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Autism Spectrum Disorders (ASDs) are neurodevelopmental disorders that don't have a direct effect on oral health, but severe difficulties in oral hygiene and dental procedures expose people with ASDs to an increased risk of oral diseases. This RCT aimed to evaluate which pedagogical tool was the best to prepare children with ASDs for their first dental examination, either video or photo aids. Two different criteria were used to evaluate their efficacy: the achieved steps into which the procedure was divided ( n = 8), and the level of cooperation according to the Frankl Behavioral Scale. One hundred-thirteen subjects were randomly assigned to the two groups and 84 subjects completed the trial (Video group n = 41; Photo group n = 43). A predictive model for the achievement of the Preliminary (1-4) or Dental (4-8) steps was performed using a multivariate logistic regression procedure. Children in the Video group achieved more steps, but the comparison between groups was statistically significant only for the Preliminary steps ( p = 0.04). The percentage of subjects judged as cooperating was similar in the two groups. The results of this study underline that behavioural intervention should be used as an effective strategy to prepare subjects with ASDs for a dental examination.

Light chain amyloidosis (AL) is caused by the aberrant overproduction of immunoglobulin light chains (LCs). The resulting abnormally high LC concentrations in blood lead to deposit formation in the heart and other target organs. Organ damage is caused not only by the accumulation of bulky amyloid deposits, but extensive clinical data indicate that circulating soluble LCs also exert cardiotoxic effects. The nematode C. elegans has been validated to recapitulate LC soluble toxicity in vivo, and in such a model a role for copper ions in increasing LC soluble toxicity has been reported. Here, we applied microscale thermophoresis, isothermal calorimetry and thermal melting to demonstrate the specific binding of Cu 2+ to the variable domain of amyloidogenic H7 with a sub-micromolar affinity. Histidine residues present in the LC sequence are not involved in the binding, and yet their mutation to Ala reduces the soluble toxicity of H7. Copper ions bind to and destabilize the variable domains and induce a limited stabilization in this domain. In summary, the data reported here, elucidate the biochemical bases of the Cu 2+ -induced toxicity; moreover, they also show that copper binding is just one of the several biochemical traits contributing to LC soluble in vivo toxicity.

Rare genetic syndromes, conditions with a global average prevalence of 40 cases/100,000 people, are associated with anatomical, physiological, and neurological anomalies that may affect different body districts, including the oral district. So far, no classification of oral abnormalities in rare genetic syndromes is present in the literature. The aim of this narrative review is to analyze literature on rare genetic syndromes affecting dento-oro-maxillofacial structures (teeth, maxillary bones, oral soft tissues, or mixed) and to propose a classification according to the detected oral abnormalities. In addition, five significant cases of rare genetic syndromes are presented. The Scale for the Assessment of Narrative Review Articles (SANRA) was followed for this review. From 674 papers obtained through PubMed search, 351 were selected. Sixty-two rare genetic syndromes involving oral manifestations were found and classified. The proposed classification aims to help the clinician to easily understand which dento-oro-maxillofacial findings might be expected in the presence of each rare genetic syndrome. This immediate framework may both help in the diagnosis of dento-oro-maxillofacial anomalies related to the underlying pathology as well as facilitate the drafting of treatment plans with the involvement of a multidisciplinary team.

