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Digital denture design requires anatomic information, an accurate maxillomandibular relationship, and parameters to guide tooth arrangement. Capturing all these data by intraoral scanning makes their immediate digitization, integration, and transfer to the computer-aided design workflow possible, which can be started without an additional procedure. The presented technique describes the digital workflow to automatically align intraoral scans of completely or partially edentulous maxillary and mandibular arches according to the maxillomandibular relationships registered in digitally designed occlusion rims adapted on the patient., (Copyright © 2019 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: The presented technique describes the intraoral scanning workflow to capture scans of edentulous arches and occlusion rims, align them as per maxillo-mandibular relationships registered in the occlusion rims, and incorporate data for tooth arrangement., Methods: On preliminary intraoral scans of the edentulous arches, design the baseplates for the occlusion rims, make a 3D print of them and finalize by adding wax. Use occlusion rims to make jaw relation record and definitive intraoral scans. Use the "Pre-preparation scan" function to link scans of occlusion rims to scans of edentulous arches and align each other., Conclusions: Making and aligning, in a single procedure, intraoral scans of the edentulous arches and occlusion rims incorporating maxillo-mandibular relationships and information for tooth arrangement, allow to proceed directly with the denture design, thus, being sensible from the treatment time efficiency point of view. The technique is applicable to both partial and complete edentulous maxillary and mandibular arches. Nonetheless, care should be taken in stabilizing occlusion rims, whose shape is characterized by a reduction in size of the baseplates. In addition, its accuracy in comparison with the current clinical best practice based on conventional procedure requires to be addressed by further research., (Copyright © 2019 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.)

Aim: Musashi 2 (MSI2), which is an RNA-binding protein, plays a fundamental role in the oncogenesis of several cancers. The aim of this study is to investigate the expression of MSI2 in Oral Squamous Cell Carcinoma (OSCC) and evaluate its correlation to clinic-pathological variables and prognosis., Materials and Methods: A bioinformatic analysis was performed on data downloaded from The Cancer Genome Atlas (TCGA) database. The MSI2 expression data were analysed for their correlation with clinic-pathological and prognostic features. In addition, an immmunohistochemical evaluation of MSI2 expression on 108 OSCC samples included in a tissue microarray and 13 healthy mucosae samples was performed., Results: 241 patients' data from TCGA were included in the final analysis. No DNA mutations were detected for the MSI2 gene, but a hyper methylated condition of the gene emerged. MSI2 mRNA expression correlated with Grading ( p = 0.009) and overall survival ( p = 0.045), but not with disease free survival ( p = 0.549). Males presented a higher MSI2 mRNA expression than females. The immunohistochemical evaluation revealed a weak expression of MSI2 in both OSCC samples and in healthy oral mucosae. In addition, MSI2 expression directly correlated with Cyclin-D1 expression (p = 0.022). However, no correlation has been detected with prognostic outcomes (overall and disease free survival)., Conclusions: The role of MSI2 expression in OSCC seems to be not so closely correlated with prognosis, as in other human neoplasms. The correlation with Cyclin-D1 expression suggests an indirect role that MSI2 might have in the proliferation of OSCC cells, but further studies are needed to confirm such results.

Statement of Problem: Limited evidence is available for the marginal fit of multiunit fixed dental prostheses (MFDPs) fabricated with digital technologies compared with those fabricated with conventional techniques., Purpose: The purpose of this systematic review and meta-analysis was to answer the following question: Does digital workflow for the fabrication of tooth-supported or implant-supported MFDPs provide better marginal fit than the conventional workflow?, Material and Methods: PubMed, SCOPUS, EBSCO, and Web of Science databases were searched for controlled in vitro studies addressing direct comparison of the fit of MFDPs produced with digital or conventional workflows and excluding studies addressing interim restorations, MFDPs on mixed abutments (teeth and implants), or studies in which reproduction of the basic master cast was performed in 1 group. Vertical and horizontal marginal fit were the primary outcomes; meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with subgroup analysis for tooth- or implant-supported MFDPs., Results: Four studies published between 2011 and 2015 met the inclusion criteria and were included in the review. They investigated 3-unit partial fixed dental prostheses, exhibited a high degree of heterogeneity, and reported data only regarding vertical marginal fit. MFDPs fabricated with digital techniques presented a nominally higher vertical marginal discrepancy than those fabricated with the conventional technique, but the mean difference (MD) (19.8 μm, 95% confidence interval [CI]: -12.1; 51.7) has no statistical significance. The same is also applicable to subgroup analysis for a tooth-supported (MD=45.8 μm, 95% CI: -45.4; 137.0) or implant-supported (MD=14.7 μm, 95% CI: -38.6; 68.1) MFDP., Conclusions: Digital technologies offer a reliable alternative to conventional techniques for the fabrication of tooth- or implant-supported 3-unit fixed partial dentures; additional studies with up-to-date technologies and for prostheses with more than 3 units are recommended to provide stronger evidence., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: Tumor associated macrophages (TAMs) are among the most abundant cells of the tumor microenvironment. Several studies have been performed to investigate whether TAM markers, namely CD68 and CD163, could serve as prognostic factors in patients with squamous cell carcinoma of the head and neck (SCCHN). The aim of this systematic review and meta-analysis was to synthetize the available evidence of the literature about the role of CD68+ and CD163+ TAMs as prognostic factors in SCCHN., Materials and Methods: This systematic review was performed according to the guidelines reported in the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Meta-analysis of overall survival, disease-free survival and progression-free survival was performed using the inverse of variance test. A random- or a fixed- effect model was used on the basis of the presence of heterogeneity. Risk of bias assessment and subgroup analysis were also performed., Results: High stromal expression of CD163+ TAMs correlated with both poor overall survival (HR, 2.26; 95% CI: [1.47, 3.47]; P < 0.001) and progression-free survival (HR, 2.29; 95% CI: [1.11, 4.71]; P = 0.03). Conversely, abundance of CD68+ TAMs was not associated with overall survival (HR, 1.25; 95% CI: [0.86, 1.80]; P = 0.24) and disease-free survival (HR, 2.06; 95% CI: [0.84, 5.05]; P = 0.11)., Conclusions: Findings from this study revealed that whilst IHC analysis of the generic macrophage marker CD68+ has no prognostic utility in patients with SCCHN, the M2-like marker CD163+ predicts poor prognosis. Our data suggest that assessment of CD163+ TAMs in SCCHN has potential for future clinical use. Further well-standardized studies should be performed to confirm these results., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

