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This study aims to evaluate the impact of a single session of intraoral and extraoral photobiomodulation (PBM) on controlling pain and improving a patient’s daily activities following surgical extraction of the impacted mandibular third molar, using combined three wavelengths: “445 nm, 660 nm, and 970 nm”. A pilot study was conducted on 22 patients undergoing extraction of an impacted mandibular third molar. The patients were randomly divided into two groups: (1) The Test Group consisted of patients subjected to immediate postoperative PBM. The extraoral PBM parameters were power = 550 mW and spot area = 5 cm2, while the intraoral parameters were power = 200 mW and spot area = 2 cm2. (2) The Control Group consisted of the patients not subjected to PBM. For all the patients, the pain was evaluated via a Numeric Rating Scale (NRS) on day 0, day 1, day 3, and day 7 after surgical intervention. The patient’s daily activities were evaluated on day 7 via a custom-made questionnaire. A statistically significant difference was observed between groups in the pain NRS scores on day 0 (p = 0.022), day 1 (p = 0.047), and day 7 (p = 0.028). No significant difference was found on day 3 (p = 0.153). A marginal statistical significance was observed with the number of painkillers taken (p = 0.054). No significant difference was observed with the questionnaire score (p = 0.206). This pilot study showed a significant reduction in postoperative pain on days 0, 1, and 7 with a single session of intraoral and extraoral PBM. However, the number of painkillers taken and the scores of the daily activities questionnaire did not show statistical significance despite the observed better results in patients subjected to PBM.

Introduction: The number of people with migrant status living in Europe is proliferating. Most of the refugees in Italy come from war zones, and many of them denounce having been victims of persecutory acts in their country of origin. Highly cultured migrant populations have shown better results and oral health behaviour than those who were poorly cultured. The PROTECT project aimed to build a network for the early management of head and neck pathologies among refugees and migrants, promoting the dissemination of correct information about the prevention and treatment of these pathologies. Materials and methods: A national cross-sectional study among the refugees and migrant population in the Lazio region, Italy, from February 2018 to September 2021 was performed. The oral health of 3023 participants was investigated within a network of 56 reception centres and cultural associations. Data collected via an oral health survey questionnaire gathered information on participants’ demographic factors, migration status and dental behaviours and clinical examinations of the participants with the help of mouth mirrors, periodontal probes and artificial light. Results: The mean age was 31.6 ± 13.1, and among all the subjects, 2058 were male (68.1%) and 965 were women (41.9%). Most participants were born in Nigeria, followed by Bangladesh, Pakistan, Somalia, Mali and Senegal. The overall oral pain prevalence was 48.2%. The prevalence of patients claiming poor oral hygiene was 32.4%; 36.2% of the subjects consumed high amounts of sugar; and 26.7% saw their dentist for a check-up in the last year. At the clinical examination, 68.9% of patients had caries experience (considering decay of deciduous teeth, and caries of permanent teeth and teeth with fillings), with 32.2% showing pulpal involvement. Low levels of oral hygiene were also found at the clinical examination, with 46.5% of patients presenting plaque and calculus. The trend of the DMFT index was found to be 5.41. Good periodontal health (CPI = 0) was present in approximately 33.5% of patients. The CPI = 1 index reported bleeding from gingivitis in 37% of patients; tartar was found in 27% of patients (CPI = 2). The percentage of patients with CPI = 3 was 3.6%. Just over half (52.2%) of the migrants examined had malocclusion, and only 0.7% had a malocclusion in treatment. Conclusions: The goal to be achieved is to develop education and prevention programs for head–neck diseases, and perhaps even more. The first step towards this goal can be removing the obstacles migrants encounter in accessing health care.

