of this study, it can be stated that an objective assessment of site-specific bone density before the installation of dental implants may provide valuable clinical information for the selection of implant size and the planning of a patient-specific drilling protocol.

The current paper presents a case report of lower eyelid reconstruction after removal of a basal cell carcinoma. Our novel reconstruction method consists of translation and rotation of a paramedian forehead flap into the defect, conjunctivorhinostomy for reconstruction of the nasolacrimal duct, and placement of a sandwich ear cartilage graft that is primarily seated into the forehead flap to maintain the vertical dimension of the eyelid. This “all-in-one” technique has the advantage of one-step reconstruction, avoiding multiple surgical procedures.

Background: Advancements in therapeutic approaches and standard medical interventions have significantly improved the prognosis of patients with differentiated thyroid cancer. However, uncertainties remain regarding the optimal timing and protocols for dental implant placement in patients undergoing radioiodine-131 (I-131) therapy. Debates continue about the potential effects of radiation on osseointegration dynamics and implant viability. This in vitro study assessed the impact of radiodiodine-131 (I-131) used for differentiated thyroid cancer on the structure of zirconia and titanium implants. Methods: A total of 60 implants were utilized, with distribution into two cohorts: titanium implants (Ti, n = 30) and zirconia implants (Zr, n = 30). Subsequently, the Ti and Zr implants were immersed in I-131 solution and retrieved at specified time intervals: 0, 6, 12, 24, 48 h, and 8 days post irradiation. The analyses used to characterize the structure of the implants were radioactivity, scanning electron microscopy, atomic force microscopy, roughness, and Vickers hardness assessment. Results: The findings indicate that the zirconia implants exhibited minimal ultra-structural topographic changes after irradiation. Notable topographical changes and debris deposition on zirconia surfaces became evident after 24 h, with cumulative effects observed after 192 h. The titanium implants, on the other hand, showed surface alterations beginning at 12 h of exposure. Significant changes, including erosive patterns and substantial debris deposits, occurred after 48 and 192 h, leading to increased surface roughness by 24 h. Implants exposed for 12 and 24 h formed a statistically significant group, indicating the onset of surface alteration accumulation. The erosion debris confirmed the surface alterations induced by radioiodine-131 exposure. Conclusions: Overall, the Zr implants demonstrated greater stability compared to the Ti implants following radioiodine-131 exposure.

Background and objectives: The aim of this systematic review was to assess the available evidence of using enamel matrix derivate in the treatment of peri-implantitis. Materials and methods: Three electronic databases (PubMed, Scopus, and Web of Science) were searched until August 2022 to identify relevant articles. The inclusion criteria consisted in human clinical studies that reported the use of enamel matrix derivate (EMD) in surgical and non-surgical treatment of peri-implantitis. The risk of bias was assessed using Cochrane risk of bias tool for randomized clinical trials (RCTs) and for non-RCTs ROBINS-I tool. Results: Clinical studies included were published between 2012 and 2022 and consisted of two randomized clinical trials (RCTs) for non-surgical therapy and two RCTs, three prospective cohort studies, and one retrospective case series in surgical therapy. Due to the heterogeneity of patients’ characteristics and assessment of peri-implant therapy, statistical analysis could not be achieved. Conclusions: The use of EMD indicated a positive effect on both surgical and non-surgical therapy. However, the available literature is scarce, with low evidence in non-surgical approach and modest evidence in surgical approach using EMD. More RCTs with standardize protocols are necessary to evaluate the efficacy of using EMD in both therapies.

Background and objectives: The aim of this systematic review was to assess the electronic literature about the benefits of using hyaluronic acid (HA) in the surgical periodontal treatment of infrabony defects. Materials and methods: This review was conducted under the PRISMA guidelines. The electronic search was conducted on PubMed, Scopus, Web of Science, and Cochrane databases until February 2022. The inclusion criteria consisted of human clinical trials that reported the use of HA in open-flap debridement (OFD) for infrabony defects. The assessment of risk of bias was performed using the Cochrane risk of bias tool. Statistical analysis was performed using Review Manager. Results: Overall, three RCTs were found eligible for the statistical analysis. Probing depth (PD) reduction and clinical attachment level (CAL) gain in the HA test group presented WMs of −1.11 mm (95% CI −2.38 to 0.16 mm; p = 0.09) and −1.38 mm (95% CI −2.26 to −0.49 mm; p = 0.002), respectively. However, the heterogeneity of the RCTs was high, and the risk of bias, in general, was low. Conclusions: The use of hyaluronic acid seems to have beneficial effects in periodontal surgery using OFD, in terms of PD and CAL. To draw a clear conclusion, more adapted and well-designed clinical trials are needed to assess the advantage of this product in comparison with other products.

