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Francesca Zotti,1 Rinaldo Zotti,2 Massimo Albanese,1 Pier Francesco Nocini,1 Corrado Paganelli21Department of Surgery, Dentistry, Paediatric and Gynecology, University of Verona, 37134 Verona, Italy; 2Department of Orthodontics, School of Dentistry, University of Brescia, 25100 Brescia, ItalyPurpose: To determine whether the use of social media is useful in improving compliance and follow-up attendance among patients wearing retainers after orthodontic treatment.Patients and methods: Sixty post-orthodontic patients (aged 16–19 years), randomized in two groups: follow-up supported by participation in WhatsApp chat group (SG), and Control Group (CG). All patients were scheduled for quarterly check-ups for monitoring of orthodontic stability by measurement of intercanine width at the beginning of the study (t0) and every 4 months t1, t2, t3) for 1 year of observation. Patients in the SG additionally participated in a WhatsApp chat group, where they would send, on a weekly basis, snapshots showing his/her occlusion. Every month, the orthodontist acting as the moderator awarded the best five snapshots by publishing a ranking in the chat.Results: Participants in the SG featured smaller changes from the intercanine widths at baseline (at debonding) compared to the CG patients at all times during 1 year of follow-up. Follow-up attendance was regular in both groups in the first 8 months of follow-up. After that, patient compliance decreased in the CG, with eight patients missing check-up appointments.Conclusion: Engaging adolescent patients directly through WhatsApp activity seems to increase regularity in wearing removable retainers, attendance to follow-up schedule, and yield better long-term outcome in terms of orthodontic stability and compliance.Keywords: apps, technologies, orthodontics relapse, orthodontic compliance, patient compliance, young patients

This report documents a case of bisphosphonate-related osteonecrosis of the jaw (BRONJ) after dental implant placement in an osteoporotic patient treated with alendronate for 6 years. A 63-year-old patient underwent rehabilitation of the posterior mandible with 2 dental implants in 2006 while taking alendronate to treat osteoporosis. The surgical procedure was uneventful. Both implants integrated well, and in November 2006 the patient wore a fixed partial prosthesis. Alendronate was never discontinued. In June 2008 a painful cheek swelling of the left mandible developed, associated with gingival bleeding. Since then, the patient underwent several courses of antibiotics, without relief of symptoms. In June 2009 the patient was referred to our department. An area of infected and exposed necrotic bone in the left mandible enclosed 1 dental implant. A panoramic radiograph and computed tomography scan showed an increased bone marrow density with peri-implant bone sequestration. The technetium Tc 99m scintigraphy-labeled granulocytes were positive for active bone infection. Bone exposure persisted for 8 weeks, and diagnosis of oral nitrogen-containing bisphosphonate (N-BP)-related osteonecrosis was made. On the basis of a review of the literature, this is the 10th case of BRONJ after implant placement in patients taking oral N-BPs. Despite the low risk of BRONJ occurrence after implant surgery in oral N-BP users, the fate of dental implants in these patients remains uncertain. Therefore patients at risk must be given a full explanation of the potential risks of implant failure and BRONJ development. Because the potential role of infection is still debated, great attention should be paid to the long-term oral hygiene of implant-prosthetic restorations. [ABSTRACT FROM AUTHOR]

The accuracy of panoramic radiography (RX) and ultrasound (US) in the evaluation of both the length of the osteotomic gap and the quality of new bone formation in patients undergoing mandibular distraction osteogenesis (DO) was assessed, verifying the results against intraoperative and histologic findings. In 31 patients, three RX and three US examinations were performed after DO. RX and US findings were each independently compared, at the time of distractor removal, to the direct intraoperative measurement of the osteotomic gap and to the histologic evaluation of the maturity of a resected specimen. No significant differences (P>0.1) resulted at any step between RX (average length: 18.19 mm) and US (18.29 mm) measurement of the osteotomic gap. In the assessment of the callus maturity the difference between RX and US (P<0.001) was statistically significant: at the final control the maturity score averaged 0.612 at RX, 3 at US and 3 at histology. RX and US are equally reliable in the measurement of the osteotomic gap, while US is much more accurate than RX in the evaluation of the callus maturity. US-based follow-up might allow a safe shortening of the fixation period. [ABSTRACT FROM AUTHOR]

