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Dentinogenesis imperfecta (DI) is an autosomal dominant genetic disease that affects both deciduous and permanent teeth, with an incidence of 1 out of 6,000 to 1 out of 8,000. Teeth affected with DI type II present bulbous crowns, short and constricted roots, marked cervical constriction, translucent enamel and amber dentin. Also, they present a partial or total obliteration of pulp space, due to continuous dentin production. SEM analysis has shown an undulated dentin-enamel junction (DEJ) with irregularities and locally wide spaces between the two structures instead of a strict junction and a regular linear surface. Treatment options for patients affected by DI-II are intended to protect and restore function and aesthetics of both posterior and anterior teeth. In literature are presented many different therapies, but mainly centered on cemented prosthetic restorations instead of adhesive restorative procedures. We present in this paper a DI-II case successfully treated in 2005 with extensive adhesive rehabilitation.The 13 years follow-up proves the reliability of adhesion to dentine and enamel for indirect adhesive restorations even on this kind of anomalous substrates.

The roles of nitric oxide (NO) synthase (NOS) enzyme in pathological mechanisms of the oral cavity are still incompletely understood. The aim of this study was to investigate the expression of the endothelial, neuronal and inducible isoforms of NOS (eNOS, nNOS and iNOS) in oral lichen planus (OLP) development in humans. OLP and healthy oral mucosa biopsies were taken for mRNA and protein analysis of NOS isoenzymes by RT-PCR, western blot and immunohistochemistry. The mRNA and protein levels of eNOS and nNOS were present in all samples, with a significant increase only for eNOS in OLP. The normal oral mucosa exhibited only small amounts of iNOS mRNA and protein, while it showed a significant rise in OLP samples. These results were confirmed by immunohistochemical analysis. Our findings suggest that NO produced by increased eNOS and iNOS expression may have circulatory and immune functions in the development of OLP. The roles of nitric oxide (NO) synthase (NOS) enzyme in pathological mechanisms of the oral cavity are still incompletely understood. The aim of this study was to investigate the expression of the endothelial, neuronal and inducible isoforms of NOS (eNOS, nNOS and iNOS) in oral lichen planus (OLP) development in humans. OLP and healthy oral mucosa biopsies were taken for mRNA and protein analysis of NOS isoenzymes by RT-PCR, western blot and immunohistochemistry. The mRNA and protein levels of eNOS and nNOS were present in all samples, with a significant increase only for eNOS in OLP. The normal oral mucosa exhibited only small amounts of iNOS mRNA and protein, while it showed a significant rise in OLP samples. These results were confirmed by immunohistochemical analysis. Our findings suggest that NO produced by increased eNOS and iNOS expression may have circulatory and immune functions in the development of OLP

Prolidase Deficiency (PD) is a rare hereditary disease consisting in developmental delay, mental retardation, facial dysmorphism, splenomegaly, recurrent pulmonary infections and skin lesions.The present study reports a case of PD treated in the Paediatric Section of the Department of Dentistry and Surgery at the University of Bari. A special diagnostic and clinical approach to the patient was useful to improve his quality of life and identify some new aspects of this systemic disease. In particular, clinical features never described before are reported: low hair line, decreased osteotendinous reflexes, long upper lip, microrhinia, dentoskeletal Class III, dental age (Proffit) older than chronological age, fusion of 2nd and 3rd cervical vertebrae, incomplete atlanto-occipital fusion.

To assess the microbial level of Streptococcus Mutans and Lactobacillus spp. during rapid palatal expansion, and compare the data with untreated control patients.Thirty patients aged between 6-9 years were enrolled in this study (15 males and 15 females). The patients were divided into three groups: 10 patients were treated with rapid palatal expander (RPE) (Test Group 1), 10 patients were treated with Mc Namara expander, and 10 patients were enrolled in the control untreated group. Whole stimulated saliva was collected from each patient at three time points: before initiation of expansion therapy (baseline at T0), after 3 months (T1), after initiation of treatment, and after 6 months from T0 (T2). The protocol of rapid palatal expansion for the two groups was as follows: at placement of the expander 4 activations were performed by the orthodontist (1 mm expansion), followed by 4 activations per day by the parents (two in the morning and two in the evening, 1 mm per day total) to be repeated for 7 days.Statistics: In this study a different trend in the microbial colonisation for the two treated groups was observed. In the Test Group 1, in which patients were treated with the RPE, there was a significant difference between Strp T0 T1 and between Strp T0 and T2 (p0.05). There was also a significant difference between LAC T1 T0 and LAC T2 and T0 (p0.05). In the Test Group 2, treated with McNamara expanders, it was found was a significant difference between LAC T2 T0 and LAC T1 T0. In the same group it was also found a significant difference between Strp T2 T0; T1 T0; T1 T2 (p0.05).The level of the various species of bacteria changes during rapid palatal expansion, and this seems to depend on the type of orthodontic expander. During rapid palatal expansion treatment it is also advisable a periodical microbial monitoring using in-office bacteria tests.

