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Purpose: To investigate the prevalence of dental caries and periodontal disease in children with ASD, and to analyse the necessity of treatment and the prevalence of using general anaesthesia in order to perform it., Materials and Methods: A search was performed covering the last 10 years utilising the following databases: Pubmed, Scopus, Medline, BASE, Science Citation Index, Science Direct, Web of Science. Four reviewers evaluated each study. Review findings were summarised using the PRISMA Statement for reporting. Thirteen articles were included in this systematic review., Results: When analysing the articles selected, the evidence turned out did not show a common DFMT and dmft for the groups of children affected by Autism Spectrum Disorder considered. When compared to group of unaffected children, groups of ASD children not always showed a higher prevalence of caries but always higher Periodontal Indexes (PI and GI), resulting in higher prevalence of periodontal disease. Where the treatment was performed and taken into consideration, there was a high incidence of necessity of General Anaesthesia due to the lack of collaboration of the children., Conclusion: The high prevalence of treatment under general anaesthesia and the often-reported negative behaviour evidence how there is a lack of protocols specifically designed for these patients, in order to better improve their collaboration and subsequently their oral health and so additional strategies for a preventive care should be applied for these patients.

Background : The objective of this study is to evaluate the application of National guidelines for prevention and clinical management of traumatic dental injuries (NGPCMTDI) in developmental age published by the Italian Ministry of Health. Methods : In the present retrospective and multicenter study, 246 patients who underwent dental injury were selected to assess the management of the traumatic event compiled with the protocol provided by the National guidelines. Each health worker involved completed a form related to the dental injury in order to standardize the collected data. Two reference centers have been identified for data collection. Analyses for comparisons between groups were performed using the X 2 test for categorical variables or by Fisher exact test as appropriate. Statistical significance was assumed at p < 0.05. Results : Evaluating the distribution by age we concluded that: 27.24% of the enrolled patients were aged 1-5 years, 51.63% 6-10 years, and 19.92% 11-17 years. The dental injuries occurred in 10.16% of the situations at home, 50.81% at school, 28.86% during recreation, and 9.35% at the gym. The deciduous dentition is involved in 34.96% of the traumas while the permanent dentition is involved in 69.51%. Conclusion : From the present study it emerged that the National guidelines are not uniformly applied.

Today, biomaterial research on biomimetic mineralization strategies represents a new challenge in the prevention and cure of enamel mineral loss on delicate deciduous teeth. Distinctive assumptions about the origin, the growth, and the functionalization on the biomimetic materials have been recently proposed by scientific research studies in evaluating the different clinical aspects of treating the deciduous tooth. Therefore, appropriate morpho-chemical observations on delivering specific biomaterials to enamel teeth is the most important factor for controlling biomineralization processes. Detailed morpho-chemical investigations of the treated enamel layer using three commercial toothpastes (Biorepair, F1400, and F500) were performed through variable pressure scanning electron microscopy (VP-SEM) and energy dispersive X-ray spectroscopy (EDS) on deciduous teeth in their native state. A new microscopy methodology allowed us to determine the behaviors of silicate, phosphate, and calcium contents from the early stage, as commercially available toothpastes, to the final stage of delivered diffusion, occurring within the enamel layer together with their penetration depth properties. The reported results represent a valuable background towards full comprehension of the role of organic-inorganic biomaterials for developing a controlled biomimetic toothpaste in biofluid media.

Background : Pulpotomy of primary teeth provides favorable clinical results over time; however, to date, there is still not a consensus on an ideal pulp dressing material. Therefore, the aim of the present systematic review was to compare pulpotomy agents to establish a preferred material to use. Methods : After raising a PICO question, the PRISMA guideline was adopted to carry out an electronic search through the MEDLINE database to identify comparative studies on several pulp dressing agents, published up to October 2019. Results : The search resulted in 4274 records; after exclusion, a total of 41 papers were included in the present review. Mineral trioxide aggregate (MTA), Biodentine and ferric sulphate yielded good clinical results over time and might be safely used in the pulpotomies of primary molars. Among agents, MTA seemed to be the material of choice. On the contrary, calcium hydroxide showed the worst clinical performance. Although clinically successful, formocreosol should be replaced by other materials, due to its potential cytotoxicity and carcinogenicity. Conclusion : MTA seemed to be the gold standard material in the pulpotomy of primary teeth. Promising results were also provided by calcium silicate-based cements. Further randomized clinical trials (RCTs) with adequate sample sizes and long follow-ups are encouraged to support these outcomes.

Probabilistic caries risk assessment models (P-CRA), such as the Cariogram, are promising tools to planning treatments in order to control and prevent caries. The usefulness of these models for informing patients and medical decision-making depends on 2 properties known as discrimination and calibration. Current common assessment of P-CRA models, however, ignores calibration, and this can be misleading. The aim of this paper was to provide tools for a proper assessment of calibration of the P-CRA models and improve calibration when lacking. A combination of standard calibration tools (calibration plot, calibration in-the-large, and calibration slope) and 3 novel measures of calibration (the Calibration Index and 2 related metrics, E50 and E90) are proposed to evaluate if a P-CRA model is well calibrated. Moreover, an approach was proposed and validated using data from a previous follow-up study performed on children evaluated by means of a reduced Cariogram model; Platt scaling and isotonic regression were applied showing a lack of calibration. The use of the Cariogram overestimates the actual risk of new caries for forecast probabilities <0.5 and underestimates the risk for forecast probabilities >0.6. Both Platt scaling and isotonic regression were able to significantly improve the calibration of the reduced Cariogram model, preserving its discrimination properties. The average specificity and sensitivity for both Platt scaling and isotonic regression using the cut-off point p= 0.5 were >83 and their sum well exceeded 160. The benefits of the proposed calibration methods are promising, but further research in this field is required., (© 2020 S. Karger AG, Basel.)

Traumatic injuries to the primary dentition are critical events in dentistry not only due to the need for urgent care, but also since they have potential sequelae in the permanent dentition, with a prevalence ranging from 12% to 74%. The aim of this article was to provide an overview of the prevalence, etiology, and clinical and radiographic characteristics as well as the management of permanent teeth sequelae resulting from traumatic injuries to their deciduous predecessors. An extensive literature review was performed to reveal the current evidence on enamel discoloration with or without hypomineralization/hypoplasia, crown dilaceration, odontoma-like malformation, root anomalies, partial or complete arrest of root formation, sequestration of the permanent tooth germ, and eruption disturbances.

