Search

Introduction: Within the field of periodontology, there has been a proposal for the utilization of noninvasive laser therapy as a potential treatment for persistent periodontitis. The Laser-Assisted New Attachment Procedure (LANAP) employs an Nd:YAG laser as a specific technique. Through its interaction with endogenous chromophores, the Nd: YAG laser exhibits a selective effect on the evaporation of granulation tissue, therefore establishing a correlation with reduced bleeding. The study also examined Oxygen High-Level Laser Therapy (OHLLT). The OHLLT technique employs a high-power diode laser in combination with hydrogen peroxide solutions to facilitate the liberation of singlet oxygen, which possesses antibacterial attributes, within the periodontal pockets. The existing literature indicates their potential to promote the regeneration of tooth support tissues. Objective: The aim of this study is to assess the subjective pain levels reported by patients who have undergone surgery using the OHLLT protocol versus those who have undergone surgery using the LANAP technique. Methods: A total of 20 individuals with a stage III–IV periodontitis diagnosis were recruited for the study. The participants were randomly divided into two groups, each consisting of 10 individuals: Group 1, comprising patients treated according to the LANAP protocol, and Group 2, comprising patients treated according to the OHLLT protocol. After their initial session of nonsurgical periodontal therapy, individuals provided feedback regarding their level of pain, utilizing a Numerical Rating Scale (NRS) comprising time intervals of 0 h (T0), 6 h (T1), 12 h (T2), 24 h (T3), 48 h (T4), and 7 days (T5). The Wilcoxon–Mann–Whitney statistical test was employed to assess the variations in NRS scores between Group 1 and Group 2 at each recording period. (p ≤ 0.05). In addition, a microbiological assessment of the bacterial load in the periodontal region was conducted on all subjects using real-time PCR testing at two time points: prior to treatment (T0) and seven days post-treatment (T5). Results: The findings of this study indicate that the OHLLT group exhibited significantly lower pain levels compared to the LANAP group at all time intervals, except for the preoperative period, where no significant difference was observed (p < 0.05). Group 2 exhibited a more rapid decrease in pain, as demonstrated by a score test approaching zero within 24 h. The quantity of periodontal bacteria seen seven days post-treatment was similar between the two groups and was found to be decreased compared to the pre-treatment levels. Conclusions: The OHLLT and LANAP regimens have demonstrated efficacy in the nonsurgical management of periodontal disease. Nevertheless, it should be noted that the OHLLT approach does not subject the patient to any thermal hazards, unlike the LANAP method. The postoperative discomfort experienced following the OHLLT procedure is indeed reduced, as this technique is characterized by lower invasiveness and reduced dependence on the operator. [ABSTRACT FROM AUTHOR]

In the past, complex rehabilitations, such as the rehabilitation of an entire arch with a prosthesis on implants, were reserved for the few patients who presented an optimal state of health as the interventions were long and traumatic. Nowadays, the use of devices such as the Magnetic Mallet and the laser allows us to perform the same interventions in less time and in a minimally invasive way. The case report we present shows how a fragile patient, subjected to the insertion of eight implants on the same day, had a positive response, thanks to the use of a Magnetic Mallet to prepare the implant sites, the application of the photodynamic therapy without dye (diode laser + hydrogen peroxide) to decontaminate the post-extraction alveoli and the use of an erbium laser to induce more bone bleeding and promote healing. The implants were then loaded in 48 h with a Toronto-type temporary total prosthesis. The patient had a pain-free and complication-free outcome. It is interesting to note how technological development, aimed at reducing the morbidity of surgery, makes it possible to perform almost all surgical therapies, even the most advanced, on any patient, regardless of general health conditions. [ABSTRACT FROM AUTHOR]

A case of home care is proposed on a frail non-ambulatory patient who presents an old lower total prosthesis in resin broken in several parts. The various pieces of the prosthesis were joined by the patient, as if it were a puzzle, using a glue for plastics and wood. The union of the parts attached with glue was the consequence of the lockdown in the COVID-19 period and of the economic hardship experienced by the elderly disabled patient during the pandemic period. The procedure for preserving the glued parts was carried out carefully, trying not to modify the edges of the glued pieces, to join them correctly, thereby restoring the correct occlusion to subsequently perform the relining. The old lower total prosthesis obtained after the repair and relining operations allowed for the restoration of the patient's chewing and smile. The procedure presented is easily repeatable, risk-free and achievable even in a short time, satisfying elderly non-self-sufficient patients who need interventions for prosthetic emergencies during a period of confinement. [ABSTRACT FROM AUTHOR]