The objective of this study was to analyse the relationship between obesity and periodontal disease in children. The null hypothesis is that obese and normal weight children show no different degree of periodontal status.The sample for this case control study consisted of 20 males and 24 females with a mean age of 9.43±2.05 years old and mean body mass index standard deviation score (BMI-SDS) of 2.16±0.37 in the test group, and 33 males and 26 females with a mean age of 9.67±1.46 years old and BMI-SDS of 0.22±1.79 in the control group. The periodontal status was assessed using plaque accumulation, bleeding on probing (BOP) index, probing depth (PD) and clinical attachment level (CAL).The test group showed higher plaque deposits and BOP and the difference between the two groups was statistically significant (p0.05). No significant difference between the two groups was found regarding the loss of clinical attachment, though it was worse in obese children. Categorical variables described as frequency and percentage were compared using the Fisher's exact test or test chi square. Continuous variables were analysed using the Mann-Whitney test.The study showed an association between obesity and periodontal risk indicators in children that in the long term may lead to oral conditions. The oral health of overweight/obese subjects should be more carefully supervised and checked in order to prevent oral alterations.

This study was conducted in order to determine the ocular correction effects on electromyography activity of anterior temporal, masseter, sternocleidomastoid and anterior digastric muscles in children with functional mandibular lateral-deviation.This study was performed on 32 subjects, aged between 8 and 12 years with functional lateral deviation of mandible and oculo-extrinsic muscular tone disorders. After complete ophthalmologic evaluation and ocular correction prescription, the children were randomly divided into two groups: study and control. In the study group (16 subjects) EMG activity at rest was recorded in the following conditions: with eyes closed; with eyes open; with ocular correction modified through electromyographic control. In the control group (16 subjects) EMG activity at rest was recorded in the following conditions: with eyes closed; with eyes open; with conventional ocular correction. Data were acquired in 15-seconds trial using a SEMG K7, while the subjects maintained rest dental position.Both groups presented a significative correlation between value of lateral-deviation and the degree of ocular-extrinsic muscular tone disorders (r=0.69). In addition, a significant statistical increase of EMG activity at rest with eyes open in both groups was observed in the anterior temporal left and right. A significant decrease of EMG activity with open eyes was observed only with ocular correction upon electromyographic control (study group). The findings, expressed as Symmetry Index, showed a significant increase of muscles imbalance right/left with conventional methods of ocular correction (p0.0001).The significant worsening in EMG activity, mainly observed with conventional corrective lenses, could have an important consequence in clinical diagnostic and therapeutic behaviour because anterior temporal muscles are important in postural position of the mandible. Instead EMG corrective lenses could improve tonus and balance of stomatognathic muscles and, therefore, support the functionality of orthodontic treatment. Moreover, the data suggest an interesting new tool in order to reach an interdisciplinary approach to complex growth disorders represented by functional lateral deviation of mandible and ocular-extrinsic muscular tone disorders.