Calcium hydroxide apexification and Mineral Trioxide Aggregate (MTA) apexification are classical treatments for necrotic immature permanent teeth. The first tend to fail for lack of compliance given the high number of sessions needed; the second has technical difficulties such as material manipulation and overfilling. With both techniques, the root development is interrupted leaving the tooth with a fragile root structure, a poor crown-to-root ratio, periodontal breakdown, and high risk of fracture, compromising long-term prognosis of the tooth. New scientific literature has described a procedure that allows complete root development of these specific teeth. This regenerative endodontic procedure (REP) proposes the use of a combination of antimicrobials and irrigants, no canal walls instrumentation, induced apical bleeding to form a blood clot and a tight seal into the root canal to promote healing. MTA is the most used material to perform this seal, but updated guidelines advise the use of other bioactive endodontic cements that incorporate calcium and silicate in their compositions. They share most of their characteristics with MTA but claim to have fewer drawbacks with regards to manipulation and aesthetics. The purpose of the present article is to review pertinent literature and to describe the clinical procedures protocol with its variations, and their clinical application.

Background: Dental caries is a recognized worldwide public health problem. Despite being one of the most effective strategies against dental caries, the excessive use of fluorine may result in a potential risk of developing dental fluorosis especially in children under age of six. The purpose of this work is to analyze a fluorine-free toothpaste containing Biomimetic Hydroxyapatite to assess enamel re-mineralizing and repairing properties., Results: The study was performed in vitro and in vivo, comparing the hydroxyapatite toothpaste with two others toothpaste containing different fluorine concentrations. The coating effect of the micro-structured Hydroxyapatite nanoparticles reintegrates the enamel with a biomimetic film reproducing the structure and the morphology of the biologic Hydroxyapatite of the enamel. As demonstrated, the coating is due to the deposit of a new layer of apatite, which presents fewer particles than the natural enamel, not based on the chemical-physical changes occurring in fluorinated toothpastes. Moreover, it shows resistance to brushing as a consequence of chemical bonds between the synthetic and natural crystals of the enamel., Conclusions: The use of Biomimetic Hydroxyapatite toothpastes has proven to be a valuable prevention measure against dental caries in primary dentition since it prevents the risk of fluorosis.

Oral signs are frequently the first manifestation of autoimmune diseases. For this reason, dentists play an important role in the detection of emerging autoimmune pathologies. Indeed, an early diagnosis can play a decisive role in improving the quality of treatment strategies as well as quality of life. This can be obtained thanks to specific knowledge of oral manifestations of autoimmune diseases. This review is aimed at describing oral presentations, diagnosis, and treatment strategies for systemic lupus erythematosus, Sjögren syndrome, pemphigus vulgaris, mucous membrane pemphigoid, and Behcet disease.

Background: Reverse headgear (a facial mask) is one of the most frequently used interceptive orthodontic devices in patients with Class III malocclusion. It is a simple device but may present some drawbacks related to pressure on the skin generated by the forehead and chin supports linked to the maxillary intraoral appliance by elastics. This can cause injury to the chin and lips., Methods: Patients between 7 and 8 years of age were selected from the Unit of Pediatric Dentistry. Orthopedic therapy with a rapid palatal expander and reverse headgear was prescribed for all subjects. The patients were divided into two groups: those who used a facial mask without a silicone chin cup and those who used a facial mask with a silicone chin cup., Results: Two-hundred subjects including 90 male patients and 110 female patients were enrolled. The groups that used a facial mask with and without a silicone chin cup included 100 patients each. The percentage of subjects without irritation was significantly greater in the group with a silicone chin cup than in the group without a silicone chin cup., Conclusions: The authors propose a simple and effective solution to prevent skin irritation on the chin caused by a facial mask. A chin mask is a custom solution that can prevent injury to the chin during treatment when coupled with facial mask therapy.

Background: Secondary caries are considered the main cause of dental restoration failure. In this context, anti-biofilm and bactericidal properties are desired in dental materials against pathogens such as Streptococcus mutans. To this purpose, graphene based materials can be used as fillers of polymer dental adhesives. In this work, we investigated the possibility to use as filler of dental adhesives, graphene nanoplatelets (GNP), a non toxic hydrophobic nanomaterial with antimicrobial and anti-biofilm properties., Results: Graphene nanoplatelets have been produced starting from graphite intercalated compounds through a process consisting of thermal expansion and liquid exfoliation. Then, a dental adhesive filled with GNPs at different volume fractions has been produced through a solvent evaporation method. The rheological properties of the new experimental adhesives have been assessed experimentally. The adhesive properties have been tested using microtensile bond strength measurements (µ-TBS). Biocidal activity has been studied using the colony forming units count (CFU) method. The anti-biofilm properties have been demonstrated through FE-SEM imaging of the biofilm development after 3 and 24 h of growth., Conclusions: A significantly lower vitality of S. mutans cells has been demonstrated when in contact with the GNP filled dental adhesives. Biofilm growth on adhesive-covered dentine tissues demonstrated anti-adhesion properties of the produced materials. µ-TBS results demonstrated no significant difference in µ-TBS between the experimental and the control adhesive. The rheology tests highlighted the necessity to avoid low shear rate regimes during adhesive processing and application in clinical protocol, and confirmed that the adhesive containing the 0.2%wt of GNPs possess mechanical properties comparable with the ones of the control adhesive.

Objectives: To define the possible complications of oral surgery in childhood in patients affected by type 1 Osteogenesis imperfecta (OI) and treated with bisphosphonates (BP)., Methods: The study was conducted among 20 patients in childhood with an age range 8-14 (12 ♂ e 8 ♀) affected by OI. Patients were initially evaluated at the Policlinico Umberto I, University Hospital of Rome, Rare Disease Center Skeletal Dysplasia-Bone Metabolic Pathologies and after at the Policlinico Umberto I, University Hospital of Rome, Head and Neck Department, UOC Pediatric Dentistry., Results: From this experience, we showed that a proper patient management from the medical and dental point of view can protect these patients from the risk of post-operative problems, such as onj, soft tissue flogos, intraoral and extraoral fistulas, failure to heal the post-extractive alveolus, infections, post-operative pain and pathological fractures. The follow-up, ranging from a minimum of 2 years to a maximum of 5 years, have not demonstrated the presence of particular complications or healing defects., Conclusions: The clinical experiences observed in these patients are encouraging because no postoperative complications have been observed compared to patients non-affected by OI.

