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Aim The purpose of this epidemiological study was to assess the prevalence of malocclusion, its association with caries experience, and level of oral hygiene in the Apulian population. Materials and methods Study design: A total of 530 paediatric patients (267 girls, 263 boys), aged 8-10 years (±SD 1.2) were randomly selected from primary schools in Apulia (Italy). The Decayed, Missing and Filled Teeth (DMFT/dmtf) index), the Dental Aesthetic Index (DAI), recorded according to the WHO criteria, were used by two calibrated examiners to diagnose dental caries and malocclusion, respectively. Results Except for the presence of dental calculus, Class II malocclusion, open bite and dental crowding, (p > 0.05), all variables in the negative binomial regression showed a significant relationship with the incidence rate of caries in deciduous teeth. Statistics: Children were clinically examined in a community dental office. Statistical analysis was carried out using R version 3.5.1. Conclusions The study outcomes underline the need for preventive care programmes to improve oral health conditions as well as to decrease oral pathology risk factors in the Apulia region.

OBJECTIVE: The clinical use of mesenchymal stem cells (MSCs) in regenerative medicine either in tissue repair or tissue reconstruction has given highly interesting results thanks to their particular nature. Sources that have attracted the attention of medical scientists from where stem cells (SCs) in adults could be obtained are different and, dental tissues have certainly become an optimal source of MSCs. Dental tissue is a main reservoir of two types of MSCs dental bud (DBSCs) that constitute the immature precursor of the tooth and dental pulp (DPSCs) that are derived from dental inner pulp and partly from dental follicle tissue and can differentiate into several cell phenotypes as osteoblast, chondrocyte, hepatocytes, cardiomyocytes, neuron and beta cells.PATIENTS AND METHODS: Normal impacted third molars and tooth buds were collected from adults and adolescents underwent to extractions for orthodontic reasons. The expression of the five sternness genes Nanog, OCT4, Sox2, c-Myc and Klf4 were investigated by qRTPCR in two different dental stem/progenitor cells: dental pulp stem cells (DPSCs) and stem cells from dental bud (DBSCs), differentiated toward osteoblastic phenotype and not.RESULTS: Both DPSCs and DBSCs are easy to access and we found their expression of the typical mesenchymal sternness makers and osteogenic capacity due to the effective presence of embryonic gene regulators like Nanog, OCT4, Sox2, c-Myc and Klf4. Both DBSCs and DPSCs could represent a valid tool in regenerative medicine and translational applications.CONCLUSIONS: The results depicted here provide, for the first time to our knowledge, a comparative outcome about the stemness properties generated from accessible tissues such as DPSCs and DBSCs. These two types of SCs showed few different distinctive genetic traits supposedly in relation to their origin, location and stage of maturation. Certainly these SCs reserve solid potential for human clinical application in autologous procedure for bone, hard tissue and soft tissue regeneration, easy to isolate, ready availability, high-biocompatibility and safety and no ethical restrictions.

OBJECTIVE: Mesenchymal stem cells (MSCs) have been deeply investigated in regenerative medicine because of their crucial role in tissue healing, such as tissue regeneration. Dental-derived stem cells (d-DSCs) are easily available from dental tissues, which can be isolated from all age patients with minimal discomfort. PATIENTS AND METHODS: Normal unerupted third molars tooth buds were collected from adolescents' patients underwent to extractions for orthodontic reasons. The expression of the genes Kruppel-like factor 4 (Klf-4), octamer-binding transcription factor 4 (Oct-4), homeobox transcription factor Nanog (NANOG) was investigated in d-DSCs obtained from dental bud (DBSCs), differentiated toward osteoblastic phenotype and not. RESULTS: Our results showed that DBSCs expressed Oct-4, Nanog, and Klf-4 in undifferentiated conditions and interestingly the expression of such genes increased when the cells were kept in osteogenic medium. CONCLUSIONS: These attractive stemness properties, together with the effortlessly isolation, during common oral and maxillofacial surgical procedures, from undifferentiated tissues such as dental bud, make this kind of d-DSCs a promising tool in regenerative medicine, having the potential for clinical applications, and reinforcing the present challenge to develop new preventive and healing strategies in tissue regeneration.