In peri-implantitis, treatment lasers are effectively used to enhance implant surfaces' decontamination of bacteria. The type of lasers commonly used and tested in dentistry are Nd:YAG, Er:YAG and diodes. The Er:YAG laser is considered to be effective in removing biofilm from implant surfaces. Photodynamic therapy (PDT), realized with low-level laser therapy (LLLT) and a photosensitizer, seems to have limited efficacy in peri-implantitis management, while diode lasers used with high frequency and power (Wiser, Doctor Smile), performed with hydrogen peroxide 10 vol. 3% (OHLLT), seems to lead to a deep sanitization of implant surfaces, without any thermal effect. The aim of our retrospective controlled study is to compare an oxygen high-level laser therapy (OHLLT) protocol with OHLLT with an Er:YAG laser (Pluser, Doctor Smile) in order to maximize bacterial removal and to evaluate if an Er:YAG laser could improve hard tissue regeneration with respect to OHLLT alone. Two hundred and ten implants affected by peri-implantitis were divided into two groups: 88 implants were treated with OHLLT alone (control group) while 122 underwent OHLLT and Er:YAG treatment (test group). Mean bone loss before (T0) and after treatment (T1) (with a follow-up of 5 years) was registered for all implants. The collected data were analyzed with the Statistical Package for Social Sciences (SPSS) version 11.5. No statistically significant differences were found. In the OHLLT group, we noticed a mean bone loss after treatment of 2.1 mm in the upper arch and 2.4 mm in the mandible. In the OHLLT + Er:YAG group, the results indicate a mean bone loss of 2.0 mm in the upper arch and 2.5 mm in the mandible. Both groups showed a mean bone loss after treatment of 2.3 mm. According to the Kolmogorov–Smirnov test, overall, data followed a normal distribution (value of the K-S test statistic = 0.0912; p = 0.36112). OHLLT plays a central role in enhancing clinical results in peri-implantitis treatment, leading to an effective bacterial decontamination. Our results showed no statistically significant differences between OHLLT and OHLLT + Er:YAG laser; thus, the potential advantageous role of Er:YAG has been downgraded with the analysis of our study. [ABSTRACT FROM AUTHOR]

Peri-implantitis management could be performed either with a surgical or non-surgical approach to the implant surfaces. Various treatment options have been proposed in the literature, such as antiseptic and antibiotic therapies, chemical agents, curettes, ultrasonic, air abrasive, rotary titanium brushes and laser treatments; in particular, photodynamic therapy combined with hydrogen peroxide (OHLLT) has proved to be efficient in the removal of bacterial biofilm from implant surfaces. The aim of our study is to compare OHLLT performed with a surgical approach to a non-surgical approach. We selected a cluster of 227 implants affected by peri-implantitis: 139 implants were treated with a non-surgical approach and 88 implants with a surgical approach. Bone loss pre-operative and post-operative (with a follow-up of five years) have been registered. The collected data were entered on the Statistical Package for Social Sciences (SPSS) version 11.5. The results indicate a statistically significant difference between the two groups, with a mean bone loss after treatment of 2.3 mm for OHLLT with a surgical approach and 3.8 mm for OHLLT with a non-surgical approach; according to the Kolmogorov–Smirnov test, the overall data followed a normal distribution (value of the Kolmogorov–Smirnov test statistic = 0.0891; p = 0.35794). Thus, a surgical approach in the case of peri-implantitis seems to be more effective, probably due to the possibility of a deeper sanitization of implant surfaces, hardly reachable with only non-surgical approach. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate two different kinds of rough implant surface and to assess their tendency to peri-implantitis disease, with a follow-up of more than 10 years. Data were obtained from a cluster of 500 implants with Ti-Unite surface and 1000 implants with Ossean surface, with a minimum follow-up of 10 years. Implants had been inserted both in pristine bone and regenerated bone. We registered incidence of peri-implantitis and other causes of implant loss. All patients agreed with the following maintenance protocol: sonic brush with vertical movement (Broxo), interdental brushes, and oral irrigators (Broxo) at least two times every day. For all patients with implants, we evaluated subgingival plaque samples by phase-contrast microscopy every 4 months for a period of more than 10-years. Ti-Unite surface implants underwent peri-implantitis in 1.6% of the total number of implants inserted and Ossean surface implants showed peri-implantitis in 1.5% of the total number of implants. The total percentage of implant lost was 4% for Ti-Unite surfaces and 3.6% for Ossean surfaces. Strict control of implants leads to low percentage of peri-implantitis even for rough surfaces dental implants. [ABSTRACT FROM AUTHOR]