Introduction: Immune Checkpoint Inhibitor (ICI) drugs have led to a revolution in the treatment of different forms of cancer, shifting the target of action from cancer cells to the patient’s immune system, enhancing their responses against the tumor itself. On the other hand, this mechanism can lead to responses against oneself, with the appearance of immune-related adverse events. The aim of the present study was to examine the immune-related adverse events (irAEs) affecting the mucous membranes of the oral cavity and the possible correlation between these and skin toxicities, which are reported in the literature as the most common adverse events. Materials and methods: Thirteen patients treated with anti-Programmed Death (PD-1) drugs (pembrolizumab, nivolumab, and cemiplimab) were selected. The data collected include the general history of the patient and the type of anticancer treatment. The sample was then analyzed by recording the alterations found on the mucous membranes of the oral cavity and on the skin. Finally, the average time that elapsed between the start of immunotherapy and the onset of lesions was analyzed. Results: Patients often had multiple lesions at the same time. Hyperkeratosis was found in three patients, candidiasis (pseudomembranous and median rhomboid glossitis) in two patients, epithelial atrophy in four patients, and ulcerative areas in two patients. One patient reported xerostomia with dysphagia. The anatomical areas most involved were the dorsal tongue and palate. Skin irAEs included skin rash erythema (n = 7) with diffuse redness, the presence of small bubbles with a crusty outcome, and dryness of the skin in the affected areas. Discussion: In the literature, there are few studies that analyze how irAEs affect the mucous membranes of the oral cavity in patients treated with ICI drugs. The most frequently described lesions are lichenoid reactions and xerostomia. Moreover, the development of mucositis, generally of low grade, has been reported. The present study has confirmed the data from the literature and, in addition, reports two cases of candidiasis, an adverse event that has never been shown in the literature. Conclusions: irAEs have the potential to affect any organ. The only way to avoid the occurrence of serious events that is currently available is early interception, which is only possible through the knowledge of these manifestations. It is therefore considered necessary to deepen our knowledge of oral irAEs and their correlation with dermatological toxicities, allowing for a multidisciplinary classification of the patient and a timely diagnosis of any adverse event and avoiding progression to more advanced stages, which could lead to the temporary or permanent suspension of anticancer drugs.

The aim of this cross-sectional pilot survey was to assess patients’ perception and acceptance of a tele(oral)medicine program during the COVID-19 pandemic. We conducted a telephone survey on 84 patients of MoMax ambulatory at the Department of Oral Sciences and Maxillofacial Surgery at “Sapienza” University of Rome, Polyclinic Umberto I. Demographic characteristics of the patients were recorded, and a 24 question-survey was completed. A Chi-square test and an ANOVA test were performed with a significance level of 5% to determine the association between two target questions of the survey (Q22 and Q23) and specific variables such as computer skills, conditions influencing the experience of the conventional visit, and the difficulty in taking intraoral photos. Sixty-two (73.8%) patients declared an interest in the use of a tele(oral)medicine program. Furthermore, 41 (48.8%) participants preferred this type of visit to a conventional odontostomatological visit. Significative statistical associations were found between patients’ interest in a tele(oral)medicine service and computer skills, conditions influencing the experience of the conventional visit, and the difficulty in taking intraoral photos. Our study showed that the tele(oral)medicine program appears to meet the expectations and needs of our patients.

(1) Background The incidence of oral cavity lesions related to human papillomavirus (HPV) is 3%. There are no reliable data in the literature on recurrence rates of HPV-related oral cavity lesions. The only data available concern gynecological infections, which have a recurrence rate of ~30%. Recurrence may be due to a failure to completely eradicate the lesion, persistence of the viral infection, or persistence of an immune-compromised state. Therefore, the study aimed to ascertain the most effective therapeutic strategy to achieve complete eradication of the virus and avoid a possible recurrence of lesions, based upon the long-term behavior of the virus with the type of treatment. (2) Methods: Systematic searches of the Cochrane Library, EMBASE, Pubmed, Web of Science, clinicaltrials.gov, and SCOPUS were performed. Restrictions were placed on the date of publication and language. Only English or Italian language articles published between Jan 1990 and Dec 2019 were included in the meta-analysis. The following keywords and/or corresponding medical subject heading terms were used: “oral papillomavirus lesions” and “oral HPV lesions” or “treatment”, “therapy”, “therapeutics,” and “management”. (3) Results: Upon systematic literature review of all analyzed HPV-lesion treatment techniques, 36 studies on laser and cold scalpel eradications were selected. These studies document an excellent success rate from excisional treatments using both laser and cold scalpel and report low recurrence rates with both techniques, respectively 5.98% and 4.07%. (4) Conclusions: The meta-analysis revealed that additional studies with greater sample sizes are needed for these two treatment methods. It would also be appropriate to carry out case-controlled studies, preferably RCTs, to determine the best treatment for eradicating HPV-related lesions.

