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Caries and periodontal diseases are a neglected epidemic by millions of Italians who suffer unnecessarily from them. Both diseases are preventable and the combination of high prevalence, high morbidity and relative inattention from the National Health Service (NHS), makes caries and periodontal disease a significant public health problem. In this perspective, the World Health Organization and the University of Milan have promoted a national epidemiological study aimed at a sample of 4, 6 and 12-years-old students from schools in the North, Central and South of Italy. The study provides for the administration of a questionnaire to parents and a dental examination carried out at school by dentists trained by the WHO. In our town the epidemiological study planning and the survey were carried out by professors of the School of Specialization in "Pediatric Dentistry" (Prof. G. Giuliana and Prof. G. Pizzo) supported by specialist dentists from the same School, calibrated according to the WHO methodology. The survey was carried out between 2017 and 2019 involving 2701 children attending schools in the 8 districts of the town. The parents were sent a letter which explained the nature of the survey and contained a pre-printed form for the issue of informed consent to participate in the survey with a questionnaire regarding the family nuclear, the oral hygiene and eating habits of the minor and the child's previous dental experiences. The ICDAS (International Caries Detection and Assessment System) was used to detect the prevalence of carious lesions. The dentist used for each child visited a dental mirror and the CPI (Community Periodontal Index) index for periodontal assessment. Preliminary results showed that 25.3% of 12-years-old students had gingival bleeding and 41.1% had tartar. The caries index (ICDAS) shows us that as early as 4 years, 20% of children have initial carious lesions, 37% have dentine caries and that 34.38% have highly destructive caries. At 12 years, 34.95% had initial carious lesions, 46% had cavities that already affected dentin and that 42.44% had highly destructive cavities. The exigence to implement a program of prevention / early treatment of caries/gingivitis in pediatric subjects living in Palermo, since the first months of child's life, was born from the data analysis. The project "Un sorriso per 54 tutti i bambini", carried out at the U.O. of "Pediatric Dentistry" of Policlinico Paolo Giaccone in Palermo, was therefore finalised in order to 1) improve efficiency and effectiveness in the promotion of the oral health of minors, through the creation of a preventive / assistance route of significant social health impact; 2) assess the effectiveness of the preventive methodologies adopted

The aim of the following study is to identify and quantify microorganisms in the saliva of black stain patients using species-specific probes for Actinomyces israelii, Actinomyces naeslundii, Streptococcus mutans and Lactobacillus spp, as well as a universal probe for bacterial 16S rDNA, to obtain the figure of the total bacterial counts (for test and control group). This study represents a first phase of the research line on extrinsic tooth pigmentation on developmental age patients. Materials and methods. The selected sample is composed of 20 subjects aged between 2 and 15 years and in good general and oral health among the patients included in a dental examination trial at the Department of Pediatric Dentistry of the University Hospital of Palermo, after obteining informed consent from parents. Subjects with a positive anamnesis for systemic diseases or with enamel defects were excluded from the study. Exclusion criteria were also a diet including regular use of tea, coffee, iron supplements, or antibiotic therapies in the 3 months prior to enrollment and the use of mouthwashes/toothpastes containing antiseptics. Parents/tutors were asked to complete a questionnaire on their occupational status and level of education, as well as their eating habits, the frequency of brushing and the patient's dental records. A sample of 20 patients without BS was used as control group. From all subjects participating to the study a sample of 5ml of unstimulated saliva was recovered from the right and left buccal area through a sterile syringe, after 2 minutes waiting for the accumulation of an adequate amount of saliva. Statistical analysis was carried out using descriptive and inferential statistics (mean and standard deviation; chi-square test, t test for non-paired data). StatView 5.0.1 statistical software (SAS Institute, Cary, NC, USA) was used for this purpose, and the tests were considered significant at p values less than or equal to 0.05. The study protocol will be presented for approval to the Palermo 1 ethics committee.

