Antonio D’Agostino

Sliding Genioplasty Using Fresh-Frozen Bone Allografts

OBJECTIVE To present our experience in the use of fresh-frozen human bone allograft as an interpositional grafting material for sliding genioplasty to correct chin deformities. METHODS Ten patients underwent sliding genioplasty using morcellized and corticospongious fresh-frozen human bone. Four patients underwent orthognathic surgery associated with genioplasty. Six patient underwent genioplasty associated with rhinoplasty. Panorex, lateral, and frontal cephalogram and computed tomographic scans have been performed for each case preoperatively and 12 months after surgery. One patient subsequently asked for plate removal, and with his consent, a bone biopsy specimen was obtained during the operation. RESULTS Stable aesthetic and functional results were observed in all cases. No infections occurred, and no bone resorption has been clinically or radiologically observed. CONCLUSION The use of fresh-frozen bone allograft reduces patient morbidity and operative time, providing a stable and excellent aesthetic result.

Modified technique for endoscopic endonasal reduction of medial orbital wall fracture using an absorbable packing

PurposeThe purpose of this study was to describe a modified technique using only biological dura substitute (Lyoplant®) associated or not to a sheet of Medpore® (porous polyethylene plate) avoiding the use of Silastic® or Merocel® packing for endoscopic endonasal reduction of medial orbital wall fracture.MethodsAn interventional case report was used involving two patients with medial orbital wall fracture that were treated with the modified technique. Postoperatively, the patients were evaluated for visual acuity, enophthalmos, extraocular motility, and diplopia.ResultTwelve months after surgery, patients recovered completely without any residual eye symptoms or complications, and postoperative CT showed a completely corrected medial orbital wall fractures.ConclusionThe reported technique proved itself to be safe and effective, and it may be expected to have advantages over the conventional endoscopic approach using a non-absorbable packing, avoiding the need for long-term nasal packing and a secondary removal procedure.

Rehabilitation of a complex midfacial defect by means of a zygoma-implant-supported prosthesis and nasal epithesis: a novel technique

PurposeSeveral authors have described zygoma implants as a reliable surgical option to rehabilitate severe maxillary defects in case of extreme atrophy or oncological resections. The aim of this study is to report a new technical approach to the rehabilitation of a complex oronasal defect by means of a zygoma-implant-supported full-arch dental prosthesis combined with a nasal epithesis.Patients and methodsThe patient presented with a subtotal bilateral maxillectomy and total rhinectomy defect because of a squamous cell carcinoma of the nose. No reconstructive surgery was performed because of the high risk of recurrence; moreover, the patient refused any secondary procedure. After surgery, the patient presented a wide palatal defect associated to the absence of the nasal pyramid. Zygoma-retained prostheses are well documented, and they offer good anchorage in rehabilitating wide defects after oncological surgery and a good chance for patients to improve their quality of life. We hereby describe two prosthetic devices rehabilitating two iatrogenic defects by means of a single intraoral implant-supported bar extending throughout the oronasal communication, thus offering nasal epithesis anchorage.ResultsAt 1-year follow-up after functional prosthetic loading, no implant failure has been reported. Clinical and radiological follow-up showed no sign of nasal infection or peri-implantitis. The patient reported a sensitive improvement of his quality of life.ConclusionsSimultaneous oral and nasal rehabilitation of complex oronasal defects with zygoma-implant-supported dental prosthesis and nasal epithesis represents a reliable surgical technique. According to this clinical report, the above-mentioned technique seems to be a valuable treatment option as it is safe, reliable and easy to handle for both surgeon and patient.

Human adipose stem cells induced to osteogenic differentiation by an innovative collagen/hydroxylapatite hybrid scaffold

Novel biomaterials are of paramount importance for bone regrowth. In this study, we investigated human adipose stem cells (hASCs) for osteogenic, osteoconductivity, and osteoinductivity effects of an innovative collagen/hydroxylapatite hybrid scaffold. In hASCs that were grown on this scaffold, osteogenic genes were analyzed for their expression profiles, together with adhesion and extracellular matrix genes. In hASC integrins, basement membrane constituents and collagens were up‐regulated, together with cell proliferation. In addition, expression of osteopontin and activated focal adhesion kinase was studied at the protein level. Our in vitro data indicate that hASCs, together with hybrid biomaterial, is an important model of study to investigate in vitro bone induction.—Mazzoni, E., D’Agostino, A., Manfrini, M., Maniero, S., Puozzo, A., Bassi, E., Marsico, S., Fortini, C., Trevisiol, L., Patergnani, S., Tognon, M. Human adipose stem cells induced to osteogenic differentiation by an innovative collagen/hydroxylapatite hybrid scaffold. FASEB J. 31, 4555–4565 (2017). www.fasebj.org

La scelta del colore in odontoiatria

Riassunto Obiettivi La corretta scelta del colore puo essere operata con il metodo tradizionale, basato sull’uso di scale colore, oppure utilizzando le recenti tecnologie di colorimetria, spettrofotometria digitale ed RGB (Red Green Blue Technology). Obiettivo del lavoro e confrontare l’uso di scale colore tradizionali e spettrofotometri al fine di valutare la loro efficacia. Materiali e metodi E stata effettuata una revisione della letteratura utilizzando specifiche parole chiave e criteri di selezione per la scelta del colore in odontoiatria restaurativa. I risultati ottenuti sono stati poi analizzati. Risultati e discussione Nei vari lavori esaminati la scala guida cromatica riveste ancora un ruolo fondamentale come riferimento visivo, essendo utile sia all’inizio del trattamento sia per il controllo finale del risultato. Conclusioni Nei limiti della letteratura esaminata, la percezione del colore e la valutazione finale della qualita del prodotto si basano, sia per l’operatore sia per il paziente, sulla valutazione visiva. Benche quest’ultima sia ancora il gold standard, puo essere utile associarvi la tecnologia spettrofotometrica digitale per coadiuvare la scelta del colore piu corretta.