In light chain amyloidosis (AL), fibrillar deposition of monoclonal immunoglobulin light chains (LCs) in vital organs, such as heart, is associated with their severe dysfunction. In addition to the cellular damage caused by fibril deposition, direct toxicity of soluble prefibrillar amyloidogenic proteins has been reported, in particular, for cardiotoxicity. However, the molecular bases of proteotoxicity by soluble LCs have not been clarified. Here, to address this issue, we rationally engineered the amino acid sequence of the highly cardiotoxic LC H6 by introducing three residue mutations, designed to reduce the dynamics of its native state. The resulting mutant (mH6) is less toxic than its parent H6 to human cardiac fibroblasts and C. elegans. The high sequence and structural similarity, together with the different toxicity, make H6 and its non-toxic designed variant mH6 a test case to shed light on the molecular properties underlying soluble toxicity. Our comparative structural and biochemical study of H6 and mH6 shows closely matching crystal structures, whereas spectroscopic data and limited proteolysis indicate that H6 displays poorly cooperative fold, higher flexibility, and kinetic instability, and a higher dynamic state in its native fold. Taken together, the results of this study show a strong correlation between the overall conformational properties of the native fold and the proteotoxicity of cardiotropic LCs., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: The number of pediatric patients affected by HIV still remains high, mainly in developing countries, where the main cause of infection is vertical transmission from the mother. Even today, a large number of these children do not have access to treatment, and, without proper care, they die in the first few years of life. Objective: The aim of our review was to assess the prevalence of oral hard and soft tissue lesions in HIV-positive pediatric patients by identifying the most common manifestations and the overall impact that they may have on the children's quality of life. Study design: A systematic review of the articles in the English language in PubMed and Scopus was conducted in March 2019 in order to identify the main epidemiological and cross-sectional studies on the topic. Results: Oral diseases are still one of the most common manifestations in HIV-positive pediatric patients, and they often represent the first form in which immunosuppression shows itself. An analysis of the literature shows that candidiasis is the most common oral lesion found in HIV-positive children. A significant incidence of gingivitis and gingival disease is also evident, though not strictly correlated to HIV infection. However, thanks to the introduction of new antiretroviral therapies, the incidence of HIV-related oral lesions is decreasing. Conclusions: An HIV-positive children care program should also include dental protocols, as oral disease negatively influences the quality of life, affecting both functional and social aspects.

Control of bleeding after oral surgery is mandatory in patients taking anticoagulants. There are different haemostatic measures to prevent post-surgical bleeding. The aim of the present paper is to study the use of a haemostatic agent, calcium sulphate (CaS) (P30, Ghimas, Bologna, Italy) for controlling post-surgical bleeding in a group of patients treated with warfarin therapy for thromboembolic states. Twenty teeth (12 mandibular molars, 8 maxillary molars) in 20 patients (14 male and 6 females) with a mean age of 54.3 years (±10.3 years) were included in the study. The patients were divided into 2 groups; in the study group of 10 patients calcium sulphate was used in layers to fill the socket after extraction, while for the 10 patients in the control group put a gauze with tranexamic acid was put in the extraction site immediately after extraction, and half an hour after extraction. The outcome was bleeding in subsequent days. Bleeding at post-operative day 1 was significant in 5 patients of the control group, however, in the study group treated with calcium sulfate there was no bleeding in any patient (p value 0.0055). CaS demonstrated to be a good haemostatic agent for controlling bleeding after oral surgery in patients taking anticoagulants., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

Osseointegrated dental implants showed elevated success rates on the long-term treatment in the last ten years. However, the risk of peri-implantitis and implant failure is the main complication of implantology. The presence of a micro gap at the implant-abutment connection (IAC) allows microorganisms to penetrate and colonize the inner part of the implant leading to biofilm accumulation and consequently to peri-implantitis development. Some chemical devices (CD) has been studied to reduce bacterial penetration at IAC level but no one have been demonstrated to be effective for this purpose. Aim of the present study is to evaluate the effectiveness of a new chemical formulation STCX-1, placed in the internal part of dental implants for killing bacteria present in the IAC. To identify the antibacterial power of SXTC-1 at interface between implant-abutment connection, the passage of genetically modified Escherichia coli across IAC was evaluated. A total of eight implants were used (Edierre Implant System, Edierre SpA, Genova, Italy). The inner side of four out of the eight implants were firstly contaminated with few microliters of pure bacteria, subsequently were treated with SXTC-1 for few second and finally, the antibacterial was replaced with Lysogeny Broth (LB) and antibiotics without bacteria. The remaining four implants were not treated with SXTC-1 and just filled with LB with antibiotics. Bacteria viability was determined by measuring their Optical Density (OD) at 600nm. The analysis revealed that, in untreated implants, bacteria grew (internally and externally) for the first 48 hours, but subsequently they started to dye. In treated implants, instead, bacteria grew just in the space surrounding the device suggesting that, even if bacteria were able to get into, they immediately died thanks to the presence of SXTC-1. The STCX-1 liquid formulation have been demonstrated to be an adjuvant CD effective for prevention of of bacterial colonization at IAC level., (Copyright 2019 Biolife Sas. www.biolifesas.org.)

