Search

The intraoral scanner represents an important innovation in the world of dentistry, capable of transforming and digitizing conventional workflows and significantly improving communication with the patient, especially in pediatric age. The aim of this study is to investigate how digital dentistry, using the intraoral scanner, can interact in the communicative trinomial dentist–pediatric patient–parents and how this tool can be useful in communicating and understanding the received message. The value of the introduction of digital dentistry on communication schemes is evaluated by administering a questionnaire of 17 questions. A sample of 100 children aged between 6 and 12 years was studied. Of the sample of children/parents included in the study, 50 were re-examined 4 weeks after the first visit to re-administer the questionnaire. Internal consistency, assessed through Cronbach's alpha, was adequate, being alpha equal to 0.728. Test–retest reliability was assessed with Cohen's kappa index for dichotomous variables (percentage of agreement was >85.71%), and for the discrete variables it was assessed with the Intraclass Correlation Coefficient (ICC). The reliability was moderate (0.5 < ICC < 0.75) for Q4, Q9, Q11 and Q1; for the other answers, the reliability was poor (ICC < 0.5) and not statistically significant. The digital approach is confirmed not only as a powerful innovation from an engineering or clinical point of view, but also as a useful tool for a more effective communication in the approach to pediatric patients. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the present study is the three-dimensional (3D) analysis of molar and incisor movements that occur during the correction of the upper midline deviation by using the Mesial-Distalslider appliance. Materials and Methods: A total of 20 consecutive patients (12 women and 8 men; mean age 19.6 ± 11.1 years) were selected from the Orthodontic Department of Heinrich-Heine University of Düsseldorf. To correct the upper midline deviation (>2 mm), the patients were treated with asymmetric mechanics (mesialization on one side and distalization on the contralateral side) with the aid of Mesial-Distalslider. Dental casts were taken for each patient before (T0) and after the treatment (T1). The casts were 3D digitized and the models were superimposed on the palatal anterior region. Three-dimensional molar movements and sagittal incisor movements (proclination and retroclination) were assessed for T0 and T1. Results: At the end of the treatment, the total movements of the molars resulted in 4.5 ± 2.2 mm (antero-posterior direction), −0.4 ± 2.4 mm (transverse direction) and 0.3 ± 0.9 mm (vertical direction) on the mesialization side, and −2.4 ± 1.7 mm (antero-posterior direction), −0.5 ± 1.5 mm (transverse direction) and 0.2 ± 1.4 mm (vertical direction) on the distalization side. Incisor displacement was 0.9 mm ± 1.7 (mesialization side) and 0.6 mm ± 0.7 (distalization side). Conclusion: The Mesial-Distalslider appliance could be considered a valuable tool in orthodontic treatment for upper midline correction. Within the limits of a retrospective study, asymmetric molar movements appeared possible without clinically relevant anchorage loss. [ABSTRACT FROM AUTHOR]

Background: Early mixed dentition represents a critical phase since crowding conditions can occur. The interceptive resolution of dental crowding allows favorable arch and occlusal development. The aim of the present investigation was to evaluate dentoalveolar changes of clear aligner treatment planned to manage lower incisor crowding, loss of arch length, and midline deviation in early mixed dentition. Methods: A total of 13 patients (7 females, 6 males, 9.4 ± 1.2 age) treated with clear aligners were selected. Arch dimensions and incisor inclinations were evaluated before (T0) and at the end of interceptive treatment (T1). A paired t-test was chosen to compare T1–T0 changes. The level of significance was set at 5%. Results: The greatest significant increase in mandibular width was observed at the level of the first deciduous molars (+2.44 ± 1.4 mm), followed by the second permanent molars (+2.16 ± 1.4 mm). Lower arch length and arch depth showed a statistically relevant increase (2 ± 0.6 mm and 4.5 ± 1.6 mm, respectively). The mean lower dental midline changes were statistically significant (1.42 ± 0.73 mm). Conclusions: Early treatment with clear aligners, including the combination of transversal arch development, maintenance of leeway space, and guidance of eruption, represents a valid treatment strategy in early mixed dentition to manage arch crowding and occlusion development. [ABSTRACT FROM AUTHOR]