The Weather Research and Forecasting (WRF) model with online coupled chemistry (WRF-Chem) is applied to study an intense Saharan dust outbreak event affecting the Italian peninsula in 15 and 16 April 2018. According to the MODIS retrievals, this intrusion was characterized by an intense aerosol optical depth (AOD) peak value in the southern Mediterranean. Measurements within the Dry Deposition Network Across the Mediterranean (XMed-Dry) are compared with the output of the WRF-Chem model. XMed-Dry samples from Lecce (Italy), Athens (Greece) and San Lawrenz/Gozo (Malta) were analysed with respect to aerosol particle size distribution, relative dust contribution, and composition. The discrepancy between the model and measured deposition indicate the need to formulate in WRF-Chem more sophisticated deposition schemes, this will need to evaluate the sensitivity of the results to the precise particle size limits chosen for the aerosol model. Moreover, satellite retrievals from MODIS sensors elaborated with the MAIAC algorithm, Aeronet stations, and measurements of PM10 at the selected sites were also considered. In a numerical domain that spans the Mediterranean and the northern Saharan desert, two different dust emission schemes, namely Gocart-AFWA and the Shao-2001, were tested and compared with multiplatform observations for simulation period covering the dust outbreak. Actual results indicate that both emission schemes would benefit from replacing the static erodibility map and soil particle distribution with remote sensed and in-situ observational data.

The lower lip-splitting incision associated with different types of mandibulotomy, in order to obtain wide access to total or subtotal glossectomy, is described. In those cases, high rates of functional and aesthetic deficit and postoperative morbidity (more in cases of patients in which adjuvant radiotherapy has been performed) are described. We present our experience in the treatment of patients undergoing total or subtotal glossectomy and contemporary reconstruction with flaps, and without lip-splitting incision and mandibulotomy. Materials and Methods: Data about patients affected by malignant tumors requiring total or subtotal (posterior third of the tongue) resection that were treated at our department from January 2004 to December 2014 were retrospectively reviewed. Data evaluated included: T and N stage, resection margins, operation time, and post-operative complications, such as fistula and flap necrosis. Results: 41 patients were identified. In two cases microscopic infiltration of one margin was found (R1); in one case a close margin was identified. In 26 cases reconstruction was performed using free flaps, and in the remaining cases a pectoralis major flap was used. In three cases postoperative complications were observed. Discussion and conclusions: In theory, lip-splitting and mandible discontinuity could allow for increased access and tumor visualization, and could facilitate flap positioning. Nevertheless, in our experience, it is not necessary in the case of total or subtotal glossectomy.

The aim of the study was to observe the effectiveness of a photo-biomodulation (PBM) protocol for the prevention of oral mucositis (OM) in patients undergoing allogeneic hematopoietic stem cell transplantation (aHSCT). A case-control study was conducted on 40 patients undergoing aHSCT. The patients were divided into two groups; the preventive group (PG) included 20 patients (7 females and 13 males) who were subjected to intra-oral PBM for five sessions a week, starting one day before the conditioning regimen and continuing until the 10th day after transplantation (D+10). In each session, ten points on the at-risk mucosal surfaces were irradiated using a double diode laser that emits two wavelengths simultaneously at 650 nm and at 904–910 nm with the following parameters at each point: energy of 4 J, and power of 88.9 mW. The control group (CG) included 20 patients (10 females and 10 males) who were not subjected to laser therapy and were selected retrospectively to compare the obtained results. For all patients, OM was assessed by the World Health Organization (WHO) grading scale. Eight patients in the PG did not experience OM during their hospitalization period (with grade 0). Severe OM was observed in 40% of the patients in the PG, while in the CG, severe OM was shown in 85% of the patients. The mean duration of OM in the PG was significantly lower than that of CG (4.7 days in the PG and 15 days in the CG) (p < 0.001). The study demonstrated that the preventive PBM protocol reduced the severity and duration of OM in patients undergoing aHSCT.