Nonsyndromic cleft lip with or without cleft palate is the most common craniofacial anomaly affecting around 1 in 700 live births worldwide. Clefts of the human face can be classified anatomically as cleft palate only (CPO), cleft lip only (CLO), cleft lip and palate (CLP) or a combined group of cleft lip with or without cleft palate (CL/P), based on different in embryologic development. These malformations have some genetic origin, in fact several association studies have been performed to obtain important information about the candidate genes; but more important are gene-environment interactions that play an increasing role in its etiology. Epidemiological studies have shown how environmental factors (alcohol, smoking, drugs), as well as possible gene-environment interactions, play an important role in the onset of the malformation. On the contrary, folic acid intake seems to have a protective effect. In this review, we analyze the role of environmental factors related to onset of cleft., (Copyright 2019 Biolife Sas. www.biolifesas.org.)

The aim of this review is to determine if there is a relationship between periodontal disease and stroke. The included case-control and cohort studies mediate the incidence of stroke and periodontal disease by analyzing different parameters. A literature review was carried out in PubMed, Scopus and Embase databases using the key word "stroke" AND "periodontal disease". An amount of 932 articles came out from our research on these three databases. These articles were selected according to PRISMA criteria. The following inclusion criteria were established: studies conducted in humans, articles published in English and published in the last ten years. Exclusion criteria were: experimental studies on animals, articles published more than 10 years ago, non-English language articles, articles of non-indexed journals, and articles not directly related to the association between stroke and periodontitis. These criteria reduced the number of articles from 932 to 399. At the end, articles that appeared to be repeated in different databases have been eliminated: 254 articles remained. All these articles titles were reviewed by the authors, who decided whether or not to include them in the review. We selected an amount of 43 articles. These studies were reviewed by reading the titles and abstracts, and by finally selecting the ones with the same topic of this review. When titles or abstracts were not clear, the complete article was read. At the end 7 articles were selected. In addition, 2 systematic reviews and 1 article, cited in the discussion, and regarding the protocol used in patients suffering from cardiovascular diseases and periodontitis, were selected. The quality of these articles was evaluated through the JADAD system. In conclusion, patients with stroke have a higher prevalence of periodontitis., (Copyright 2019 Biolife Sas. www.biolifesas.org.)

Mandibular third molars (MM3s) are responsible for pericoronitis, primary and/or secondary crowding of the dentition, odontogenic tumors and cysts, periodontal defects associated with the posterior part of mandibular second molars. Tooth extraction is indicated for prophylactic and therapeutic purpose in patients with problems caused by impacted teeth. Common postoperative complications associated with third molar extraction are alveolitis (0.5e32.5%), infection (0.9e4.2%), postoperative bleeding (0.2e1.5%), transient dysfunction of the inferior alveolar nerve (0.6e5.5%), and permanent dysfunction of the inferior alveolar nerve (0.1e0.9%). A literature review reveals number of individual case reports of accidental displacement to various anatomical locations, namely, the infratemporal fossa, pterygomandibular space, lateral pharyngeal space, submandibular space, and sublingual space., (Copyright 2019 Biolife Sas. www.biolifesas.org.)

Diabetes mellitus (DM) and periodontal disease (PD) are both chronic diseases. From one side, DM have an adverse effect on PD, and on the other side PD may influence DM. Systemic therapy of DM with glycaemic control, affects the progress of PD. Reversely treatment of PD combined with the administration of systemic antibiotics seems to have a double effect on diabetic patients reducing the periodontal infection and improving the glycaemic control. Inflammation, altered host responses, altered tissue homeostasis are common characteristic of both DM and PD. The potential common pathophysiologic pathways of direct or reverse relationship of DM and PD are still unknown and further in vitro and in vivo studies are needed to explore this relationship., (Copyright 2019 Biolife Sas. www.biolifesas.org.)

Osseointegration can be affected by oral conditions; in particular, the micro gap at the implantabutment-connection (IAC) represents a site for dental plaque aggregation favoring bacterial leakage that can increase inflammatory cells at the level of the IAC, causing peri-implantitis. This micro gap, once early colonized, may constitute a bacterial reservoir that could subsequently contaminate fixture's surroundings and interfere with peri-implant tissues health. The aim of this review is to describe, according to the most recent literature, the different kind of implant-abutment connection and their ability to reduce bacterial leakage and thus preventing peri-implantitis. The following database were consulted: Pubmed (n=26), Scopus (n=90), Research gate (n=7) and 123 articles were found. Duplicates were excluded and after reading abstract and titles, those articles that were off topic were also excluded. The remaining ones (n=24) were assessed for full-text eligibility. We excluded 5 articles because they were case reports, 2 because there was no clear reference to the relationship between IAC and bacterial leakage and 2 because they were not pertinent to the argument. Fifteen articles were included in the review. From the review, it is clear that a relationship between the IAC and bacterial leakage exists. All the connections presented an amount of micro-gap and bacterial micro-leakage but conical and mixed connection systems seem to behave better. Moreover, both connections seem to have a better load distribution and the mixed one has anti-rotational properties, very useful during the positioning of the prosthesis., (Copyright 2019 Biolife Sas. www.biolifesas.org.)

