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id=\”eael-adv-accordion-f7bb7e9\” data-accordion-id=\”f7bb7e9\” data-accordion-type=\”accordion\” data-toogle-speed=\”300\”>\n <div class=\”eael-accordion-list\”>\n <div id=\”implantologia-computer-guidata\” class=\”elementor-tab-title eael-accordion-header\” tabindex=\”2591\” data-tab=\”1\” aria-controls=\”elementor-tab-content-2591\”><span class=\”eael-advanced-accordion-icon-closed\”><i aria-hidden=\”true\” class=\”fa-accordion-icon fas fa-plus\”></i></span><span class=\”eael-advanced-accordion-icon-opened\”><i aria-hidden=\”true\” class=\”fa-accordion-icon fas fa-minus\”></i></span><span class=\”eael-accordion-tab-title\”>IMPLANTOLOGIA COMPUTER GUIDATA</span><i aria-hidden=\”true\” class=\”fa-toggle fas fa-angle-right\”></i></div><div id=\”elementor-tab-content-2591\” class=\”eael-accordion-content clearfix\” data-tab=\”1\” aria-labelledby=\”implantologia-computer-guidata\”><p><p>L’implantologia computer guidata è un approccio innovativo che con <strong>l’ausilio del computer</strong> rivoluziona e migliora, per il paziente e per il chirurgo, l’intervento di posizionamento degli impianti dentali. Consente di <strong>pianificare tutte le fasi della terapia implantare</strong>: diagnosi, fasi dell’intervento ed esecuzione con precisione, rapidità, zero dolore e spesso senza tagli né punti di sutura.</p></p></div>\n </div><div class=\”eael-accordion-list\”>\n <div id=\”sale-degenze-post-intervento\” class=\”elementor-tab-title eael-accordion-header\” tabindex=\”2592\” data-tab=\”2\” aria-controls=\”elementor-tab-content-2592\”><span class=\”eael-advanced-accordion-icon-closed\”><i aria-hidden=\”true\” class=\”fa-accordion-icon fas fa-plus\”></i></span><span class=\”eael-advanced-accordion-icon-opened\”><i aria-hidden=\”true\” class=\”fa-accordion-icon fas fa-minus\”></i></span><span class=\”eael-accordion-tab-title\”>SALE DEGENZE POST-INTERVENTO</span><i aria-hidden=\”true\” class=\”fa-toggle fas fa-angle-right\”></i></div><div id=\”elementor-tab-content-2592\” class=\”eael-accordion-content clearfix\” data-tab=\”2\” aria-labelledby=\”sale-degenze-post-intervento\”><p><p>Salottini di degenza dedicati al post-intervento chirurgico e a coloro che devono affrontare sedute di più ore. In totale privacy puoi prenderti il tuo tempo per rilassarti, fare il ghiaccio dopo l’intervento, leggere, ascoltare musica nell’attesa di un familiare.</p></p></div>\n </div><div class=\”eael-accordion-list\”>\n <div id=\”sedazione-cosciente\” class=\”elementor-tab-title eael-accordion-header\” tabindex=\”2593\” data-tab=\”3\” aria-controls=\”elementor-tab-content-2593\”><span class=\”eael-advanced-accordion-icon-closed\”><i aria-hidden=\”true\” class=\”fa-accordion-icon fas fa-plus\”></i></span><span class=\”eael-advanced-accordion-icon-opened\”><i aria-hidden=\”true\” class=\”fa-accordion-icon fas fa-minus\”></i></span><span class=\”eael-accordion-tab-title\”>SEDAZIONE COSCIENTE</span><i aria-hidden=\”true\” class=\”fa-toggle fas fa-angle-right\”></i></div><div id=\”elementor-tab-content-2593\” class=\”eael-accordion-content clearfix\” data-tab=\”3\” aria-labelledby=\”sedazione-cosciente\”><p><p>La sedazione cosciente è una <strong>tecnica ansiolitica</strong> che permette alle persone particolarmente ansiose (si parla di <strong>pazienti odontofobici</strong> ovvero che soffrono di “paura del dentista”) di poter affrontare gli interventi odontoiatrici o trattamenti leggermente invasivi o lunghi (come le cure canalari, gli impianti dentali, etc) in uno stato di <strong>estremo rilassamento e senza avvertire né dolore né stress</strong>.</p></p></div>\n </div></div>\t\t</div>\n\t\t”,”editSettings”:{“defaultEditRoute”:”content”}}]}

Le ulcerazioni sono lesioni simili alle erosioni ma più profonde e dolenti. Le più frequenti sono quelle di origine infiammatoria. Le ulcere infiammatorie possono essere su base traumatica, come l’ulcera da decubito, ovvero la classica lesione dolente causata dal trauma della protesi mobile (la classica dentiera che “balla” mentre si mangia o si parla) sulle mucose della bocca. In altri casi possono essere su base autoimmune (pemfigoide delle mucose orali) o immunitaria (eritema multiforme) e infettiva.
Le ulcerazioni di origine infettiva rappresentano spesso uno stato di immunodepressione del paziente (neoplasie, chemioterapia e radioterapia, neutropenie, diabete scompensato, AIDS) o più raramente rientrano in un quadro clinico più complesso, è il caso ad esempio di sifilide o leishmaniosi nell’uomo.
Le ulcerazioni più comuni in assoluto sono le afte.