Background: Data from epidemiological studies investigating the prevalence and severity of malocclusions in children are of great relevance to public health programs aimed at orthodontic prevention. Previous epidemiological studies focused mainly on the adolescence age group and reported a prevalence of malocclusion with a high variability, going from 32% to 93%. Aim of our study was to assess the need for orthodontic treatment in a paediatric sample from Southern Italy in order to improve awareness among paediatricians about oral health preventive strategies in pediatric dentistry., Material and Methods: The study used the IOTN-DHC index to evaluate the need for orthodontic treatment for several malocclusions (overjet, reverse overjet, overbite, openbite, crossbite) in a sample of 579 children in the 2-9 years age range., Results: The most frequently altered occlusal parameter was the overbite (prevalence: 24.5%), while the occlusal anomaly that most frequently presented a need for orthodontic treatment was the crossbite (8.8%). The overall prevalence of need for orthodontic treatment was of 19.3%, while 49% of the sample showed one or more altered occlusal parameters. No statistically significant difference was found between males and females., Conclusions: Results from this study support the idea that the establishment of a malocclusion is a gradual process starting at an early age. Effective orthodontic prevention programs should therefore include preschool children being aware paediatricians of the importance of early first dental visit. Key words: Orthodontic treatment, malocclusion, oral health, pediatric dentistry., Competing Interests: Conflict of interest statement:The authors declare that they have no conflict of interest.

Background: Coeliac disease is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten, and possible relationships between coeliac disease and dental pathogenic conditions during childhood have been poorly investigated., Aim: The dental pulp plays a pivotal role in the immune defence against possible entry of pathogens from teeth, and the aim of this work was to investigate quantitative transcription levels of selected genes (IL-9, IL-11, IL-15, IL-18, IL-21, IL-27, MICA, IFN-γ) coding for pro-inflammatory immune innate activities in the pulp of primary teeth from healthy children and children with coeliac disease., Design: The pulp from primary teeth of 10 healthy children and 10 children with coeliac disease was used to extract RNA and prepare cDNA for quantitative PCR transcription analysis employing commercial nucleotide probes for selected genes., Results: In children with coeliac disease, the genes coding for pro-inflammatory cytokines IFN-γ, IL-11, IL-18, and IL-21 were significantly overexpressed, suggesting the possible importance of these cytokines in the relationships between coeliac disease and dental disorders., Conclusion: For the first time, we reported in dental pulp of children possible relationships between coeliac disease and modulation in transcription of cytokine-dependent inflammatory activities., (© 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: The chemical-physical properties of novel and long-standing calcium silicate cements versus conventional pulp capping calcium hydroxide biomaterials were compared., Methods: Calcium hydroxide-based (Calxyl, Dycal, Life, Lime-Lite) and calcium silicate-based (ProRoot MTA, MTA Angelus, MTA Plus, Biodentine, Tech Biosealer capping, TheraCal) biomaterials were examined. Calcium and hydroxyl ion release, water sorption, interconnected open pores, apparent porosity, solubility and apatite-forming ability in simulated body fluid were evaluated., Results: All calcium silicate materials released more calcium. Tech Biosealer capping, MTA Plus gel and Biodentine showed the highest values of calcium release, while Lime-Lite the lowest. All the materials showed alkalizing activity except for Life and Lime-Lite. Calcium silicate materials showed high porosity values: Tech Biosealer capping, MTA Plus gel and MTA Angelus showed the highest values of porosity, water sorption and solubility, while TheraCal the lowest. The solubility of water-containing materials was higher and correlated with the liquid-to-powder ratio. Calcium phosphate (CaP) deposits were noted on materials surfaces after short aging times. Scant deposits were detected on Lime-Lite. A CaP coating composed of spherulites was detected on all calcium silicate materials and Dycal after 28 days. The thickness, continuity and Ca/P ratio differed markedly among the materials. MTA Plus showed the thickest coating, ProRoot MTA showed large spherulitic deposits, while TheraCal presented very small dense spherulites., Conclusions: calcium silicate-based cements are biointeractive (ion-releasing) bioactive (apatite-forming) functional biomaterials. The high rate of calcium release and the fast formation of apatite may well explain the role of calcium silicate biomaterials as scaffold to induce new dentin bridge formation and clinical healing.

The problem of identifying potential determinants and predictors of dental caries is of key importance in caries research and it has received considerable attention in the scientific literature. From the methodological side, a broad range of statistical models is currently available to analyze dental caries indices (DMFT, dmfs, etc.). These models have been applied in several studies to investigate the impact of different risk factors on the cumulative severity of dental caries experience. However, in most of the cases (i) these studies focus on a very specific subset of risk factors; and (ii) in the statistical modeling only few candidate models are considered and model selection is at best only marginally addressed. As a result, our understanding of the robustness of the statistical inferences with respect to the choice of the model is very limited; the richness of the set of statistical models available for analysis in only marginally exploited; and inferences could be biased due the omission of potentially important confounding variables in the model's specification. In this paper we argue that these limitations can be overcome considering a general class of candidate models and carefully exploring the model space using standard model selection criteria and measures of global fit and predictive performance of the candidate models. Strengths and limitations of the proposed approach are illustrated with a real data set. In our illustration the model space contains more than 2.6 million models, which require inferences to be adjusted for 'optimism'.

Reciprocating instruments made from M-wire alloy have been proposed to reduce the risk of fracture. No information is available on the surface alteration after single and multiple uses in root canals. Two reciprocating NiTi instruments were used on extracted teeth up to three times. ESEM/EDS analysis was conducted to determine defects, alterations, and wear features of the apical third of instruments and metallographic analysis was performed on the cross-section of new and used instruments to compare alloy properties. Topography of apical portion was evaluated by AFM before and after uses. Extracted single-rooted teeth were divided into two groups and instrumented according to the manufacturer's recommendations with: (A) WaveOne Primary and (B) Reciproc R25. Each group was divided into three subgroups according to the number of canals instrumented: 1, 2, and 3, respectively. Chi square test was performed to verify homogeneity of defects distribution and GLM to evaluate the differences of RMS at baseline and after use for both groups (α level 0.05). No instrument fractured and no spiral distortions were observed under optical microscope even when the number of uses increased. Not significant differences were found for WaveOne and Reciproc. Blades presented a wrapped portion in WaveOne group and a more symmetrical feature in Reciproc group. Metallographic analysis revealed in both groups the presence of twinned martensitic grains with isolated flat austenitic areas. Both instruments demonstrated limited alteration, such as tip deformation and wear. This study confirmed the safe clinical use of both instruments for shaping multi-rooted teeth., (© 2014 Wiley Periodicals, Inc.)