Background: The injection of local anesthetics is the procedure that still causes the most fear and anxiety in a dental session; to minimize this problem, we can use topical anesthesia. The aim of this study is to analyze the tolerability and the clinical efficacy in the control of pain, during the subsequent injection of the local anesthetic, of an experimental anesthetic patch with a new formulation, which was previously tested in gel formula. Methods: A total of 150 children, aged 4 to 9 years, were included in the study. Each patient was treated using three different pre-anesthesia methods (placebo gel, experimental gel, and experimental patch), according to a split-mouth procedure, within a week of each other. The injection pain was analyzed using the WBFPRS and FLACC scales. Patients' caregivers' satisfaction was recorded at the end of the procedures. The data were analyzed using one-way ANOVA-RM, Wilcoxon–Mann–Whitney, Mann–Whitney U, and χ2 tests. Results: In this study, significantly higher pain ratings were observed with the topical placebo gel and lower pain ratings were observed with the experimental patch. Conclusion: The use of the patch proved to be very effective in reducing pain both subjectively and objectively, in the absence of both local and systemic side effects, validating its use in the oral mucosa. [ABSTRACT FROM AUTHOR]

Background: This review was based on the following question: "What is the state-of-the-art regarding the effect of zinc exposure in the oral cavity on a population of adults and children, compared to dental products containing materials other than zinc, considering in vivo (clinical trials and observational studies) and in vitro studies?" according to a PICOS strategy format. This study aims to analyze zinc application in dental materials, with different compositions and chemical formulations, considering how mechanical and biological properties may influence its clinical applicability. Methods: In vivo (clinical trials: controlled clinical trials (CCTs) and randomized controlled trials (RCTs); and observational studies: case control and cohort studies) trials or in vitro studies published in English or Italian during the last 10 years on children and adult patients with zinc exposure were included by three different reviewers using the MEDLINE (via PubMed), Scopus, and Web of Science electronic databases. Results: Titles and abstracts were evaluated following the eligibility criteria. The full texts of eligible studies were then reviewed against the inclusion/exclusion criteria. Scientific and technical information of the 33 included studies were collected into evidence tables, reporting data on in vivo and in vitro studies. A narrative approach was adopted. Conclusions: Antibacterial activity was found to be the most studied property of zinc, but further investigations are needed to establish adjuvant zinc therapies in patients with oral disease. [ABSTRACT FROM AUTHOR]

Novel foods, including edible insects, are emerging because of their nutritional characteristics and low environmental impacts and could represent a valid alternative source of food in a more sustainable way. Edible insects have been shown to have beneficial effects on human health. Insect-derived bioactive peptides exert antihypertensive, antioxidant, anti-inflammatory, and antimicrobial properties and have protective effects against common metabolic conditions. In this review, the roles of edible insects in human health are reported, and the possible applications of these peptides in clinical practice are discussed. A special mention is given to the role of antimicrobial peptides and their potential applications in controlling infections in orthodontic procedures. In this context, insects' antimicrobial peptides might represent a potential tool to face the onset of infective endocarditis, with a low chance to develop resistances, and could be manipulated and optimized to replace common antibiotics used in clinical practice so far. Although some safety concerns must be taken into consideration, and the isolation and production of insect-derived proteins are far from easy, edible insects represent an interesting source of peptides, with beneficial effects that may be, in the future, integrated into clinical and orthodontic practice. [ABSTRACT FROM AUTHOR]

This paper aims to represent the orthodontic treatment of two young patients with skeletal Class I relationship and unilateral impacted canines (case 1 with palatally displaced canine and case 2 with buccally displaced canine). Before starting full-mouth alignment, canines are moved away from the roots of the neighbouring teeth. The protocol involved a surgical phase carried out in order to expose the canine and traction it with TADs (temporary anchorage devices) and an orthodontic phase performed to finalize the alignment. The canines were moved through vertical and distal force vectors by using TADs as well as a cantilever spring. As soon as the crown of the canine was fully visible, digital impressions were taken to start the digital planning of the orthodontic phase. At the end of the treatment, results show a control of the facial aesthetics both from the frontal and lateral perspectives with a harmonious profile. The molar and canine Class I relationship was achieved with the recovery of the impacted canines and the overbite and overjet were normalized. [ABSTRACT FROM AUTHOR]