BACKGROUND: Oral lichen planus (OLP) is considered to be an autoimmune disease of unknown aetiology that affects the mucosae, especially the oral cavity. Objective: We compared tacrolimus 0.1% ointment and clobetasol 0.05% ointment for the treatment of OLP. PATIENTS AND METHODS: A total of 32 patients (20 females and 12 males; all white, Italian origin, mean age of 43.6+/-18.4 years; 16 patients per treatment group) were treated with tacrolimus or clobetasol ointment for 4 weeks in a randomized, double-blind, clinical trial. Pain severity, burning sensation, and mucosal lesion extension were assessed using a four-point scale. RESULTS: At the end of the treatment period, symptom scores were significantly lower in the tacrolimus group than in the clobetasol group. CONCLUSION: The results of this study suggest that tacrolimus 0.1% ointment is more effective than clobetasol propionate 0.05% ointment in the treatment of OLP. However, other studies are needed to confirm the effectiveness of this treatment before it can be recommended for use in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Oral squamous cell carcinoma (OSCC) represents the most common oral malignancy. Despite recent advances in therapy, up to 50% of the cases have relapse and/or metastasis. There is therefore a strong need for the identification of new biological markers able to predict the clinical behaviour of these lesions in order to improve quality of life and overall survival. Among tumour progression biomarkers, already known for their involvement in other neoplasia, a crucial role is ascribed to the urokinase-type plasminogen activator receptor (uPAR), which plays a multiple role in extracellular proteolysis, cell migration and tissue remodelling not only as a receptor for the zymogen pro-uPA but also as a component for cell adhesion and as a chemoattractant. The purpose of this study was to gain information on the expression of uPAR in OSCC and to verify whether this molecule can have a role as a prognostic/predictive marker for this neoplasia.Methods: In a retrospective study, a cohort of 189 OSCC patients was investigated for uPAR expression and its cellular localization by immunohistochemistry. As standard controls, 8 normal oral mucosal tissues free of malignancy, obtained from patients with no evidence or history of oral cavity tumours, were similarly investigated. After grouping for uPAR expression, OSCCs were statistically analyzed for the variables age, gender, histological grading (G), tumour size, recurrence, TNM staging and overall survival rate.Results: In our immunohistochemical study, 74 cases (39.1%) of OSCC showed a mostly cytoplasmic positivity for uPAR, whereas 115 were negative. uPAR expression correlated with tumour differentiation grade and prognosis: percentage of positive cases was the greatest in G3 (70.4%) and patients positives for uPAR expression had an expectation of life lower than those for uPAR negatives.Conclusion: The results obtained in this study suggest a role of uPAR as a potential biomarker useful to identify higher risk subgroups of OSCC patients. [ABSTRACT FROM AUTHOR]

Purpose: Zygomatic implants are considered one of the last options for the rehabilitation of severe maxillary atrophy when standard implants cannot be placed. They offer several advantages but can also present complications. This study aimed to investigate the long-term clinical and radiographic outcomes of zygomatic implant placement., Materials and Methods: A retrospective chart review was conducted, and the inclusion criteria consisted of patients previously treated with zygomatic implants who had Class V or VI maxillary bone atrophy according to Cawood and Howell, and with a minimum follow-up period of 2 years after prosthetic loading. Outcome measures included implant and prosthesis survival rate, biological and biomechanical complications, and Lund-Mackay staging score before and after implant placement., Results: The study included 78 patients who received a total of 274 zygomatic implants. The mean follow-up period was 90.4 ± 26.0 months. Seventeen implant failures occurred, resulting in a survival rate of 93.8%, with a statistically significant negative correlation with smoking habits (P = 0.049), anchorage to the two zygomatic bone cortices (bicorticality) (P 0.001) and soft tissue complications (P 0.001). The prosthetic success rate was 92.3%. A statistically significant increase in maxillary sinus radiopacity was recorded when comparing the situation before and after surgery (P 0.001), and the intrasinus pathway had a statistically significant influence on that increase (P = 0.003)., Conclusions: Zygomatic implants utilised for rehabilitating patients with severe maxillary atrophy have shown favourable outcomes. Nonetheless, owing to potential complications, strict case selection is necessary, combined with regular recall visits and proper oral hygiene maintenance. Furthermore, this type of surgery necessitates specialised training and expertise on the part of the practitioner.

Objectives : This study aimed to determine the impact of standing electric scooters on maxillofacial on the Italian territory. Methods : The authors analyzed the epidemiology of the injuries to define electric mobility's impact on maxillofacial surgery practice. For this retrospective cohort study, data were collected by unifying the standing e-scooter-related fractures database from 10 Italian maxillofacial surgery departments. The reference period considered was from January 2020 to December 2023. The main data considered included age, gender, type of access, time slot of admission, type of admission, alcohol level, helmet use, dynamics of the accident, and area of the fracture. Results : A total of 79 patients were enrolled. The average age of the participants was approximately 31 years. The blood alcohol level was found to be above the Italian norm in 15 cases (19%). Only one patient wore a helmet. The most affected facial third was the middle one with 36 cases (45.5%), followed by the lower one (31, 39.3%). The most recurrent patterns were fractures of the orbito-malar-zygomatic complex (15, 19%), followed by multifocal (bifocal, trifocal) fractures of the mandible (14, 17.5%). Conclusions : This study demonstrated how maxillofacial fractures related to the use of electric scooters are associated with complex patterns, associated with a high rate of post-surgical aftermaths.