ObjectiveThis study aimed to investigate salivary levels of Streptococcus mutans (S. mutans) and Lactobacilli, and other salivary indices in subjects wearing clear aligners (CA) in comparison with multibrackets orthodontic appliances (MB).Materials and methodsA sample of 80 participants (46 males and 34 females) was included in the study: 40 subjects (aged 20.4±1.7 years) were treated with CA, and 40 (aged 21.3±1.7 years) were treated with MB. Plaque index (PI), salivary flow, buffering power of saliva, and salivary levels of S. mutans and Lactobacilli were evaluated prior to start of orthodontic treatment (t0), after 3 months (t1) and 6 months (t2).ResultsCA patients maintained PI at level 0 over time, while MB participants experienced a statistically significant increasing trend of PI over time. In addition, at t2, 37.5% of MB participants (15 subjects over 40) showed risky salivary levels (CFU/ml>105) of S. mutans (odds ratio = 7.40; 95% C.I. = 1.94-28.25; chi-square = 10.32; p = 0.001) as well as Lactobacilli (odds ratio = 23.40; 95% C.I. = 2.91-188.36; chi-square = 15.31; p = 0.0001).ConclusionsComparing all the data, subjects treated with CA achieved lower salivary microbial colonization after 6 months of treatment compared with MB. Different additional strategies for plaque control and salivary microbial colonization must be triggered considering the type of orthodontic appliance.

Aim This study aimed to investigate salivary concentrations of Streptococcus mutans (S. mutans) and some Lactobacilli, and plaque index (PI) in patients wearing fixed versus removable orthodontic appliances. Methods A sample of 90 orthodontic patients (56 males and 34 females) was included in the study: 30 subjects (aged 21.5±1.5 years) were treated with removable clear aligners (CA), while for other 30 cases (aged 23.3±1.6 years) a fixed multibrackets appliance (MB) were utilized, and 30 patients (aged 18.2 ±1.5 years) wearied a removable positioner (RP). Salivary concentrations of S. mutans and Lactobacilli and PI were evaluated prior to start of the orthodontic treatment, after 3 months and 6 months. Results After 6 months, 40% of MB patients (12 subjects over 30) showed a concentration of S. mutans associated to high risk of developing tooth decay (CFU/ml>105), differently from participants wearing removable appliances (odds ratio = 5.05; 95% C.I. = 1.72‐14.78; chi‐square = 9.64; p = 0.0019). The same trens was observed for the concentration of Lactobacilli (odds ratio = 4.33; 95% C.I. = 1.53‐12.3; chi‐square = 8.229; p = 0.004). In addition, over the duration of the study, CA patients maintained PI at 0 level, while MB patients experienced a statistically significant increasing trend of PI over time, and their PI became clinically/statistically relevant after 6 months, respect to CA and RP patients. Conclusions Comparing all the data, while, after 6 months, only about 10% of CA patients and 13.3% of RP patients achieved a microbial colonization which may lead to high risk of caries development, about 40% of MB patients ‐ and 20% after 3 months ‐ showed a high level of vulnerability to developing caries, which require additional strategies for plaque control and microbial colonization to be employed.

Background The transinfection of the endosymbiotic bacterium Wolbachia provides a method to produce functionally sterile males to be used to suppress mosquito vectors. ARwP is a wPip Wolbachia infected Aedes albopictus which exhibits a bidirectional incompatibility pattern with wild-types. We coupled a modelistic approach with laboratory experiments to test ARwP as a control tool and evaluate the possible occurrence of population replacement following the release of ARwP females in a wild-type (SANG) population. Repeated male-only releases were simulated and tested in the laboratory in comparison with releases contaminated with 1% ARwP females. Model simulations also investigated how migration affects the outcome of contaminated releases. Finally, the mean level of egg fertility and the long-term evolution of populations constituted by two Wolbachia infection types were studied by testing SANG and ARwP Ae. albopictus and performing more general model simulations. Results The model was parametrized with laboratory data and simulations were compared with results of biological trials. Small populations of ARwP males and females were theoretically and experimentally demonstrated to rapidly become extinct when released in larger SANG populations. Male-only releases at a 5:1 ratio with respect to the wild-type males led to a complete suppression of the SANG population in a few generations. Contaminated releases were efficient as well but led to population replacement in the long term, when the wild-type population approached eradication. Migration significantly contrasted this trend as a 5% population turnover was sufficient to avoid any risk of population replacement. At equal frequencies between ARwP and SANG individuals, the mean egg fertility of the overall population was more than halved and suppression was self-sustaining until one of the two infection types extinguished. Conclusions In the case of bidirectional incompatibility patterns, the repeated release of incompatible males with small percentages of contaminant females could lead to population replacement in confined environments while it could be managed to target high efficiency and sustainability in wild-type suppression when systems are open to migration. This possibility is discussed based on various contexts and taking into consideration the possibility of integration with other control methods such as SIT and the use of larvicides. Electronic supplementary material The online version of this article (10.1186/s13071-018-3208-7) contains supplementary material, which is available to authorized users.