The aim of the current study was to assess patient and parental satisfaction following treatment during mixed dentition with two removable orthodontic devices: elastodontic appliances (EAs) and clear aligners (CAs). Consecutive patients below the age of 12 years who had completed the active phase of EA or CA therapy were recruited. A dedicated written questionnaire divided into four sections was used to measure parental and patient satisfaction regarding treatment experiences and treatment outcomes. The total sample included 56 subjects: 28 belonged to the EA group (7 girls and 21 boys; mean age 11 years); 28 belonged to the CA group (12 girls and 16 boys; mean age 9 years). Patients and parents of both the EA and CA groups were satisfied with the treatment experiences and outcomes. According to parental reporting, EA treatment was significantly more painful than CA therapy (p = 0.003), but this was not confirmed by the patients (p = 0.100). Both parents and patients reported EAs being significantly more difficult to wear than CAs (p < 0.001 and p = 0.001, respectively). Functional improvements were reported, including a reduction in grinding sounds in the CA group (p = 0.020) and breathing improvements in the EA group (p = 0.023). According to the parents, school life and social life were significantly improved in the CA group, as compared to the EA group (school life p < 0.001, social life p = 0.001). Finally, parents belonging to the CA group found that their child's treatment was much shorter than expected (p = 0.003). [ABSTRACT FROM AUTHOR]

The aim of the present study was to test a new topical anesthetic gel with a different formulation (10% lidocaine, 10% prilocaine) to analyze its effectiveness in pain control, during the subsequent injection of local anesthetic, and the presence of any side effects. Methods: The study's research design was a randomized controlled clinical trial on 300 children, aged 5–8 years, divided into two groups, each of 150 patients, according to pre-injection procedures (presence or absence of topical anesthesia). The injection pain was analyzed using the Wong-Baker Faces Pain Rating Scale (PRS) and the Face, Legs, Activity, Cry, Consolability Scale (FLACC). At the end of the procedures, patients' parents' satisfaction was recorded. The data were analyzed using the Student's T test, Mann–Whitney U test and Chi-square test. Results: There were statistically significant differences between the two groups both in the PRS and FLACC ratings. Both in subjective and objective pain evaluations, significantly higher pain ratings were observed in the group without topical anesthesia. There was also a statistically significant difference in terms of patients' parents' judgment, as in the group with the use of topical anesthetic the level of parental satisfaction is statistically higher. Conclusion: The experimental anesthetic has proved very effective in its use as a topical gel in both pain measurement scales, thus validating its use on the oral mucosa, for its pharmacological and psychological effect, in the total absence of local and systemic side effects. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder that is very common in pediatric patients. In the literature, there are very few studies concerning the association between OSAS and class III malocclusion in children. The use of a rapid maxillary expander (RME) in association with the Delaire mask is a common treatment protocol for class III malocclusion. The aim of this work was to evaluate the cephalometric variations of upper airway dimensions and OSA-related clinical conditions after orthodontic treatment with an RME and the Delaire mask, as recorded in pediatric patients with a class III malocclusion who were affected by OSAS. In this preliminary study, 14 pediatric patients with mixed dentition, aged between 6 and 10 years, were selected. All patients were treated with an RME and the Delaire mask. Pre- and post-treatment cephalometric radiographs were traced, analyzed, and compared. The results demonstrated a significant increase in the upper airway linear measurements and the nasopharyngeal and oropharyngeal dimensions (p ≤ 0.05). This increase creates an improvement in airway patency and in OSAS-related clinical conditions. The use of the RME in association with the Delaire mask can be effective in the treatment of pediatric patients with a class III malocclusion who are affected by OSAS. [ABSTRACT FROM AUTHOR]

Obstructive Sleep Apnea (OSA) in children needs a multidisciplinary approach. Even if the first-line treatment of pediatric OSA is adenotonsillectomy, nowadays rapid palatal expansion (RPE) is considered a valid additional treatment. The aim of this study is to evaluate cephalometric changes in upper airways dimensions after rapid palatal expansion (RPE) in children suffering from Obstructive Sleep Apnea (OSA). A total of 37 children (range age 4–10 years) with diagnosis of OSA referred to Dentistry Unit of Bambino Gesù Children's Research Hospital IRCCS (Rome, Italy) were included in this pre-post study and underwent lateral radiographs at the start (T0) and at the end (T1) of a RPE treatment. Inclusion criteria were: diagnosis of OSA confirmed by cardiorespiratory polygraphy (AHI > 1) or pulse oximetry (McGill = >2), skeletal maxillary contraction evaluated by presence of posterior crossbite. A control group of 39 untreated patients (range age 4–11 years), in good general health, was set up. A paired T-test was used to investigate the statistical differences between T0 and T1 values in both groups. The results showed a statistically significant increase of nasopharyngeal width in the treated group after RPE treatment. Moreover, the angle that identifies mandibular divergence compared to palatal plane (PP-MP°) was significantly reduced. In the control group, no statistically significant differences were observed. The present study showed that RPE treatment determines a significant sagittal space increase in the upper airways space and a counterclockwise mandibular growth in children with OSA compared to a control group. These results suggest that a widening of the nasal cavities induced by RPE may support a return to physiological nasal breathing and promote a counterclockwise mandibular growth in children. This evidence confirms the crucial role of the orthodontist in the management of OSA in pediatric patients. [ABSTRACT FROM AUTHOR]