In periodontology, lasers have been suggested for the nonsurgical treatment of chronic periodontitis. Many wavelengths were tested, but unfortunately, most parts were not efficient. An Nd:YAG laser was applied in a specific protocol named the laser-assisted new attachment procedure (LANAP). LANAP seems to facilitate the refurbishment of new tissues from supporting structures of the periodontium, wherein the unhealthy surface of the roots exhibits pristine attachments in human beings. Photodynamic therapy (PDT) was investigated too. The aim of our study is to show the effects of oxygen high-level laser therapy (OHLLT) in removing all bacterial deposits on the root or implant surface by means of mechanical instrumentation and laser irradiation compared to LANAP and to nonsurgical debridement of periodontal pockets. At 7 days post-treatment, a real-time PCR test had similar results on the OHLLT and LANAP groups. After 9 months, all periodontal pockets were treated successfully, not showing significant differences in the clinical results between OHLLT and LANAP and with a decrease in the plaque index, bleeding on probing and probing depth compared with the nonsurgical debridement group. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of our study is to describe a fast molecular method, able to distinguish and quantize the two different genotypes (652 and JP2) of an important periodontal pathogen: Actinobacillus actinomycetemcomitans. The two genotypes show differences in the expression of an important pathogenic factor: the leukotoxin (ltx). In order to evidence this, we performed a real time PCR procedure on the ltx operon, able to recognize Aa clinical isolates with different leukotoxic potentials. Methods The specificity of the method was confirmed in subgingival plaque and saliva specimens collected from eighty-one Italian (Sardinian) subjects with a mean age of 43.9, fifty five (68 %) of whom had various clinical forms of periodontal disease. Results This procedure showed a good sensitivity and a high linear dynamic range of quantization (107-102 cells/ml) for all genotypes and a good correlation factor (R2 = 0.97–0.98). Compared with traditional cultural methods, this real time PCR procedure is more sensitive; in fact in two subgingival plaque and two positive saliva specimens Aa was only detected with the molecular method. Conclusion A low number of Sardinian patients was found positive for Aa infections in the oral cavity, (just 10 positive periodontal cases out of 81 and two of these were also saliva positive). The highly leukotoxic JP2 strain was the most representative (60 % of the positive specimens); the samples from periodontal pockets and from saliva showed some ltx genotype for the same patient. Our experience suggests that this approach is suitable for a rapid and complete laboratory diagnosis for Aa infection.

Many studies have shown success with immediate loading of dental implants. The purpose of this paper is to report on a procedure that places implants with a sandblasted and acid-etched surface and loads them with a fixed, provisional, immediately loaded mandibular complete denture, all in a single day. The various surgical, prosthetic, and laboratory phases are explained, with particular attention paid to a luting technique that is able to reduce prosthetic misfit. A series of 14 patients was treated with this protocol and followed for a mean of 28.2 months. A 100% implant survival rate was achieved, and all prostheses were in place and functioning at the most recent follow-up. [ABSTRACT FROM AUTHOR]

This article presents the case report of the bilateral 3-dimensional reconstruction of a posterior mandible in a 48-year-old woman. Titanium meshes and Regena form demineralized freeze-dried bone allograft were used for bone regeneration. After 5 months the titanium mesh was removed, and after another 4 months, 4 Straumann sandblasted, large-grit, acid-etched implants were placed, 2 on each side of the mandible. During implantation a bone specimen was collected and sent for histologic examination. The definitive fixed prosthesis was fabricated after an additional 4 months. The clinical and histologic results are shown. The implants were followed for 18 months after implant loading; no signs of bone loss or infection were observed. [ABSTRACT FROM AUTHOR]

Introduction: The treatment of a true unilateral posterior crossbite often requires asymmetric maxillary expansion; however, this is challenging to achieve with conventional expansion methods because of several biomechanical limitations. In this paper, we introduce a new protocol for the treatment of a unilateral posterior crossbite in adults based on maxillary orthodontic expansion assisted by corticotomy and low-level laser therapy (LLLT) performed on the crossbite side. Methods: The study sample included 15 adults (8 females, 7 males) affected by a true unilateral posterior crossbite, with a mean age of 21.6 ± 3.1 years at the at the beginning of treatment. After the application of orthodontic appliances (palatal expander and self-ligating brackets), corticomy was performed at the buccal aspect of the crossbite side while LLLT was monthly administered up to the correction of the crossbite. The efficacy of the technique was evaluated through measurements performed on maxillary digital models. Results: All subjects reported successful correction of the posterior unilateral crossbite, and functional occlusion was achieved as well. The average expansion was greater at the crossbite side compared to the unaffected side and such difference was significant at the levels of first premolars (P < 0.05), second premolars (P < 0.05) and first molars (P < 0.05). Conclusion: Orthodontic maxillary expansion assisted by unilateral corticotomy and LLLT was effective in the treatment of the true unilateral crossbite. [ABSTRACT FROM AUTHOR]