Objective: To evaluate which of the following indicators of socio-economic status (SES) has the strongest association with dental caries status in a 6-year-old population: the educational level of each parent (individual-level); the mean price of housing/m2 in the area where the family resides; or the mean per capita income in the area where the family lives (area-level)., Material and Methods: Dental caries was recorded in 2,040 schoolchildren (42.5% boys, 57.5% girls) using decayed/missed/filled surface index (d3 level) in primary dentition. Parents filled in a standardised questionnaire regarding nationality, level of education, frequency of dental check-up and perception of child's oral health and child's oral hygiene habits., Results: At the individual-level of SES, mothers' educational level was associated with their children's caries severity (chi2(9) = 147.51 p < 0.01): as educational level rose the proportion of children with high numbers of carious lesions fell. The two income indicators (area-level SES) were not associated. A multinomial logistic regression model was run for caries risk factors. Caries severity was used as dependent variable and the model was stratified by mothers' educational level. Mothers' perception of child's oral health was the only covariate that was always associated in every caries severity strata and for each level of mothers' education., Conclusions: The present study shows that mothers' educational level is a useful individual SES indicator for caries in Italian children living in a low-income population.

Background: Even today, use of Glass Ionomer Cements (GIC) as restorative material is indicated for uncooperative patients., Aim: The study aimed at estimating the surface roughness of different GICs using or not their proprietary surface coatings and at observing the interfaces between cement and coating through SEM., Materials and Methods: Forty specimens have been obtained and divided into 4 groups: Fuji IX (IX), Fuji IX/G-Coat Plus (IXC), Vitremer (V), Vitremer/Finishing Gloss (VFG). Samples were obtained using silicone moulds to simulate class I restorations. All specimens were processed for profilometric evaluation. The statistical differences of surface roughness between groups were assessed using One-Way Analysis of Variance (One-Way ANOVA) (p<0.05). The Two-Way Analysis of Variance (Two-Way ANOVA) was used to evaluate the influence of two factors: restoration material and presence of coating. Coated restoration specimens (IXC and VFG) were sectioned perpendicular to the restoration surface and processed for SEM evaluation., Results: No statistical differences in roughness could be noticed between groups or factors. Following microscopic observation, interfaces between restoration material and coating were better for group IXC than for group VFG., Conclusions: When specimens are obtained simulating normal clinical procedures, the presence of surface protection does not significantly improve the surface roughness of GICs.

Aim: The manual files are still widely used for initial canal negotiation prior the use of nickel-titanium shaping instruments, to determine working length and to verify patency. A mechanical glide path can be performed using manual files with handpieces, such as M4 Handpiece (SybronEndo, USA) that allows a 30°/30° reciprocating motion. The Pathfinders (SybronEndo, USA) are hand files designed to negotiate complex canals, made from stainless steel (SS) or carbon steel (CS) alloys. The aim of this in vitro study was to compare cyclic fatigue resistance of these two different types of manual Pathfinder instruments used in a M4 reciprocating handpiece in double curved artificial canals., Materials and Methods: Manual instruments designed for glide path (size #9 ISO .02 taper) made from different alloys were selected: Group SS -stainless steel Pathfinders (Sybron Endo) and Group CS - carbon steel Pathfinders size K2 (Sybron Endo). Ten instruments of each group were tested for resistance to cyclic fatigue with a reciprocating M4 handpiece inside an artificial S-shaped canal; the time to fracture was recorded for each file and data were statistically analyzed (ANOVA)., Results: Mean values (and SD) were 527 (± 89) seconds for the CS instruments and 548 (± 104) seconds for the SS files. No significant differences were observed between groups (p=0,062)., Conclusions: According to the results, both carbon and stainless steel instruments presented similar fatigue resistance when used with M4 reciprocating handpiece in double curved canals.

In dental practice there is an increasing need for predictable therapeutic protocols able to regenerate tissues that, due to inflammatory or traumatic events, may suffer from loss of their function. One of the topics arising major interest in the research applied to regenerative medicine is represented by tissue engineering and, in particular, by stem cells. The study of stem cells in dentistry over the years has shown an exponential increase in literature. Adult mesenchymal stem cells have recently been isolated and characterized from tooth-related tissues and they might represent, in the near future, a new gold standard in the regeneration of all oral tissues. The aim of our review is to provide an overview on the topic reporting the current knowledge for each class of dental stem cells and to identify their potential clinical applications as therapeutic tool in various branches of dentistry.

A randomized clinical trial was performed in schoolchildren (6-7 yrs) to evaluate fluoride concentration in interproximal fluid after the placement of 3 different sealants. The sample consisted of 2,776 children randomly divided: 926 in the high-viscosity Glass-ionomer Cement group (GIC group), 923 in the fluoride Resin-based group (fluoride-RB group), and 927 in the no-fluoride Resin-based group (RB group). In total, 2,640 children completed the trial. Sealants were applied following manufacturer's instructions. Interproximal fluid samples were collected at baseline and 2, 7, and 21 days after application of sealants, by insertion of a standardized paperpoint into the interproximal mesial space of the sealed tooth for 15 seconds. Fluoride concentration was evaluated by means of a fluoride ion-selective electrode. At 2 days after sealant application, fluoride concentration was significantly higher in GIC and fluoride-RB groups compared with that in the RB group (p < .01). Mean fluoride concentrations after 7 days were 2.54 (SE 0.68) ppm, 0.85 (SE 0.26) ppm, and 0.53 (SE 0.11) ppm for the three groups, respectively. After 21 days, fluoride concentration in the GIC group remained higher than that in the other two groups. High-viscosity GIC sealants increased the fluoride concentrations in interproximal fluid more than did a Resin-based sealant containing fluoride.

