Roberta Marini

Geomorphological classification of urban landscapes: the case study of Rome (Italy)

ABSTRACT The results of a long-lasting geomorphological survey carried out in Rome are summarized. A method aimed at integrating survey data, historical maps, aerial photographs and archaeological and geomorphological literature produced a geomorphological map of the present-day historical centre. The geomorphology of Rome is related to the paleogeographical conditions prior to the founding of the City; they allow us to recognize the stages of landscape evolution of the ancient Caput Mundi (Capital of the World). The study area has been affected by continuous man-made changes to the drainage network and to the topographic surface over the last 3000 years. It has forced the authors to develop innovative solutions to undertake effective analysis of the urban environment and the legend of the geomorphological map in this peculiar context. The resulting map is useful for urban planning and archaeological research.

Immediate loading of post-extractive single-tooth implants: a 1-year prospective study.

PURPOSE The aim of this prospective clinical trial was to assess clinical, radiological, and esthetic outcomes of immediate-loaded post-extractive implants after 1 year of follow-up. MATERIALS AND METHODS Twenty-four consecutive patients (15 females and nine males) with a mean age of 47.27 years (range 35-65) requiring single-tooth extraction in the maxillary or mandibular anterior or premolar areas were enrolled. Twenty-five NobelActive implants (Nobel Biocare, Göteborg, Sweden) were placed and loaded immediately after tooth extraction. The definitive prosthetic restoration was delivered 6 months later. Clinical parameters, marginal bone loss, as well as, pink and white esthetic scores (PES and WES) were evaluated at 3, 6, and 12 months after implant placement. RESULTS After 12-month follow-up period, a success rate of 91.67% was reported: Two of the 25 initially placed implants were lost after 4 weeks due to lack of osseointegration. The mean marginal bone loss after 1-year follow-up was 0.383 (SD ± 0.749) at mesial site and 0.278 (SD ± 0.595) at distal site. No statistically significant changes in the full-mouth plaque score (FMPS) and in the full-mouth bleeding score (FMBS) were observed from baseline to 12 months. The mean total PES/WES was 17.13 ± 1.91 (range: 13-20). None of 23 implants had an overall score <12 (threshold of clinical acceptability). CONCLUSION Within the limitations of the present study, when careful patient selection and strict clinical protocol are observed, the immediate placement and loading of a single NobelActive(™) implant in a fresh extraction socket may be considered a valuable and predictable option in terms of implant success as well as hard and soft tissues stability.

Graftless sinus augmentation technique with contextual placement of implants: a case report

IntroductionThe positioning of implants in the jaw bones with contextual graftless lateral approach sinus lifting is finding an increasingly broad consensus in the literature.Since the 1970s, various clinical research projects have been conducted on applications of biological and synthetic biomaterials in bone regenerative surgery, both in sinus lift procedures and in cystic cavity filling after cystectomy or in bone defects in regenerative periodontal surgery. Currently, we are finding that there is an increasing trend of clinicians aiming to adopt graftless techniques, with satisfactory results in terms of implant survival in the long term.In our study, through a case report, we describe a variant of graftless sinus augmentation technique with contextual implant placement, emphasizing the role of the blood clot, combined with collagen sponges, as a natural scaffold and the osteogenic potential of the subantral membrane in guided bone regeneration, with reduced morbidity of the patient.Case presentationTo describe the surgical technique, the clinical case of a 38-year-old Caucasian woman with a lateral posterior edentulism was selected. The rehabilitation was solved by a graftless sinus augmentation technique with a contextual implant placement.For each implant, a resonance frequency analysis evaluation was reported as implant stability quotient values. The performance of the implant stability quotient values followed a gradual increase from time zero to the sixth month, as the clot was differentiated into osteoid tissue and then into bone tissue, due to the scaffold effect conferred by the equine collagen sponge. The stabilization phase took place between the fourth and the sixth month, according to the implant stability quotient values.ConclusionsOur graftless sinus augmentation technique seems to be very predictable thanks to the osteoconductive principles on which it is based, and in association with the proper management of peri-implant soft tissue, so as to increase the amount of keratinized tissue, which could represent the new gold standard for this type of rehabilitation in the future.