Aim. In periodontology lasers have been suggested for the photodynamic therapy (PDT): such therapy can be defined as the inactivation of cells, microorganisms, or molecules induced by light and not by heat. The aim of this study was to evaluate results of PDT using a 980 nm diode laser (Wiser Doctor Smile, Lambda SPA, Italy) combined with hydrogen peroxide, comparing a pulsed diode laser (LI) activity to a high-frequency superpulsed diode laser (LII). Materials and Methods. Primary fibroblasts and keratinocytes cell lines, isolated from human dermis, were irradiated every 48 h for 10 days using LI and LII combined with SiOxyL+™ Solution (hydrogen peroxide (HP) stabilized with a glycerol phosphate complex). Two days after the last irradiation, the treated cultures were analyzed by flow cytofluorometry (FACS) and western blotting to quantify keratin 5 and keratin 8 with monoclonal antibodies reactive to cytokeratin 5 and cytokeratin 8. Antimicrobial activity was also evaluated. Results. Both experimental models show the superiority of LII against LI. In parallel, stabilized HP provided better results in the regeneration test in respect to common HP, while the biocidal activity remains comparable. Conclusion. The use of high-frequency lasers combined with stabilized hydrogen peroxide can provide optimal results for a substantial decrease of bacterial count combined with a maximal biostimulation induction of soft tissues and osteogenesis. [ABSTRACT FROM AUTHOR]

Aim. Endosseous implants are widely used to replace missing teeth but mucositis and peri-implantitis are the most frequent long-term complications related with dental implants. Removing all bacterial deposits on contaminated implant surface is very difficult due to implant surface morphology. The aim of this study was to evaluate the bactericidal potential of photodynamic therapy by using a new high level laser irradiation protocol associated with hydrogen peroxide in peri-implantitis. Materials and Methods. 10 patients affected by peri-implantitis were selected for this study. Medical history, photographic documentation, periodontal examination, and periapical radiographs were collected at baseline and 6 months after surgery. Microbiological analysis was performed with PCR Real Time. Each patient underwent nonsurgical periodontal therapy and surgery combined with photodynamic therapy according to High Level Laser Therapy protocol. Results. All peri-implant pockets were treated successfully, without having any complication and not showing significant differences in results. All clinical parameters showed an improvement, with a decrease of Plaque Index (average decrease of 65%, range 23–86%), bleeding on probing (average decrease of 66%, range 26–80%), and probing depth (average decrease of 1,6 mm, range 0,46–2,6 mm). Periapical radiographs at 6 months after surgery showed a complete radiographic filling of peri-implant defect around implants treated. Results showed a decrease of total bacterial count and of all bacterial species, except for Eikenella corrodens, 6 months after surgery. Conclusion. Photodynamic therapy using HLLT appears to be a good adjunct to surgical treatment of peri-implantitis. [ABSTRACT FROM AUTHOR]

The article presents case reports of patients with osteoporosis receiving biphosphonate therapy to demonstrate the potential of rehabilitating the jaw with full-arch technique. Two of the patients treated in the study received both submerged and immediately loaded (IL) implants. The pathogenesis of bisphosphonate-induced osteonecrosis of the jaw (BONJ) is discussed. Also noted is the benefit of biphosphonates in the integration of dental implants.

An intraoral luting technique between electroformed gold copings and a metallic framework for a cement-retained, implant-supported metal-resin-fixed complete-denture is presented. The peculiarity is the different prosthetic design with the metallic framework that was 1.5 mm shorter than the margin of the electroformed copings. As a consequence, the conventional thick prosthesis margin (electroformed copings, cement for the luting phase, framework) was modified into a thin electroformed prosthesis seal (0.3 mm) just beyond the apical limit of the esthetic material. Passive fit between the framework and the electroformed gold copings was achieved during the intraoral luting phase. The procedure was efficient and standardized and enhanced esthetics. [ABSTRACT FROM AUTHOR]