One of the main issues in using intraoral scans for the fabrication of removable dentures is that scans need to be aligned to each other. The workflow presented provides aligned intraoral scans of the arches and of the occlusion rim incorporating maxillo-mandibular relationships and information for tooth arrangement in a single procedure. Thus, after intraoral scanning, the clinician can proceed directly with the denture design., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background: ADAR1 is an enzymatic protein, which catalyzes a RNA editing reaction by converting Adenosine to Inosine, and its expression has been found to be dysregulated in many cancer types. The aim of this study was to analyze the expression of ADAR1 in oral squamous cells carcinoma., Methods: In order to analyze the ADAR1 mRNA expression, data from The Cancer Genome Atlas (TCGA) database were downloaded and analyzed. In addition, immunohistochemistry analysis was performed on an institutional database including 46 samples of oral squamous cell carcinoma in a tissue microarray (TMA)., Results: No statistically significant correlation linked the mRNA ADAR1 expression to any clinic-pathological variables in the TCGA database. Immunohistochemistry analysis of ADAR1 showed different expressions between normal mucosa and tumor tissue. Focusing on the subcellular localization, the nuclear expression of ADAR1 correlated with higher grading of differentiation (ρ = 0.442; P-value = 0.002); the general expression of ADAR1 either in cytoplasm or in nuclei, correlated with the Gender of patients (Cytoplasm expression: ρ = -0.295; P-value = 0.049; while for nuclear expression: ρ = +0.374; P = 0.011); cytosol expression resulted to be an independent protective prognostic factor (HR = 0.047; C.I. 95% 0.007-0.321; P-value = 0.002)., Conclusion: Higher expression of ADAR1 into the cytoplasm resulted to be an independent prognostic factor. In order to understand ADAR1 role in cancer, further studies should be performed, in bigger cohort and under a bio-molecular point of view., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Orthodontic treatment has important correlations with periodontal changes. Various mechanical and biological factors are involved in determining such changes, but anatomical and morphological variables, generally addressed as periodontal biotype, play a key role. In measurement of such modifications, digital and non-contact reverse engineering technologies may be of tremendous advantage. The aim of this study is to retrospectively evaluate, in a series of digitized dental casts, some of the parameters addressing periodontal biotype and correlate them to extent and direction of tooth movement. Pre- (T0) and post-treatment (T1) dental casts of 22 patients were scanned by 3Shape TRIOS 3® scanner. A number of variables (crown ratio, gingival margin position, gingival contour, papillae position, gingival scallop) were investigated and their variations calculated after digital measurements on single casts at T0 and T1, or after direct measurement (T1 vs T0) on the superimposition and alignment of digital models. Univariate and multivariate statistics were then performed. No significant correlation was detected between the sagittal or vertical movement of dental crown and displacement of the gingival margin. On the other hand, vestibular gingival contour resulted significantly altered by vestibular and extrusion movements. Further studies are needed to ascertain the differential effect of bone and soft tissue on such modifications. The relationship between orthodontic treatment and the periodontium overcomes the consideration of gingival recession and includes all the concepts of periodontal biotype with its characteristics. Digital technologies and non-contact reverse engineering techniques now available have the potential to allow a more precise definition of such a relationship.

Survivin is a well-known protein involved in the inhibition of apoptosis in many different cancer types. The aim of this study was to perform an integrated bioinformatic and histologic analysis in order to study the expression and prognostic role of Survivin and its related gene BIRC5 in oral cancer. Publicly available databases were accessed via Gene Expression Omnibus and Oncomine, in addition raw data from The Cancer Genome Atlas (TCGA) were also obtained in order to analyze the rate of gene mutation, expression and methylation in patients with oral squamous cells carcinoma (OSCC). Immunohistochemistry (IHC) was also performed in order to evaluate the nuclear and cytoplasmic expression of Survivin and their correlation with cell proliferation in samples from OSCC patients. Results of this study revealed that Survivin is rarely mutated in OSCC samples and upregulated when compared to non-cancerous tissue. A negative correlation between the methylation of the island cg25986496 and BIRC5 mRNA expression was detected from TCGA data. IHC staining revealed that cytoplasmic (and not nuclear) expression of Survivin is associated with poor overall survival in OSCC patients, while the nuclear expression correlates with higher proliferation rate. In addition, data from TCGA database revealed that BIRC5 gene expression is an independent prognostic factor for OSCC patients.

The production of removable dentures from intraoral scans has been problematic. In addition, the digital design and fabrication of a single-arch denture cannot be routinely managed. The workflow presented provides a proof of concept that an optical intraoral scan of the edentulous maxilla is feasible and that a functional single-arch maxillary denture can be designed and fabricated using a digital protocol., (Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Introduction: The aim of this systematic review was to analyse current evidence regarding differences in early and late implant failure as well as in marginal bone level (MBL) changes between submerged and non-submerged healed dental implants., Methods: PUBMED, SCOPUS, EMBASE and Web of Science databases were searched for prospective randomized and non-randomized controlled studies addressing direct comparison between submerged and non-submerged implant healing, without performing immediate loading. Early and late implant failure (before or after 6 months from implant placement, respectively) together with MBL were the investigated outcomes. Risk of bias assessment was performed using the Cochrane Collaboration Tool for Randomized clinical trials. Meta-analysis was performed and the power of the meta-analytic findings determined by trial sequential analysis (TSA)., Results: Eleven studies met the inclusion criteria and were included in the review. Results of this systematic review revealed a small higher rate (2%) of early implant failure when a non-submerged healing approach is performed. Late implant failure appears not to be different in submerged or non-submerged healing, but the power of evidence, as determined by TSA, is not high. If we consider MBL changes at 1 year from implant load, it seems that non-submerged healing may better preserve marginal bone, although with a small effect size (0.13 mm)., Conclusions: Implants placed with a non-submerged technique have a higher risk (2%) of early failure. The power of the evidence about the effects on MBL is low, but present results seem to favour non-submerged healing, although with a very small effect size., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Digitalization of the design and manufacture of removable complete dentures has numerous advantages. The workflow as presented integrates current open digital technologies into a functional protocol, enabling complete dentures to be designed and fabricated without system-specific trays or instruments. This is done by using a conventional technique to acquire anatomic information., (Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Survivin, an anti-apoptotic molecule abundantly expressed in most human neoplasms, has been reported to contribute to cancer initiation and drug resistance in a wide variety of human tumors. Efficient downregulation of survivin can sensitize tumor cells to various therapeutic interventions, generating considerable efforts in its validation as a new target in cancer therapy. This review thoroughly analyzes up-to-date information on the potential of survivin as a therapeutic target for new anticancer treatments. The literature dealing with the therapeutic targeting of survivin will be reviewed, discussing specifically squamous cell carcinomas (SCCs), and with emphasis on the last clinical trials. This review gives insight into the recent developments undertaken in validating various treatment strategies that target survivin in SCCs and analyze the translational possibility, identifying those strategies that seem to be the closest to being incorporated into clinical practice. The most recent developments, such as dominant-negative survivin mutants, RNA interference, anti-sense oligonucleotides, small-molecule inhibitors, and peptide-based immunotherapy, seem to be helpful for effectively downregulating survivin expression and reducing tumor growth potential, increasing the apoptotic rate, and sensitizing tumor cells to chemo- and radiotherapy. However, selective and efficient targeting of survivin in clinical trials still poses a major challenge., Competing Interests: The authors declare no conflict of interest.

