Search

Aims: To evaluate osteoradionecrosis (ORN) incidence in a cohort of patients undergoing tooth extraction (TE) before radiotherapy (RT) for head and neck cancers. Methods: The study protocol was approved by the Ethics Committee of Università Cattolica del Sacro Cuore (ID‐2132) and registered at clinicaltrials.gov (ID: NCT04009161). TE was performed in case of signs of pericoronitis, periapical lesions, restorative impossibility, severe periodontitis. ORN was defined as exposed bone at an unhealed post‐extraction socket in the absence of oncological recurrence. The RT plans were reviewed, and each post‐extractive socket was contoured to calculate the received radiation dose. Results: In total, 156 patients with 610 TE were enrolled. The mean follow‐up was 567 days. ORN was diagnosed in four patients (2.6% of patients and 0.7% of TE). Need for osteotomy and radiation dose at the extraction site were associated with ORN (OR for osteotomy: 21.9, 95% CI: 2.17–222.2, p = 0.009; OR for RT dose: 1.1, 95% CI: 1–1.15, p = 0.05). Conclusions: TE appears to be a significant risk factor for ORN, particularly when osteotomy is required, and post‐extraction sockets receive a high RT dosage. This study proposes a decision‐making algorithm for TE and outlines a straightforward surgical protocol. [ABSTRACT FROM AUTHOR]

Objectives: Literature reports highlighted the presence of discriminatory episodes towards individuals infected with human immunodeficiency virus (HIV) on behalf of dental care workers. The purpose of this study was to assess hygienists' attitude when treating HIV-infected individuals in the era of highly active antiretroviral therapy (HAART). Methods: A national observational study was carried out on all the members of an Italian hygienist association. An anonymous questionnaire was mailed to 1247 hygienists: the questionnaire investigated demographic data, the relationship between the hygienists and HIV-infected persons, to identify the presence of discriminatory behaviour, the hygienists' scientific knowledge of HIVrelated problems and the precautions normally used in the office to prevent cross-infections. Results: Of the 1247 questionnaires that were delivered to hygienists, 287 (23%) were completed and returned within a 6-month period. A total of 287 hygienists answered the question 'Did you ever deny treatment to an HIV-infected persons?' and 17 hygienists (5.9%) replied 'Yes'. Protective eyewear [odds ratio (OR), 0.036; 95% confidence interval (CI), 0.002-0.818; P = 0.037] and public practice [OR, 2.93; 95% CI, 0.97-8.87; P = 0.057] were associated with refusing to treat HIV-infected persons. Conclusion: Our findings highlight the existence of episodes of discrimination by some hygienists towards HIV-infected individuals. From clinical point of view, this discriminatory behaviour may expose the dental health care workers and their patients to a greater risk of cross-infection. [ABSTRACT FROM AUTHOR]

In the last years, the use of tests with predictive value for scholastic progress has become widespread. While there is an aptitude test already in use for admission to our Dental School, we have also been conducting, without consequence to their admission, an investigation into the manual dexterity of candidate students. The aim of this test is to investigate basic manual dexterity, not ability following exercise. As previous, no such specific test had been formulated; the choice of test criteria we made was new. The tests investigated over five consecutive Academic years the ability to discern characteristics of a surface, to distinguish between different types of consistency, hand–eye co-ordination, the graphic activities, laterality and muscular strength. A re-test for some years was conducted afterwards. The results provided an overall evaluation: insufficient; sufficient; good; very good; excellent. Students who came from non-technical high schools showed a good comprehension of questions put to them, use of strategy, description of procedures; and final checking but a certain clumsiness in the hand–eye co-ordination test and a tendency to use one hand only. Students coming from technical high schools showed a less immediate grasp of questions put to them, sometimes requiring their repetition, disorganised behaviour in blind-fold tests, insufficient use of strategies and little checking but notable ability in hand–eye co-ordination tests and dextrous simultaneous use of both hands. These results were then correlated with the result of the aptitude test. In conclusion, a notable correspondence between student selection based on the aptitude test and the experimental manual dexterity test was verified. This correspondence outlines that manual dexterity is not only a ‘manual’ but a ‘mental’ ability . [ABSTRACT FROM AUTHOR]