Background: Needle breakage during the administration of dental analgesia is an extremely rare event. Case report: A case of needle breakage during the administration of an inferior alveolar nerve block occurred in a child with KBG syndrome. During the injection, a sudden movement of the child caused the breakage of the needle. The next day, the retrieval of the needle was performed surgically under general analgesia. Follow-up: Three months after the surgery the healing was good. Two years later the child underwent a dental extraction with the aid of nitrous oxide/oxygen analgesia/anxiolysis. Conclusion: Needle fracture is a possible event during the administration of dental analgesia in children.

This study investigated differences in periodontal health variables between buccally impacted maxillary canines (BIMC) and palatally impacted maxillary canines (PIMC) after surgical-orthodontic treatment with open technique. Nineteen patients were enrolled: 10 with unilateral BIMC (5 men, 5 women; mean age 18.50 +/- 1.96 years) and 9 with unilateral PIMC (4 men, 5 women; mean age 19.44 +/- 2.40 years). Probing depth and keratinized tissue were recorded 12 months after surgical-orthodontic treatment, and the differences between the 2 sides were analyzed as primary outcomes. In addition, data for BIMC and PIMC were directly compared. In the BIMC group, probing depths were significantly higher for lateral incisors than for the untreated side (P = 0.044), and keratinized tissue values were significantly lower for canines than for the untreated side (P = 0.006). No significant differences were observed in the PIMC group. In BIMC, surgical-orthodontic treatment with open technique resulted in loss of periodontal keratinized tissue in the treated tooth and periodontal attachment loss in adjacent lateral incisors. However, the periodontal status of PIMC was not affected by surgical-orthodontic treatment with open technique.

Background The aim of this study was to evaluate the antiplaque effects of an alcohol-free essential oil (alcohol-free EO) mouthwash and an amine fluoride/stannous fluoride with zinc lactate (SnFl-Zn) mouthwash compared to a positive control of chlorhexidine (CHX) mouthwash, using an in vivo plaque regrowth model of 3 days. Materials and methods The study was designed as a double-masked, randomized, crossover clinical trial, involving 20 volunteers to compare two different mouthwashes, using a 3-day plaque accumulation model. After receiving thorough professional prophylaxis at baseline, over the next 3 days, each volunteer refrained from all oral hygiene measures and performed two daily rinses with 20 ml of the test mouthwashes. A 0.20% CHX rinse served as a positive control. At the end of each experimental period, plaque was assessed, and the panellists completed a questionnaire. Each subject underwent a 14-day washout period, and then, there was another allocation. Results The SnFl-Zn mouthwash has shown a better inhibitory activity on plaque regrowth compared to the alcohol-free EO mouthwash in the whole mouth (plaque index = 1.93 against 2.45, respectively), but there was less of an effect compared to the CHX group, with an overall plaque index of 1.41. The differences of 0.52 between alcohol-free EO and SnFl-Zn and between SnFl-Zn and CHX and of 0.96 between alcohol-free EO and CHX were all statistically significant (P < 0.001). Conclusion The alcohol-free EO mouthwash seemed to have less of an inhibiting effect on plaque regrowth than the amine fluoride/SnFl-Zn mouthwash and the CHX control.

The aim of this randomized clinical trial was to evaluate whether a recently described multi-sensor approach called BIONOTE® is accurate enough to verify the efficacy of treatment of patients with halitosis. A treatment with Lactobacillus brevis (CD2)–containing lozenges, compared with placebo was tested. The BIONOTE® was compared with traditional techniques used to detect halitosis: OralChroma™ and two calibrated odor judges enrolled for the organoleptic assessments. Twenty patients (10 treated and 10 placebo), suffering from active phase halitosis were included in the study. Treatment consisted of Lactobacillus brevis (CD2)—containing lozenges or placebo, 4 tablets/day for 14 days. t0 was before the beginning of the study, t1 was day 7 and t2 was day 14. The effectiveness of treatment was assessed through: (1) Rosenberg score, (2) Winkel tongue coating index (WTCI) anterior and posterior, (2) OralChroma™, (3) the new developed multi-sensor approach, called BIONOTE® (test technique). Only the WTCI anterior revealed statistically significant changes between t0 and t2 data (p = 0.014) in the treated group. Except for the WTCI anterior, all diagnostic methods revealed the lack of effectiveness for halitosis of a 14-days treatment with Lactobacillus brevis (CD2)–containing lozenges. The BIONOTE® multisensor system seems accurate in addition to OralChroma™ to assess the initial condition of halitosis and its mitigation during treatment.