Introduction: Alveolar ridge preservation (ARP) techniques aim to reduce resorption after tooth extraction. The combination of a graft material covered with a resorbable membrane represents one of the most common strategies performed in the clinical practice. The aim of this systematic review is to analyze evidence regarding potential benefits of ARP procedures performed with allogenic/xenogenic grafts in combination with a resorbable membrane coverage in comparison with spontaneous healing., Methods: Electronic databases were screened independently to select studies suitable for inclusion in this review. Horizontal ridge width reduction (HRWR) and vertical ridge height reduction (VRHR) were investigated as primary outcomes and volume changes (VC) as a secondary outcome. Meta-analysis was performed using the inverse of variance test with a random effect model. Adjustment for Type I and II errors and analysis of the power of evidence was performed with trial sequential analysis (TSA)., Results: Seven studies met the inclusion criteria and were included in the quantitative synthesis. Meta-analysis revealed that the combination therapy resulted in a lower rate of resorption for both HRWR (-2.19 mm, 95% confidence interval [CI]: -2.67 to -1.71 mm) and VRHR (-1.72 mm, 95% CI: -2.14 to -1.30 mm). For VC no meta-analysis was performed due to insufficient data. Analysis of the power of the evidence performed with TSA showed that the number of both studies and sockets analyzed is sufficient to validate such findings, despite the high rate of heterogeneity., Conclusions: Use of bone graft covered by a resorbable membrane can decrease the rate of alveolar ridge horizontal and vertical resorption after tooth extraction. The power and reliability of the evidence is strong enough to confirm the above-mentioned findings, despite the high rate of heterogeneity of included studies., (© 2017 American Academy of Periodontology.)

Background: In the present paper, the authors analyze the effect of the "Swallowing Occlusal Contact Intercept Appliance" (SOCIA) in treatment of children with hyperdivergent Class II malocclusion. This functional appliance has no intra-oral anchorage, but induces a continuous periodontal, muscular, and articular stimulation., Methods: Twenty-six patients with hyperdivergent growth and class II malocclusion were selected and treated with SOCIA appliance. Cephalometric analysis was performed before treatment (T1) and immediately after the treatment (T2)., Results: After 24 months treatment authors observed a modification of maxillary growth with a reduction of the divergence with an increase of the posterior facial height, a modification of condylar inclination and forward position of the a hyoid. No modifications was observed about the ANB angle. After treatment the open bite was resolved with a reduction of the inclination of the upper incisors., Conclusions: SOCIA is a reliable functional appliance in growing age patients with a hyperdivergent pattern growth, anterior open bite and class II molar malocclusion.

Background: To evaluate if changes in lower incisor position following orthodontic treatment are correlated with development of gingival recessions., Material and Methods: Pre- and post-treatment digital models and lateral cephalograms of 22 subjects were collected retrospectively. The clinical crown length, gingival scallop, and papilla height of the central lower incisor were measured along with the cephalometric incisor's inclination, the distance from the mandibular plane, and the distance between the Infradentale and Menton points. Statistical correlations between gingival and cephalometric variables were studied. In addition, two groups were defined based on the post-treatment incisor inclination value ('normal' or 'proclined') and compared., Results: The incisor inclination was correlated with the change in gingival scallop and papilla height. Moreover, there was a statistically significant difference in clinical crown height and gingival scallop between the 'normal' group and the 'proclined' group., Conclusions: Changes in lower incisor position, especially an excessive proclination, after orthodontic treatment may play a role in the development of gingival recession. Key words: Orthodontic treatment, Incisor inclination, IMPA, Gingival recession, Alveolar bone., Competing Interests: Conflict of interest statement:The authors state that they have no conflicts of interest.

Oral squamous-cell carcinoma (OSCC) and most human tumors are characterized by an imbalance of regulatory mechanisms controlling cell processes such as apoptosis. Survivin, a member of the inhibitor of apoptosis family, is overexpressed in most solid and hematological malignancies and correlates with a reduced overall survival rate. Thus, the aim of this study was to find a correlation between nuclear Survivin expression and clinicopathologic data and the prognosis in OSCC patients. A total of 152 OSCC samples were investigated by immunohistochemistry for nuclear Survivin expression. Then, Survivin was scored semiquantitatively using an immunoreactivity score (IRS), calculated by multiplying the percentage of positive cells with the staining intensity. Using a digital image analysis software, OSCC patients were stratified into 4 groups. Results showed that patients with a lower IRS score displayed better survival rates than patients with a higher IRS score, reaching statistical significance. As the expression of Survivin at the nuclear level seems to suggest a poor prognosis in OSCC patients, the evaluation of nuclear Survivin IRS may be a useful tool to identify patients with more aggressive and disseminated disease, influencing follow-up and therapeutic protocols.