Background: Tentative bioinformatic predictions were performed to comprehend the complexity of the gene interaction networks of the T lymphocyte cell cycle and of human periodontitis. This study aims to identify and rank genes involved in osseous augmentation or bone remodeling to obtain groups with more numerous predicted associations called the leader gene clusters. Methods: An iterative search (consisting of a consecutive expansion-filtering loop) was performed for which only genes involved in a specific process were identified. For each gene, predicted associations with all other involved genes were obtained from a Web-available database (Search Tool for the Retrieval of Interacting Genes/Proteins) and the weighted number of links (WNL), given by the sum of only high-confidence predicted associations (results with a score ≥0.9), allowing gene ranking. Genes belonging to higher clustering classes were identified. Results: A total of 161 genes potentially involved in bone-volume augmentation and 128 genes connected with the bone-remodeling phenomenon were identified. For the bone-volume augmentation process, only one gene belonged to the leader gene group, whereas six other genes were classified as cluster B genes; for the bone-remodeling phenomenon, three leader genes were identified, whereas six other genes formed the cluster B group. No one gene belonged to leader gene clusters of both processes, whereas one gene of each higher cluster group belonged to the immediately lower cluster of the opposite process. Only three genes of the higher clusters were experimentally involved in both analyses. Conclusions: A de nova identification was performed based on the data mining of leader genes involved in bone-volume augmentation or bone remodeling to acquire primeval information about their molecular basis and to plan future ad hoc targeted experiments. For several genes of the upper clusters, an active role in the bone processes was already known, but the present analysis suggested that they play a major role in the analyzed phenomena. The role of the transcription factors as leader genes and the numerous orphan genes (genes with WNL = 0) recovered probably attest to a lack of information regarding these processes, which could be further clarified through specific DNA microarray experiments. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this research is to assess the analgesic efficiency of Photobiomodulation (PBM) in pain reduction in young patients during rapid maxillary expansion therapy. Materials and Methods: Thirty patients were included and allocated to an experimental group [Rapid Palatal Expansion (RPE) and PBM] and a control group (RPE only) at random. Inclusion criteria were skeletal age from CVS1 to CVS3, examined on the cephalometric lateral teleradiography, with cervical vertebra staging and completed eruption of upper first molar. Exclusion criteria were previous orthodontic treatment, bone disease, disability, or skeletal age from CVS4. Patients referred the pain they felt using a Numerical scale rate (NRS), ranging from 0 to 10, with specific intervals of time: 6 h, 12 h, 24 h, and from days 2 to 7. The Wilcoxon-Mann-Whitney test was used to evaluate differences in NRS reported values between the two groups. Results: The final sample included 30 patients, 14 males and 16 females, with a mean age of 7.8 ± 1.2 years. The pain that was felt at each time interval and the maximum score of pain were significantly lower in the experimental group (p < 0.05) and decreased faster in the experimental group, with a score test near to 0 after 2/3 days. Conclusions: PBM is efficient in reducing the intensity and the time of pain felt by young patients that undergo rapid maxillary expansion. [ABSTRACT FROM AUTHOR]

Copyright of Implant Dentistry is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Implant Dentistry is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The year 2020 will be remembered around the world for the Coronavirus pandemic. The better-known Coronavirus disease (COVID-19) is transmitted between individuals through the droplets produced by infected people and is an infectious disease caused by a type of Coronavirus when they exhale, cough or sneeze, or touch a contaminated surface and then touch their eyes, nose or mouth. The pandemic has activated all those measures that provide for a state of emergency with consequent remodeling of health facilities in cases of urgency that cannot be deferred. In this work, a path within a public or private medical facility was highlighted, using individual protective devices for the patient, establishing behaviors that can reduce the spread of the virus. The COVID-19 path has allowed the health personnel and the staff of the study to be able to work in peace as there is the perception of the total containment of the spread of the virus. Coronavirus disease (COVID-19) is an infectious disease caused by a Coronavirus type transmitted through droplets produced by infected people when they cough, sneeze or exhale. Our proposal in dictating the sequence and types of protective devices to be worn by patients minimizes the contagion between patients in a professional healthcare office and is applicable for any type of infectious emergency.

Objective: The purpose of this research is to assess the analgesic efficiency of Photobiomodulation (PBM) in pain reduction in young patients during rapid maxillary expansion therapy. Materials and Methods : Thirty patients were included and allocated to an experimental group [Rapid Palatal Expansion (RPE) and PBM] and a control group (RPE only) at random. Inclusion criteria were skeletal age from CVS1 to CVS3, examined on the cephalometric lateral teleradiography, with cervical vertebra staging and completed eruption of upper first molar. Exclusion criteria were previous orthodontic treatment, bone disease, disability, or skeletal age from CVS4. Patients referred the pain they felt using a Numerical scale rate (NRS), ranging from 0 to 10, with specific intervals of time: 6 h, 12 h, 24 h, and from days 2 to 7. The Wilcoxon-Mann-Whitney test was used to evaluate differences in NRS reported values between the two groups. Results: The final sample included 30 patients, 14 males and 16 females, with a mean age of 7.8 ± 1.2 years. The pain that was felt at each time interval and the maximum score of pain were significantly lower in the experimental group ( p < 0.05) and decreased faster in the experimental group, with a score test near to 0 after 2/3 days. Conclusions : PBM is efficient in reducing the intensity and the time of pain felt by young patients that undergo rapid maxillary expansion.

