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The authors report on a patient with Chiari I malformation associated to Waardenburg phenotype, multiple malformations, osteochondrodysplasia and microdeletion of 1q21,1 chromosome, of which they underline the rarity. The pathogenesis connected to the features of neural crest cells-derived structures with mesodermal-derived tissues, mainly in the facial and boundary region of malformed posterior cranial fossa, is discussed. The authors hypothesize that chromosomal microdeletion, acting directly or on contiguous gene(s) or by long range control of gene expression, have modified the function of some developmental genes, causing consequently the association of symptoms observed in the patient. [ABSTRACT FROM AUTHOR]

The authors discuss about the relationships between oculoauriculo- vertebral spectrum (OAVS), a malformative condition affecting eyes, ears and vertebral structures mainly derived from neural crests, and autosomal dominant progressive external ophthalmoplegia (adPEO) - an electron transport chain disorder characterized by palpebral ptosis and muscular symptoms - on the basis of laboratory data and clinical signs in a case belonging to a family in which symptoms of both diseases occur. Hemifacial microsomia and ears abnormalities were the main neural crest cells (NCC) derived signs for OAVS diagnosis. Palpebral ptosis and the associated hyperlactacidemia with high Lactate to Pyruvate ratio were main signs for the suspicion of adPEO, but the diagnosis was proposed by clinical, biochemical, electrophysiological and genetic methods because the biopsy not always is diagnostic, as in our case. The association of two groups of symptoms (malformed, NCCrelated, and myopatic-electron transport related) in the same subject as observed in our case and partially in the family, may be ascribed to nuclear abnormalities and mitochondrial electron transport disorder, respectively, as well as to a possible common etiopathogenetic mechanism. In some cases of OAVS, the malformations may be consequent to oxidative phosphorilation disease (OXPHOS) derangement, as previously demonstrated; the extensive determination of lactacidemia may be important to address the research on OAVS patients in the mitochondrial/OXPHOS genetic domain, with advantage in the knowledge of OAVS pathogenesis. [ABSTRACT FROM AUTHOR]

Lesch-Nyhan syndrome, described in 1964 by Lesch andNyhan, is a X-linked recessive disorder, occurring in 1 : 100000 to 1 : 380000 live births. LNS is characterized by a decrease in activity of hypoxanthine guanine phosphoribosyl transferase, an enzyme involved in purine metabolism, resulting in overproduction of uric acid. Hyperuricemia and neurological features including choreoathetoid spasticity, self-mutilation, and mental retardation clinically characterize this syndrome. In LNS patients the typical feature is loss of tissue from biting themselves with partial or complete amputation of fingers, lips, and tongue. The self-mutilation compares with the eruption of the deciduous teeth. Several drugs trials have been administered to improve self-destructive behavior and invasive treatment approaches, such as extractions of teeth and orthognathic surgery, have been suggested with variable effectiveness. Nowadays prevention is, therefore, the standard of care. The role of dentistry is essential in the management of the self-mutilating behavior, because the teeth represent the main self-injury instrument. This report presents a revision of various therapeutic approaches to manage self-destruction, highlighting the effectiveness of a preventive treatment. It describes a new technique: a resin mouthguard, realized at Gaslini Hospital, to obtain immediate healing of the oral lesions, confirmed in the follow-up period. [ABSTRACT FROM AUTHOR]

Abstract: Periodontal disease, progressing from gingivitis to periodontitis, affects the majority of the world population. Its pathogenesis is related to a complex interaction between environmental, microbial, genetic and other host factors, tobacco smoking being the most important environmental risk factor. Conflicting results are reported in the literature regarding the effects of smoking habits on cytogenetic damage in exfoliated oral cells. We report herein the results of a study evaluating, for the first time, the frequency of micronucleated and binucleated cells in the gingival epithelium. There was no significant elevation of these cytogenetic end-points in 43 subjects as related to smoking habits (never-smokers, ex-smokers, and current smokers) and periodontal disease (mild, moderate, or severe forms of gingivitis and periodontitis). Therefore, the overall data emerging from the present study do not support the evidence for an association between smoking habits, periodontal disease and genotoxic damage in gingival epithelial cells. [Copyright &y& Elsevier]

The promotion of oral health in pediatrics stands as an institutional requirement in countries such as Italy where children's dental disorders still register a high incidence despite high levels of general health. Guidelines indicate the need to target a large age group and stress the relevance of parental education, whom pediatricians and dentists should address to. In this respect, teething is paradigmatic, due to the interactions between inflammation of the gingival mucosa, the possible associations with systemic symptoms as well as the psychological parental component. Teething products include: remedies used in folk medicine (chamomile and rose honey), whose clinical efficacy has not been proved; local anesthetics (lidocaine and benzocaine), easily absorbed by the oral mucosa and able to provide for a rapid, though short-lived relief; salicylates, prescribed by pediatricians in selected cases where the pain and inflammatory component is very high; systemic anti-inflammatory (paracetamol in elixir formulation), prescribed only in particularly serious cases, whereas they are sold over the counter in numerous countries; and - last but not least - film-forming devices containing hyaluronic acid, whose efficacy has been clinically tested in various children disorders of the oral cavity, including teething.

In the present paper we report on a case of oculo-auriculo-vertebral spectrum presenting fluorescence in situ hybridization and comparative genomic hybridization tests negative, hypotonia of some branchiomeric muscles (with velo-pharyngeal insufficiency, dysphagia and nasal voice) and non-branchiomeric muscles (with strabismus and limb hypotrophy). On the basis of the left quadriceps muscle biopsy, showing anisometry and prevalence of type 1 fibers, and on literature data, we underline the relevance of TBX1 gene (regulator of neural crest cells and activator of myogenic factors in branchiomeric muscles development) and of PAX3 gene (present in neural crest, inducing migration of these cells and reported in non-branchiomeric muscles). We conclude that the case of OAVS presented a generalized myopathy and we hypothesize that a cluster of genes strictly neural crest cells related, including TBX1 and PAX3, may be responsible of the branchiomeric and non-branchiomeric myopathy; alternatively, a regulatory mechanism abnormally common to OAVS and velo-cardio-facial syndrome could be present.

Periodontal disease, progressing from gingivitis to periodontitis, affects the majority of the world population. Its pathogenesis is related to a complex interaction between environmental, microbial, genetic and other host factors, tobacco smoking being the most important environmental risk factor. Conflicting results are reported in the literature regarding the effects of smoking habits on cytogenetic damage in exfoliated oral cells. We report herein the results of a study evaluating, for the first time, the frequency of micronucleated and binucleated cells in the gingival epithelium. There was no significant elevation of these cytogenetic end-points in 43 subjects as related to smoking habits (never-smokers, ex-smokers, and current smokers) and periodontal disease (mild, moderate, or severe forms of gingivitis and periodontitis). Therefore, the overall data emerging from the present study do not support the evidence for an association between smoking habits, periodontal disease and genotoxic damage in gingival epithelial cells., (Copyright © 2012 Elsevier GmbH. All rights reserved.)