Aim: In order to enhance clinical improvement of intrabony defects, the addition of enamel matrix derivatives (EMD) to bone substitues (BS) has been investigated. The aim of this systematic review is to figure out whether such a combination, in comparison to the treatment with BS alone has beneficial effects on the following outcomes: clinical attachment level (CAL) gain, probing depth (PD) reduction and recession (REC)., Methods: Electronic databases (PUBMED, SCOPUS, EBSCO Host Research Databases and Web of Knowledge) were searched for randomized controlled trials in humans addressing the use of a combination of BS and EMD versus a control group with BS alone for the treatment of intrabony defects, with a minimum of 6 months of follow-up; meta-analysis and trial sequential analysis were then performed., Results: From a total of 1,197 records screened by title and abstract, nine studies were read full-text and five out of them included in the meta-analysis. No significant differences have been demonstrated both for CAL gain, PD reduction and REC between test and control groups., Conclusions: In the treatment of intrabony defects, the addition of EMD to BS seems to be not beneficial in terms of CAL gain, PD reduction and REC changes. However, such results should be considered with caution because of the small number of studies included in the meta-analysis and their heterogeneity., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: To improve the efficacy and outcomes of regenerative therapy for furcation defects, the use of platelet concentrates (PCs) in addition to open flap debridement (OFD) has been investigated. The aim of this systematic review is to evaluate whether mandibular Class II furcation defects treated with the addition of PC to OFD heal with a significant improvement in the following: 1) horizontal clinical attachment level (HCAL); 2) vertical clinical attachment level (VCAL); 3) probing depth (PD); and 4) level of gingival margin (LGM)., Methods: Electronic databases (MEDLINE, EBSCO Library, Cochrane Database of Systematic Reviews, and SCOPUS) were searched for randomized clinical trials to address the use of PCs in combination with OFD compared with a control group without PCs for the treatment of mandibular Class II furcation defects in humans and to provide data on the above reported outcome measures. The results of selected studies were converted to mean difference and standard error and interpolated using the inverse of variance test. Heterogeneity was investigated using both the Higgins index and the Q test., Results: Of 254 articles screened, only 11 were read in full text, and three of these were included in the meta-analysis. The addition of PCs to OFD revealed a small improvement in the following: 1) HCAL (mean difference, 1.36 mm; 95% confidence interval [CI] = 1.07 to 1.65); 2) VCAL (mean difference, 1.54 mm; 95% CI = 1.23 to 1.85); and 3) PD (mean difference, 1.83 mm; 95% CI = 1.36 to 2.29). No differences were found for the LGM. Heterogeneity across the studies was high, and all the three included studies were performed in one country., Conclusions: Adding PCs to OFD for the treatment of mandibular Class II furcation defects may lead to slight improvements in clinical parameters. Nonetheless, because of the high heterogeneity of the very small number of reported studies and the small effect size, no definitive conclusion can be achieved about the clinical application of such a treatment option.

Periodontal diseases (PD) affect about half of the adult population all over the world. PD is caused by bacterial infection which induces an inflammatory response with progressive destruction of the periodontal tissues and finally the loss of teeth. Tobacco smoking (TS), alcohol consumption, and systemic diseases (SDs), such as cardiovascular diseases, diabetes mellitus, respiratory diseases, osteoporosis, malnutrition and stress, are considered additional risk factors. This short review examines the potential causal association between PD, TS and SDs. There is strong evidence that PD is associated with an increased risk of SDs. In addition, many patients with SDs are also affected by PD, which can be mild or severe, and tobacco smokers manifest a greater risk of developing PD. The aim of this manuscript is to investigate the effects of periodontal therapy on the management of SDs and influence of TS on PD. This manuscript includes many randomized controlled trials and reviews to test the effects of different periodontal therapies for patients with SDs. A definite conclusion on the relationship between PD and SDs is lacking, however, there is sufficient evidence to justify periodontal treatment to prevent SDs; in fact, PD is prevalent in the middle-aged population and can have a significant impact on systemic health.

Periodontal disease (PD) is one of the prevalent diseases in the adult population. The ethiology of PD has never been completely understood, however, loss of balance between the host immune system and the microbial virulence of PD pathogens may be considered the trigger of PD. In fact, the immune system, activated by microbiological agents, attacks the host and not the biofilm bacteria, causing the destruction of periodontal tissue, alveolar bone and loss of teeth. Parasites may play an important role in the pathology of PD. The first studied and the most common parasite in the oral cavity is Entamoeba gingivalis. A possible link between E. gingivalis and PD has never been demonstrated completely, however E. gingivalis is infrequently found in people without PD. In addition, there is evidence that E. gingivalis could favour the onset and progression of PD. In conclusion, we can assert that E. gingivalis and PD may be correlated. This relationship can open new therapeutical approaches for treating PD, particularly in cases refractory to therapy.

The use of chemical devices for domestic oral hygiene in periodontal patients has led to new treatment strategies aiming primarily at a control of infection. Over the last few years, carvacrol and thymol (CT) have been subjected to many scientific and medical studies. The purpose of the present study was to assess the effect of CT on the red complex bacteria using Polymerase Chain Reaction (PCR) for microbiological analysis. Five patients with a diagnosis of chronic periodontitis in the age group >25 years, were selected. None of these patients had received any surgical or non-surgical periodontal therapy and demonstrated radiographic evidence of moderate bone loss. After scaling and root planning, patients received a CT gel to be used at home. Four non-adjacent sites in separate quadrants were selected in each patient for monitoring, based on criteria that the sites localize chronic periodontitis. Microbial analysis (MA) was analyzed at baseline and at day 15. SPSS program was used for statistical purposes and a paired samples correlation was performed at the end of the observation period. Although an absolute reduction was observed among the studied bacteria (i.e. Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, Campylobacter rectus and Total bacteria loading) none reach a statistical significant value. The present study demonstrated that CT gel has a small impact on oral biofilm. Additional studies are needed to detect the efficacy of CT gel.

There is currently an increasing interest in exploring human saliva to identify salivary diagnostic and prognostic biomarkers, since the collection of saliva is rapid, non-invasive and stress-free. Diagnostic tests on saliva are common and cost-effective, particularly for patients who need to monitor their hormone levels or the effectiveness of undergoing therapies. Furthermore, salivary diagnostics is ideal for surveillance studies and in situations where fast results and inexpensive technologies are required. The most important constituents of saliva are proteins, the expression levels of which may be modified due to variations of the cellular conditions. Therefore, the different profile of proteins detected in saliva, including their absence, presence or altered levels, is a potential biomarker of certain physiological and/or pathological conditions. A promising novel approach to study saliva is the global analysis of salivary proteins using proteomic techniques. In the present study, surface-enhanced laser desorption/ionization-time-of-flight/mass spectrometry (SELDI-TOF/MS), one of the most recent proteomic tools for the identification of novel biomarkers, is reviewed. In addition, the possible use of this technique in salivary proteomic studies is discussed, since SELDI technology combines the precision of matrix-assisted laser desorption/ionization-TOF/MS proteomic analysis and the high-throughput nature of protein array analysis.