Dental caries is a public health problem in children and is more prevalent in low-socioeconomic-status groups. The aim of this study is to assess the association between migrant families and the prevalence of caries among young children in Italy. This is a cross-sectional study. In the age range of 3 to 5 years, a total of 266 migrant children and 301 nonmigrant children were examined in three Italian charity dental centers. All children had families with low SES. The dmft was determined by intraoral examination performed by six pediatric dentist specialists to assess their dental health. In this study, the prevalence of caries (71%) and the mean dmft (3.68; SD: 1.52) of migrant children were statistically significantly higher than the percentage (52%) and the mean dmft of the nonmigrant control group (3.10; SD: 1.65) with no differences between genders. For the migrant children, the mean (0.49; SD: 0.32) of restorations (filled teeth) was statistically significantly lower than that of nonmigrant children (1.20; SD: 0.48). This study highlights that dmft values and the prevalence of caries are higher in migrant children than in nonmigrant children. In addition, the control group shows a higher level of dental caries than the national mean. [ABSTRACT FROM AUTHOR]

Tooth decay remains one of the most common diseases in children, although it is a preventable injury and despite significant advances that has been made in terms of attention and care for oral hygiene. Several studies have shown the association between prevalence of tooth decay in children and parents' incorrect oral care habits, with a low educational level and a low socioeconomic background. The question that arises concerns the actual oral hygiene knowledge of mothers, fathers, family members or caregivers of young patients; therefore, the aim of this review is to investigate the genesis of gaps in the topic. A literature search was conducted through the Scopus and PubMed search engine and ended in May 2022; only studies from the past 20 years were included. Current evidence suggests that parents and caregivers still have little knowledge about their children's oral health: there is not enough awareness about the importance of preventing oral diseases, due to poor attention to good oral hygiene but also lack of information from health professionals and institutions. In the future, all the professionals involved in the pregnant woman's care should increase parents' knowledge, solve their doubts, collect and compare data in order to design effective intervention programs. [ABSTRACT FROM AUTHOR]

Aim: The following case report aims to show a novel orthopaedic appliance to reduce the side effects of the orthopaedic Class III treatment through the use of two acrylic splints combined with a PowerScope device. Materials and Methods: This case report describes the treatment of a 6-year-old patient with a skeletal Class III relationship with a maxillary deficiency and a severe hyperdivergency. The patient underwent a sagittal orthopaedic treatment with a PowerScope device for 12 months. The retention period lasted 4 months. Results: The response of the craniofacial complex to the active orthopaedic treatment of the Class III malocclusion with the PowerScope™ device splints consisted of significant changes in maxillary growth and position. Both angular and linear sagittal measurements of the maxilla showed improvements during active treatment, respectively, of 0.6° and 1.2 mm (SNA from 75.8° to 76.4°; maxillary length from 38.8 mm to 40 mm). These effects allowed for a highly significant improvement in the maxillomandibular skeletal relationships. ANB improved by 1.6° and Wits appraisal by 4 mm. Using this appliance in a hyperdivergent patient, we obtained a vertical control of the mandible with a SN/Go-Gn stable value at 40° and a significant improvement of the ANS-PNS/GoGn angle from 30° to 28°. Conclusion: The Class III orthopaedic treatment with the PowerScope™ telescopic and NiTi spring device mounted on the upper and lower resin splints in a Class III correction offered good vertical control during the early orthopaedic treatment by improving the skeletal discrepancy and controlling the hyperdivergency, which is one of the most difficult factors to control in Class III malocclusions. [ABSTRACT FROM AUTHOR]

