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Purpose: Orthopantomograms (OPT) are used to assess the anatomical relationship between the inferior alveolar nerves (IAN) and the roots of third molars and the related risk of postextraction iatrogenic neurological lesions. When the risk is high, computed tomography (CT) or conebeam CT may be warranted. We investigated how dentists judged the need for CT from OPT to ascertain whether they comply with criteria of justification, appropriateness and optimisation in prescribing examinations involving radiation., Materials and Methods: A total of 2,713 letters were sent to Italian dentists (Veneto region), inviting them to access an Internet Web site showing 20 OPTs and answer a questionnaire on the need for CT or periapical X-ray. The gold standards were CT images corresponding to the OPTs. The respondents' answers were rated for appropriateness and their tendency to over- or underprescribe CT., Results: The questionnaire was completed by 11.9% of the dentists contacted. The response rate was compatible with a Web survey. Their answers generally came close to the gold standard, achieving a mean appropriateness rating of 0.636 (range 0-1). An overlap between the mandibular canal and the third-molar root was the anatomical relationship most often noted. Recommendations for CT were proportional to the number of radiographic signs indicating a risk of inferior alveolar nerve injury. Periapical X-ray was considered useful by 54.9% of dentists not recommending CT. The main reason stated for not recommending CT was that it was unnecessary for the purposes of the extraction., Conclusions: Our survey revealed a cautious approach among the professionals interviewed, who tended to overprescribe CT.

Aim: Female patients on estroprogestinic therapy undergoing extraction of the third lower molar have a higher incidence of postoperative complications (dry socket -DS- pain). The purpose of this study is to verify such data and analyse if there are risk factors for the appearance of other postoperative complications., Methods: One hundred eighteen non-smoking healthy patients were included who underwent extraction of the impacted third lower molar (38 on oral contraceptives, OC, 80 as control). After the extraction, patients were prescribed with a pharmacological therapy, consisting of a per os antibiotic and antiseptic rinse. Each patient was examined after 7 days following surgery to verify the state of tissues. In addition subjective postoperative pain (VAS - Visual Analogue Scale) and intake of analgesic drugs were recorded., Results: One case of DS (2.64%) occurred in the OC group, and 1 case of DS occurred in control-patients group (1.25%) (P=0.4436). The postoperative pain proved significantly higher in OC compared to control (first and fifth postoperation day). In OC a predisposition to dehiscence of the wound (86.84% P=0.0021) and emergence of laterocervical lymphadenitis (81.57% P=0.0010) was found, while no cases of postextractive abscesses and trismus of the masseter were found., Conclusion: Although no correlation between DS and estroprogestinic therapy has been found, a more difficult healing of tissues has been observed as well as a significantly higher subjective pain index in the postoperative days considered in OC patients.

Objectives: To evaluate how Hospital Discharge Records (SDO) and Certificates of Delivery Care (CEDAP) can be utilized to determine the number of deliveries and births; to calculate indicators for monitoring mother-infant health status, the exposure to risk factors during pregnancy and the health care provided., Design and Setting: CEDAP and SDO of all patients admitted to any hospital in the Veneto Region (4.7 million inhabitants, about 44,000 births) during the year 2003 were considered. An area-based study on deliveries and births, a retrospective cohort study on pregnancies, and a prospective cohort study on newborns up to the first year of age were performed to calculate health indicators. These indicators were compared to two official data sources: National Institute of Statistics (ISTAT) and Italian National Institute of Health (ISS)., Main Outcome Measures: Descriptive indicators concerning mother-infant health status (conception, pregnancy, delivery, newborns and events during the first year of age)., Results: SDO provide highly accurate data on pregnancies, births and stillborns, which overlap with values reported by ISTAT Combining data from SDO and CEDAP with findings fom the process of tracking mothers and infants'cohorts, allows the calculation of many indicators on conception (n. 9), pregnancy (n. 8), delivery (n. 8), newborn (n. 15), and events during the first year of age (n. 6). In the Veneto Region the general fertility rate is 40.95% per hundred, with a relatively late mean age at delivery (32 years). Pregnant women undergoing prenatal invasive procedures are 23.5% and the caesarean section rate is 29%. Infants born to foreign mothers are 16%, whereas 2.5% are conceived through assisted reproduction techniques, 0.9% are very low birth weight, and 0.3% are extremely low birth weight; neonatal and infant mortality rates are 2.2% per hundred and 2.9% per hundred respectively., Conclusion: The proposed system is immediately feasible also at a local level, making reliable and informative data available to guide health policies.

Induced abortion was legalized in Italy in 1978. After an initial increase in the incidence, from 187,631 in 1979 to 234,801 in 1983, induced abortion has steadily decreased to 140,398 in 1996. Analysis of the abortion rates has shown that the main decrease has been among married women aged 25-35, while there has been an increase among unmarried women. Women with lower levels of education tend to have higher rates and housewives have higher rates than women in paid work. Programmes for the prevention of induced abortion should be directed at directed at easily accessible groups: women who have just delivered a baby, couples who marry, teenagers in school and women who have already had an induced abortion. In any case, the need for rationalisation of the procedure to obtain an induced abortion is urgent.