Endodontics is the branch of deciduous teeth pediatric dentistry that deals with the treatment of the root canal system. The goal of therapy is to maintain as long as possible the element in the dental arch to prevent alterations of orthognathodontic, infectious, and functional history and eruptive sequence. Although manual instrumentation has been widely used and still preferred by some practitioners, has limitations that affect the actual ability to clean the channel, the ability to create steps, perforations, dentinal plugs and fractures of the instrument. On the other hand, the disadvantages are the high cost of the instruments in nickel-titanium, which must be frequently replaced, and the risk of compromising the stability of the tooth due to an excessive consumption of dentinal tissue. The use of computed microtomography (μCT) of extracted elements has a considerable advantage in the study of dental hard tissues. The purpose of this study was to analyze the anatomy of the endodontic system of the elements deciduous.

Introduction: The pathogenesis of temporomandibular joint intracapsular disease (TMJI) is multifactorial and its diagnosis is not easy. In this work authors show two types of clinical analysis: the Condylar Position Indicator (CPI) and T-Scan 2 system., Material and Methods: Twenty patients (mean age of 24.5 years) with TMJI problem and 10 healthy matched subjects (mean age: 25.4 years) were selected. Analysis of TMJI was performed on each patient by means of Condylar Position Indicator (CPI) and T-Scan System II tests., Results: Eight patients presented vertical symmetrical condylar distraction greater than healthy subjects (P-value<0.001). T-Scan showed a difference of Percentage of Force (POF) not greater than 5%. Seven patients showed sagittal shift greater than healthy subject (P-value<0.001). T-Scan records showed a difference of POF greater than 5%. Five non-healthy subjects presented sagittal, vertical, transverse shift greater than healthy subjects (P-value<0.001). T-Scan records show a difference of POF greater than 5%., Conclusion: In this work authors present a new method of analysis. CPI indicates discrepancy of the condyle position in CO from CR and T-Scan allows the operator to study all teeth contacts and occlusal forces taking place during dynamic jaw movement., (Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Aim: This was to validate a taste test on healthy school children. A cross-sectional study was designed to perform a standardised clinical evaluation of the gustatory sensitivity., Materials and Methods: Forty (18 males and 22 females) children were selected. Inclusion criteria were age between 5 and 12 years, absence of systemic disease and no antibiotic treatment in the last six months. The taste assessment tests were performed following a standardised protocol, repeated at two different intervals: a) tested at time 0; b) tested after 20-30 days. Tests were performed using a pipette with the sample solution: sucrose, sodium chloride, citric acid and quinine hydrochloride at different concentrations. The examiner reported in a grid the flavour perceived by the subject. A placebo (tap water) was administered in between the flavours, Results: The majority of the subjects detected the bitter taste at the lowest concentration (mean=1.83). The sour taste was detected with the second concentration (mean=2.56). The sweet solution was detected with the most diluted concentration (mean=1.56). The salty taste has a threshold of 2 (mean=2.04), which means that the majority of subjects detected the salty solution with the second concentration. Regarding the perceived intensity, it increases with the increasing concentrations and it reaches maximum values that are inversely proportional to the threshold, corresponding to the second concentration. Moreover, no statistically significant gender differences were detected regarding the threshold values or the perceived intensity., Conclusion: The proposed test allows for a controlled, reliable and standardised evaluation of the gustatory modality.

Purpose: To evaluate the fluoride concentration in enamel after the use of different fluoride products and 48 hours after the cessation of fluoride use., Methods: 16 enamel slabs were divided and treated for 15 days as following: Group A, with an amine fluoride toothpaste and mouthrinse (1400 and 250 mg/L(-1), respectively); Group B, with an amine fluoride toothpaste (1400 mg/L(-1)) and mouthrinse without fluoride; Group C, with a sodium fluoride toothpaste (1400 mg/L(-1)) and mouthrinse (250 mg/L(-1)). Chemical biopsy and multiple means were used to determine fluoride concentration. The data were statistically analyzed using the two-way ANOVA and Tukey HSD tests (P<0.05)., Results: After 15 days of fluoride product use, Group A samples had the highest fluoride uptake (0.19 microg mm(-2)) (P<0.05). 48 hours after the interruption of fluoride product usage, a higher fluoride concentration was found in Group A samples. Although all fluoride products led to an enamel uptake, amine fluoride products promoted the most effective long-term uptake.

This paper reports the management of two clinical cases, in which the upper right central incisor was fused with a supernumerary tooth and the upper left central incisor was macrodontic. A radiographic examination revealed that the fused teeth had two separate roots. Hemisectioning of the fused teeth was performed, the supernumerary portion was extracted and the remaining part was reshaped to remove any sharp margins and to achieve a normal morphology. The macrodontic central incisors were not treated. At 12-months post-surgery there were no periodontal problems and no hypersensitivity. Orthodontic treatment was performed to appropriately align the maxillary teeth and to correct the malocclusion.

Aim: Describe the occurrence of dental caries in a sample of pre-school children and school children, aged 3 and 12, and study the possible association between caries and malocclusion., Methods: We selected and analyzed the medical records of a sample of 588 patients who had their first dental examination at the Pediatric Dentistry Unit, Department of Oral and Maxillofacial Sciences of Policlinico Umberto I, "Sapienza" University of Rome., Results: In the sample, 55.4% of the children had no decayed deciduous elements, while 44.6% had at least one decayed deciduous element. The prevalence of decayed permanent teeth was 10.2%, while 89.8% had no decayed permanent teeth. In the sample, 9.4% of the children showed advanced carious lesions, that needed tooth extraction and 6.6% needed a space maintainer for post-extractive interceptive treatment. In the sample, 26.7% of the examined patients had increased overjet, while 3.7% had decreased overjet and 25.4% of the sample had an increased overbite, 11, 2% had reduced over-bite values. A percentage over 10% of the sample had an anterior openbite in centric occlusion. The prevalence of posterior crossbite among entire samples was 19.8%., Conclusions: Although the incidence of caries disease was high in the selected samples, the study did not show a statistically significant association between caries and clinical orthodontic abnormalities, except for the association between the midline deviation and the severe carious diseases, necessitating extraction.

This study aims to critically summarize the literature about bisphenol A (BPA), indicate whether and how those risks are real and emphasize how it is eventually possible to prevent them. With this in mind, we should consider nature, risks and control of BPA, as well as its presence and its role in sealants and composites. It is important to note that we will focus on literature exclusively written about the possible estrogenic activity (and not about the general toxicology profile) of BPA or its possible derivatives released from composites and sealants (without mentioning, or covering just briefly, similar activities performed by their components).

