Publications by authors named "Fortunato Alfonsi"

This study aimed to describe a case of simultaneous guided bone regeneration (GBR) and implant placement in a patient with prior aesthetic implant failure, focusing on achieving optimal aesthetic and functional outcomes, and to perform a literature review of the current evidence. A 38-year-old male presented with an improperly positioned implant at the level of the right upper central (tooth 2.1), leading to aesthetic and functional issues.

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Purpose: Immediate implant placement is a reliable solution to replace hopeless teeth, but this procedure may be associated to an increased risk of soft tissue complications in case of thin biotype. The use of tissue-level implants with a convergent transmucosal profile has been advocated to increase space for soft tissue, contributing to improve their stability and esthetics. The aim of this retrospective study was to evaluate the esthetic outcomes and the Patient-Reported Outcome Measures (PROMs) of immediately placed implants with a convergent transmucosal profile.

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The success of implant-supported fixed complete dental prostheses (ISFCDPs) depends on multiple factors: some are related to the fixtures, such as fixture material, surface characteristics, positioning, and type of connection to prosthetic components; others are related to the prostheses, such as design and materials used. Zirconia is a material widely used in fixed prosthodontics, whether on natural teeth or on implants, with excellent results over time. Regarding the use of zirconia for ISFCDPs, the 2018 ITI Consensus Report stated that "implant-supported monolithic zirconia prostheses may be a future option with more supporting evidence".

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The basis for dental implant success comes not only with the titanium implant osseointegration but also depends on other factors such as the development of a soft tissue barrier, which protects the peri-implant bone from the oral environment. The characteristics of surfaces in contact with peri-implant soft tissues may affect the capacity of peri-implant mucosal cells to create a tight seal around the implant, thus influencing long-term implant success. Many histological studies on animals have been conducted on different materials to better understand their influence on peri-implant soft tissues, with the limitation that results from animal studies cannot be fully translated in humans.

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The management of patients under treatment with Direct Oral Anticoagulants (DOACs) has led clinicians to deal with two clinical issues, such as the hemorrhagic risk in case of non-interruption or the risk of thromboembolism in case of suspension of the treatment. The primary aim of this retrospective study was to evaluate the incidence of perioperative bleeding events and healing complications in patients who were under treatment with Rivaroxaban and who received dental implants and immediate prosthetic restoration. Patients treated with Rivaroxaban (Xarelto 20 mg daily) and who needed implant rehabilitation were selected.

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Background: Dental implants placed in medically compromised patients have predictable outcomes and a high rate of survival, compared to those placed in healthy patients. The aims of this study were to observe and compare implant survival/success rates and soft tissue response to tissue-level implants placed in healthy and medically compromised patients with a 1-year follow-up.

Methods: Seventy-two patients, 36 healthy patients (20 females and 16 males) and 36 medically compromised patients (18 females and 18 males) affected by cardiovascular diseases (arrythmia, hypertension, atrial fibrillation, bypass and pacemaker surgery), depression, endocrine metabolic diseases (hypercholesterolemia, type II diabetes, Hashimoto's thyroiditis), gastrointestinal diseases (gastritis, hiatal hernia, gastric ulcers), asthma, osteoporosis or glaucoma received one tissue-level implant.

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Article Synopsis
  • The study explored the impact of customized healing abutments versus standard ones on tissue healing around immediate dental implants following bone grafting.
  • A total of 36 patients participated, with the results showing that those with customized abutments had better outcomes regarding tissue health (higher Papilla Index) and less bone loss after 4 and 12 months.
  • The findings suggest that customized healing abutments can enhance healing and esthetics compared to standard options for patients receiving immediate implants.
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Medication-related osteonecrosis of the jaw are bone exposures in the maxillofacial region that does not heal after 8 weeks from the observation of a health care provider in patients with history of the intake of antiresorptive agents and no previous irradiation of the craniofacial region. Initially attributed only to the intake of bisphosphonates they have later been associated also with the intake of other classes of antiresorptive medications.This retrospective study analyzed records from patients with documented medication-related osteonecrosis of the jaws treated in our unit.

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Purpose: The purpose of the present cohort study was to investigate the 3-year efficacy and clinical performance of implant-supported rehabilitations in posterior mandibles augmented with the sandwich osteotomy technique.

Materials And Methods: Twenty-three partially edentulous patients who developed atrophy of the posterior mandible (residual ridge height, 3 to 7 mm) were treated (32 surgical sites) with vertical bone augmentation using interpositional equine cancellous bone blocks and porcine corticocancellous bone particulate. All implants were placed 4 months after augmentation and were loaded with fixed dental prostheses.