SEC III protocol: Early treatment of dentoskeletal Class III malocclusions. The early treatment of dentoskeletal Class III malocclusion is one of the more challenging situations for orthodontists, mainly for the uncertainty of stable long-term results due to the interaction of both environmental and genetic aetiological factors. Several interceptive protocols have been proposed during the past decades. The SEC III protocol includes two occlusal acrylic Splints combined with Class III elastics and chin cup. The protocol was proposed to facilitate Class III dentoskeletal correction by eliminating the intercuspation and the tongue thrust with clockwise mandibular rotation and minimal dentoalveolar compensation. The main difference with all the other appliances is the vertical control, which is crucial in difficult cases such as hyperdivergent Class III malocclusions.

Aim Dental caries is one of the most common oral diseases affecting children. The complex multifactorial aetiology of caries involves host (saliva composition and tooth enamel characteristics), oral microflora and substrate (oral hygiene quality and dietary habits composition). Occlusal characteristics may be also a factor in dental caries development. The aim of this aepidemiologic study was to verify the association between DMFT (Decayed, Missed, Filled Teeth) index and occlusal characteristics, dietary habits, oral hygiene habits and parents' education level in a sample of 12-year-old schoolchildren from Southern Italy. Materials and Methods A sample of 536 children was examined to detect dental caries status and several occlusal variables (i.e. molar relationship, overjet and overbite, presence of crossbite, scissor bite, crowding, diastemas and/or midline deviation). A questionnaire to retrieve parents' educational level, patient's dietary and oral hygiene habits was administered. The associations among these variables were assessed statistically through the Χ2 test. Results A positive association was found between caries, parents' social status and some occlusal disorders. va specificato, l'abstract non può essere una caccia al tesoro. In relation to occlusal variables, crossbite (Χ2=3.96, P=0.04) was significantly associated to caries. A significant association was also found between the education level of mothers (Χ2=7.74, P < 0.01) and fathers (Χ2=6.35, P=0.01) and the presence of caries. Dietary habits, oral hygiene and remaining occlusal characteristics were not associated with caries presence (all P > 0.05). Conclusions Of the evaluated occlusal characteristics only posterior crossbite was associated with caries prevalence. Education level of the parents was the other factor significantly associated with caries. Dietary habits, oral hygiene frequency and the remaining occlusal characteristics were not associated with dental caries.

Purpose: To evaluate the effectiveness of low-level laser therapy (LLLT) on dental pain felt during cavity preparation of carious lesions in permanent teeth of adults. Methods: The study was carried out on 88 teeth with dental caries requiring class I restorations in 24 subjects with a pain score > 7 but < 10 measured using a 0-10 visual analogue scale (VAS) in a preliminary test of pain threshold (PTPT) for each subject receiving a class I cavity preparation on another tooth without local anesthesia. The 88 teeth included were randomly allocated to test and control groups, each with 44 teeth. All teeth were treated with LLLT prior to the mechanical preparation of the cavity without local anesthesia, except that the laser device was kept in idle mode in the control group. After cavity preparation, subjects scored pain intensity using the VAS. The Wilcoxon test was used to analyze data and the values with P< 0.05 were considered significant. Results: All subjects scored a pain reduction in the test group compared with the control group (P< 0.0001), with a reduction of 42% and 16%, respectively, compared to pain felt during the PTPT. The use of LLLT prior to mechanical preparation of a cavity by lowering pain intensity might reduce the quantity of drugs used for pain control required during restorative procedures. (Am J Dent 2018;31:267-271 ).

Background: The aim of this study was to investigate the prevalence of cleft sidedness, and the number of congenitally missing teeth in regard to cleft type and gender. Methods: The charts, models, radiographs, and intraoral photographs of 201 cleft patients including 131 males with the mean age of 12.3 ± 4 years and 70 females with the mean age of 12.6 ± 3.9 years were used for the study. T test, Chi-square, and binomial tests were used for assessment of the data. Results and conclusions: One hundred forty-eight of the subjects suffered from cleft lip and palate followed by 41 subjects who suffered from cleft lip and alveolus. Chi-square test did not show any significant difference between the genders. Binomial test showed that left-sided cleft was more predominant in unilateral cleft lip and palate patients (P < 0.001). This study also showed that the upper lateral incisors were the most commonly missing teeth in the cleft area.

