Leonardo Romano

Introduction: This pioneering study delves into the dynamics of intraoral pressure, examining its consistency across different subjects and conditions. The null hypothesis is a different pressure at rest between the intraoral zone and the atmospheric pressure. Materials and Methods: Utilizing a novel apparatus and method, based on the concept of communicating vessels, the research aimed to measure resting intraoral pressure at the vestibular level. Results: The findings revealed no significant variations in intraoral pressure across different individuals or under varying sectors of analysis or wakefulness versus sleep state. The average resting pressure in the oral vestibule was identified to be −1.25 mmHg, suggesting a residual relative negative pressure post‐swallowing that could aid in various physiological functions. Discussion: The values found align with previous studies on swallowing and with studies that have attempted to measure the intraoral pressure exerted by the muscles of cheeks and lips. The study further supports existing theories on peri‐implant tissue maturation and the role of oral vacuum in promoting gingival growth. Specifically, it suggests a potential impact of the negative pressure gradient on gingival microcirculation as an explanation for the volumetric growth of gingival tissue. Conclusion: Within the limitation of the present sample size, this research confirms the hypothesis related to intraoral pressure in understanding various physiological processes within the oral cavity, paving the way for further exploration in this domain with implications for dental and oral health practices.

Background: This article describes a novel approach for the reconstruction of vertical and horizontal bone defects in the anterior maxilla that involves the use of an autogenous block graft harvested and rotated from the same surgical site. A case with a 3-year follow-up, featuring a vertical-horizontal bone deficiency, is presented as an example. Case presentation: A bone deficiency is presented at the 2.2 position. Through the use of a piezoelectric instrument, a bone block apical to the defect is harvested. The osteotomy produces a preoperatively planned volume and shape of the bone block, which is then perfected, flipped upside down and fixed using osteosynthesis screws, with the thickest portion in the crestal area. The reconstruction provided sufficient volume for the implant rehabilitation. After 3.5 years, bone remodelling appears contained; the horizontal volume is maintained. Conclusions: When residual anatomy appears eligible for this approach, this technique may represent an alternative to ectopic bone harvesting, thus reducing the patient’s discomfort and surgical invasiveness.

An implant’s thread design plays a key role in enhancing primary stability by optimising the distribution of loading forces and biomechanical structural interlocking. An increase in bone-to-implant contact (BIC) surface availability affects osseointegration timing and leads to different biomechanical behaviours. To assess their theoretical impacts on osseointegration functionality, this study aims to analyse and compare the surface areas of two different thread designs: progressive knife-edge and V-shaped metric ISO ones. Six implant models are virtually created, with progressive knife-edge threads, non-self-tapping ISO threads, and ISO threads with tapping areas, considering two arbitrary diameters (3.8 mm and 4.6 mm). For both diameters, the models also have identical lengths (9.5 mm) and external outlines. The total, superior half, and inferior half external surface areas are measured using a digital tool (SolidWorks 2023 SP 5.0, Dassault Systèmes, Waltham, MA, USA). Then, the percentage difference in external surface area (ΔESA) is calculated. A greater ΔESA is found in the knife-edge design compared to the ISO thread self-tapping implants for the 4.6 mm diameter (ΔESA = +9.9%). However, for the 3.8 mm diameter, the ΔESA is −1.5% in favour of the ISO self-tapping model. Considering the apical half of the models, the ΔESA is always greater in the knife-edge models, varying from +9.3% to +23.5%. Implants with progressive knife-edge threads offer a significantly larger external surface area than those with ISO threads for the 4.6 mm rather than the 3.8 mm diameter. Considering the apical halves of the implants, the tapping area negatively affects the ΔESA, as well as the ISO thread design. Future research is needed to investigate whether the inspected surface area differences correspond to significant primary and secondary stability variations.