Rapid maxillary expansion (RME) is considered an effective treatment in the management of sleep-disordered breathing (SDB) and malocclusions in pediatric patients, not only because it is able to correct the transverse maxillary deficiency, but it also widens the floor of the nasal cavities, leading to a drastic and immediate reduction in air resistance and facilitating a normal nasal breathing pattern. The aim of this study was to evaluate cephalometric changes in the upper airway's dimensions and facial morphology in pediatric SDB patients treated with RME, comparing data with a no-SDB group treated with RME for malocclusion. In this retrospective study, pre-treatment and post-treatment cephalometric variables were measured on lateral skull radiographs from 20 SDB pediatric patients (nine males and 11 females) aged 6 to 9 years (mean age 7.61 ± 0.6), treated with a rapid maxillary expander, and 20 control patients without SDB (nine males and 11 females) aged 6 to 11 years (mean age 8.4 ± 0.5). In both groups, there were statistically significant changes in the variables indicating the airway's dimensions and mandibular sagittal position in relation to the cranial base, with a skeletal class II correction in SDB children. Rapid maxillary expansion is associated with an increase in upper-airway dimensions in SDB children, as well as in control healthy subjects, with a possible correction of class II relationship. [ABSTRACT FROM AUTHOR]

The aim of the present study is to represent the orthodontic treatment of a young patient with a skeletal Class III malocclusion(Wits Appraisal −9 mm), in which the extractions of the first lower premolars were performed to obtain a class III camouflage using direct temporary anchorage devices (TADs). The patient reported a history of three years of orthodontic treatment at another clinic and the radiographic evaluation revealed an important impairment of the upper root incisors. A treatment was performed with a fixed appliance in the upper and lower arches using an archwire sequence of 0.16 CuNiTi, 19 × 25 CuNiTi, 19 × 25 SS and was carried out in 18 months. Post-treatment records of our patient show a control of facial esthetics from the frontal and lateral perspectives, with a harmonious soft-tissue profile. A Class I canine was achieved and her overbite and overjet were normalized by retracting the mandibular anterior teeth and carrying out a bodily mesialization of the posterior sector into the extraction space. In conclusion, the "pseudoankylosis system" used in this case allowed the desired result to be achieved with minimal change to the lower incisal inclination and without overloading the anterior upper and lower sectors, thus reducing the risk of further root resorption and patient compliance. [ABSTRACT FROM AUTHOR]

