Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Κυριακή 1 Ιανουαρίου 2023

Single‐retainer all‐ceramic resin‐bonded fixed dental prostheses: Long‐term outcomes in the esthetic zone

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Abstract

Objectives

To present an update on the concept of cantilevered single-retainer all-ceramic resin-bonded fixed dental prostheses (RBFDPs) first presented 25 years ago in the Journal of Esthetic Dentistry.

Overview

The initially presented case of the concept was followed clinically over 26 years and is presented along with two additional clinical long-term cases using varying methods to obtain an esthetic and hygienic ovate pontic design. Veneered alumina and zirconia ceramic (3 mol% yttria–tetragonal zirconia polycrystalline ceramic; 3Y-TZP) was used and bonded with a phosphate monomer containing luting resin after 50 μm alumina particle air-abrasion at 0.25 MPa pressure. The restorations replacing incisors did not debond and soft tissues in the pontic area were maintained over 26 years.

Conclusions

Cantilevered single-retainer all-ceramic RBFDPs today made from veneered 3Y-TZP zirconia ceramic can be considered a standard of care for the replacement of single incisors and provide an excellent esthetic outcome with a long-term preservation of soft tissues in the pontic area.

Clinical Significance

Bonding nonretentive oxides ceramics such as alumina and zirconia ceramic with phosphate monomer containing luting resins after alumina particle air-abrasion is durable over decades. This proves that bonding to zirconia ceramic is not of any problem when adequate methods are used. Single-retainer zirconia ceramic RBFDPs maintain soft tissues in the edentulous area of single missing incisors and often deem implants unessential for this indication.

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Soft tissue esthetics around immediately provisionalized delayed implants with and without connective tissue graft: A randomized clinical trial pilot study

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Abstract

Objective

Evaluate the peri-implant soft tissue esthetics following a single, immediately provisionalized, delayed implant with/-out subepithelial connective tissue graft (SCTG).

Material and Methods

The eligible patients were randomized into two groups. Immediate provisionalization was performed with (test group: SCTGG) or without SCTG (control group: NGG). The soft tissue esthetics was assessed by Pink Esthetic Score (PES) and Mucosal Scarring Index (MSI), at 6 and 12 months, following final implant restoration.

Results

The SCTGG, compared to NGG, yielded a 0.2 increased PES at 12 months (95% confidence interval (CI): −1, 1.4) and a 0.2 decreased MSI score (95% CI −0.9, 0.5) with no statistically significant differences in PES and MSI between both groups (p > 0.05).

Conclusion

Soft tissue grafting around immediately provisionalized delayed implants could exhibit comparable results to immediate provisionalization alone in terms of peri-implant soft tissue esthetics using PES and MSI (ClinicalTrials.gov Identifier: NCT03770975).

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Role of mechano-sensitive non-coding RNAs in bone remodeling of orthodontic tooth movement: recent advances

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Orthodontic tooth movement relies on bone remodeling and periodontal tissue regeneration in response to the complicated mechanical cues on the compressive and tensive side. In general, mechanical stimulus regu...
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Stereotactic Partial Breast Irradiation: What Does the Future Hold?

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imageBreast irradiation has evolved significantly over the last several decades. Accelerated partial breast and stereotactic breast irradiation have evolved as strategies to reduce irradiated volumes, preserve appropriate oncologic control, and improve cosmetic outcome. The sequencing and/or combination of stereotactic partial breast irradiation with novel systemic agents is of great interest to the oncologic community. Here we explore the landscape of modern trials and opine on the future of partial breast irradiation.
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Weekly Symptom Profiles of Non‐hospitalized Individuals Infected with SARS‐CoV‐2 During the Omicron Outbreak in Hong Kong: A Retrospective Observational Study from a Telemedicine Centre

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Abstract

Background

Omicron BA.2.2 is the dominant variant in Hong Kong outbreak since December-31 2021. There is no study reporting the weekly symptom profile after infection.

Methods

In this retrospective study, participants who tested positive for SARS-CoV-2 after December-31 2021 and registered in the telemedicine system between March 14-May 6 2022 were analysed.