Aim: Obstructive sleep apnea syndrome (OSAS) is the most common type of sleep apnea and it is caused by complete or partial obstruction of the upper airway. Adenotonsillar hypertrophy, obesity, cranio-facial anomalies and neuromuscular diseases are the main risk factors for the development of OSAS in the pediatric age. Specially several studies identify the relationship between respiratory disorders in sleep and obesity, and, in particular, between OSAS and obesity, designing a prevalence of OSAS among obese subjects between 14 and 78%. The diagnosis of OSAS in the child is of great importance as it can lead to neurocognitive and behavioral complications, growth retardation, systemic arterial hypertension, pulmonary hypertension, cardiovascular disease and metabolism. The WHO (World Health Organization) has established the new criteria for the classification of Obesity on the basis of BMI and the risk of comorbidities, identifying a moderate risk for underweight subjects, a very low risk for normal weights and an increased risk from severe to severe for overweight and obese individuals respectively. According to that the aim of this study is to evaluate the correlation between obstructive sleep apnea syndrome and cephalometric variables in children considering age and BMI. Materials and methods: Children aged 7–10 years and 11-14 years with no genetic syndrome, previous otorhinolaryngologic or orthodontic therapy treatments are being selected from our Departments of Paediatric Dentistry, University of Palermo, and from the Department of Orthodontics, University of Messina (Italy). All patients so far recruited and visited for orthodontic problems were in mixed or early permanent dentition phase, with the first upper molars fully erupted and presented to the history of several symptoms of Osas, such as recurring episodes of shallow or paused breathing during sleep, waking up frequently to urinate, morning headaches, memory or learning problems and not be able to concentrate or feeling irritable. Dental records and lateral cephalometric radiographs were obtained for all of the patients and than they have been subjected to paediatric, otolaryngology and polysomnography visits. Subject with a positive diagnosis of Osas were studied and they were divided in group based on their BMI. In all groups the inter-molar distance in dental records was measured, and the cephalometric traces have been calculated. As reported by the study by Galeotti et al. the cephalometric measurements analysed are S-PNS, ad1-PNS, and ad2-PNS for the nasopharynx; p-pp and pa for oropharynx; H-H’ for the Hyoid bone; SNA for the maxilla; SNB;ANB and Go-Me for the mandible; S-Go, N-Me and P-A for facial Height; SN for cranial base; SN-MP and PP-MP for the typology, and angle ArGoMe for Growth prevision. At the time that children are still in the way of recruitment the results may not yet be defined; however it is necessary to emphasize the importance of the study, because in the child respiratory disturbances in the sleep, and in particular the OSAS, are often underestimated, despite representing the third place between the threats of health after the smoke and the excess of weight.

Gingival inflammation is caused by bacterial plaque (dental biofilm) that accumulates daily on the teeth.Results in redness, slight swelling, or "puffiness" of the gums and bleeding on tooth brushing. Treatment involves thorough professional tooth cleaning and effective daily removal of dental plaque by tooth brushing and cleaning between the teeth. Necrotising ulcerative gingivitis (NUG) is a more serious condition that is mainly found in developing countries associated with people with severe malnutrition or HIV/AIDS with low CD4 T-cell counts.

Aim. Dementia is a common disorder among the elderly. Alzheimer’s disease (AD) is the most common cause of dementia. In addition to known risk factors (e.g. age and familiarity) of AD, recently it has been suggested a possible promoting role for chronic inflammatory infective diseases. Periodontal disease (PD) is a frequent chronic multi-bacterial infection involving the tissues supporting the teeth; in addition to promoting inflammation locally, the periodontal pathogens possess mechanisms able to influence the systemic balance of inflammatory mediators. Similarly to other systemic diseases (e.g. cardiovascular disease, diabetes, renal diseases and low birth weight), a possible link has been proposed between PD and the development and progression of AD. Aim of the present study was to evaluate the oral health status and the prevalence/severity of PD in a group of patients affected by AD compared to a control group of healthy subjects. Materials and methods. A case-controlled clinical trial was designed to compare patients with AD (Test group - T; n = 16; M: 8; F: 8, range age 64-93 yrs) with healthy controls (Control group - C; n = 16; M: 8; F:8; range age 64-92 yrs). The population study was named ZAP (Zabut Aging Project) and all participants, enrolled in a Sicilian rural community (Sambuca di Sicilia, AG, Italy), were matched for age and sex. Following variables were recorded: smoking and drinking habits, number of teeth, Decayed Missed Filled Teeth scoring (DMFT), measurement of the probing depth (CPI and PSR index). The association between AD and PD, socio-demographic and behavioural-clinical variables was assessed using the χ2 test or Fisher’s exact test, as appropriate. To measure the association level, crude OR and the 95% Confidence Interval (CI) were calculated. Statistical significance of the difference in the average DMFT between cases and controls was assessed using the Student’s t-test. A p value ≤0.05 was considered statistically significant. Results. One patient of T group was a smoker versus four of C group; four T patients were drinker versus two of C group. Seven of T group (43.7%) were totally edentulous, conversely only 2 (12.5%) of controls have the same condition (p=0.04). With respect to oral status, DMFT index was 23.7 ±9.0 in T patients versus 25.2±7.8 in controls (p=0.633). There were no significant differences between T and C groups regarding periodontal index: high PSR and CPI scores (>3) were recorded in 77.8% of AD patients and 46.1% of health cases (p >0.05). A similar distribution among two groups was observed regarding the other investigated variables (e.g. smoking and drinking habits). Conclusions. In this rural Sicilian adult/elderly community, poor oral health is frequent with a DMFT score higher than general population. The obtained data do not support the hypothesis of a major prevalence and severity of PD among AD patients. However, to confirm these preliminary results the recruitment of a wider sample size and further data, regarding proteomic salivary profiles and RT PCR-based microbiological investigation on sub-gingival plaque samples, still need in order to better clarify the role of PD and periodontal pathogens in the AD natural history.