Background: Uncooperative children require sedative approach for dental treatment. The aim was to assess the effectiveness of Propofol in "Non-Operating Room Anesthesia" (NORA) for paediatric dental treatment; intraoperative side effects; postoperative side effects; post-discharge effects. Methods: a prospective study, involving 109 uncooperative children undergoing sedation in NORA using Propofol for dental treatment, was performed. Working sessions, success/failure, intraoperative and postoperative side effects, number of treatment; type of procedure were assessed. Parents completed a post-discharge questionnaire on: pain; crying; fever; vomiting; headache; drowsiness; excitability; irritability; ability to eat; drugs and medical care needing. Results: Success: 96.7%. Intraoperative side effects: 33.3%. Postoperative side effects: 6.4%. Statistically significant association between: intraoperative side effects and age (p = 0.001), health status (p = 0.0007), weight (p = 0.038), respectively; intraoperative side effects and number/type of dental treatment (p = 0.0055) and scaling (p = 0.0001), respectively. For post-discharge questionnaires, statistically significant association between: age and crying (p = 0.0001) and headache (p = 0.002), respectively; health status and crying (p = 0.015) and drugs needing (p = 0.04), respectively; weight and crying (p = 0.0004); extraction and pain (p = 0.0001) and crying (p= 0.0073), respectively; scaling and crying (p = 0.04), excitability and irritability (p = 0.03), respectively. Conclusion: Propofol in NORA was effective with minimal side effects. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the dimensions of the upper and lower arches in children affected by OSAS with different levels of severity of obstruction.Methods: Twenty-seven Caucasian children (14 males, 13 females; mean age 6, range 5.2-6.1 years) with a diagnosis of OSAS determined by polysomnography were enrolled in this study. The dimensions of both dental arches were measured, and the data were compared among children affected by severe, moderate, and mild OSAS.Results: Statistically significant differences among the three groups revealed that children with severe OSAS had the highest values of upper intercanine and intermolar distances in the sample.Discussion: A severe OSAS grade (AHI > 10) is associated with statistically significantly higher upper intercanine and intermolar distances compared with mild and moderate grades. An early approach to OSAS in children with late primary dentition is auspicated in order to prevent an influence on dental arches growth. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to evaluate the effects of ultra-low-frequency transcutaneous electrical nerve stimulation (ULF-TENS) on pain and electromyographic values in subjects affected by temporomandibular disorders. Methods: A retrospective evaluation of 80 non-consecutive patients (58 women, 22 men, mean age 35.3 ± 9.9 years) suffering from pain associated with temporomandibular disorders was performed. The sample was treated with ULF-TENS, and outcomes were evaluated by anamnestic index, dysfunction index, visual analog scale, and surface electromyography of the masticatory muscles. Results: An improvement was seen in pain and electromyographic values. The visual analog scale showed a mean decrease from 8 to 2; surface electromyographic values in the masseter area decreased from 2.7 ± 0.1 to 1.5 ± 0.1. Conclusion: ULF-TENS seems to be effective in reducing pain symptomatology of subjects affected by temporomandibular disorders, with a reduction in the surface electromyographic activity in the masseter area. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to analyze the mandibular condylar volumein a sample of subjects 11-26 years old.Methods: CBCT condylescans from 94 patients (mean age 18.2 ± 4.5 y) acquired with areconstructed layer thickness of 0.5 mm and a 512×512 matrix were examined. Data on condylar volume were compared among three groups with different age ranges: 11-16 years, 17-21years, and 22-26 years. Condylar volumetric measurements were performed with Mimics™ software.Results: A significant increase in condylar volume from puberty to young adulthood was detected (p < 0.01). Females showed a higher condylar volume in the 17-21 y group compared with the 11-16 y group. Males showed differences among all three groups.Conclusion: The mandibular condyle growth seems to continue at least until 17-21 years in males but seems to stop before 17 years in females. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate salivary concentrations of Streptococcus mutans (S. mutans) and some Lactobacilli, and plaque index (PI) in patients wearing fixed versus removable orthodontic appliances. Methods: A sample of 90 orthodontic patients (56 males and 34 females) was included in the study: 30 subjects (aged 21.5±1.5 years) were treated with removable clear aligners (CA), while for other 30 cases (aged 23.3±1.6 years) a fixed multibrackets appliance (MB) were utilized, and 30 patients (aged 18.2 ±1.5 years) wearied a removable positioner (RP). Salivary concentrations of S. mutans and Lactobacilli and PI were evaluated prior to start of the orthodontic treatment, after 3 months and 6 months. Results: After 6 months, 40% of MB patients (12 subjects over 30) showed a concentration of S. mutans associated to high risk of developing tooth decay (CFU/ml>105), differently from participants wearing removable appliances (odds ratio = 5.05; 95% C.I. = 1.72‐14.78; chi‐square = 9.64; p = 0.0019). The same trens was observed for the concentration of Lactobacilli (odds ratio = 4.33; 95% C.I. = 1.53‐12.3; chi‐square = 8.229; p = 0.004). In addition, over the duration of the study, CA patients maintained PI at 0 level, while MB patients experienced a statistically significant increasing trend of PI over time, and their PI became clinically/statistically relevant after 6 months, respect to CA and RP patients. Conclusions: Comparing all the data, while, after 6 months, only about 10% of CA patients and 13.3% of RP patients achieved a microbial colonization which may lead to high risk of caries development, about 40% of MB patients ‐ and 20% after 3 months ‐ showed a high level of vulnerability to developing caries, which require additional strategies for plaque control and microbial colonization to be employed. [ABSTRACT FROM AUTHOR]

Background. Dental caries is a serious oral health concern with high prevalence in preschool children. Aim. To assess the association among oral health-related behaviors, socioeconomic factors, and dental caries in Italian preschool children. Design. 513 preschool children from 3 to 6 years of age, enrolled in nursery schools in central Italy, represent the population of the present study. The children underwent dental clinical examination and were divided on the basis of their caries experience in the primary dentition ("Yes" or "No"). Nonparametric analysis and univariate and multivariate logistic regression models were applied to evaluate the contribution of oral health-related behaviors and socioeconomic factors to the caries experience in the primary dentition. Results. 419 children were caries free, and 94 children had caries experience in the primary dentition, corresponding to the 18.4% of participants. Different oral health-related behaviors and socioeconomic factors resulted to be associated with caries development. In particular, the mother's foreign nationality results in a strong predictive factor. Conclusions. The multivariate logistic model revealed factors significantly affecting caries experience in the primary dentition, which were the mother's nationality, the number of dental visits in a year, and the personal impression by the mother. [ABSTRACT FROM AUTHOR]

