Vincenzo Bruno

The use of a prosthetic template to maintain the papilla in the esthetic zone for immediate implant placement by means of a radiographic procedure

Implant placement in the esthetic zone requires precise preoperative diagnosis and treatment planning combined with excellent clinical skills. One of the most important factors needed to achieve an optimal esthetic outcome, in addition to the 3-dimensional (3-D) positioning of the dental implant, is to maintain or regenerate the interproximal papilla. This article describes a technique to fabricate a template that includes important aspects of rehabilitation in this area.

High risk of temporomandibular disorder in irritable bowel syndrome: Is there a correlation with greater illness severity?

AIM To investigate the prevalence and the risk of temporomandibular disorders (TMDs) in patients with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhoea, and mixed) compared to the general population. METHODS Between January 2014 and December 2015 we enrolled consecutively adult patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy controls (HC) without IBS. At enrollment, we analyzed all patients for the presence of TMDs according to the Research Diagnostic Criteria for TMD. RESULTS We enrolled 91 IBS patients (23 IBS-D, 30 IBS-C and 38 IBS-M) and 57 HC in the study. We found a higher risk of having TMD (OR = 3.41, 95%CI: 1.66-7.01) compared to the HC. The risk of having TMD was independent of IBS-subtype. Multiple regression analysis showed that facial pain was positively related to abdominal pain and higher level of depression. CONCLUSION IBS patients had a more than three times greater risk of TMD compared to HC. The risk of having TMD was similar in different IBS subtypes. IBS patients that also fulfilled criteria for TMD seem to share along with chronic facial and abdominal pain a significant co-occurrence with psychiatric disorders and female preponderance.

Dental erosion in patients seeking treatment for gastrointestinal complaints: a case series

IntroductionEating disorders which embrace anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified can be life-threatening due to general medical complications; however, the diagnosis of eating disorder is often delayed due to a low suspicion index. Gastroenterologists are health care providers who may come into contact with patients with undiagnosed eating disorders; it has been previously demonstrated that patients with eating disorders frequently have a significant association with functional dyspepsia. Signs of dental erosion have been described in patients with eating disorders; hence, they may help to identify eating disorders in patients who present with functional dyspepsia and deny having an eating disorder.Case presentationIn this report we describe three cases (a 25-year-old white woman, a 24-year-old white woman, and a 40-year-old white man) with undiagnosed eating disorders, in which a more comprehensive approach, such as the recognition of dental erosion joined with a careful gastrointestinal investigation, was performed to reach a final diagnosis of an eating disorder.ConclusionsThe screening for dental erosion in patients seeking or receiving medical treatment for dyspeptic symptoms in a gastrointestinal out-patient clinic could be an aid for gastroenterologists to recognize the presence of an underlying eating disorder.A close collaboration with dentists, in addition to psychiatrists, could provide a more favorable treatment outcome.

Computer Guided Implantology Accuracy and Complications

The computer-based method allows the computerized planning of a surgical implantology procedure, using computed tomography (CT) of the maxillary bones and prosthesis. This procedure, however, is not error-free, unless the operator has been well trained and strictly follows the protocol. A 70-year-old woman whom was edentulous asked for a lower jaw implant-supported prosthesis. A computer-guided surgery was planned with an immediate loading according to the NobelGuide technique. However, prior to surgery, new dentures were constructed to adjust the vertical dimension. An interim screwed metal-resin prosthesis was delivered just after the surgery; however, after only two weeks, it was removed because of a complication. Finally, a screwed implant bridge was delivered. The computer guided surgery is a useful procedure when based on an accurate 3D CT-based image data and an implant planning software which minimizes errors.

Implant Prosthetic Rehabilitation with Bone Regenerative Techniques after Fracture of the Upper Central Incisors

A case of implant-bone prosthetic rehabilitation, after the fracture of the maxillary central incisors, which had been treated with grafting of a bone substitute, is reported. This case was followed by the normal procedures of implantology within the traditional timeframe for bone regeneration. However, a barrier membrane was not used which shows that even along with the use of graft material a sufficient amount of bone could be achieved for a subsequent rehabilitation. Therefore, after a five-year follow-up period, osseointegration was maintained with no marginal bone loss.

Clinical Relevance of Bone Density Values from CT Related to Dental Implant Stability: A Retrospective Study

Purpose The majority of the techniques used to assess the primary implant stability are subjective and empirical and can be used during or after the surgery. The aim of this study is to evaluate the bone density prior to surgery, in order to give recommendations to the clinician about the best surgical technique and the type of implant which is needed. Materials and Methods A surgeon operated on 75 patients for 269 implants over the period 2010–2014. He required a CT to plan the surgery and he documented the type, the diameters, and the lengths of the implants, the insertion torque, and the ISQ values. At a later stage another clinician measured bone density and cortical thickness. We endeavoured to get the most accurate superimposition between the implants placed by the surgeon and those placed by the clinician. Results In maxilla ISQ showed a significant positive correlation with HU values detected for coronal-buccal (r = 0.302; p = 0.020) and middle-lingual (r = 0.295; p = 0.023). Torque showed a positive correlation with cortical bone thickness at the middle of the ridge (ρ = 0.196; p = 0.032). Conclusion It is important to take into consideration the Hounsfield Units and the cortical thickness as predictive parameters during the preoperative assessment, with regard to the choice of the implant type as well as the surgical technique.