Due to the impact of the Covid-19 pandemic on dental treatments, the present research aimed to assess the infection rate among dental practitioners from Romania and to analyze the economic impact of Covid-19 on dental offices. We designed a web-based survey distributed to dental practitioners from Romania. The survey included questions that assessed demographic data from the dentists who completed the questionnaire, along with economic aspects and epidemiological aspects related to the impact of the COVID-19 pandemic on dental practitioners. Five hundred and seven dentists completed the survey. Three-quarters of the assessed dental offices reported a decrease in the income and patient volume compared to 2019. More than half of the patients visiting the dental office paid more attention to the risk of infection and to prevention methods. Most dental offices implemented specific protective equipment for doctors. Three thousand seven hundred thirty-five dental practitioners were working in the 507 assessed dental offices, and among them, 238 COVID-19 cases of contamination were recorded. High contamination rates were registered in October (48, 20.1%), November (66, 27.7%), and December 2020 (52, 21.85%). Contamination mostly took place at home (114 cases, 47.8%) or resulted from event attendance. This study underlines an overall greater level of safety and an increased patient addressability in dental offices.

Background and Objectives: Peri-implantitis is a biologically driven complication that jeopardizes dental implant longevity. While chemical decontamination is frequently employed as an adjunct to mechanical debridement, its impact on implant surface integrity and cellular compatibility remains insufficiently defined. This study aimed to evaluate the effects of several chemical agents used in peri-implantitis treatment on the surface morphology and potential biocompatibility of titanium dental implants. Materials and Methods: Twenty-five Ti6Al4V implants were exposed to one of the following agents: saline solution, 3% hydrogen peroxide, 40% citric acid, 17% EDTA, and a mixture (1:1) of citric (2%) and phosphoric (1N) acids. This in vitro study employed a 7-day immersion protocol to accentuate surface effects under controlled laboratory conditions, acknowledging that clinical exposures are substantially shorter. Surface topography was evaluated by Atomic Force Microscopy, while cellular response and corrosion products were assessed using Scanning Electron Microscopy. Surface roughness parameters were statistically analyzed. Results: Hydrogen peroxide induced selective corrosion of the β phase and formed a compact passivation layer that supported mesenchymal stem cell adhesion. Citric acid etched grain boundaries, producing localized roughness that also permitted cell proliferation. EDTA caused advanced grain dissolution and debris accumulation, increasing surface roughness but impairing cellular adhesion. The citric–phosphoric acid mixture led to the highest roughness values and visible corrosion debris. In all cases, macrostructural integrity of the implants was preserved. Conclusions: Chemical agents used in peri-implantitis treatment induce distinct surface alterations on titanium implants. Controlled use of hydrogen peroxide and citric acid may enhance surface biocompatibility, while aggressive protocols such as EDTA and acid combinations require caution due to their adverse effects on surface morphology and cellular response. These findings may inform the development of optimized decontamination protocols for clinical management of peri-implantitis.

Background: The aim of the present study was to determine the value of multiparametric MRI in the preoperative differential diagnosis of parotid tumors, which is essential for therapeutic strategy selection. Methods: A three-year prospective study was conducted with 65 patients. Each patient was investigated preoperatively with multiparametric MRI and surgical excision of the tumor was performed. The preoperative imaging diagnosis was compared with the histopathological report. Several MRI parameters were analyzed, including T1 and T2 weighted image (WI), apparent diffusion coefficient (ADC), time to peak (TTP), and the time intensity curve (TIC). Results: In the differential diagnosis of benign from malignant tumors, T2WI and ADC showed statistically significant differences. Multiparametric MRI had a sensitivity, specificity, and accuracy of 81.8%, 88.6% and 92.3%, respectively. All of the studied parameters (T1, T2, TIC, TTP, ADC) were significantly different in the comparison between pleomorphic adenomas and Warthin tumors. With reference to the scope of this study, the conjunction of multiparametric and conventional MRI demonstrated a sensitivity, specificity, and accuracy of 94.1%, 100%, and 97.8%, respectively. Conclusions: Morphological analysis using conventional MRI combined with diffusion-weighted imaging (DW) and dynamic contrast–enhanced (DCE) multiparametric MRI improved the preoperative differential diagnosis of parotid gland tumors.

Background and Objectives: The aim was to systematically review the available literature regarding the use of polymers as a bone substitute for the treatment of periodontal infrabony defect. Materials and methods: Three databases (PubMed, Scopus and Web of Science) were searched to find all relevant studies published in English from inception until September 2021 using a combination of keywords. The inclusion criteria consisted of human clinical studies which reported the use of a polymer-based bone substitute in the treatment of infrabony defects. Results: 164 studies were provided from the databases. Of these, five articles were eligible and reported favorable outcome in terms of probing depth, clinical attachment gain and defect fill at the follow-up (3 months and 6 months). Conclusions: Polymer based-bone substitutes may represent a useful alternative in treating infrabony defects. Due to the limited number of studies, more research is needed to sustain the advantages of these products.

The aim of this study was to evaluate the microscopic structure of soft tissue covering titanium plates and screws used in jaw surgery (mandible fracture and orthognathic surgery), after a minimum period of 12 months from insertion, and to quantify the presence of any metallic particles. Periosteum covering the osteosynthesis plates was removed from 20 patients and examined by light microscopy in order to assess the cell morphological changes and the possibility of metal particles presence in the soft tissue. Local signs of tissue toxicity or inflammation were taken into consideration when evaluating the routine removal of titanium maxillofacial miniplates. No signs of screw loosening or acute inflammation were detected on the osteosynthesis site, but de-coloration of the periosteum was seen, and metallic particles were observed to have migrated into the soft tissues. Even if the titanium is well-tolerated by the human body in time, without severe local or general complications, our findings suggest that plate removal should be considered after bone healing has occurred.