Aim: The aim of the present study was to investigate the diagnostic and prognostic potential of proteomic signatures in saliva of patients with oral squamous cell carcinoma (OSCC)., Materials and Methods: Data from SELDI-TOF mass spectrometry of saliva from 45 OSCC patients and 30 healthy controls were analyzed by means of univariate and multivariate statistical approaches, in order to identify proteomic OSCC signatures, reduce dimensionality and build models for discriminating between OSCC and controls, as well as predict nodal status., Results: The saliva proteome presents significant modifications in OSCC patients; some of them seem to be related to nodal involvement, and may be useful for knowledge advancement regarding oral carcinogenesis and definition of diagnostic and prognostic biomarkers. Our attempt to create a predictive model using different artificial neural networks (i.e. feed-forward (FF), radial basis function (RBF), vector quantization (VQ)) demonstrated that such biostatistical tools are powerful but not all network architectures have similar performance. RBF architecture showed the best diagnostic performance (91.89%), whereas FF had the best (77.27%) prognostic accuracy (distinguishing between N(-) and N(+))., Discussion: Searching for potential biomarkers among differently expressed peptides is a challenge requiring for appropriate strategies that still remain to be defined. A number of factors may potentially impair results, e.g.: (i) a group's definition for adequate comparison; (ii) reduction of data dimensionality and selection of variables to be tested in predictive models; (iii) selection of the biostatistical tool for predictive models., (Copyright© 2016, International Institute of Anticancer Research (Dr. John G. Delinasios), All rights reserved.)

Curcumin (diferuloylmethane) is a polyphenol derived from the Curcuma longa plant. Curcumin has been used extensively in Ayurvedic medicine, as it is nontoxic and exhibits a variety of therapeutic properties, including antioxidant, analgesic, anti-inflammatory and antiseptic activities. Recently, certain studies have indicated that curcumin may exert anticancer effects in a variety of biological pathways involved in mutagenesis, apoptosis, tumorigenesis, cell cycle regulation and metastasis. The present study reviewed previous studies in the literature, which support the therapeutic activity of curcumin in cancer. In addition, the present study elucidated a number of the challenges concerning the use of curcumin as an adjuvant chemotherapeutic agent. All the studies reviewed herein suggest that curcumin is able to exert anti-inflammatory, antiplatelet, antioxidative, hepatoprotective and antitumor activities, particularly against cancers of the liver, skin, pancreas, prostate, ovary, lung and head neck, as well as having a positive effect in the treatment of arthritis.

Aim: The aim of this study is to highlights possible differences in the volume of shaping and canal surface area after the using of common endodontic devices ProTaper Universal and WaveOne systems., Methods: Forty ISO 15, 0.02 taper, S-shaped endo-training Blocks (Dentsply, Maillefer) were assigned in two groups (n = 20 for each group). For each block the initial working length (WL) was evaluated with a 10 K-files (Dentsply Maillefer), so the glide path was created with PathFile 1, 2 and 3 (Dentsply Maillefer) at the WL. After that, simulated canals in the group 1 were shaped with S1, S2, F1 and F2 at WL; while in group 2 it was used single-file WaveOne primary in reciprocating motion. After shaping, the resin blocks were analysed with Skyscan 1172 scanner (Skyscan, Kontich, Belgium) and then volumetrically at a source voltage of 65 kV and a source current of 153 uA., Results: No statistically differences (P > 0.05) have been found in terms of volume and surface area after the use of ProTaper Universal and WaveOne systems., Conclusions: Although, results from micro-CT analysis revealed that Wave One result in a decrease of volume and surface area of shaping than ProTaper Universal, differences are not statistically significant.

Introduction: Facial growth changes the position of the jaws (in particular vertical position of the maxilla and antero-posterior position of the mandible) and may, in turn, modify the position of the tongue and the hyoid bone, thus, generating modifications of the upper airway space. In the present paper, effects on upper airway space and tongue position of a new functional appliance, the swallowing occlusal contact intercept appliance (SOCIA) have been investigated., Materials and Methods: Retrospective cephaolmetric study of twenty-four children (mean age 9.46±1.60) with hyperdivergent Class II malocclusion with mandibular retrusion and atypical deglutition, was performed on radiographs taken before and after 24 months treatment with "SOCIA" appliance. The variables considered in this study, and analysed by means of a Paired t-test with a 5% level of significance, included the distance between the base of epiglottis (EB) and the tip of the tongue (TT), the distance from the tongue dorsum to EB-TT (TGH), the distance between the posterior nasal spine PNS and EB (VAL), SPAS, MAS and IAS (i.e. superior, medium and inferior pharyngeal airspace width)., Results: Our findings showed a significant increase in tongue length (TT-EB) and tongue height (TGH); thus, confirming the reposition of the tongue from a lower posture to its physiological position onto the palatal spot. These modifications of the tongue posture had effects on the upper airway space. The most important modifications were observed in SPAS, with a significant 5.9 mm increase. Some increase was found also for MAS (0.83 mm) and IAS (1.1 mm) but without statistical significance. A significant increase (7.75 mm) was also found for VAL, probably as a result of the augmentation of posterior facial height., Conclusions: SOCIA appliance is capable to improve tongue position and the superior posterior airway space, and, consequently, to improve deglutition, phonation and respiratory function., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Schizophrenia patients have been reported to be more impaired in comprehending non-literal than literal language since early studies on proverbs. Preference for literal rather than figurative interpretations continues to be documented. The main aim of this study was to establish whether patients are indeed able to use combinatorial semantic processing to comprehend literal sentences and both combinatorial analysis, and retrieval of pre-stored meanings to comprehend idiomatic sentences. The study employed a sentence continuation task in which subjects were asked to decide whether a target word was a sensible continuation of a previous sentence fragment to investigate idiomatic and literal sentence comprehension in patients with paranoid schizophrenia. Patients and healthy controls were faster in accepting sensible continuations than in rejecting non-sensible ones in both literal and idiomatic sentences. Patients were as accurate as controls in comprehending literal and idiomatic sentences, but they were overall slower than controls in all conditions. Once the contribution of cognitive covariates was partialled out, the response times (RTs) to sensible idiomatic continuations of patients did not significantly differ from those of controls. This suggests that the state of residual schizophrenia did not contribute to slower processing of sensible idioms above and beyond the cognitive deficits that are typically associated with schizophrenia.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an adverse reaction that may occur in patients administered with bisphosphonates (BP). This condition can cause high morbidity and hinder quality of life. Its treatment is complex and often unsatisfactory, and prevention strategies may have limited effectiveness, if any. Thus, managing patients treated with BP may result in exposure of the practitioner to legal liability or malpractice claims: legal actions pursuant to BRONJ are reported to be underway on three continents. Nonetheless, the attribution of liability, if any, is a complex process requiring, on the basis of current knowledge, a robust and pragmatic approach to the facts, which must be identified from the point of view of the time, place and individuals involved. This means a comprehensive consideration of the sequence of actions from bisphosphonates prescription to BRONJ occurrence (as well as immediately after, and any action potentially related to its causation or worsening) is required in order to determine if a breach in informing, diagnosing, managing or referring the patient took place, as well as determining if the patient was compliant in attending to prescriptions and follow-up programmes.