Aim: The clinical management of OLP represents a considerable challenge for the oral physician. The aim of this review is to assess the main intervention used in the management of OLP and the efficacy of every type of treatment., Materials and Methods: We searched and analyzed PubMed database for articles on OLP management. Only randomized controlled trials, comparing an active treatment with placebo, or between different active treatments, were considered in this systematic review. Only patients with symptomatic OLP were included and interventions of all types were considered (topical treatment, systemic drugs, non pharmacological intervention)., Results: A total of 25 randomized controlled trials were examined and included in this review. Steroids are the most frequently employed drug in the treatment of OLP and their efficacy and safety are demonstrated. Also calcineurin inhibitors and photo-dynamic therapy are used in different studies for OLP management, with positive results., Conclusion: Topical steroids remain the first-line treatment for symptomatic OLP, however, many different pharmacological and non-pharmacological therapies would represent a valid alternative for its management, but, nowadays they require further investigations., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

HIV infection is one of the major health problem of the last decades. This disease causes a chronic infection that can lead to acquired immunodeficiency syndrome (AIDS). According to the Global AIDS update, released in 2016 by HIV department of World Health Organization (WHO) and by the Joint United Nations Program on HIV/AIDS (UNAIDS), at the end of 2015, 36.7 million people were infected by HIV: 34.9 million of these were adults and 1.8 million were children under 15 years of age. The same report shows that during 2015, 2.1 million of new infection cases have occurred all over the world and about 1.1 million people have died for HIV. The aim of this short review is to up-date of the main HIV-related oral manifestations and their correlation with HAART (Highly Active Antiretroviral Therapy) and CD4+ T-cell count. Despite that more than 20 years have elapsed, this classification still remains valid: even today, group 1 lesions are found in the majority of HIV-positive patients with oral manifestations. Group 1 includes the following conditions: oral candidiasis (pseudomembranous candidiasis, erythematous candidiasis, angle cheilitis), oral hairy leukoplakia, periodontal diseases (necrotizing gingivitis, necrotizing periodontitis, linear gingival erythema), Kaposi’s sarcoma, and non-Hodgkin’s lymphoma. Melanotic hyperpigmentation, HSV infection and HPV infection, which are included in group 2, are also common. Oral candidiasis, oral hairy leukoplakia, Kaposi’s sarcoma and HSV infection are the lesions that have seen the major drop in their incidence after the HAART introduction. The increase in CD4+ T-cell count is not significantly correlated to the decrease of every type of oral lesions, but it is statistically significant only in relation to oral candidiasis (p-value less than 0.001). Oral lesions are an important sign of immunodepression and with the introduction of HAART their incidence has strongly decreased, particularly in urban areas. Nevertheless, developing countries still have a high prevalence of these manifestations because of the persistence of many risk factors, like the difficulty to access treatment, poor oral hygiene, low socioeconomic status and late diagnosis.

Light chain amyloidosis (AL), the most common systemic amyloidosis, is caused by the overproduction and the aggregation of monoclonal immunoglobulin light chains (LC) in target organs. Due to genetic rearrangement and somatic hypermutation, virtually, each AL patient presents a different amyloidogenic LC. Because of such complexity, the fine molecular determinants of LC aggregation propensity and proteotoxicity are, to date, unclear; significantly, their decoding requires investigating large sets of cases. Aiming to achieve generalizable observations, we systematically characterised a pool of thirteen sequence-diverse full length LCs. Eight amyloidogenic LCs were selected as responsible for severe cardiac symptoms in patients; five non-amyloidogenic LCs were isolated from patients affected by multiple myeloma. Our comprehensive approach (consisting of spectroscopic techniques, limited proteolysis, and X-ray crystallography) shows that low fold stability and high protein dynamics correlate with amyloidogenic LCs, while hydrophobicity, structural rearrangements and nature of the LC dimeric association interface (as observed in seven crystal structures here presented) do not appear to play a significant role in defining amyloid propensity. Based on the structural and biophysical data, our results highlight shared properties driving LC amyloid propensity, and these data will be instrumental for the design of synthetic inhibitors of LC aggregation.