The aim of the study is to observe retrospectively the correlation between Oral Squamous Cell Carcinoma (OSCC) and risk factors; including tobacco, alcohol and Family History of Cancer (FHC). A total of 478 patients were included retrospectively from the database of the Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome. A Test Group (TG) consisted of 239 patients with a confirmed diagnosis of OSCC. A Control Group (CG) consisted of 239 patients without history and/or diagnosis of oral cancer. The logistic regression models were used to calculate the adjusted Odd Ratios (ORs) associated with alcohol, tobacco and FHC; including the General Family History of Cancer (GFHC) and Family History of Head and Neck Cancer (FHHNC) and their 95% Confidence Intervals (CI). The high rate of tobacco consumption was associated with an OR of 1.035 (95% CI 1.001–1.070) and a statistical significance (p = 0.041). Drinker patients showed a significant risk of developing OSCC (p = 0.05) and the OR was 1.035 (95% CI 1.010–1.061). The GFHC was associated with a marginal risk of OSCC with an OR of 1.095 (95% CI 0.953–1.259), without significance (p = 0.199). The FHHNC showed a notable risk increase with an OR of 1.871 (95% CI 0.902–3.882), without significance (p = 0.092). Alcohol and tobacco may be associated with an increase in the risk of OSCC.

In the last decade, some researchers and professionals have been engaged in the study of methods and techniques that can build high wind turbines while containing construction costs within the limits of economic convenience. Among the most promising solutions is that of using innovative devices to mitigate the structural demand for the towers. The reduction in the stress demand in the foundation makes the strategy particularly interesting for the repowering of existing plants, where it is convenient not to demolish and rebuild the foundation, but rather to reuse the existing one for the new plant. A semi-active vibration control strategy, based on the adoption of controllable dissipative devices, is presented herein. The proposed technique requires the tower to be equipped with a measurement system suitable for the real time monitoring of structural response. Performing reliable high-frequency measurements of the horizontal displacement of points located at heights of tens of meters is not simple. With the purpose of assessing the efficiency and feasibility of Global Navigation Satellite System (GNSS)-based systems for the control of wind turbine structures, the proposed paper tries to investigate the characteristics and data processing techniques that are able to make the GNSS useful for such applications. Several numerical simulations were carried out with reference to a case-study wind turbine to quantitatively assess how the performance of the control system changes as the features of the monitoring system worsen, and finally to draw conclusions and suggestions for the minimum performance that monitoring devices must have for an effective reduction in structural demand.

The study aimed to evaluate the antimicrobial effect of photodynamic therapy (PDT) with the use of Toluidine Blue (TB) on extracted teeth infected with biofilms of Enterococcus faecalis. Fifty-four extracted teeth with single-roots and single canals were mechanically shaped, autoclaved, and contaminated with E. faecalis. They were randomly divided into six groups: two groups were negative and positive control groups, two groups were subjected to mechanical instrumentation and PDT with different pre-irradiation times and irradiation times, and two groups were subjected to chemo-mechanical endodontic treatment and PDT with different pre-irradiation times and irradiation times. In PDT groups, after the application of TB, the canals were irradiated with a diode laser of wavelength 635 nm, with a fiber diameter of 200 μm and 100 mW of power in continuous mode. The bacterial load was evaluated using a BioTimer Assay protocol. The greatest reduction of bacterial load was observed in groups of combined PDT with chemo-mechanical treatment. The reductions of bacterial load in groups of combined PDT with chemo-mechanical treatment, and in the positive control group, were significant (p < 0.01) when compared to that of the negative control group. Photodynamic therapy as an adjunctive modality may improve the disinfection capacity of conventional endodontic treatment against E. faecalis.