Chronological age (CA) plays a fundamental role in forensic dentistry (i.e. personal identification and evaluation of imputability). Even though several studies outlined the association between biological and chronological age, there is still great variability in the estimates. The aim of this study was to determine the possible correlation between biological and CA age through the use of two new radiographic indexes (Oro-Cervical Radiographic Simplified Score - OCRSS and Oro-Cervical Radiographic Simplified Score Without Wisdom Teeth - OCRSSWWT) that are based on the oro-cervical area. Sixty Italian Caucasian individuals were divided into 3 groups according to their CA: Group 1: CAG 1 = 8-14 yr; Group 2: CAG 2 = 14-18 yr; Group 3: CAG 3 = 18-25 yr; panorexes and standardised cephalograms were evaluated according Demirjian's Method for dental age calculation (DM), Cervical Vertebral Maturation method for skeletal age calculation (CVMS) and Third Molar Development for age estimation (TMD). The stages of each method were simplified in order to generate OCRSS, which summarized the simplified scores of the three methods, and OCRSSWWT, which summarized the simplified DM and CVMS scores. There was a significant correlation between OCRSS and CAGs (Slope = 0.954, p < 0.001, R-squared = 0.79) and between OCRSSWWT and CAGs (Slope = 0.863, p < 0.001, R-squared = 0.776). Even though the indexes, especially OCRSS, appear to be highly reliable, growth variability among individuals can deeply influence the anatomical changes from childhood to adulthood. A multi-disciplinary approach that considers many different biomarkers could help make radiological age determination more reliable when it is used to predict CA., (Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Objective: The aim of the study was to investigate the possible epidemiological relationship between hepatitis C virus (HCV) chronic infection and oral lichen planus (OLP) in centre-south Italy., Methods: In a case-control study three groups of patients were investigated: group 1 (82 patients): patients with histologically confirmed OLP were tested for HCV infection; group 2 (165 patients): patients with chronic HCV infection were examined for OLP; group 3 (466 participants): control group: healthy individuals who had been hospitalized in the Trauma-Orthopaedic Ward and had been tested for HCV., Results: In group 1, 11.4% of the participants were HCV-positive and HCV was found in 10.8% of the patients above 50 years of age. Eight participants (5.5%) of group 2 showed lesions possibly related to OLP: only two had a histology consistent with OLP. In group 3, 5.4% participants had chronic HCV infection, but HCV was found in 10% of the participants of 50 years and above. A weak overall association between HCV and OLP (odds ratio 2.27; 95% confidence interval 0.94, 5.35; P<0.05) was seen and the result was not statistically significant in participants aged 50 years and above (odds ratio 1.08; 95% confidence interval 0.39, 2.88; P=0.86)., Conclusion: Our data suggest that no clear association exists between OLP and chronic HCV disease. It is possible that the association is mainly due to the frequency of each disease in the population.

Objective: To investigate the problems in seeking dental care faced by HIV-positive individuals in Italy., Methods: A multicenter observational study was performed by distributing an anonymous self-administered questionnaire to patients of six public healthcare facilities specialized in the treatment of individuals with HIV infection. The questions concerned personal data potentially correlated with discrimination, the patient-dentist relationship before and after HIV diagnosis, and the reasons for seeking dental care in public facilities. We also evaluated the patients' discomfort in the patient-dentist relationship after HIV diagnosis, performing univariate and multivariate analyses., Results: Of the 1,500 questionnaires distributed; 883 were filled-out completely. A total of 630 persons received dental care after HIV diagnosis: 209 (33.2%) did not tell the dentist that they were seropositive. Of those who did, 56 were refused care. For patients treated by a private dentist, having been treated by the same dentist before diagnosis was a risk factor for great discomfort in the patient-dentist relationship (P < 0.002). Being treated in public facilities was associated with having received dental care after HIV diagnosis (P < 0.001) and a primary school education (P < 0.001)., Conclusions: There exist episodes of discrimination on the part of some dentists, and a relatively high proportion of HIV-positive persons do not disclose their seropositivity to the dentist. Dentists should be provided with training for promoting both ethically acceptable practices and suitable clinical management of HIV-positive persons.