This study aimed to assess by surface electromyography (sEMG) the changes in sub-mental, orbicularis oris, and masticatory muscle activity after a lingual frenulectomy. Rehabilitation exercises in subjects with ankyloglossia, characterized by Class I malocclusion, were assessed as well. A total of 24 subjects were selected. Thirteen subjects (mean age 7±2.5years) with Class I malocclusion and ankyloglossia were treated with lingual frenulectomy and rehabilitation exercises, while 11 subjects (mean age 7±0.8years) with normal occlusion and normal lingual frenulum were used as controls. The inclusion criteria for both groups were the presence of mixed dentition and no previous orthodontic treatment. The sEMG recordings were taken at the time of the first visit (T0), and after 1 (T1) and 6months (T2) for the treated group. Recordings were taken at the same time for the control group. Due to the noise inherent with the sEMG recording, special attention was paid to obtain reproducible and standardized recordings. The tested muscles were the masseter, anterior temporalis, upper and lower orbicularis oris, and sub-mental muscles. The sEMG recordings were performed at rest, while kissing, swallowing, opening the mouth, clenching the teeth and during protrusion of the mandible. These recordings were made by placing electrodes in the area of muscle contraction. At T0, the treated group showed different sEMG activity of the muscles with respect to the control group, with significant differences at rest and during some test tasks (p

Objectives The aim of this pilot study was to evaluate the periodontal effects during rapid palatal expansion (RPE) or slow palatal expansion (SPE) and to compare them by means of some clinical indices, in order to establish the possible differences and advantages of one of these treatments in periodontal terms. Methods 10 patients (aged 6 to 7 years; average age 6.3 years) were submitted to RPE treatment and other 10 patients (aged 6 to 8 years, average age 6.3 years) to SPE treatment. They were treated with the Haas expander. The selected clinical indices (plaque index, PI; papillary bleeding index, PBI; probing pocket depth, PPD) were collected three times during the treatment (t0, detected 7 days after the periodontal prophylaxis, at the beginning of the active orthodontic therapy; t1, detected during the active therapy; t2, detected after retention). All measurements were performed by the same examiner. The protocol was approved by the ethics committee. Results The effects of the prophylaxis were excellent to control inflammation and dental plaque before the beginning of the orthodontic-orthopaedic treatment, as in both the two groups, the PI and the PBI values were equal to 0. In the group receiving slow expansion, the PPD remained unchanged from t0 to t1, while it significantly increased from t0 to t1 in the group of rapid expansion. At t2 the values of the two groups returned to be overlapping. Conclusions Both rapid and slow expansion treatments present potential irritation effect (increase of PI index and PBI index) on the periodontium, suggested by the significant increase of PI and PBI from t0 to t1 in both the two groups; therefore prophylaxis and periodic controls are very important. There are no long-term benefits that might be referred unequivocally to one of the two treatments in terms of periodontal consequences, as demonstrated by the lack of significant differences between the two groups at t2.

This study investigated the microbial level of Streptococcus mutans and Lactobacillus spp. during an orthodontic treatment, and compare the data with untreated control subjects. Sixty young adult subjects were selected (average 20.5, DS 1.62), among which 40 underwent an orthodontic treatment (20 were treated with self-ligating brackets and 20 with conventional brackets) and 20 were controls. Plaque Index, salivary flow and buffering capacity of saliva were assessed before the beginning of the orthodontic treatment. Then the microbial counts were obtained by using an in-office bacteria test. The plaque index (PI) increased over time in each group as well as salivary flow, mostly in subjects treated with self-ligating brackets, suggesting a difference between conventional and self-ligating brackets. S.mutans showed a different trend of colonization in the two treated groups, as for subjects treated with conventional brackets it showed the greater value at the early stage of treatment (T1), followed by a decrease at T2. Lactobacillus spp. showed significant increase over time in the two treated groups, respect to the control group. Linear regression analysis showed no significant predictor for the microbial count at T2. The assortment of the various species of bacteria change over time during the orthodontic treatment, and seems to show different trends, depending on the type of orthodontic device. Consequently a periodical microbial monitoring using in-office bacteria tests, seems indicated.