Abstract Introduction Advances in paediatric oncology led to the increase in long-term survival, revealing the burden of therapy-related long-term side effects. We evaluated overall and cause-specific mortality in a large cohort of Italian childhood cancer survivors (CCSs) and adolescent cancer survivors identified through the off-therapy registry. Materials and methods CCSs alive 5 years after cancer diagnosis occurring between 1960 and 1999 were eligible; the last follow-up was between 2011 and 2014. Outcomes were reported as standardised mortality ratios (SMRs) and absolute excess risks (AERs). Results Among 12,214 CCSs, 1113 (9.1%) deaths occurred. Survival at 35 years since diagnosis was 87% (95% confidence interval [CI]: 86–88) and at 45 years was 81% (95% CI: 77–84). CCSs had an 11-fold increased risk of death (SMR 95% CI: 10.7–12), corresponding to an AER of 48 (95% CI: 45–51). Mortality decreased by 60% for survivors treated most recently (1990–1999). The most frequent causes of death were recurrence of the original cancer (56%), a subsequent neoplasm (19%) and cardiovascular diseases (5.8%). Among those who survived at least 15 years after diagnosis, a secondary malignancy was the leading cause of death. Conclusions This study confirms the impact of recent advances in anticancer therapy in reducing mortality, mainly attributable to recurrence but also to other causes. However, overall mortality continues to be higher than in the general population. A long-term follow-up is needed to prevent late mortality due to secondary neoplasms and non-neoplastic causes in CCSs. Highlights • Childhood cancer survivors have higher rates of death than their peers in the general population. • Late mortality after childhood cancer reduced steadily over the decades between 1960 and 1999. • Recurrence of the original cancer is the main cause of mortality in the first 15 years from diagnosis, but afterwards, other causes, primary second malignant tumours and cardiovascular events are the leading cause of death. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the prevalence of the signs and symptoms of temporomandibular disorders (TMD) among Italian adolescents.Methods: The data were recorded from 567 subjects (246 males and 321 females; age range 11-19 years), grouped according to age and molar class relationship.Results: Forty-four point one percent of subjects showed at least one sign or symptom of TMD, which were significantly more frequent in the 16-19 year-old group (52.9%) in respect to the 11-15 year-old group (39.8%) (χ 2 = 8.78; p = 0.003). Signs and/or symptoms were about 1.6 times more frequent in subjects with Class II/1 malocclusion (χ 2 = 13.3, p = 0.0003), mostly for TMJ sounds (χ 2 = 1.444; p = 0.036). Myalgia was more frequent in females than in males (χ 2 = 3.882; p = 0.049).Conclusion: TMD signs and/or symptoms among Italian adolescents seem diffused (44.1%). Therefore, all adolescents should be screened thorough medical history and clinical examination. [ABSTRACT FROM AUTHOR]

Purpose. The purpose of this cross-sectional study is to evaluate the presence of any correlations between dysfunctions related to visual impairments and dental occlusion. Methods. The test group included 34 subjects (21 males and 13 females; mean age 11 ± 2 years) randomly selected with the following inclusion criteria: absence of any diagnosis for problems at visual level except those related to refractive defects, visual acuity of at least 1.0, absence of any syndrome or malformation in the craniofacial area, good general health, and absence of any systemic disease able to influence the vision or the craniofacial growth. They underwent visual clinical tests to evaluate the presence of fusional vergence defects and amplitude. Each patient underwent an orthodontic clinical exam and the occlusal molar relationship of each subject was recorded and considered as occlusal variable. A statistical analysis with Chi-Squared test was performed in order to analyze the associations between the visual defects and the occlusal variable. Results. A statistically significant association between the molar occlusal relationship and the occurrence of exodeviations was observed. The percentage of subjects presenting fusional amplitudes with convergence lower of the cut-off value was statistically significantly higher in the group of occlusal molar second class. Conclusions. The results obtained show that there is an association between occlusal second molar class and fusional vergence defects. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the reliability of 6-mm-long implants compared with normal-length implants placed in a vertical augmented atrophic posterior mandible, supporting cemented single crowns. Thirty-six patients with bilateral posterior edentulous mandible and presenting a bone availability height less than 9 mm from the mandibular canal were enrolled in this study. Patient hemiarches were randomized to receive both 6-mm-long and normal-length implants (10 mm). The technique used for the vertical bone augmentation was the ''sandwich'' technique, using a bone substitute block as graft. The data outcomes at 1 year postloading follow-up were the loss of implants and complications. Eighty-six 6-mm-long implants and 84 normal implants were inserted. Five short implants and 13 normal implants were lost. In 28 patients, complications occurred, and in 21 cases, the complication was present on the side of the ridge vertical augmentation. From the statistical analysis, the association between the side of the ridge augmentation and the side of occurrence of the complication was statistically significant (P < .05). The results from this trial suggest short implants can be preferred over vertical bone augmentation for the placement of longer implants in the rehabilitation of edentulous posterior mandibles. These initial results must be confirmed by larger and longer follow-ups of 5 years or more. [ABSTRACT FROM AUTHOR]