Background: Orofacial trauma (OFT) occurs frequently in children and requires thorough evaluation not only by paediatric dentists but also by all specialists involved in emergency services, particularly in cases involving children under 3 years of age, given their inability to directly participate in clinical-anamnestic evaluations. Addressing early childhood orofacial trauma resulting from maltreatment, this study explores the key role played by various healthcare professionals, including paediatric dentists, general dentists, maxillofacial surgeons, dental hygienists, and paediatricians, in the optimal management of these cases. In the event of trauma due to suspected or confirmed mistreatment, it is essential that all healthcare workers involved have precise knowledge of the appropriate course of action from both a clinical and legal point of view, guaranteeing maximum protection for the young patient. This is particularly significant as cases of mistreatment with apparently minor consequences can degenerate into situations of irreparable severity. The latest guidelines from the International Association of Dental Traumatology (IADT) in 2020 continue to emphasise the potential correlation between OFT and cases of abuse or violence. Recent recommendations in the literature highlight the importance of facilitating mandatory reporting of incidents to relevant authorities and improving information sharing between dental healthcare professionals and child welfare services. A new flow diagram, called Paediatric Orofacial Trauma Alert (P.O.T.A.), has been proposed at the University of Verona. This tool is specifically designed to assist specialists dealing with early childhood orofacial trauma cases by assisting them in identifying potential cases of maltreatment. In this innovative approach, the collaborative efforts of general dentists, paediatric dentists, maxillofacial surgeons, dental hygienists and paediatricians play a vital role in cases of abuse. In addition to restoring the oral health of young patients, these professionals can activate a vast network of contacts, ensuring not only optimal oral health care but also providing comprehensive support to victims. The objective is to safeguard not only the physical but also the psychological well-being of these vulnerable subjects.

Obesity's role in thyroid cancer development is still debated, as well as its association with aggressive histopathological subtypes (AHSs). To clarify the link between Body Mass Index (BMI) and AHS of differentiated thyroid carcinoma (DTC), we evaluated patients who underwent thyroidectomy for DTC from 2020 to 2022 at four European referral centres for endocrine surgery. Based on BMI, patients were classified as normal-underweight, overweight, or obese. AHSs were defined according to 2022 WHO guidelines. Among 3868 patients included, 34.5% were overweight and 19.6% obese. Histological diagnoses were: 93.6% papillary (PTC), 4.8% follicular (FTC), and 1.6% Hürthle cell (HCC) thyroid carcinoma. Obese and overweight patients with PTC had a higher rate of AHSs ( p = 0.03), bilateral, multifocal tumours ( p = 0.014, 0.049), and larger nodal metastases ( p = 0.017). In a multivariate analysis, BMI was an independent predictor of AHS of PTC, irrespective of gender ( p = 0.028). In younger patients (<55 years old) with PTC > 1 cm, BMI predicted a higher ATA risk class ( p = 0.036). Overweight and obese patients with FTC had larger tumours ( p = 0.036). No difference was found in terms of AHS of FTC and HCC based on BMI category. Overweight and obese patients with PTC appear to be at an increased risk for AHS and aggressive clinico-pathological characteristics.

Purpose: To evaluate the effectiveness and accuracy of a proposed duplication technique in terms of one- and three-dimensional discrepancies between an original abutment and polyurethane duplicates obtained through a conventional workflow in single-implant rehabilitation., Materials and Methods: A titanium, shoulderless abutment was chosen for a single-implant cemented rehabilitation. The master cast was made using a plastic-based die system, and the implant portion was separated. The implant section was consecutively duplicated eight times using a manual technique with polyvinyl siloxane and unfilled polyurethane resin as impression and die materials. The duplicates were analyzed with a coordinate-measuring machine (SmartScope Flash 200, Optical Gaging Products): one- and three- dimensional discrepancies were determined for each duplicate on 20 analysis points (A to T) located on the abutment surface. Changes in the abutment radius were also calculated to estimate the effects on cement thicknesses., Results: One-dimensional discrepancies were -0.5 Å} 61.2 μm, -6.6 Å} 39.7 μm, and -19.4 Å} 47.8 μm on the X, Y, and Z axes, respectively; three-dimensional variation was -66.4 Å} 60.1 μm. Friedman test showed no significant difference between duplicates' one-dimensional variations on X (P = .059), Y (P = .156), or Z (P = .223) axes; a significant difference was found regarding three-dimensional changes (P < .001). Dunn test showed higher discrepancies on the X axis and on the abutment head. Mean variation of the abutment radius was -12.09 μm., Conclusions: The abutment duplication technique was shown to be an accurate and repeatable procedure for single cementable restorations.