Background Allergy represents a risk factor at the base of sleep-disordered breathing in pediatric age. Among allergic diseases, the atopy is characterized by a tendency to be “hyperallergic.” Sleep-disordered breathing is also known in orthodontics as correlated with the morphology of craniofacial complex. The aim of this study was to investigate the relation between atopy and sleep-disordered breathing (oral breathers with habitual snoring), comparing atopic children with sleep-disordered breathing (test group) with nonatopic ones with sleep-disordered breathing (control group), in the prevalence of dento-skeletal alterations and other risk factors that trigger sleep-disordered breathing, such as adenotonsillar hypertrophy, turbinate hypertrophy, obesity, and alteration of oxygen arterial saturation. Methods In a group of 110 subjects with sleep-disordered breathing (6 to 12 years old), we grouped the subjects into atopic (test group, 60 subjects) and nonatopic (control group, 50 subjects) children and compared the data on the following: skin allergic tests, rhinoscopy, rhinomanometry, night home pulsoxymetry, body mass index, and dento-facial alterations. Results Even if our results suggest that atopy is not a direct risk factor for sleep-disordered breathing, the importance of a physiologic nasal respiration in the pathogenesis of sleep-disordered breathing seems to be demonstrated in our study by the higher prevalence of hypertrophy in the adenotonsillar lymphatic tissue, odontostomatological alterations, alterations of the oxygen saturation to pulsoxymetry, and higher prevalence of obesity observed in our children with sleep-disordered breathing, in percentages higher than that of the general pediatric population previously observed in the literature. Conclusions The importance of a physiologic nasal respiration in the pathogenesis of sleep-disordered breathing is demonstrated in our study.

Among treatments in the literature for myofascial pain syndrome (MPS), the most reliable therapies in dentistry are spray and stretch, and, although less frequently used, anesthetic injection. Adult MPS subjects are often treated using fixed orthodontic therapy for resolution of malocclusion. There is no clarity in the literature on the prognosis of MPS during orthodontic therapy. The purpose of this study was to analyze the prognosis of MPS during orthodontic treatment of subjects with malocclusion, initially diagnosed as having MPS. The analysis covered the medical records of 91 young adult Caucasians scheduled for orthodontic treatment for various malocclusions. Thirty-seven of the patients were initially diagnosed as also having MPS (T0). Thirty patients began the orthodontic treatment and were recalled for a re-evaluation of MPS after dental alignment and dental class correction was achieved (T1). A wait-and-see strategy was applied in seven subjects who were included as the control subjects. They received no treatment for MPS. At T1, a statistically significant decrease was observed in the study group in the presence of any clicking or creaking noises from the jaw joint, a significant jaw joint and jaw muscle pain reduction, and a quality of life improvement. Among patients who were depressed at the beginning of treatment, the majority felt better at the follow-up evaluation. On muscular palpation, a statistically significant decrease was found on the visual analogic scale value of the middle fibers of the temporalis muscle, temporalis tendon, clavicular and sternal division of the sternocleidomastoid muscle, masseter muscles, and posterior cervical muscles. The temporalis and the masseter muscles showed a significant decrease in the number of subjects with trigger points (TrPs) in all areas in the study group, after treatment. The digastric and sternocleidomastoid muscles also showed a significant reduction in the number of subjects with TrPs. Subjects with MPS and malocclusion were treated using a fixed orthodontic treatment. They showed improvement, although no resolution, in the signs and symptoms of MPS, compared with the untreated control group.