Le afte sono le ulcerazioni più frequenti in assoluto. Sono le lesioni più fastidiose e odiate dai pazienti, ma al contempo non devono preoccupare. Le afte hanno un’eziologia multi-fattoriale, ovvero possono essere dovute a numerose cause che concorrono insieme. Generalmente le afte sono causate da un trauma di natura chimica o fisica in concomitanza a un’attività anomala del sistema immunitario del paziente.
Nella stragrande maggioranza dei casi le afte rientrano nel quadro clinico dell’Aftosi Minor, caratterizzata dalla comparsa di lesioni ulcerose di diametro inferiore a 1 cm e spesso legate a periodi di stress o al ciclo mestruale. Solo nel 10% dei casi si ha invece l’Aftosi Maior che si manifesta con afte più grandi e profonde.
Le afte rappresentano uno stato di iperattività del sistema immunitario che causa microvasculiti che a loro volta sfociano nell’ulcerazione che di norma dura dai 3 ai 6 giorni. Ad oggi non esiste una cura per prevenirle, tuttavia sono disponibili farmaci ad azione lenitiva che permettono di ridurre il bruciore e il tempo di permanenza in bocca.
Talvolta le afte possono essere una spia di malattie sistemiche. Sono quattro le malattie associate ad aftosi: la celiachia, il morbo di Chron, la rettocolite ulcerosa e il morbo di Behcet.

Il Virus dell’Herpes Simplex (HSV) causa eruzioni vescicolari a carico delle mucose della bocca, secondo due modalità: la malattia sistemica o la forma localizzata. La seconda è la forma più diffusa, molto contagiosa, spesso localizzata al labbro, e dà spesso luogo a recidive.
Il contagio avviene per contatto fisico con soggetti affetti ma anche con la saliva (contatto indiretto). Al termine di un periodo di incubazione di circa 14 giorni si può avere un rash vescicolo-bolloso su mucose orali e peri-orali (si parla di gengivo stomatite erpetica primaria).
In seguito alla risoluzione di questa fase (3 settimane), il virus migra lungo il nervo trigemino raggiungendo il ganglio di Gasser dove rimane quiescente fino a che non si risveglia. Il virus si può riattivare a seguito di numerosi fattori scatenanti quali stress, febbre, esposizione a raggi UV, traumi, ciclo mestruale.
Una volta riattivato il virus migra lungo le fibre assonnati del trigemino e si manifesta nelle solite zone in cui era entrato la prima volta causando le classiche lesioni bollose-vescicolose.

Sono lesioni molto frequenti spesso dovute a candidosi e riscontrabili sul dorso della lingua. In tal caso la diagnosi è semplice perché la patina biancastra è facilmente spatolabile e quindi asportabile meccanicamente tramite strofinamento.
Quando ciò non avviene siamo di fronte a zone di mucosa di iperortocheratosi o di iperparacheratosi, ovvero un’iperplasia dello strato corneo della mucosa che appare bianca perché l’ispessimento nello specifico non fa trasparire i vasi sanguigni della sotto-mucosa.
Nella stragrande maggioranza dei casi le macchie bianche sono dovute a traumatismi da sfregamento, primo fra tutti è il trauma da morsicamento della guancia che però scompare nel giro di 21 giorni dalla rimozione della causa traumatizzante. Nei portatori di protesi mobili sono abbastanza frequenti le forme di ipercheratosi delle creste edentule BARK (bilaterali) e ARK (monolaterali).
Macchie bianche sono spesso associate al fumo di sigaretta. In questi casi sono frequenti le cheratosi da tabacco, ovvero risposte tessutali al fumo che però devono essere tenute sotto controllo perché il fumo è una grave fattore di rischio per il carcinoma del cavo orale.
Spesso la lesione è priva di significato eziopatologico (non se ne conoscono le cause) e viene definita leucoplachia, ovvero “chiazza bianca”. La leucoplachia va tenuta sotto stretta osservazione e talvolta va eseguita biopsia in quanto può trasformarsi in carcinoma del cavo orale.
Per ultimo ma non per importanza ricordiamo il lichen planus orale. Ha l’aspetto di strie biancastre bilaterali che si presentano sulla mucosa delle guance. E’ relativamente frequente (colpisce circa il 2% della popolazione), è una malattia benigna ma comunque non va sottovalutata perché spesso associata a connettiviti e altre patologie sistemiche come il lupus eritematoso sistemico, la sclerodermia, l’artrite reumatoide.

Nella maggior parte dei casi le escrescenze sono dei rigonfiamenti della mucosa orale dovuti a trauma. Un esempio per tutti è la morsicatura delle guance. Possono presentarsi come piccole palline o come rilievi acuminati.
Altre lesioni molto frequenti sono le epulidi, ovvero delle neoformazioni benigne di tipo iperplastico reattivo. Le epulidi sono delle escrescenze della gengiva costituiti da emangiomi (angiomi ematici).
Si trovano frequentemente nelle donne in stato di gravidanza o che assumono anti-concezionali orali, oppure in pazienti che assumono farmaci antiepilettici, immunosoppressori o calcioantagonisti. Spesso la terapia consiste nell’asportazione laser o chirurgica.

Rientrano entrambi nella categoria delle escrescenze. Il papilloma è una piccola lesione peduncolata, di norma solitaria, dal tipico aspetto a cavolfiore bianco e roseo. Solitamente si può ritrovare sul palato e sulla lingua.
Il condiloma invece si presenta come una lesione solitaria o multipla con superficie liscia e acuminata. Sedi più frequenti sono la gola, il palato molle, i frenuli e il dorso della lingua.
Sia il papilloma che il condiloma sono escrescenze legate al papilloma virus (HPV).
La trasmissione è possibile nel cavo orale e avviene per contatto. Quando le lesioni sono multiple spesso si accompagnano a stati di deficit immunitario.
Papillomi e conditomi vanno tenuti sotto controllo se persistenti si possono eliminare tramite asportazione chirurgica ed è bene farli esaminare perché possono portare al carcinoma del cavo orale.