The role of the ocular disorders (OD) in pathogenesis of MMp is still a controversal issue. Ocular arc reflexes (OAR) may involve changes in head and neck posture and generate modifications of contraction resulting in muscle contraction and finally weakness. sEMG tests were performed on 28 patients (13 with masticatory muscles pain and myopia/15 healthy) in rest position with eyes open and eyes closed. Patients group control (healthy patients) showed no significance difference in sEMG record in open/close test. In non healthy patients there were great differences between the sEMG recordings with eyes closed and open. Temporalis and masseters showed a statistical difference of means activation in two tests (temporalis p = 0.0010; masseters = 0.0006). Great difference there was in means muscles activation between open eyes healthy test and non healthy. No difference in close eyes test was evaluated in temporalis and masseters close test in the two groups. The exact causes of MMp are still unknown. The role how ocular disorders (OD) may play an important role in pathogenesis of MMp is still a controversal issue. Ocular arc reflexes (OAR) may involve changes in head and neck posture and generate modifications of contraction resulting in muscle contraction and finally weakness.

Objectives: A series of patients affected by desquamative gingivitis (DG) was investigated in order to evaluate relation patterns among clinical parameters relevant to plaque-induced periodontitis, periodontal microbiological data and the presence of DG lesions., Patients and Methods: Eight oral lichen planus (OLP) and four mucous membrane pemphigoid (MMP) patients were examined. Periodontal measurements (performed at six sites per tooth on all teeth) included probing depth (PD), gingival recession (REC), clinical attachment loss (CAL) and full-mouth plaque (FMPS) and bleeding (FMBS) scores; the presence and the exact location (site by site) of DG lesions were carefully recorded. Sub-gingival plaque samples were collected and examined by means of real-time PCR for the quantitative determination of the six most important marker organisms of periodontitis. Statistically significant differences and correlation of studied variables between DG-positive and DG-negative sites were investigated in MMP and OLP cases using Mann-Whitney test (p < 0.05) and the Spearman rank correlation coefficient, respectively., Results: OLP gingival lesions do not significantly affect CAL, although the presence of such lesions may reduce REC and increase PD and FMPS. MMP gingival lesions significantly worsened CAL and increased REC and FMPS. In both OLP and MMP cases, no significant difference was found between DG-positive and DG-negative sites as regards the relative percentage of the investigated species on the total bacterial load. Correlations between the presence of DG lesions and clinical parameters (CAL, PD, REC) were not significant (p < 0.05). Significant correlations were found for the presence of gingival OLP lesions and Aggregatibacter actinomycetemcomitans (AA) and for the absence of gingival MMP lesions and AA., Conclusions: These findings are not definitive, but highlight the need for further investigations of periodontal clinical and microbiological aspects of disorders causing DG in order to clarify their potential interference with plaque-related periodontitis.

Recently, it has been reported that patients administered with bisphosphonates (BP), in particular cancer patients receiving intravenous amino-bisphosphonates, as well as patients taking oral BP for prevention/treatment of diseases of altered bone turnover, may be affected by a significant adverse reaction-BP-related osteonecrosis of the jaws (BRONJ). This condition may cause high morbidity and detriment of quality of life. Its treatment is complex and often unsatisfactory, and prevention strategies may have limited effectiveness, if any; thus, BRONJ may become a source of litigation in the near future. Although most cases seem to be triggered by invasive dental procedures and oral health care providers are more exposed to malpractice claims and legal actions pursuant to BRONJ, the attribution of liability requires caution. In fact, types of possible negligence claims against oral health care providers have already been highlighted. However, according to the medico-legal methodology, since BRONJ is an adverse reaction to BP administration, the attribution of liability, if any, requires a comprehensive consideration of the chain of events and figures acting before, and potentially related to BRONJ. The physician prescribing BP at the start of this chain has specific duties which we are going to address, and breaching these duties may set the stage for potential liability claims.

The authors report a case of oral tuberculosis in a 38-year-old heavy cigarette smoker man. He showed a painful, non-healing ulcer with indurated borders of the lateral surface of the tongue. No tonsil or lymph node enlargement was also noted. The medical history was not significant for systemic disease. Histopathological examination showed granulomas exhibiting a central caseinating necrotic focus, surrounded by mononuclear cells, epithelioid histiocytes and multi nucleated Langhans giant cells. A mantle of lympocytes and fibrous tissue surrounded the granulomas. Since the morphologic picture oriented for tubercoloid granulomata, a Ziehl-Neelsen staining of the tissue was performed. Chest radiography did not detect any pulmonary or nodal disease. On the bases of these results a diagnosis of oral tuberculosis was established.

Several drugs may have a number of adverse reactions (ADRs) involving the oro-facial region. The dose of the drug and the time required for the reaction to take place are relevant parameters; nonetheless, ADRs mechanisms are not always known and ADRs are not always predictable since aspects other than drug pharmacodynamics and/or pharmacokinetics, as well as various interacting variables contribute to the final outcome. All tissues and many functions of the oral cavity can be affected. In particular, salivary function is frequently involved and hypo-salivation is the main manifestation; several mucosal lesions with different morphology (ulcerations, vesiculobullous lesions, white lesions, pigmentations, swelling) are also possible. Taste, sensation and trigeminal function alterations have been reported and the recent evidence regarding the occurrence of jawbones osteonecrosis, especially in bisphosphonates treated patients, is increasing. Clinical management may be quite difficult due to the multiplicity of involved classes of drugs and substances (dental materials, foods), the variety of affected tissues and functions, the type of produced lesions and disturbances, the complexity of related pathogenetic mechanisms (if known), the difficulties in assessing causality and managing drug withdrawal and/or dose adjustment, as well as in establishing specific treatments, if any. In this paper the most common and significant oral ADRs, their related aspects and importance (including medico-legal implications) for health care providers will be discussed.