Aim: Sealing of pits and fissures is one of the most effective techniques in caries prevention: however incomplete removal of plaque debris, can cause lack of retention of the sealant., Materials and Methods: Sixty first permanent molars were sealed for this study. The teeth were divided into four groups. All teeth were isolated with a dental dam before cleaning and coronal polishing was performed with synthetic bristles or air polishing. Disclosing solution was used to reveal plaque. Three different operators performed cleanings and sealing., Results: The results show that the plaque indicator was necessary to ensure complete cleansing of pit and fissures. PROPHYflex3 was the easiest and most effective device for removing plaque and debris. Synthetic bristles failed to thoroughly cleanse the surface in most attempts., Conclusion: Results suggest that pits and fissures should be cleaned with a plaque indicator and air polishers before placing a sealing material to ensure complete removal of plaque from the tooth.

Aim: In this work authors show a diagnostic criteria in study of TMID: neuro occlusal clinical evaluation (NOE), T-Scan 2 system and surface electromyography (sEMG)., Methods: Nine patients 25-30 years old with TMID problem and 9 healthy group control have been selected and examined. On each patients it has been performed NOE, T-Scan and sEMG test. NOE has been calculated on each patient photos lateral mandibular excursion angle called: masticatory functional angle (AFM). T-Scan System is a computerized occlusal analyzer that provide in-depth understanding of the overall balance of the occlusion. At the same time of T-Scan record sEMG tests, in resting position and in maximum clench, have been performed., Results: In healthy control there were no AFM difference. In no healthy group there were difference between the two AFM greater than 6 degrees. T-Scan COF showed how in healthy group control there was never a difference of COF greater than 5%. In no healthy group the difference were greater than 5% P<0.05. T-scan showed difference of time force in maximum intercuspidation (MIFT) in healthy respect TMID patients. In healthy patients MIFT was higher than TMID patients P<0.05. sEMG test showed in non healthy group a great asymmetrical activation of masseter (MM). MM activation were greater on side affected by joint sound than the balance side P<0.001. sEMG show how in TMID patients maximum masseter activation is always lower than maximum masseter activation of healthy subjects P<0.001., Conclusion: Neuro occlusal clinical evaluation (NOE) in TMID patients is supported by instrumental evaluation.

AIM.: The lactic bacteria are Gram-positive microorganisms with coccus or stick shape, which share a number of physiological and biochemical properties. Several experimental evidences suggest the possibility of using lactic acid bacterial as a preventive or therapeutic potential approaches, alternative or complementary to prevention or treatment protocols currently followed in several pathological conditions. Lactobacillus brevis is able, through the arginine-deiminase activity, to subtract the substrate (arginine) to nitric oxide synthase, and to inhibit in vitro generation of nitric oxide from rat's peritoneal macrophages. These data led us to study the in vivo L. brevis anti-inflammatory effect choosing as experimental model the gingivitis. MATERIALS AND METHODS.: In our study were examined 21 subjects, 16 males and 5 females, aged between 5 and 12 years, with marginal gingivitis problems who have been given chewing gum containing the principle to test in measure of three per day. RESULTS.: At the time T1, after treatment, 18 patients no longer showed inflammation; 2 of them had a slight inflammation and only 1 patient still showed a moderate inflammation. CONCLUSIONS.: From our research, as confirmed by clinical and laboratory investigation, results an effective anti-inflammatory action of arginine-deiminase system that some bacteria possessing.

Aim: The aim of this study was to observe dentine and enamel surfaces of deciduous teeth under SEM after cavity preparation with Er:YAG laser using different fluences. The results showed that when using Er:YAG laser for cavity preparation in deciduous teeth, no carbonisation or cracks were observed on the enamel and dentine surfaces using energy output between 150-250 Mj, and frequency 15 Hz. The SEM images of the dentine and enamel surfaces were similar to previous studies on permanent teeth: enamel with a typical "lava flow" appearance as a result of an open core of the prism that has lost its typical hexagonal aspect and the dentine with opened tubules plus a difference in the mineral thickness between peritubular and intertubular., Conclusion: The difference between the SEM images of deciduous enamel and dentine when using three different energies (150-200-250 mJ) is not significant in order to recommend the use of one type of output energy. In addition, the SEM images are similar TO those of permanent teeth.

Aim: This study had two main goals: the evaluation of caries experience in permanent teeth and the analysis of malocclusion prevalence., Study Design: Observational cross-sectional survey., Methods: The sample consisted of all the 5th graders of 'Gio Leonardo di Bona', the only Public School in Cutro, a small urban area in Southern Italy (10,000 inhabitants). The clinical examination was performed by a trained dentist at the school infirmary, and no radiographs, study casts, or previous written records of the children were available. DMFS-DMFT and Index of Orthodontic Treatment Need (IOTN) were used to fulfil the study objectives. After the examination, parents received a report on presence/absence of dental caries and possible orthodontic treatment need. Statistics All data were analysed with StatView and Stata 8.0 software. The Chi-square test was applied to compare prevalence rates. The Chi-square linearity was used to evaluate whether caries and malocclusion prevalence changed with a steady trend with reference to sex., Results: The 94% (n. 97) of the whole sample gave a positive consent to the screening. The overall mean of DFS was 4.30 (4.74 SD) while the mean of DFT was 2.60 (2.03 SD). The 22.7% of the sample had DFS/T = 0. Statistically significant difference between genders according to DFS (p = 0.017) and DFT (p = 0.002) distribution was found, being females' significantly lower than males'. Using the DHC-IOTN, 51.6% of the children were assigned to the no/little need, 26.8% to borderline need and 21.6% to a great need for orthodontic treatment. There was no statistically significant difference by gender according to distribution of occlusal traits (p> 0.05), except in the anterior cross bite, being males significantly more affected (p = 0.030)., Conclusions: We believe that oral health and orthodontic surveys performed on a higher number of patients at an early age are critical in order to enhance early treatment, thus avoiding severe malocclusions and progression of dental caries. The results of our study indicate that 21.6% of the sample had an objective orthodontic treatment need (grades 4-5 DHC-IOTN). The single Aesthetic Component (AC) score of the IOTN failed to identify orthodontic treatment needs in our sample: only 13% rated themselves as being in categories 5-10 (great aesthetic need for treatment). With reference to dental caries, males had a mean DFT (3.20) higher than the WHO's 2000 Oral Health Goal for 12-years-olds (DFT = 3) while females (DFT = 1.96) were significantly under this target. The children were advised to undergo regular examinations and to change their lifestyle habits.

