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The predictability of transcrestal sinus floor elevation (tSFE) in elevating the sinus membrane following posterior maxillary ridge resorption has been widely demonstrated. To minimize complications and increase success, a literature search was conducted to validate procedures used for tSFE. A decision tree based upon timing of perforations was then developed to improve membraneperforation management during the procedure. At each surgical procedure, the clinician is encouraged to use size of the perforation, time during the procedure in which the perforation occurred, and resulting symptoms to determine the best treatment approach. This article discusses all possible sinus membrane perforations based on timing of that surgical procedure, allowing the clinician to recognize and successfully rectify this clinical complication while successfully completing the surgery. With this aim, a classification of sinus membrane perforations occurring during tSFE is proposed, simultaneously providing guidelines to effectively manage these complications.

Objective: The surgical extraction of an impacted third molar involves a wide range of consequences such as trismus, swelling, and pain, as well as more significant complications, temporary or permanent, that can manifest altered sensitivity of the tongue or lips. The purpose of this prospective study was to evaluate the effects of three different flaps on postoperative discomfort considering trismus, edema, and pain, after the extraction of impacted third molars. The data derived from the analysis of the surgical trials performed at the Oral Surgery Unit, Department of Surgical, Reconstructive and Diagnostic Sciences, IRCCS Policlinico, University of Milan, directed by Professor F. Santoro, MD. Method and Materials: This study, developed over 2 years, involved 238 patients for a total of 238 extractions of impacted mandibular third molars. The 238 surgeries were performed on 114 men and 124 women: 54 avulsions were performed with the elevation of an envelope flap (Group 1), 48 avulsions through the elevation of a triangular flap (Group 2), and the remaining 136 avulsions were performed using a trapezoidal flap (Group 3). Results: Trismus was significantly reduced (P .05) in patients treated with envelope flap, as was the swelling perceived by the patient (P .05). Pain was closely related to the elevation of a mucoperiosteal flap and osteotomy. Our study does not reveal statistically significant differences between the three types of flap used; however, the number of analgesic tablets taken was lower in cases of elevation of a less traumatic flap (envelope and triangular flaps). Conclusion: The data collected in this study indicate the envelope flap as the most suitable for the reduction of the expression of postoperative complications such as swelling and trismus. Parole chiave: discomfort, flap, impacted third molar, surgery

Ziel: Ziel dieser Studie war die Auswertung des ästhetischen Ergebnisses monophasischer Zirkonoxidimplantate, die in ästhetisch anspruchsvolle Bereiche des Kiefers gesetzt wurden. Material und Methode: In dieser Fallserie werden die Ergebnisse von 12 monophasischen Zirkonoxidimplantaten präsentiert, die bei acht Patienten (sechs Männer und zwei Frauen) in der ästhetischen Zone gesetzt wurden. Für jedes Implantat wurde der Score für die rosa (PES, Pink Esthetic Score) und die weiße Ästhetik (WES, White Esthetic Score) ermittelt. Alle Implantate wurden in frische Extraktionsalveolen gesetzt. Ergebnisse: Die Ästhetikparameter PES/ WES ergaben einen Gesamtdurchschnittswert von 15,5 ± 1,5. Die separate Auswertung dieser Parameter ergab einen PES-Wert von 7,5 ± 1 und einen WES-Wert von 8 ± 1,13. Beide erhaltenen Werte weisen auf ein vollkommen zufriedenstellendes ästhetisches Ergebnis hin. Schlussfolgerung: Mit den gegebenen Einschränkungen im Rahmen dieser Studie erbrachten die Zirkonoxidimplantate in Bezug auf die Ästhetik sowie den Erhalt des periimplantären Weichgewebes ausgezeichnete Ergebnisse.

Purpose: The purpose of this study was to evaluate the esthetic result of monophasic zirconium dental implants, placed in the highly esthetic areas of the jaws. Material and Methods: In this case series the results of 12 monophasic zirconium dental implants placed in highly esthetic areas of 8 patients (6 male and 2 female). For each implant the Pink Esthetic Score (PES) and the White Esthetic Score (WES) were evaluated. All implants were inserted in fresh postextraction sites. Results: The esthetic parameters PES/ WES has given a total average value of 15.5 ± 1.5. Analyzing the two indices individually, the PES has given a value equal to 7.5 ± 1 and the WES has given a value equal to 8 ± 1.13. Both values obtained indicate the achievement of an absolutely satisfactory esthetic result. Conclusion: Within the limits of this study, the zirconium dental implants seems to give excellent results with regard to the esthetic result and for the maintenance of peri-implant soft tissues.