Objective: To assess if photobiomodulation (PBM) improves the efficiency of orthodontic treatment with fixed appliance during the alignment stage. Methods: Eighty-nine subjects were included in this trial and randomly assigned for treatment with fixed appliance and PBM group or with fixed appliance only (control group). Inclusion criteria were as follows: (1) age between 13 and 30 years, (2) permanent dentition, (3) class I malocclusion, (4) lower 6-6 mild crowding measured on dental cast, (5) no spaces or diastema in the lower arch, (6) no ectopic teeth, (7) nonextractive treatment plan, and (8) no previous orthodontic treatment. PBM was administered in the PBM group every 14 days using the ATP38 ® (Biotech Dental, Allée de Craponne, Salon de Provence, France) (72 J/cm 2 of fluency for each session). Dental alignment was assessed by visual inspection, and treatment time was defined in days as T2 (date of assessment of complete dental alignment)-T1 (date of brackets bonding). The number of monthly scheduled appointments was also recorded. All the data underwent statistical analysis for comparison between groups. Results: Treatment time was significantly shorter ( p  < 0.001) in the PBM group (203 days) compared with the control (260 days). Consequently, control visits ( p  < 0.001) were lower in the PBM group (7) compared with the control group (9). Conclusions: The present findings would confirm that PBM can be used to enhance the efficiency of orthodontic treatment during dental decrowding.

Aim: The aim of this work was to evaluate if the use of a silicone device for muscular rebalancing (Alifix®) can be useful in treating of temporomandibular disorders (TMD) of muscular origin and improving the electromyographic indexes of the chewing muscles., Materials and Methods: Thirteen patients (11 F and 2 M aged between 24 years and 65 years) with TMD of muscular origin according to diagnostic criteria (DC)/TMD were involved. At the first visit (T0), each patient reported the pain intensity of masseters and temporal muscles. A surface electromyography (EMG) was performed using Teethan® (Teethan S.p.A.) and then Alifix® was delivered instructing the patient on its use. Each subject was visited again after 1 month (T1) and 2 months (T2). New EMG had been made at T1 and T2, and patients were asked again to report the pain intensity. Statistical analysis was calculated between T0 and T1, T1 and T2, and T0 and T2 for all EMG, and muscle pain measurements by Wilcoxon test with statistical significance p < 0.05., Results: Regarding the pain values between T0 and T1, T1 and T2, and T0 and T2, the difference is statistically significant, since the intensity of pain between T0 and T2 is decreased, if not disappeared, in 90% of cases. The use of Alifix® also determined a gradual improvement in the values of the EMG indexes, which, however, is not statistically significant., Conclusion: The effectiveness of Alifix® is demonstrated clinically but not at an instrumental level. Further studies involving a larger sample and taking longer therapy duration are needed., Clinical Significance: Alifix® works by improving the blood circulation of the muscle, which allows the removal of catabolites with a consequent reduction of the algic symptomatology and promotes a greater supply of oxygen. It also encourages a conversion of IIA type muscle fibers into slow-twitch type I fibers that are more resistant to neuromuscular fatigue.

Aim: The aim of this study is to verify if the thickness of soft tissues and inclination of the incisors have some relation with profile, to analyze its relevance considering these two parameters separately and to screen how the combination of different inclinations and different thickness can generate different facial patterns., Materials and Methods: The study was performed on 47 Caucasian patients aged between 6 years and 16 years of divided into 24 males and 23 females. None of the patients presented craniofacial changes of syndromic nature. All patients presented a value of SNA in between 80° and 84°. The inclination of the upper incisor related to the bispinal plane was between 104° and 116°. Each radiograph has been digitized or analyzed directly in digital format. To analyze the relationships between soft tissues and position of the incisors using various cephalometric measures and statistical methodology were used., Results: Analysing the general correlation between all the cephalometric parameters considered, the results found show that the thickness of the tissues had an effect in modifying the aesthetic profile with respect to the position of the incisors. The cephalometric parameters related to the esthetic profile of the maxilla are all linked by strong correlations, especially correlation between SU, ULA and LS were very high. The differences between the means were statistically significant for different groups. Using the values of Mx1 and thickness of the lip as independent variables, while the LS, SU, ULA and NLA values as dependent variables all results are significant with respect to the prediction p < 0.05., Conclusion: Thickness of the soft tissues showed a significant influence on the profile with respect to the position of the incisors., Clinical Significance: Data obtained highlighted that thickness of the soft tissues must be taken into account before starting an orthodontic treatment in order to obtain best aesthetic results., How to Cite This Article: Maddalone M, Losi F, Rota E, et al. Relationship between the Position of the Incisors and the Thickness of the Soft Tissues in the Upper Jaw: Cephalometric Evaluation. Int J Clin Pediatr Dent 2019;12(5):391-397., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.)