The oral mucosa offers an interesting site for the application of dosage forms that release drugs within/throughout the oral mucosa, by assuring a high drug bioavailability for topic and systemic effects. However, the relative permeability of the oral mucosa and the washing effect related to the oral fluids and mechanical stresses must be considered in the formulation of oral dosage forms. Since a sustained drug release can be guaranteed only if dosage forms remain in contact with the oral site of absorption/application for a prolonged time, the development of mucoadhesive dosage forms is mandatory. The mucoadhesion is a complex phenomenon and the mucoadhesive bond consists of two different parts, the mucoadhesive polymers and the mucous substrate. In addition to factors related to the oral mucosa and oral environment features, the physical-chemical characteristics of mucoadhesive polymers must be also considered as factors influencing the mucoadhesive bonds. While it is not possible to modify the mucosal features or it is possible to modify or inhibit only in part certain mucosal processes, the knowledge of polymer properties influencing mucoadhesive bonds allows to modify or to control these properties in developing increasingly effective mucoadhesive systems. The aims of this review are to discuss the several mechanisms and factors behind the phenomenon of mucoadhesion with particular reference to the features of the oral environment, oral mucosa, and polymeric compounds influencing mucoadhesion process. Finally, a brief mention to the main mucoadhesive dosage forms designed for oral transmucosal drug delivery is made.

During past decades the relationship between dentistry and internal medicine and especially the concept of the so-called focal infection theory have long been a matter of debate. The pathogenesis of focal diseases has been classically attributed to dental pulp pathologies and periapical infections. Nonetheless, in recent years, their role is being dismissed while increasing interest is being devoted to the possible associations between periodontal infection and systemic diseases. In fact, periodontal pathogens and their products, as well as inflammatory mediators produced in periodontal tissues, might enter the bloodstream, causing systemic effects and/or contributing to systemic diseases. On the basis of this mechanism, chronic periodontitis has been suggested as a risk factor for cardiovascular diseases associated with atherosclerosis, bacterial endocarditis, diabetes mellitus, respiratory disease, preterm delivery, rheumatoid arthritis, and, recently, osteoporosis, pancreatic cancer, metabolic syndrome, renal diseases and neurodegenerative diseases such as Alzheimer's disease. Various hypotheses, including common susceptibility, systemic inflammation, direct bacterial infection and cross-reactivity, or molecular mimicry, between bacterial antigens and self-antigens, have been postulated to explain these relationships. In this scenario, the association of periodontal disease with systemic diseases has set the stage for introducing the concept of periodontal medicine. This narrative review summarizes the evolution of focal infection theory up to the current pathophysiology of periodontal disease, and presents an update on the relationships between chronic periodontitis and systemic diseases., (Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)

Objective: To study the main processes involved in oral squamous cell carcinoma (OSCC): apoptosis and inflammation., Study Design: The immunohistochemical expression of bcl-2, CD3, CD20, CD45 and CD68 were studied by standard linked streptavidin-biotin horseradish peroxidase technique in 21 paraffin-embedded OSCC specimens in order to establish their possible correlation with the degree of tumoral differentiation., Results: A trend was observed for the association of inflammatory infiltrate with the degree of tumor differentiation: well and moderately differentiated tumors tend to be associated to a dense inflammatory infiltrate (57.9% of cases), while poorly differentiated cancers seem to be associated to a low inflammatory infiltrate in 85.7% of cases. The most expressed molecule was CD68, followed by CD45, CD20 and CD3. Bcl-2 was low or moderately expressed, and immunostaining was more diffuse in moderately or poorly differentiated oral cancers., Conclusion: Inflammatory infiltrate and the degree of OSCC differentiation may be linked, but the specific role still remains unclear.

Changing demographics, including an increase in life expectancy and the growing numbers of elderly has recently focused attention on the need for geriatric dental care. Ageing affects oral tissues in addition to other parts of the human body, and oral health (including oral mucosa, lips, teeth and associated structures, and their functional activity) is an integral component of general health; indeed, oral disease can cause pain, difficulty in speaking, mastication, swallowing, maintaining a balanced diet, not to mention aesthetical considerations and facial alterations leading to anxiety and depression. The World Health Organization recommends the adoption of certain strategies for improving the oral health of the elderly, including the management and maintenance of oral conditions which are necessary for re-establishing effective masticatory function. Oral health is often neglected in the elderly, and oral diseases associated with aging are complex, adversely affecting the quality of life. Although oral health problems are not usually associated with death, oral cancers result in nearly 8,000 deaths each year, and more than half of these occur at an age of 65 years plus. This report, which is dedicated to geriatric physicians, geriatric dentistry and specialists in oral medicine reviews age-related oral changes in elderly patients and efforts to summarize the effects of aging in hard and soft oral tissues.

Objective: To evaluate beta-catenin expression in human tooth germ development., Study Design: Specimens of 7 human fetuses aged between the ninth and sixteenth week were examined for beta-catenin expression by immunohistochemistry., Results: In the bud stage, we observed catenin membranous positivity for all primitive dental lamina and dental ridge cells, cytoplasmic positivity for tooth bud and intense nuclear positivity for early-condensed dental mesenchyme. The cap stage was marked by intense cytoplasmic and nuclear positivity in the outer and inner enamel epithelium and the dental papilla and by moderate cytoplasmic positivity in the enamel knot. In the early bell stage, we noted strong cytoplasmic and nuclear staining in the inner and outer enamel epithelium, only moderate membranous and cytoplasmic staining in the stellate reticulum, a high percentage of intense nuclear positivity in the dental papilla and strong focal nuclear and cytoplasmic positivity in the dental sac., Conclusion: All areas with close contact between epithelial structures and ectomesenchymal cells showed increased expression of delocalized cytoplasmic and nuclear beta-catenin. Nuclear localization, tissue expression pattern and timing suggest a pivotal role for beta-catenin in the transcriptional activation of genes probably involved in the mesenchyme-epithelial interactions on which human tooth development is based.

Background: Desquamative gingivitis (DG) is a descriptive term used to indicate epithelial desquamation, erythema, erosions, and/or vesiculobullous lesions of the gingiva. DG is commonly associated with several mucocutaneous disorders and systemic conditions that may carry a poor prognosis and high morbidity; however, there are no clear data concerning the frequency of these disease associations., Methods: We investigated the epidemiologic features of DG in 125 patients and compared our findings with information from a literature review., Results: In our series, 88% of patients with DG had one of the following three disorders: oral lichen planus (OLP), mucous membrane pemphigoid (MMP), or pemphigus vulgaris. The most common cause of DG was OLP (75% of patients). 22% of patients had isolated gingival involvement, and there were diffuse gingival lesions in 57% of patients. Symptoms ranged from none (1%) to severe pain (10%). There was extra-oral involvement of skin in 14% of patients, conjunctiva in 7%, genital mucosa in 26%, and internal organs in 3%. Our study showed MMP to be associated with DG in only a small percentage of patients (9%); this finding may be related to the patient population, epidemiology of the specific disease, and referral and/or past diagnostic bias., Conclusion: Based on our series and recent reports, OLP seems to be the most common cause of DG.