Objectives: To evaluate the marginal integrity of class V restorations through an SEM observation and a microleakage test., Methods: Teeth with class V cavities were restored with either a flowable composite (n=20) or a glass ionomer cement (GIC) (n=20). Ten restorations in each group were immediately polished. A coating agent was applied on five polished and five non-polished restorations of each group. No coating was used on the remaining specimens. Epoxy resin replicas of the restorations were observed under a SEM and the percentage of marginal gaps was calculated. After immersion in a 2% methylene blue solution, three sections were obtained from each specimen and observed under a stereomicroscope. Occlusal and gingival microleakage were evaluated with a four-steps scoring system. The percentages of marginal gaps and the microleakage scores were analyzed with the Kruskal-Wallis ANOVA and the Mann-Whitney test with Bonferroni's correction. Occlusal and gingival microleakage were compared with the Wilcoxon test., Results: No gaps were detected after coating. The restorative materials did not differ in interfacial gaps. Immediate polishing increased the gaps of uncoated restorations (p<0.05). The microleakage decreased with coating, except for occlusal wall of polished flowable composite restorations. After coating, the occlusal microleakage was higher than the gingival (p<0.05), except for non-polished flowable composite restorations. After polishing and coating, the flowable composite showed higher occlusal microleakage than the GIC. The polishing increased the occlusal microleakage of coated flowable composite restorations., Conclusions: The coating procedure is advisable for restoring marginal integrity and reducing gingival microleakage in class V restorations.

Aim: The Er:YAG laser has proven to be effective and efficient in dental hard tissue ablation. The Minimally Invasive Dentistry (MID) approach in caries removal is to stop the disease process and to restore lost tooth structure and function, maximizing the health potential of the tooth. One of the most important concepts of the MID is to preserve as much as possible the dental tissue and this approach is even more important in primary dentition where the dimensions of the crown are smaller and the dimension of the pulp chamber is bigger in relationship to the crown. After treating 30 children's teeth (primary molars and first permanent molars) with the Er:YAG laser, we come to conclusion that laser treatment possesses the requirements of Minimal Invasive Dentistry: the possibility to ablate small area of infected layer guarantees maximum conservation of the tooth structure; using the antibacterial property of the Er:YAG laser we can decontaminate the affected layer that retains its remineralising potential; the lack of smear layer after vaporization with laser assures a better retention of the composite resin to the dentine; preparing the enamel surface with laser before etching gives a better marginal seal of the composite restoration.

Objectives: This review aimed at summarizing the laboratory evidence collected on the retentive ability of adhesive posts since their introduction in dentistry., Data: Data were searched in articles published or in press in peer-review journals listed in MEDLINE., Sources: Papers were retrieved through PubMed., Study Selection: To collect the evidence of interest, the following search terms were used: bond* AND fiber post AND in vitro; lut* AND fiber post AND in vitro; push-out AND fiber post; pull-out AND fiber post; microtensile AND fiber post. "Related Links" were also considered and articles cited in the initially retrieved papers were included if relevant. No time limit was given to the query., Conclusions: Seventy relevant papers were reviewed. The retentive ability of adhesive posts has been tested with the microtensile technique, post-pull-out and push-out tests. If small-sized specimens are obtained, such as in microtensile and thin-slice push-out, stress uniformity is favoured, local differences in bonding conditions can be discerned, and the number of teeth needed for the test can be reduced. Although adhesion to intraradicular dentin is more challenging to achieve than bonding to crown tissues, the post-retention achieved with current luting systems and techniques is adequate to ensure the clinical success of adhesive post-retained restorations. To enhance the bond at the post-core and post-cement interfaces, several chemical pre-treatments of the post-surface have been tested with positive results. Self-adhesive resin cements, recently proposed to simplify the post-luting procedure, should be investigated further with regard to durability.

Aim: To assess at the scansion electron microscope (SEM) the structural aspects of enamel hypoplasia (EH) in coeliac disease (CD) with the aim to investigate our hypothesis of a possible significant difference between structural characteristics of EH in CD affected patients and EH of non-coeliac patients. If the presence of specific features of the EH associated with CD were demonstrated, these findings would represent for the dentist early non-invasive clinical markers of diagnosis of CD in case of suspected disease., Methods: We analysed at SEM two samples of enamel fragments from hypoplasic teeth, both deciduous and permanent, harvested from 10 coeliac children (18 permanent teeth, 6 deciduous teeth; study group) and 10 non-coeliac children (16 permanent teeth, 4 deciduous teeth; control group) treated for dental caries, dental extractions for extensive caries lesions or deciduous teeth exfoliation., Results: Significant structural differences were noted between EH of non-coeliac patients and same dental ? lesion in the group with CD. In the study group, EH defects were predominantly located on the central and lateral incisors, upper and lower, both deciduous and permanent, and on the first permanent molars, and were always simmetrical. EH of permanent teeth of CD affected patients was characterised by prisms more irregularly distributed with irregular margins and less interprismatic substance than observed in non-coeliac EH. The deciduous teeth of the study group showed shorter enamel prisms with a non-parallel direction up to convergence and less interprismatic substance than observed in the control group., Conclusion: This morphological analysis at SEM of the hypoplasic enamel defects of a group of coeliac children, the first published in literature, demonstrates that the EH of deciduous and permanent teeth in CD is highly hypomineralised with shorter prisms, more irregularly distributed and less interprismatic substance than observed in the non-coeliac EH. More data are needed to validate the significance OF our observations with the aim to assess if this simple, non-invasive microscopic analysis can be considered effective for the early identification of silent cases of CD that otherwise would not be diagnosed in the paediatric age.

Aim: This paper addresses the need of the dental literature to document cases of Glycogen Storage Disease (GSD) type Ib with focus on the paediatric management of oral and dental problems and the potential complications arising from the increased susceptibility to bacterial infections, cariogenicity, and blood diathesis., Methods: Previous medical and dental papers on GSD type Ib published from 1980 to 2006 have been searched in the electronic databases PubMed and EMBASE using keywords of the NLM's Thesaurus, with the aim to retrieve important implications of treatment and preventive measures for an evidence-based multidisciplinary medical and dental management of the oral health problems of a 9-year old boy affected by GSD type Ib., Case Report: Oral and dental manifestations observed during a period of two years and relative treatments are reported from our case. Data on pharmacologic, oral hygienic, dietary, and surgical preventive measures for the control of recurrent oral infections, dental caries, gingival inflammation and risk of surgical bleeding are described. In addition, an electronic microscope structural analysis at SEM of the enamel tooth surface was conducted to identify any characteristic difference in the enamel architecture of this GSD type Ib affected patient compared with the normal enamel structure., Conclusion: The oral manifestations of our case included uncommon findings such as multiple deep oral ulcers of the tongue, labial and vestibular mucosa, which could be related with a severe impairment of the neutrophil-related immune system of the patient. At SEM, the enamel of the deciduous teeth showed dark spots of hypomineralisation which are the first published data of an enamel-related susceptibility to dental caries. The quality of life of our patient increased thanks to the oral and dental treatments and preventive oral health measures given at clinical appointments. The dentist should be prepared to face the possible complications of surgery in these patients and the hospital setting seems to allow for this clinical safety.