Aim: Cone beam computed tomography (CBCT) is the most refined and affordable method available today for the examination of an incoming patient for different dental pathologies. The aim of this paper is to evaluate the significance of some factors influencing the prevalence of apical periodontitis., Materials and Methods: An ortopantomography (OPT) and CBCT scan of the dental arches were examined for each of the selected 45 patients. The presence of apical periodontitis (AP) was compared for CBCT and OPT examination. Sensitivity, specificity, predictive values, and accuracy were calculated for CBCT, using OPT as a reference. The impact of protective/risk factors on the development of AP was examined., Results: CBCT showed higher sensitivity (250%), predictive values (111%), accuracy (111%), and specificity (101%) than OPT. It was found to have higher sensitivity in all the dentition areas, especially where empty anatomical spaces or more radiotransparent structures have a strict relationship with the tooth apex and periapical structures like upper front area, premolar areas, and, especially, in the upper molar area. The prevalence of AP increased from 16 to 17% in the case of insufficient conservative restoration or 25% in the case of microleakage, 35-42% in the case of prosthetic restoration, 56-67% for posts, and 60 and 85%, respectively, for inadequate endodontic treatment and missed canals., Conclusion: CBCT plays a decisive role in the evaluation of molar areas and in the endodontic treatment planning, when a close relationship between the apex and important anatomical structures exists. Different risk factors with different relevance are identified., Clinical Significance: As CBCT-examined results show, coronal restorations are moderate-risk factors, while insufficient endodontic treatments and posts are high-risk factors for the development of AP.

Aim: Digital orthopantomography (OPT) is usually the first examination step in supervising an incoming patient. Cone beam computed tomography (CBCT) is the most refined and affordable method to search for different dental lesions. The aim of this paper is to evaluate the effectiveness of OPT and CBCT in detecting periapical lesions in different dental groups., Materials and Methods: An OPT and a CBCT scan of the dental arches of 45 patients were examined. The presence of AP was pointed out for OPT and CBCT. Sensitivity, specificity, predictive values, and accuracy were calculated for OPT, using CBCT as the reference standard., Results: OPT showed low sensitivity (40.0), positive predictive value (90.4), negative predictive value (90.0), accuracy (90.0), and high specificity (99.2). It was found to have higher sensitivity in the lower front and premolar areas, while the lowest was found in the upper molar area., Conclusions: OPT can be used for endodontic diagnosis in the lower central and premolar sections, but CBCT plays a decisive role in the evaluation of molar areas and in the endodontic treatment planning, when a close relationship between apex and important anatomical structures exists., Clinical Significance: CBCT exposes the patient to higher doses of radiations when compared with OPT, but CBCT, with its more selective sensitivity and the possibility to offer a three-dimensional (3D) rendering of dental and periodontal structures, is an elective choice for uncertain cases and for specific dental areas.

Aim: Osteoradionecrosis of the jaws (ORNJs) is aseptic bone necrosis that develops in post-irradiated bone tissue of patients who underwent radiotherapy for head-neck tumors. The present study aims to clinically assess the regenerative ability of the ozone in the form of oil-based gel applied to the exposed bone area in the treatment of ORNJ., Materials and Methods: Eight patients who underwent radio- therapy for the treatment of cervical or neck cancer were diagnosed with ORN of the jaws at our Department, for a total of 11 sites of necrotic bone exposure (3 patients were diagnosed with more than one site of osteoradionecrosis). In the therapeutic protocol, the exposed bone lesion and osteomucosal margin were cleaned with manual debridement. Then the ORN lesion was treated with topical applications of ozone delivered as oil suspension (Ozosan® - Sanipan, Clivio, Italy) on the exposed bone for 10 minutes. The application was repeated each week until movement of the necrotic fragment was noted Results: In six patients on 8 (75%) lesions resolved with complete mucosal healing with 3 to 19 ozone applications. Total sequestration of the necrotic bone with spontaneous expulsion was observed. One patient improved his conditions shifting from a stage B2S1 to B1S1 according to He et al. classification. A patient only worsened his conditions with treatment. No toxicity was reported or observed., Conclusion: These results showed the efficacy of ozone oil suspensions in the non-invasive treatment of ORN, probably related to its properties of stimulation of local revascularization and antibacterial activity, and the good tolerability of the related protocol used., Clinical Significance: The use of this kind of medication should be included in ORNJ treatments as effective, noninvasive and self-administered.

