Journal of Osseointegration

State of the art of autologous platelet concentrates in dentistry: A narrative review

2024-08-13T14:36:35+00:00

Background Over the past 10 years, PRP and PRF have been widely used in dentistry, due to their growth factors and regenerative potentials and have expanded their use in many procedures with results that are now clinically and statistically significant. The initially described procedures included oral surgery, in general, from simple to complex extractions of included third molars. Today their use goes from periodontics to hard and soft tissue regenerative surgery, through oral wound healing up to implant therapy. The aim of this review is to evaluate the state of the art of autologous platelet concentrates in different branches of dentistry. Materials and methods A literature research was conducted through major scientific database without any restriction. Because of the large number of articles included and the wide range of methods and results among the studies found, it was not possible to report the results in the form of a systematic review or meta-analysis. Therefore, a narrative review was conducted.
Results We obtained 2236 results, of which 1621 were published in the last 10 years. After the screening of titles and abstracts, non-topic entries were excluded, 323 reviews and systematic reviews were included, of which 320 passed the English language filter.
Conclusions This review highlights the present state of the art of the use of autologous platelet concentrates in dentistry. According to several recent studies, there is an effective benefit in several clinical outcomes described in using prp or prf in different procedures, while in others further clinical studies are needed.

Use of diode laser for volume reduction of edematous gingival tissue treated with causal therapy: evaluation of clinical efficacy

2024-07-31T13:46:53+00:00

Aim The purpose of this study is to evaluate and compare the effectiveness of two different techniques for the treatment of plaque-induced gingivitis, specifically investigating whether laser-assisted causal therapy resolves gingival edema more quickly than traditional causal therapy alone.

Materials and Methods This study involved 34 patients aged between 20 and 60 years. Initially, all patients underwent a PSR to exclude those with periodontitis. Clinical parameters were recorded, and a baseline scan was performed. Patients rinsed with 0.20% CHX before receiving a professional oral hygiene session. A split-mouth protocol was used, with each patient receiving both experimental therapy (causal therapy plus diode laser) and control therapy (traditional causal therapy) on different hemi-arches, determined by randomization. Patients were instructed on proper oral hygiene techniques to perform at home. Follow-up scans and clinical assessments were conducted at 7- and 14-days post-treatment. The data were analyzed in a double-blind manner.

Results Analysis of gingival-periodontal health parameters and the volumetric values of treated areas revealed no statistically significant differences between the regions treated with diode laser adjunctive therapy and those treated with traditional causal therapy alone.

Conclusion Within the limitations of this study, diode laser therapy does not appear to facilitate a faster resolution of gingival edema caused by gingivitis compared to traditional therapy. Both treatment methods effectively reduced inflammation, but the addition of diode laser did not significantly enhance outcomes.

Full arch immediate load rehabilitation with a reduced number of implants: comparative evaluation of tissue healing after flap less and open flap surgery. Follow-up at 12 months

2024-07-31T13:22:35+00:00

Aim This study aims to evaluate and compare the success of implant-prosthetic rehabilitations using a digital protocol versus the traditional “All on Four” technique.

Materials and Methods Fifty patients at the Department of Dentistry of IRCCS San Raffaele Hospital were randomly divided into two groups: 25 underwent digital protocol rehabilitation and 25 underwent traditional rehabilitation. Key parameters such as Visual Plaque Index, Plaque Index, Probing Depth, and Bleeding On Probing were measured at multiple time intervals (T1, T2, T3, T4). Patient-reported outcomes on post-operative pain, swelling, bleeding, and overall satisfaction were assessed using questionnaires.

Results Guided surgery offered superior outcomes in terms of precision and patient comfort. Patients in the digital protocol group reported significantly lower post-operative pain, swelling, and bleeding, particularly in the initial months post-surgery. IPV and PI were initially lower in the digital group, indicating better oral hygiene maintenance, but these differences diminished over time. Both groups exhibited similar long-term outcomes regarding peri-implant bone loss and PPD.

Conclusion The findings highlight the advantages of digital planning and computer-assisted implant surgery, including enhanced surgical accuracy and improved patient experience. However, successful outcomes for both methods depend on careful patient selection, precise execution, and diligent post-operative care. Future research should aim to refine digital workflows further, assess their cost-effectiveness, and validate these findings in larger, long-term studies.

A randomized clinical trial in “All on four” rehabilitations with 6-years follow-up: digital versus traditional workflow

2024-07-31T13:20:32+00:00

Aim The present study compares and evaluates the “All on Four” type rehabilitations obtained through a traditional technique, with “All on Four” rehabilitations made using an entirely digital method, with a 6-years follow-up.

Materials and methods The workflow displayed in this study analyzes in detail each design and clinical phase of both methods, which were applied to a total of 50 patients recruited by the Department of Dentistry of the University Vita e Salute San Raffaele. The selected patients were divided into two randomized groups of 25 people: in total, 100 implants were placed in 25 patients who received a full-arch rehabilitation performed using the traditional All on Four method and 100 implants in 25 patients who received a full-arch rehabilitation performed using a digital method. After 6 years, different percentages of success were obtained: 98% of success for the group of patients treated with the traditional "All on Four" protocol and 100% of success for the group treated with the digital protocol. At each time interval a significant difference (P <0.0001) in peri-implant crestal bone loss between the two groups was detected, with an average Marginal Bone Level (MBL) at 6 years of 1.12 ± 0.25 mm in patients treated with traditional method and 0.88 ± 0.10 mm in patients treated with digital method. Patients belonging to the digital group have judged the immediate loading (92%), digital smile preview (93%), the mock-up test (98%) and guided surgery (94%) as very effective. All patients treated with a digital method reported a lower value of during-surgery and post-surgery pain compared to patients rehabilitated using traditional method.

Conclusion The totally digital protocol described in the present study represents a valid therapeutic alternative to the traditional “All on Four” protocol for implant-supported rehabilitations of edentulous dental arches.