Findings

Among registered 12950 self-quarantined COVID-19 positive patients, 11776 symptomatic patients were included for weekly symptom profile analysis. 4718 (40.1%) patients reported symptoms in the first week after positive test, 2501 (21.2%) in the second week, 1498 (12.7%) in the third week, 1048 (8.9%) in the fourth week, and 2011 (17.1%) in over four weeks. Cough was the most common symptom in all participants. Patients in the first week had higher odds of reporting fever (0.206, 95% CI 0.161-0.263, p<0.001) and sore throat (0.228, 95% CI 0.208-0.252, p<0.001). Patients in over 4 weeks had a higher odds of reporting fatigue (1.263, 95% CI 1.139-1.402, p<0.001). Further, having at least two vaccine doses linked to lower odds of having fever (0.675, 95% CI 0.562-0.811, p<0.001), but not associated with the presence of cough and fatigue. Diabetic patients had higher odds of reporting diarrhea (1.637, 95% CI 1.351-1.982, p<0.001).

Conclusion

Symptoms from omicron infection may last for more than four weeks and symptom profiles vary from week to week. Vaccination and comorbidity affect the symptom profiles.

This article is protected by copyright. All rights reserved.

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H‐Type Tracheoesophageal Fistula Cannulation for Rapid Intraoperative Localization

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H-Type Tracheoesophageal Fistula Cannulation for Rapid Intraoperative Localization

Various techniques for tracheoesophageal fistula cannulation have been reported. In this case, we created a loop using a plastic catheter. The loop allowed us to create traction for rapid intraoperative localization and to pull a difficult-to-reach fistula, superiorly into the neck, to be reached through a cervical approach. Laryngoscope, 2022


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Inflammatory profile of apical periodontitis exacerbated by cigarette smoke inhalation: histological and immunohistochemical analysis in rats

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Abstract

Aim

To evaluate the effects of cigarette smoke inhalation (CSI) on inflammation, proinflammatory mediators and haematological parameters in rats with induced apical periodontitis (AP).

Methodology

Thirty-two 3-month-old male Wistar rats were divided into four experimental groups (n=8): C - Control; S - rats with CSI; AP - rats with AP; and SAP - rats with CSI + AP. Animals in groups S and SAP inhaled cigarette smoke by remaining inside a smoking chamber for 8 minutes, 3 times daily, for 50 days. After 20 days of smoke inhalation, animals in AP and SAP groups had the pulps of the lower right first molar exposed to oral environment for 30 days to induce AP. In these subsequent 30 days, animals in group S and SAP continued with CSI. On day 50th, animals were euthanized and mandibles were histologically processed to assess inflammatory infiltrate, immunohistochemical interleukins (IL-1β, IL-6 and TNF-α), and blood sample collected for laboratory analysis. The Mann–Whitney test was performed for nonparametric data and the pairwise analyses of Student's t-test for parametric data, with a significance level of P<0.050.

Results

Inflammatory infiltrate was moderate in AP group and more severe in the SAP (P=0.010). The interleukins IL-6, IL-1β and TNF-α were higher in SAP group (P<0.001) when compared with the AP group. A greater number of red blood cells (P=0.010), haemoglobin (P=0.007), and neutrophils (P=0.014) were observed in the SAP group in comparison with the AP group.

Conclusion

Cigarette smoke inhalation induced a more severe inflammatory infiltrate, with increased levels of proinflammatory cytokines and changes in haematological parameters in rats with induced AP. Thus, cigarette smoke inhalation aggravated AP, exacerbating the inflammatory response.

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Prognostic significance of head and neck spindle cell carcinoma

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Abstract

Background

Our study investigates the prognostic significance of spindle cell histology on overall survival (OS) of conventional head and neck squamous cell carcinoma (HNSCC).

Methods

The 2004 to 2017 National Cancer Database was queried for patients with head and neck spindle cell carcinoma (HNSpCC) (n = 1572) or HNSCC (n = 242 697) of the oral cavity, major salivary glands, sinonasal tract, oropharynx, hypopharynx, and larynx treated with curative intent.

Results

Patients with HNSpCC presented more frequently with higher-grade tumors and cN0 disease than those with HNSCC (p < 0.001). In the oral cavity, the HR for death for SpCC compared with SCC was 1.33 (p < 0.001). In the oropharynx, the HR for death for SpCC compared with SCC was 1.47 (p = 0.028).

