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The main therapeutic approaches for inflammatory periodontal diseases include the mechanical treatment of root surfaces. Multi-center clinical trials have demonstrated that the adjunctive use of a chlorhexidine (CHX) chip is effective in improving clinical results compared to scaling and root planing (SRP) alone. However, some recent studies failed to confirm these clinical results, nor have any data been reported regarding the capability of the CHX chip in affecting the activity of alkaline phosphatase (ALP) in the gingival crevicular fluid (GCF). This enzyme has been related to a condition of destructive activity of periodontitis. The aim of this study is to provide further data on the clinical and biochemical effects of CHX chips when used as an adjunct to SRP. Eighty-two systemically healthy patients, aged 31-63, with moderate and advanced periodontitis were recruited from the departments of Periodontology of the University of Chieti. In each patient 2 experimental sites, located in two symmetric quadrants, were chosen with a probing depth ofor = 5 mm and bleeding on probing. The 2 sites were selected randomly at the split-mouth level; control sites received SRP alone, and test sites SRP plus 1 CHX chip. Clinical indices, including probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and the ALP activity in GCF were evaluated at baseline and after 6 months. Alkaline phosphatase activity was assayed spectrophotometrically. The PPD and CAL were significantly lower at 6 months as compared to the baseline scores in both treatments (p less than 0.01). The PPD reduction was 2.7 mm in the CHX+SRP group and 1.9 mm in the SRP alone group. The CHX+SRP group showed a significantly greater gain of clinical attachment (mean: 1.4 mm) in comparison with the SRP group (mean: 0.9; p less than 0.05). No differences were observed in the decrease of the percent of BOP-positive sites between the experimental groups. Conversely, the CHX+SRP group underwent a significantly greater decrease (p less than 0.01) of the GCF-ALP activity 6 months after treatment in comparison with the SRP alone group. The adjunctive use of the CHX chip resulted in a significant improvement of pocket reduction and clinical attachment gain as compared with SRP alone. These results were concomitant with a significantly greater reduction of the GCF-ALP activity levels.

All coated particle producers, when applying the coating layer(s) would like to know precisely what is the best coating system to use in order to answer customer’s requests. It is, therefore, of very high relevance for many industries, to have a clear understanding of what are the parameters I need to trigger in order to generate the requested quality. Such understanding was the target of this work. The specific equipments designed at Delft University of Technology enabled us to measure the resistance to attrition and the resistance to abrasion of both reference coating agents and commercially pre-mixed coating systems. The resistance to attrition was directly related to the intrinsic properties of the coating material, to the process parameters used to apply the coating layer (fluid bed coating in this case) and to the conditions in which the particles are stored. The viscoelastic properties of the coating layers were measured by using nano indentation. Very good correlation between the viscoelasticity term, tan ?, and the resistance to attrition was found. Cast and sprayed films were produced as representation of the coating film. The morphology and the structure of coating layers were mimicked much better by sprayed films which could be obtained by novel equipment designed during this work. To assess the quality of the coating layer and determine how efficient the coating process was, X-Ray micro tomography in combination with image analysis was used. This gave us a very robust set of data which could be used to correlate the quality of the coating layer to the parameters chosen during coating process and those two with the final performance of the coated particles in respect of resistance to attrition/abrasion. Finally commercially available pre-mixed coating systems were used as case study. By comparing them with the reference coating agents we could proof and quantify how important are the additives, plasticisers in primis, in increasing the coating quality and, therefore, the resistance to mechanical stresses.

Extraoral route of access is usually not considered in surgical extraction of teeth because of technical difficulties and above all because of scar resulting from surgical skin wound healing. Some specific conditions, however, should suggest the use of this kind of access. A case of an impacted transmigrated right mandibular canine in an 18-year-old girl is reported. A CT examination has been carried out to evaluate the anatomy of the impacted toot as well as its relationship with the neighbouring structures. Extraoral surgical technique is then detaily described: skin incision, muscular dissection, ostectomy, tooth extraction and suture. Esthetical result was also reevaluated after 10 years. Advantages and drawbacks of intraoral and extraoral routes of access to mandibular tooth impaction are discussed and all anatomic and topographic factors related to the present impacted canine are examined. In conclusion, it is possible to confirm that extraoral access is indicated when a tooth is superficially impacted, in the molar-premolar region, toward the lingual aspect and near the lower border of the mandible.

Florid cemento-osseous dysplasia (FLCOD) is a rare pathological entity whose classification is not yet completely defined although its non-neoplastic clinical and histologic behaviour is very clear. FLCOD is a self-limiting lesion scarcely delimited from the surrounding healthy tissue and whose surgical treatment therefore is not elective, unless inflammatory signs are present. A case of a white woman with both mandibular and maxillary involvement is presented; she was referred to us for partial impaction of her lower 3(rd) molars. Standard radiographic and CT images are examined and the patient management is discussed.

In the new edition of WHO's "Histological typing of odontogenic tumors", the mandibular infected buccal cyst, that is associated with the lower first or second permanent molars, is considered a paradental cyst as well as the inflammatory collateral cyst, which is usually related to the lower third molar. The lesion occurs on the buccal and lateral aspects of the roots of mandibular molars with vital pulp, at the eruption time, in children aged between 6 and 10 years. The inflammation is always present in these cysts and may have an important role in their pathogenesis because it stimulates hyperplasia and cystic change of the reduced enamel epithelium or the epithelial cell rests of Malassez. The authors report the case of a 7-year-old girl, in whom both first mandibular molars were affected by an infected buccal cyst. A different surgical approach was performed with marsupialization on the left side and cystectomy on the right side. The case reported here seems to be interesting because it is the second well documented case of bilateral mandibular infected cyst associated with unerupted molars and because the adopted treatment differs from the therapeutical approach suggested in the literature. A 6-year follow-up demonstrates a correct dental and bone evolution on both mandibular molar sides.