Valutazione dello spostamento tridimensionale degli impianti in giovani pazienti affetti da EDs riabilitati con overdenture implanto-supportati

Ectodermal Dysplasias syndrome (EDs) are a heterogeneous group of inherited disorders characterized by dysplasia of tissues of ectodermal origin. Complete or partial anodontia are the most frequent dental findings. Prosthetic rehabilitation is recommended from functional, esthetic, and psychological points of view. Because of the anatomical abnormalities of existing teeth and alveolar ridges, conventional prosthetic rehabilitation in young patient is often difficult. Five growing patients (age 9 to 11 years) with oligo- or anodontia were prosthetically rehabilitated. Panoramic film and Cone Bean Computerized Tomography were performed and a resin model of mandibular bone was made. Despite a remarkable multi-dimensional atrophy of the alveolar bone, the insertion of two tapered implants was possible. After a submerged healing period of 2 month, the implants were exposed and abutment connection was performed. Implants were connected with an expansion bar that permits mandibular growth and prosthetic retention. A removable prosthesis was constructed with ball attachments. Mandibular growth was followed and evaluated using the expansion guide and cephalometric radiographs. Mandibular growth in sagittal and transverse direction had no adverse effects on implant position. The expansion bar permitted the undisturbed growth of the mandible. After 4.5 years of follow-up, this study showed that Implant-supported overdenture may improve oral function, phonesis and esthetics. The mandibular rotation accompanying growth had not caused a significant problem relative to the angulation and migration of the implants. Implants can be successfully placed, restored and loaded in growing EDs patients. The cephalometric analysis supported that EDs patients show midface hypoplasia with a class III tendency, which can be avoided by early rehabilitation. Thanks to the good stability and retention of the implant-supported overdenture, patients considered the prostheses as comparable to natural teeth.

Hierarchically organized chitin-based matrices

Chitin is the second most abundant biopolymer on Earth and the most diffused across the known species, being present in more than 70 % of them. It is present in a huge variety of different structures and morphologies being a massive pool of information for new material science approach. This thesis aims to study chitin at different level of organization using diverse approaches. Three main topics are discussed in this manuscript. The first is the use of a bottom-up approach to study chitin nanofibrils self-assembly in water triggering the assembly by pH increment. Successively, the assembly was studied in presence of another pH responsive biomacromolecule, the collagen, to get new composite materials and study how the assembly and the chitin/collagen ratio influence fibroblast’s viability. The second topic focuses on biogenic organized chitin-based matrices, in both Ariolimax californicus and Loligo vulgaris. This study aims to understand the features that give raise to the properties of those matrices. Finally, in the last section a top-up approach was used to exploit natural hierarchically organized chitinous matrices to obtain organized functional materials introducing a catechol on the free amino group of deacetylated chitin (DA 77 %). In conclusion, this study of chitin at different level of organization emphasized different novelties depending on the organization level studied. Moreover, this thesis gives many possibilities for future bioinspired routes to get highly organized materials, or for highly organized functional materials based on natural chitin-based matrices.