Conclusions

After adjusting for patient, tumor, and treatment characteristics, SpCC histology had an independent adverse prognostic effect on OS in the oral cavity and oropharynx. SpCC histology does not necessarily portend poorer survival in all HNSCC.

Level of Evidence: 4.

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Clinical evaluation and patient related outcomes of one‐ and two‐piece zirconia implants at five years of loading: A case series study

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Abstract

Objective

The objective of this study was to investigate the survival and biological and mechanical complications of one-piece and two-piece zirconia implants at five years of loading.

Materials and Methods

Consecutive patients receiving zirconia implants were studied, collecting data at five years of loading on their clinical history, peri-implant health status, mechanical complications, esthetic results, and patient related outcomes.

Results

The study included 18 patients with 29 implants. The survival rate was 86% in implant-based analysis and 78% in patient-based analysis. There were no cases of peri-implantitis, but mucositis was present in 53% of implants. A mean of 4.1 ± 0.81 mm was obtained for probing depth and 1.6 ± 0.9 mm for crestal bone loss (radiographic assessment). There were no implant fractures. Major (10%) and minor (10%) prosthesis complications were observed. The esthetic outcome was moderate to almost perfect, with a high level of patient satisfaction. No significant association was found between survival rate and the presence of mucositis around one- or two-piece implants or any other study variable.

Conclusions

The survival rate is low for one- and two-piece zirconia implants. Both types of implants demonstrated a low mechanical complication rate. The incidence of periimplantitis is low but mucositis is present in 50%. Patient satisfaction related to esthetics and function is moderate to high. They represent a good option for patients requiring an alternative to titanium implants.

Clinical Relevance

Zirconia implants appear to be an alternative to the titanium option and may be indicated for patients requiring "metal-free" restorations.

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DSCS, a New Cell Line Developed in vitro From Human Stem Cells of the Apical Papilla

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Abstract

Aim

To establish and fully characterize a new cell line from human stem cells of the apical papilla (SCAPs) through immortalization with an SV40 large T antigen.

Methodology

Human SCAPs were isolated and transfected with an SV40 large T antigen and treated with puromycin to select the infected population. Expression of human mesenchymal surface markers CD73, CD90 and CD105 was assessed in the new cell line named Dental Stem Cells SV40 (DSCS) by flow cytometry at early and late passages. Cell and proliferation were also analysed. To evaluate trilineage differentiation; quantitative polymerase chain reaction and histological staining were performed.

Results

DSCS cell flow cytometry confirmed expression of mesenchymal surface markers even in late passages (100% positive for CD73 and CD90 and 98.9% for CD105 at passage (P) 25). Fewer than 0.5% were positive for haematopoietic cell markers (CD45 and CD34). DSCS cells also showed increased proliferation when compared with the primary culture after 48 h, with a doubling time of 23.46 h for DSCS cells and 40.31 h for SCAPs, and retained the capacity to grow for >45 passages (150 population doubling) and their spindle shape morphology. Trilineage differentiation potential was confirmed through histochemical staining and gene expression of the chondrogenic markers SOX9 and COL2A1, adipogenic markers CEBPA and LPL, and osteogenic markers COL1A1 and ALPL.

Conclusions

The new cell line derived from human SCAPs has multipotency, retains its morphology and expression of mesenchymal surface markers, and shows higher proliferative capacity even at late passages (P45). DSCS cells can be used for in vitro study of root development and to achieve better understanding of the regenerative mechanisms.

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Three‐point sectional‐cast digital method for transferring the interocclusal relationship for full‐mouth rehabilitation of worn dentition

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Abstract

For full-mouth rehabilitation of worn dentition, "diagnostic" interim restorations are required to reestablish the interocclusal relationship. It is important but challenging to transfer the interocclusal relationship, and to map the basic form and contour of interim restorations to the final restorations. Alignment of interim restorations and working casts is difficult when using digital workflows because of a lack of consistent hard tissue reference points. The digital workflow presented in this study used a "3-point sectional-cast digital cross-mounting method" to transfer the interocclusal relationship during full-mouth rehabilitation. An intermediate cast was made with 3 interim restorations: 1 on an incisor and 2 on molars. The interocclusal relationship and occlusal morphologies of the diagnostic interim prostheses were transferred and aligned to working casts using the 3-point sectional casts.

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