OBIETTIVI. Lo scopo di questo studio è stato valutare le caratteristiche, le altera- zioni morfostrutturali e le conseguenze disfunzionali dell’articolazione temporo- mandibolare (ATM) in pazienti affetti da artrite idiopatica giovanile (AIG).MATERIALI E METODI. Lo studio è stato condotto su 45 soggetti di età compresa tra 7 e 19 anni, affetti da AIG. Tutti i pa- zienti arruolati sono stati sottoposti a va- lutazione clinico-gnatologica (anamnesi, parametri di laboratorio, tipo di terapia) e strumentale mediante l’imaging a riso- nanza magnetica delle ATM.RISULTATI. Dei 45 pazienti del campio- ne,il37,8%presentavainteressamento dell’ATM. Tra questi pazienti (17 pazienti, 13 femmine e 4 maschi) si sono riscon- trate: forma poliarticolare 41,2% (7 ca- si), forma oligoarticolare 35,3% (6 casi), artrite sistemica 11,8% (2 casi), artrite psoriasica 5,9% (1 caso), sindrome ente- site-artrite (SEA) 5,9% (1 caso). I principalisintomi riportati erano: click temporo- mandibolare monolaterale e bilaterale, limitazione funzionale monolaterale e bi- laterale associata a dolore, click bilaterale e monolaterale durante la masticazione e laterodeviazione mandibolare associata a sintomatologia delle ATM.CONCLUSIONI. I risultati ottenuti in questo studio suggeriscono l’utilità di un’attenta valutazione gnatologica all’esordio dell’AIG. Controlli periodici associati a una diagnosi precoce sono infatti in grado di ridurre e migliorare le problematiche funzionali ed estetiche in questi giovani pazienti. OBJECTIVES. The purpose of this study was to evaluate the characteristics, the morphostructural and dysfunctional concerns of the temporomandibular joint (TMJ) in patients with juvenile idiopathic arthritis (JIA).MATERIALS AND METHODS. The study was conducted on 45 subjects with JIA, aged between 7 and 19 years. All patients enrolled were subjected to clinical evalua- tion (medical history, laboratory param- eters and type of therapy) and instru- mental evaluation (magnetic resonance imaging of the TMJ).RESULTS. Of the 45 patients analyzed in the sample, 37.8% presented involvement of TMJ. These patients (17 patients, 13 fe- males and 4 males) presented with poly- articular arthritis 41.2% (7 patients), oli- goarticular arthritis 35.3% (6 patients), systemic arthritis 11.8% (2 patients), psoriatic arthritis 5.9% (1 patient), En- thesitis Arthritis Syndrome (EAS) 5.9% (1 patient). The main symptoms reported were: TMJ unilateral and bilateral click- ing, unilateral and bilateral functional limitation associated with pain, unilater- al and bilateral clicking during chewing and mandibular lateral deviation associ- ated with TMJ symptoms.CONCLUSIONS. The results obtained in this study underline the importance of a careful gnathological evaluation at the onset of JIA. Moreover, periodic follow-ups associated with an early di- agnosis are indeed capable of reducing and improving functional and aesthetic problems in these young patients.

Orthodontic tooth movement differs significantly from the physiological tooth movement, as it determines a biological response of the surrounding tissues of the teeth, resulting in a remodelling of the periodontal ligament and the alveolar bone. The result is a biochemical adaptive response to the application of the orthodontic force with the reorganization of the intracellular and the extracellular matrix, in addition to a change of the local vascularization. This in turn leads to the synthesis and the release of arachidonic acid, growth factors, metabolites, cytokines and various enzymes. Biologically, not only the intensity of the force, but also its duration and the tissue response to the application of the same are important for tooth movement. Having these insights it will possible to examine the concept of optimal orthodontic force, a determining factor for the success of orthodontic treatment. The purpose of this revision was to describe the biological processes and future perspective of the application of orthodontic force, by providing relevant information to understand the changes at the molecular and cellular level occurring when the tissues are subjected to such forces. Knowledge on the subject of mechanics and biology in orthodontics is constantly growing, producing an increasingly strong basis for clinical success. Orthodontic tooth movement differs significantly from the physiological tooth movement, as it determines a biological response of the surrounding tissues of the teeth, resulting in a remodelling of the periodontal ligament and the alveolar bone. The result is a biochemical adaptive response to the application of the orthodontic force with the reorganization of the intracellular and the extracellular matrix, in addition to a change of the local vascularization. This in turn leads to the synthesis and the release of arachidonic acid, growth factors, metabolites, cytokines and various enzymes. Biologically, not only the intensity of the force, but also its duration and the tissue response to the application of the same are important for tooth movement. Having these insights it will possible to examine the concept of optimal orthodontic force, a determining factor for the success of orthodontic treatment. The purpose of this revision was to describe the biological processes and future perspective of the application of orthodontic force, by providing relevant information to understand the changes at the molecular and cellular level occurring when the tissues are subjected to such forces. Knowledge on the subject of mechanics and biology in orthodontics is constantly growing, producing an increasingly strong basis for clinical success.