Aim: This study investigates the association between cross linked C-terminal telopetide test (CTX) and individual surgical risk of osteonecrosis in patients taking oral bisphosphonates., Materials and Methods: 32 patients receiving bisphosphonate were treated surgically. Patients were divided into three groups according to type of drug administrated and were subjected to a treatment of oral surgery, such as simple tooth extractions and extraction of all residual teeth of the oral cavity, upon evaluation of CTX values and antibiotic prophylaxis., Results: Within the sample of 32 patients, 12 patients had been treated with bisphosphonates for several years and none developed osteonecrosis of the jaw upon surgery. As for CTX, patients treated with oral bisphosphonates showed a mean value of serum Ctelopetides of 0.2869 ng/ml. The mean value of CTX did not differ significantly between patients taking oral bisphosphonates and healthy patients not treated with bisphosphonates., Conclusion: None of the patients subjected to preoperative antibiotic prophylaxis developed osteonecrosis of the jaw after surgery. The pharmacological and surgical protocol tested appeared valid in the prevention of osteonecrosis associated to bisphosphonates.

Diabetes mellitus accelerates atherosclerotic processes, and it is known that inflammation plays a key role in atherosclerosis. The aim of the present study was to evaluate in patients with Type 2 diabetes whether serum levels of CRP (C-reactive protein) are associated with cytokine production in whole blood. A total of 89 outpatients with Type 2 diabetes were enrolled, and blood pressure, body mass index, fasting blood glucose, glycated haemoglobin, cholesterol, triacylglycerols (triglycerides) and hs-CRP (high-sensitivity CRP) were measured. IL-6 (interleukin-6), IL-1beta (interleukin-1beta) and TNF-alpha (tumour necrosis factor-alpha) were measured before and after 24 h of incubation of whole blood with LPS (lipopolysaccharide) or saline. The basal values of IL-1beta, IL-6 and TNF-alpha were low and were not significantly related to hs-CRP levels. A univariate analysis showed that the level of IL-1beta and IL-6, obtained after 24 h of incubation of whole blood with LPS, increased significantly with increasing levels of hs-CRP and, after adjusting for potential confounders, IL-1beta still remained statistically significant. In our sample of patients with Type 2 diabetes, there was no association between serum hs-CRP levels and basal levels of IL-6, IL-1beta and TNF-alpha. Conversely, a significant association was observed between serum hs-CRP levels and IL-1beta and IL-6 production after 24 h of incubation of whole blood with LPS. In conclusion, our data suggest that patients with Type 2 diabetes and high hs-CRP levels may have an enhanced reactivity in response to specific stimuli that produce different interleukins, with possible implications in inflammatory atherosclerotic processes.

Background: The aim of our study is to describe a fast molecular method, able to distinguish and quantize the two different genotypes (652 and JP2) of an important periodontal pathogen: Actinobacillus actinomycetemcomitans. The two genotypes show differences in the expression of an important pathogenic factor: the leukotoxin (ltx). In order to evidence this, we performed a real time PCR procedure on the ltx operon, able to recognize Aa clinical isolates with different leukotoxic potentials., Methods: The specificity of the method was confirmed in subgingival plaque and saliva specimens collected from eighty-one Italian (Sardinian) subjects with a mean age of 43.9, fifty five (68 %) of whom had various clinical forms of periodontal disease., Results: This procedure showed a good sensitivity and a high linear dynamic range of quantization (10(7)-10(2) cells/ml) for all genotypes and a good correlation factor (R2 = 0.97-0.98). Compared with traditional cultural methods, this real time PCR procedure is more sensitive; in fact in two subgingival plaque and two positive saliva specimens Aa was only detected with the molecular method., Conclusion: A low number of Sardinian patients was found positive for Aa infections in the oral cavity, (just 10 positive periodontal cases out of 81 and two of these were also saliva positive). The highly leukotoxic JP2 strain was the most representative (60 % of the positive specimens); the samples from periodontal pockets and from saliva showed some ltx genotype for the same patient. Our experience suggests that this approach is suitable for a rapid and complete laboratory diagnosis for Aa infection.