Background: The fundamental therapeutic problems related to amelogenesis imperfecta treatment are governed by the need to effect primary prevention interventions, reducing the risk of calculus accumulation and caries. There are also aesthetic and functional rehabilitative needs. Clinical management rehabilitation techniques vary depending on the AI type, but usually require restoration of affected teeth. Where orthodontic problems also exist, these should be corrected prior to the final restorative treatment., Case Report: The use of composite resins in aesthetic restoration of permanent anterior and posterior teeth as affected by hypoplastic AI type is described. This case illustrates a patient who suffered from less attrition than those of the hypomineralized varieties. The therapeutic choice has allowed the correction of vertical dimension without the use of preformed crowns.

Red blood cells and plasma reduced and oxidized glutathione levels, glutathione peroxidase (GSH-Px) activity, thiobarbituric acid reactants (TBAR) of both chronic ambulatory peritoneal dialysis (CAPD) patients and a matched control group were investigated in this study. Oxidized and reduced pyridinic nucleotides in red blood cells (RBC), in which NADPH is a direct expression of hexose monophosphate shunt function, were also studied. The results obtained indicate that RBC and plasma are exposed to oxidative stress in CAPD. This condition is characterized by a decreased GSH/GSSG ratio, particularly evident in RBC as a consequence of the GSSG accumulation. Lipid peroxidation is increased, as indicated by raised TBAR levels, and reduced pyridinic nucleotides are decreased. Increased GSH-Px levels and unmodified or slightly increased GSH content were observed in the RBC but not in plasma, which showed decreased GSH and unmodified peroxidase activity. Peroxidase correlated positively with TBAR levels in the RBC lysates. In a subgroup of patients treated with erythropoietin (vs. untreated patients and controls) no differences were observed in the glutathione-related parameters studied. These data suggest that a mechanism for adaptation to oxidative conditions may be present in CAPD and its effects on RBC integrity are discussed in comparison with the hemodialysis conditions previously studied.

Reduced and oxidized glutathione and pyridine coenzymes, glutathione-related enzymes and Cu,Zn-superoxide dismutase (Cu,Zn-SOD) were investigated in the RBC of patients with chronic renal failure (CRF) and in age- and sex-matched controls. The effects of hemodialysis (HD) were also studied. A defective RBC redox state was shown in the CRF group based on a decreased GSH/GSSG ratio and NADPH levels. Increased activities of glutathione transferase (GSH-S-T) and Cu,Zn-SOD were observed before HD. Dialysis apparently restores the levels of antioxidant enzymes and at the same time strongly affects the redox state. Thus we can speculate that HD can generate severe redox impairment inducing damage in RBC and plasma antioxidant enzymes. Increased erythrocyte GSSG and GSM-S-T levels coupled with a reduced hexose monophosphate shunt (HMPS) function may be useful indexes of oxidative stress in uremic anemia.

The work takes into consideration the changes of dimension undergone by alginate submitted to the sterilizing action of aldehyde glutarate, after the impression. Trough the use of computerized analyser of images, samples of sterilized alginate have been compared with control samples. The results obtained can give a useful contribution to the prophylaxis of the crossed transmission of infection in the dental field.

As previously reported, during rabbit red blood cell aging glucose phosphorylating activities show several modifications. In the first period of the red cell life span the predominant form is similar to hexokinase II, while in the mature erythrocyte the predominant glucose phosphorylating activity resembles hexokinase I. In the oldest cells glucose phosphorylating activity has a low affinity (high Km) for glucose. In this paper the modifications of hexokinase in cell aging have been studied in vivo in a young erythrocyte population synchronized by actinomycin D, and in vitro in red cells separated in fractions according to different ages. Since protein synthesis is lacking in the mature red cell, we are inclined to explain the presence of low-affinity hexokinase activity in the oldest erythrocytes as an age-dependent transformation of a primary hexokinase.

The case of a haemolytic non-spherocytic anaemia with pyruvate kinase (PK) deficiency is reported. The investigation concerns two families with a low level of PK. In the propositus and in the members of his family we have also examined the behaviour of some enzymes and the concentration of red cell metabolites. We confirm the heterogeneity of the manifestation and agree that anaemias due to PK deficiency are complex forms in which the enzyme defect is only one of the symptoms.

The kinetic properties of rabbit red blood cell hexokinase in different buffer systems have been studied. At pH 8.0 the reaction velocity (v) is about 30% higher in glycylglycine compared to Tris, Tea, Hepes or ammonium acetate buffers. The enzyme stability, heat-dependence and spectral properties of the enzyme are also affected by the buffer utilized. None of the following kinetic properties of red blood cell hexokinase varies with pH in the range 6.8-8.5: Km of glucose; Km of ATP and Ki of glucose 6-phosphate.

1. ATP-D-hexose-6-phosphotransferase activity was measured in red blood cells of man, rabbit, pig and cow. Mean values ranged from 0.60 to 1.06 units/g haemoglobin and no significant difference was obtained with different glucose concentrations. 2. The characteristics of glucose phosphorylating activities in red blood cells of the species studied were similar. 3. Chromatography on DEAE column revealed two different glucose phosphorylating activities in red cells of man, rabbit and pig, and only one in cow red cells. 4. The first hexokinase activity is the predominant form and is saturated with low glucose concentrations; the second is noticeably marked at high glucose concentrations.

In human erythrocytes, in the absence of specific enzymes, G1,6P2 synthesis and degradation are carried out by phosphoglucomutase PGM2 isoenzymes. The results presented, obtained by using partially purified preparations of these enzyme forms, suggest that erythrocyte G1,6P2 may play a crucial role in the physiological interconversion of several important sugar monophosphates.