Purpose: To investigate the plaque inhibiting effects of two commercially available mouthrinses containing essential oils (EO). Both products contained the same concentration of EO, but one of them did not contain ethanol. Methods: The study was an observer-masked, randomized, 4 × 4 Latin square cross-over design, balanced for carryover effects, involving 12 participants in a 4-day plaque regrowth model. A 0.12% chlorhexidine (CHX) rinse and a saline solution served as positive and negative controls, respectively. On Day 1, subjects received professional prophylaxis, suspended oral hygiene measures, and commenced rinsing with their allocated rinses. On Day 5, subjects were scored for disclosed plaque. Results: Differences among treatments were highly significant (P< 0.0001), with greater plaque inhibition by CHX compared to EO rinse containing ethanol (P= 0.012), which, in turn, was significantly more effective than the rinse without ethanol and the saline (P< 0.001). The reduction in plaque regrowth seen with the EO rinse without ethanol was quite similar to that elicited by saline (P> 0.05). CLINICAL SIGNIFICANCE: The ethanol-free essential oil mouthrinse did not show anti-plaque efficacy in the absence of toothbrushing.

Background: Epidemiological data revealed a marked decline in dental caries prevalence in schoolchildren of Western industrialized countries. In Italy this decline is not well documented, particularly for schoolchildren living in southern Italy. This study investigated the prevalence of caries in schoolchildren in the city of Palermo, Sicily, and assessed the relationship between socio-behavioral determinants and caries. Material/Methods: A sample of 511 schoolchildren, 153 aged 5 (29.94%) and 358 aged 12 (70.06%), was selected using the cluster sampling technique from a stratified population. The World Health Organization caries diagnostic criteria for Decayed, Missing and Filled Teeth and Surfaces for both permanent (DMFT/DMFS) and primary (dmft/dmfs) dentition was used. A questionnaire to assess oral health behaviors and socio-economic factors was completed by the parents. A logistic regression model was estimated, with DMFT/dmft index properly dichotomized as the dependent variable, and oral hygiene, dietary habits, dentist visit attendance, mother’s employment status and level of education as explanatory variables. Two separate analyses were made for 5- and 12-year-old subjects. Results: The overall prevalence of dental caries was 38.56% in 5-year-olds and 44.97% in 12-year-olds. In the case of the 5-year-olds, maternal educational level was a protective factor for caries, while in the case of the subjects aged 12, frequent snack consumption was significantly associated with caries. Conclusions: The prevalence of caries in Sicilian schoolchildren was quite high and appears to be related to socio-behavioral determinants (socio-economic background of mothers and frequency of cariogenic snack consumption).

Hybrid prosthesis supported by natural teeth (overdenture) is widely used in clinical practice and should be executed whenever the clinical conditions suggest it. Through a critical review of the literature, the anatomical, functional, psychological and clinical advantages are emphasized. Among the first ones, the prophylaxis of residual anatomical components, due to the limitation of bone resorption, and the preservation of sensorial proprioception are relevant. Important advantages are also represented by a better crown-root ratio of residual teeth supporting overdenture, with the consequent improvement of the longitudinal prognosis of such teeth. The greater retention and stability of overdenture in comparison with complete denture greatly improve the masticatory efficacy. The psychological advantages resulting from the dental anchorage, which allows the patient to be more confident in social life, are also relevant. Finally, when the dental support is lost, converting overdenture into complete denture is simple and quick, and makes easier the longitudinal clinical maintenance of the denture.