Performance of Mesenchymal Cell-Scaffold Constructs in Human Oral Reconstructive Surgery: A Systematic Review

Background: Different sources of cultured cells combined with different scaffolds (allogenic, xenogeneic, alloplastic or composite materials) have been tested extensively in vitro and in preclinical animal studies, but there have been only a few clinical trials involving humans. Aim: This study reviewed all of the English language literature published between January 1990 and December 2015 to assess the histological performance of different mesenchymal cell-scaffold constructs used for bone regeneration in human oral reconstructive procedures. Methods: An electronic search of the MEDLINE and Cochrane Central Register of Controlled Trials databases complemented by manual searching was conducted to identify studies involving histological evaluation of mesenchymal cell-scaffold constructs in human oral surgical procedures. The methodological quality of randomized controlled clinical trials and controlled clinical trials was assessed using the Cochrane Collaboration tool for assessing the risk of bias. Heterogeneity was assessed using Review Manager software. Considering the heterogeneity, the data collected were reported by descriptive methods and a meta-analysis was applied only to the articles that reported the same outcome measures. The articles were classified and described based on the material scaffolds used. Results: The search identified 1030 titles and 287 abstracts. Full-text analysis was performed for 32 articles, revealing 14 studies that fulfilled the inclusion criteria. Three randomized controlled clinical trials were identified as potentially eligible for inclusion in a meta-analysis. The studies were grouped according to the scaffold materials used: bone allograft (three studies), polyglycolic-polylactic scaffold (four studies), collagen sponge (two studies), and bovine bone matrix (five studies). The stem cells used in these studies had been sourced from the iliac crest, periosteum, dental pulp and intraoral sites. Conclusions: The very small amount of available data makes it impossible to draw any firm conclusions regarding the increase in bone formation in human oral reconstructive procedures when using graft materials engineered with autogenous stem cells.

Clinical Management of a Peri-Implant Giant Cell Granuloma.

Purpose. Implant therapy plays an important role in contemporary dentistry with high rates of long-term success. However, in recent years, the incidence of peri-implantitis and implant failures has significantly increased. The peripheral giant cell granuloma (PGCG) rarely occurs in peri-implant tissues and it is clinically comparable to the lesions associated with natural teeth. Therefore, the study of possible diseases associated with dental implants plays an important role in order to be able to diagnose and treat these conditions. Materials and Methods. This report described a 60-year-old Caucasian male who presented a reddish-purple pedunculated mass, of about 2 cm in diameter, associated with a dental implant and the adjacent natural tooth. Results. An excisional biopsy was performed and the dental implant was not removed. Histological examination provided the diagnosis of PGCG. After 19-month follow-up, there were no signs of recurrence of peri-implantitis around the implant. Conclusion. The correct diagnosis and appropriate surgical treatment of peri-implant giant cell granuloma are very important for a proper management of the lesion in order to preserve the implant prosthetic rehabilitation and prevent recurrences.

Unusual symptomatic inclusion cysts in a newborn: a case report

IntroductionDental lamina cysts are cysts that occur as white or pink small nodules, often multiple, approximately 1 to 3mm in diameter. They are typically located on the midpalatine raphe and less frequently on the maxillary and mandibular alveolar mucosa; in the latter case these can be appear to be neonatal teeth.On microscopic examination, these lesions show a stratified squamous epithelium (two to three cell layers); it is possible to find protein, keratin and/or exfoliated epithelial cells in the lumen of the lesions.Neonatal cysts usually show no particular symptoms. They are associated with an excellent prognosis because they regress spontaneously within a few weeks and are not associated to any complications. However, if pain, bleeding or other symptoms occur, a surgical excision is required.Case presentationIn this paper, we present an anomalous case of symptomatic dental lamina cyst which affected a 60-day-old male Caucasian newborn. The surgical treatment was elective in this case and 6-month follow-ups were mandatory.ConclusionsWe can underline the successful predictability of the surgical approach; however, we consider that the treatment choice should take place in the light of medical history and clinical considerations, and always be evaluated on a case-by-case basis. Further studies and reviews in this field should be performed in order to suggest guidelines for clinicians, although these cases are rare.