Introduction The objective of this study was to compare skeletal maturation in obese patients and in subjects of normal weight to evaluate the best timing for orthopedic and orthodontic treatment. The null hypothesis was that obese and normal-weight patients show similar degrees of skeletal maturation. Methods The sample for this retrospective study consisted of 50 white patients (28 boys, 22 girls) whose x-rays (hand-wrist and lateral cephalometric radiographs) were already available. The test group included 25 obese patients (11 girls, 14 boys; average age, 9.8 ± 2.11 years), and the control group included 25 subjects of normal weight (11 girls, 14 boys; average age, 9.9 ± 2.5 years). Skeletal maturation was determined by using the carpal analysis method and the cervical vertebral maturation method. Results According to the carpal analysis, there was a significant difference between skeletal and chronologic ages between the test group (11.8 ± 11.4 months) and the control group (–2.9 ± 3.1 months). Furthermore, the obese subjects exhibited a significantly higher mean cervical vertebral maturation score (2.8 ± 0.7) than did the control subjects (2 ± 0.6) ( P Conclusions Compared with the normal-weight subjects, the obese subjects showed a higher mean discrepancy between skeletal and chronologic ages according to the carpal analysis and had a significantly higher cervical vertebral maturation score. Thus, to account for the growth in obese patients with skeletal discrepancies, it might be necessary to perform examinations and dentofacial and orthopedic treatments earlier than in normal-weight subjects.

The aim of this study was to assess the changes over time associated with salivary indices and the presence of Streptococcus mutans and Lactobacillus in patients treated with Occlus-o-Guide.Two groups of patients were evaluated: a test group of 20 patients treated with Occlus-o-Guide and a control group of 20 patients not subjected to orthodontic treatment. Both groups were homogeneous for age and sex. We examined the levels of S. Mutans and Lactobacillus, the salivary flow, the buffer capacity of saliva and the Sillness and Loe plaque index (PI). The samples were taken at baseline (T0), after 3 months (T1) and after 6 months of treatment (T2). All data were compared using Student's t test.The percentage of patients with a level of Streptococcus mutans able to cause caries was decreased in the test group (T0 = 10%, T1 = %, T2 = 0%) compared to the control group (T0 = 0%, T1 = 5%, T2 = 35%), whereas the amount of Lactobacilli was different (test group T0 = 15%, T1 = 0%, T2 = 10%; control group T0 = 0%, T1 = 5%, T2 = 35%). The total salivary flow was increased in the test group (T0 = 47, T1 = 61, T2 = 61) compared to the control group, in which it had remained almost constant (T0 = 44, T1 = 45, T2 = 45). The buffer capacity of saliva was unchanged in both groups over time; the sum of PI-plaque indices was reduced in the test group (T0 = 3, T1 = 0, T2 = 2) compared to the control group (T0 = 0, T1 = 14, T2 = 27).Despite the presence of the Occlus-o-Guide device, patients are able to maintain a good level of oral hygiene, showing improvements of the examinated parameters at follow-ups.

Objective The aim of this study was to assess the level of salivary immunoglobulins and periodontal status in smokers and non-smokers. Materials and methods Unstimulated saliva of 30 subjects (mean age 24.2 ± 3.5 years) who were smokers (test group) and of 30 subjects (mean age 25.3 ± 3.8 years) who were non-smokers (control group) was collected and centrifugated; IgA, IgG, and IgM were measured with the colorimetric immunoenzymatic method. Moreover, the following periodontal clinical parameters were recorded for each subject: plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL). Results A significantly (p< 0.05) lower Ig level was observed in smoking patients (IgA: 20.0 ± 1.2 mg/dl; IgM: 19.5 ± 1.6 mg/dl; IgG: 8.1 ± 1.4 mg/dl) compared to levels in the non-smoking control group (IgA: 234.1 ± 65.2 mg/dl; IgM: 121.0 ± 31.7 mg/dl; IgG: 1049.4 ± 102 mg/dl). In the test group, PI (2.2 ± 0.3), GI (2.4 ±0.5), PD (49.3 ± 9.2%), and CAL (49.3 ± 4.6%) were higher (p< 0.05) than those observed in the control group (PI: 0.8 ± 0.4; GI: 0.7 ± 0.3; PD: 10.6 ± 2.4%; CAL: 3.1 ± 0.8%). Conclusion Smoking subjects showed lower levels of salivary IgA, IgG, and IgM and a worse periodontal condition than non-smoking subjects. On the base of our study, as smoking subjects also had lower levels of IgA, IgG, and IgM in their saliva than non-smoking subjects, despite the fact that there is little evidence that the salivary Igs have a protective action against periodontitis and that the whole saliva does not result in whole from the salivary glands, it can be concluded that the deteriorated periodontal health conditions of these patients can be attributed in part to a lowering of the host’s defense due to a decrease in the quantity of Igs in salivary fluid.