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Background: Consistent bone changes occur after tooth removal, often compromising the success of implants placed within the socket left to natural healing The long-term effect of ridge preservation on implant outcomes is still unclear.

Purpose: The aim of the study was to assess success and survival rates of implants placed in extraction sockets, with spontaneous healing, or grafted with cortical porcine bone, or collagenated corticocancellous porcine bone.

Materials And Methods: Ninety patients in need for a single premolar/molar tooth extraction and an implant treatment were selected for the present study.

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Background: Implant stability is commonly related to insertion torque. Recently, it has been suggested that higher insertion torque may lead to greater bone resorption.

Purpose: The aim of the present randomized clinical study was to evaluate the role of different insertion torque values in terms of implant success, marginal bone loss, and facial soft tissues recession.

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After a tooth extraction both hard and soft tissues undergo dimensional changes. The use of a ridge preservation technique at the moment of the tooth extraction could help could help to prevent the volume loss, thus simplifying the subsequent prosthetic and/or implant therapy. Some studies were conducted in order to examine the biomaterials and the surgical technique used for ridge preservation procedures.

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Objectives: To evaluate and compare clinical and histological changes after ridge preservation procedures with those of spontaneous healing.

Materials And Methods: Ninety patients were enrolled in the present randomized controlled clinical trial and underwent single-tooth extraction in the premolar/molar areas. Thirty sites were grafted with collagenated cortico-cancellous (coll), 30 sites with cortical (cort) porcine bone and 30 sites underwent natural healing.

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Objectives: The aim of this randomized clinical trial was to analyse and compare the volumetric changes after ridge preservation procedures using two different biomaterials and to evaluate associations between outcome variables and pristine three-dimensional aspects of the ridges.

Materials And Methods: Twenty-eight patients subjected to single-tooth alveolar ridge preservation were enrolled in the present multicentre, single-blind, prospective and randomized clinical trial. Fourteen sites were randomly allocated to each experimental group.

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Background: Oroantral communication (OAC) can be defined as a pathologic space created between the maxillary sinus and the oral cavity.This communication and subsequent formation of a chronic oroantral fistula is a common complication often encountered by oral and maxillofacial surgeons.Although various techniques have been proposed in published studies, long-term successful closure of oroantral fistulas is still one of the most difficult problems confronting the surgeon working in the oral and maxillofacial region.

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Objective: The study shows how the influence of titanium surfaces on human mesenchymal stem cells differentiates toward osteocytes lineage and how, after growth, on machined titanium disk or etched titanium disk, changes, in gene expression for RUNX1, CTNNB1, SP7, and DLX5.

Methods: Genes were analyzed by means of quantitative real-time polimerase chain reaction. Osseo genic lineage differentiation was also tested by means of the catenin-β1 immunofluorescence, induced osteoblasts, which represented the internal control.

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Background: The insertion torque value has been extensively used as an indicator for implant primary stability, which is considered a determining parameter for the implants success.

Purpose: The primary goal of the present randomized clinical trial was to evaluate and compare the clinical outcome for implants placed with high insertion torque (between 50 Ncm and 100 Ncm) and regular insertion torque (within 50 Ncm) in healed ridges.

Materials And Methods: Partially edentulous patients, missing one or more mandibular or maxillary teeth, having an adequate amount of bone, requiring implant placement, were randomized to receive Blossom CT implants with regular insertion torque (<50 Ncm) or CT implants with high insertion torque (≥50 Ncm).

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Background: Several materials have been used for ridge preservation after tooth extraction. This 5-year prospective single-cohort study is aimed at evaluating the success rate, marginal bone level (MBL), soft tissue stability, and subjective patient evaluation of implants placed in fresh extraction sockets with the use of a flapless technique and a xenograft to treat the peri-implant bone defect.

Methods: Patients requiring a single implant in fresh extraction sockets were selected.

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Objective: The purpose of this prospective single cohort study was to evaluate the use of xenograft and collagen membranes in treating full or partial buccal bone defects of fresh extraction sockets in the esthetic zone.

Materials And Methods: Thirty-three patients requiring tooth extraction in the anterior maxillary area and showing a complete or partial buccal bone plate deficiency (more than 2 mm) were consecutively enrolled and treated. Corticocancellous porcine bone and platelet-rich fibrin (PRF) with a collagen membrane were used to graft the extraction sockets, and the membranes were left exposed to the oral cavity with a secondary soft tissue healing.

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