Objective. This is a 6-month observational case-control study that aims to estimate plaque index (PI), salivary flow, buffering capacity of saliva, and specific Streptococcus mutans (S. mutans) and Lactobacillus rates in a mouth breathing late adolescents sample, after a professional oral hygiene procedure and home oral hygiene instructions. Subjects and Methods. A sample of 20 mouth breathing late adolescents/young adults (average: 19.2±2.5; range: 18–23 years) and a matched control group of nose breathing subjects (average: 18.3±3.2; range 18–23 years) were included in the study. All the participants were subjected to a professional oral hygiene procedure and appropriate home oral hygiene instructions (t0). After three months (t1) and six months (t2), the PI, salivary flow, buffering capacity of saliva, and S. mutans and Lactobacilli rates were recorded. Results. The mean buffering capacity of saliva and the salivary flow rate showed no significant difference between the two groups, all over the observational period. For PI, a significantly higher mode (score 1 of PI) was observed in the study group at t1 (score 0 = 35% of subjects; score 1 = 60%; score 2 = 5%) and t2 (score 1 = 65% of subjects, score 2 = 35%), with respect to control group. Furthermore, mouth breathing subjects show a significant 4 times higher risk to develop S. mutans CFU > 105 (CI lower limit: 0.95; CI upper limit: 9.48; chi-square: 4.28; p=0.03), with respect to the control subjects. Conclusions. Mouth breathing late adolescents show a significantly higher risk to develop S. mutans CFU > 105 and an increased level of PI. Interceptive orthodontic treatments in growing subjects, like palatal expansion, are encouraged to improve the nasal air flow. In older subjects, orthodontic treatments should be performed with removable appliances like clear aligners, in order to allow a better oral hygiene level. [ABSTRACT FROM AUTHOR]

Aim of this study was to investigate a specific airborne particle abrasion pretreatment on dentin and its effects on microtensile bond strengths of four commercial total-etch adhesives. Midcoronal occlusal dentin of extracted human molars was used. Teeth were randomly assigned to 4 groups according to the adhesive system used: OptiBond FL (FL), OptiBond Solo Plus (SO), Prime & Bond (PB), and Riva Bond LC (RB). Specimens from each group were further divided into two subgroups: control specimens were treated with adhesive procedures; abraded specimens were pretreated with airborne particle abrasion using 50 μm Al2O3 before adhesion. After bonding procedures, composite crowns were incrementally built up. Specimens were sectioned perpendicular to adhesive interface to produce multiple beams, which were tested under tension until failure. Data were statistically analysed. Failure mode analysis was performed. Overall comparison showed significant increase in bond strength (p<0.001) between abraded and no-abraded specimens, independently of brand. Intrabrand comparison showed statistical increase when abraded specimens were tested compared to no-abraded ones, with the exception of PB that did not show such difference. Distribution of failure mode was relatively uniform among all subgroups. Surface treatment by airborne particle abrasion with Al2O3 particles can increase the bond strength of total-etch adhesives. [ABSTRACT FROM AUTHOR]

Aim: The aim of this retrospective study was to evaluate the clinical and radiographic success of pulpotomy on primary molars performed by dental students compared to that performed by an expert operator.Methods: The study was conducted on 142 second primary molars in 102 children. The patients were randomly selected from the available records. The test group (treated by dental students) included 51 subjects (28 males and 23 females, mean age: 7.2 ± 1) and the control group included 51 children (29 males and 22 females, mean age: 7.4 ± 1.2 years). After pulpotomy, a clinical and radiographic evaluation after 12 months was performed. Chi-square test and odds ratio were calculated and significance level was set at p < 0.05.Results: The success rate was significantly lower, 81.6% (p < 0.05), in the test group than in the control group (93%). The test group showed less clinical and radiographic success (86% and 80%, resp.) compared to the control group (97.2% for clinical success and 93% for radiographic success).Conclusions: Pulpotomy with MTA is an effective method that ensures a good percentage of success. The clinical experience of the operator is a contributing factor. [ABSTRACT FROM AUTHOR]