Head and neck cancer is the eighth most common cause of cancer death worldwide. Its incidence varies widely among different regions. In North America and the European Union, head and neck cancer accounts for 3% to 4% of all cancer diagnoses. Conversely, in Southeast Asia and Africa, head and neck cancer accounts for approximately 8% to 10% of all cancers. Although the incidence of head and neck cancers has decreased slightly from 1975 to 2002 in the United States, approximately 46,000 new cases are still expected in 2007 alone. Even if surgery and radiotherapy have remained the core therapy in squamous cell carcinoma of the head and neck (HNSCC). Radiotherapy following surgery was the standard approach to the treatment of locoregionally advanced (LA-HNSCC) resectable disease. However, some recent developments highlighted the expanding role of chemotherapy, which is increasingly being incorporated in the management of HNSCC. Concurrent chemo-radiotherapy has shown benefits in randomized trials; in addition, chemotherapy is used by itself as palliative therapy for patients with metastatic disease. As our understanding of the molecular and cellular mechanisms involved in cancer development improves, we are better able to identify potential targets for biological therapy and to apply novel strategies to the preclinical study and clinical treatment of head and neck cancers. Current avenues of research, focusing on clinical studies evaluating antibody directed therapies and gene replacement strategies for head and neck cancer are discussed.

Necrotizing fasciitis (NF) is a highly aggressive infectious process, polymicrobial in nature, involving soft tissues with a high risk of rapid spread through superficial and deep fascial planes and muscular layers. Cervical NF is quite rare, is mostly of odontogenic origin, and may be complicated by descendant mediastinitis with a very high mortality rate. Systemic conditions impairing the patient's immune competence, such as diabetes, may play a predisposing role. An effective treatment strategy includes prompt diagnosis (clinical findings, local microbiological tests, blood culture and, if deemed necessary, histopathology), broad-spectrum antibiotic therapy as early as possible which should be later adjusted according to antibiogram results, stabilization of vital functions and, if possible, elimination/ treatment of predisposing factors. This paper describes a complex and emblematic case.

Purpose: Survivin, an inhibitor of apoptosis protein and a cell cycle regulator, has been detected in the majority of human cancers. Five splice variants (survivin, survivin-2alpha, survivin-2B, survivin-3B, and survivin-DeltaEx3) have been identified; their expressions have been investigated here., Methods: By means of RT real-time PCR and immunohistochemistry, we have evaluated survivin isoform expressions at both mRNA and protein levels in human normal oral tissue, precancerous lesions, and oral squamous cell carcinoma (OSCC). Their correlations with the pathological findings have also been analyzed., Results: Expression levels of all survivin transcript variants were markedly elevated in OSCC when compared to normal tissues. One-way analysis of variance (ANOVA) revealed highly significant up-regulation of survivin (P = 0.001), survivin-DeltaEx3 (P = 0.001) and survivin-2B (P = 0.004), whereas survivin-3B showed a minor increase in OSCC compared to normal mucosa., Conclusions: Our findings suggest that survivin isoforms deregulation may have significant implications in tumor aggressiveness and prognosis.

A possible relationship between periodontal diseases (PDs) and cardiovascular diseases (CVDs) has been supposed and investigated. This review of the literature focuses exclusively on published studies on current theories and models of correlation between PDs and CVDs. A literature search of clinical and observational studies, in the English language, was performed in MEDLINE/PubMed, OVID database and Cochrane Oral Health Group's Trial Register. In addition, references cited in reviewed studies were evaluated for relevant papers. Various mechanisms are described in order to explain this possible association such as a hyper-responsive inflammatory response to chronic infections in predisposed individuals, and systemic effects of periodontal microorganisms including blood platelet aggregation, atheroma formation, increase in lipid levels, activation of acute phase reaction and systemic production of proinflammatory mediators, but a ultimate relation as well as the potential mechanisms have not been defined yet. Controversial result can be related to different method or objectives of studies including different study design, exposure evaluation, outcome variables and clinical endpoints considered. This paper provides a narrative review of the epidemiological studies dealing with the potential association between PDs and cardiovascular events. A precise association between PDs and CVDs, as well as the involved mechanisms are not yet well defined. Additional large-scale longitudinal epidemiological and intervention studies are necessary to validate this association.

Deregulated expression of inhibitors of apoptosis may contribute to cancer by aberrantly extending cell viability and facilitating the insurgence of resistance to chemo- and radiotherapy. In this study, we have investigated, by immunohistochemical technique, the expression and potential prognostic significance of survivin in a series of 49 clear cell type renal cell carcinoma (ccRCC). Survivin expression was significantly associated with poorly differentiated, advanced stages and more aggressive ccRCCs (p < 0.05). Patients with low survivin expression had statistically significant better survival rates than patients with high survivin expression (p < 0.05). This may be relevant for follow-up protocols design and/or alternative therapeutic approaches.

Background: Eating disorders (ED) are a group of psychopathological disorders affecting patient relationship with food and her/his own body, which manifests through distorted or chaotic eating behavior; they include anorexia nervosa, bulimia nervosa and ED not otherwise specified and may be burdened with life-threatening complications. As oral manifestations of ED can occur in many phases of disease progression, they play a significant role in assessment, characterization and prognosis of ED., Methods: Mucosal, dental, and salivary abnormalities associated with ED have been reviewed. Relations between oral menifestations and pathogenesis, management and prognosis of ED have been critically analysed., Results: Oral manifestations of ED include a number of signs and symptoms involving oral mucosa, teeth, periodontium, salivary glands and perioral tissues; differences exist between patients with anorexia and bulimia. Oral manifestations of ED are caused by a number of factors including nutritional deficiencies and consequent metabolic impairment, poor personal hygiene, drugs, modified nutritional habits and underlying psychological disturbances., Conclusion: Oral manifestations of ED can cause impairment of oral function, oral discomfort and pain, and an overall deterioration of aesthetics and quality of life. Their treatment can contribute to overall patient management and prognosis.