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Dentoskeletal class II malocclusion due to a protruded upper dental arch is a major reason for an orthodontic treatment. In these cases, the correction of class II can be hindered by molar distalization, obtained with 'no-compliance therapy' that involves the use of appliances which minimize the need for such co-operation and attempt to maximize the predictability of results. The aim of this review was to outline the effectiveness of no-compliance fixed orthodontic devices in the molar distalization. After selection according to the inclusion/exclusion criteria, 16 articles from 2000 to 2019 were qualified for the final analysis. The literature shows various no-compliance fixed devices whose effect is to distalize the maxillary molars. The present revision allows to conclude that there is a need to increase the number of studies, especially with regard to the most recently introduced devices in the literature. The analysed studies allow to hypothesize that these appliances act with a minimal variability of molar distalization and disto-inclination among them, although different effects among the appliances can be observed as regards to the anchorage.

Oral rehabilitation of edentulous maxilla is particularly difficult because of the lack of bone in correspondence of maxillary sinuses, therefore, the surgeon is forced to place implants in sites where bone is more prevalent. In addition, patients require more frequent oral immediate rehabilitation in order to reduce the discomfort related to wearing a total denture. A viable solution to provide stability and retention of the prosthesis in a short time is represented by the technique of intraoral welding supporting total denture or fixed prosthesis. This goal may be achieved thanks to the technique of welding titanium bars onto implant abutments. In fact, the procedure can be performed directly in the mouth, eliminating the possibility of errors or distortions due to prosthetic procedures. This paper describes a case report and the most recent data regarding long-term success and high predictability of intraorally-welded titanium bar in immediate loading implants., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

The aim of this study is to evaluate the success of functional rehabilitation of one dental session in patients with severe disabilities such as severe autism, baby bottle syndrome and severe odontophobia, and to assess how patient compliance pre- and post-intervention changes in moderate sedation. Between the beginning of 2016 and the end of 2018, 20 pedodontic patients with severe odontophobia, severe autism and baby bottle syndrome who needed dental treatment came to our attention. Patients were aged between 3 and 12 years, including 9 males and 11 females, including 10 odontophobics, 6 with severe autism and 4 with baby bottle syndrome. During the first visit, these patients were evaluated with a rating scale to evaluate the need to carry out dental intervention in a moderate sedation regime. We were able to treat 18 of the 20 patients, and carried out a total of 45 extractions, 4 oral hygiene sessions, 60 dental caries, 29 root canal treatments and 13 sealing pits and fissures. Before and after treatment, each patient's mood was assessed by using a test. Control visits were performed after 30 days, 3 months and the last one after 6 months. After the last follow-up visit, the patient was asked to complete the assessment test of his mood so that it could be compared with the one completed before the intervention. Complete functional and aesthetic rehabilitation of the patient's oral cavity was carried out in a single session. Emotional state and patient compliance improved one year after surgery in about 67% of patients, especially in children with odontophobia. Children with severe autism showed less collaboration in post-intervention assessment. The approach with moderate sedation was effective for the elimination of pain and for the treatment of preventive care, also improving the compliance and the mood of young patients., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

The aim of present study is to evaluate the greater risk of periodontal disease in subjects affected by cardiovascular disease. The statistical study includes 200 patients equally divided into a test and a control group. The test group is made up of hospitalized patients from the cardiology division of the S. Salvatore hospital of L'Aquila and the second made up of subjects that frequented a dental clinic. All patients were subject to anamnesis and clinical evaluation for periodontal disease. The index used for this clinical examination were CPTIN index (Community Periodontal Index for Treatment Needs), pocket depth index (PPD), probing bleeding index (PBI), and plaque index (Silness, Loe). All data were collected and a comparative analysis was done of the results obtained from the two groups. Analysing the data concerning the average of lost and present teeth in the oral cavity and the damage of periodontal attachment we notice that cardiopathic subjects had a loss of periodontal attachment 2 times greater than in the control group and major condition of edentulism. A frequency test called the "chi-square test" showed that cardiopathic patients had a greater frequency of periodontal disease. The development of periodontal disease in subject suffering from coronary heart disease is faster and more aggressive than in healthy subjects. Therefore, the prevention of periodontal disease is simple and effective way to reduce the risk of cardiovascular disease., (Copyright 2019 Biolife Sas. www.biolifesas.org.)

The aim of this study was to evaluate the adjunctive benefit offers by the administration of a chlorhexidine based local drug deliver (Chlo-SITE) into periodontal socket after a full mouth disinfection session. The study design was a randomized, crossover, clinical trial conducted on 60 non-smokers subjects with chronic periodontitis. Each volunteer was subjected to a one-stage full mouth disinfection session and, immediately after that, test product (Chlo-SITE) was inserted in 1 pocket in 2 quadrant. The 1° and 4° quadrant were used for the study with the application of antiseptic (Test); the 2° and 3° as a control. Periodontal probe (PD), bleeding on probing (BOP) and plaque index (PI) was collected at baseline (T0), after 7 days (T1), after 4 weeks (T2). The results of this study suggest that the application of xanthan-based chlorhexidine gel (Xan-CHX) offers a great benefit in improving of the indices in chronic periodontitis., (Copyright 2019 Biolife Sas. www.biolifesas.org.)

Nonsyndromic cleft lip with or without cleft palate is the most common craniofacial anomaly affecting around 1 in 700 live births worldwide. Clefts of the human face can be classified anatomically as cleft palate only (CPO), cleft lip only (CLO), cleft lip and palate (CLP) or a combined group of cleft lip with or without cleft palate (CL/P), based on different in embryologic development. These malformations have some genetic origin, in fact several association studies have been performed to obtain important information about the candidate genes; but more important are gene-environment interactions that play an increasing role in its etiology. Epidemiological studies have shown how environmental factors (alcohol, smoking, drugs), as well as possible gene-environment interactions, play an important role in the onset of the malformation. On the contrary, folic acid intake seems to have a protective effect. In this review, we analyze the role of environmental factors related to onset of cleft., (Copyright 2019 Biolife Sas. www.biolifesas.org.)

The aim of this study was to investigate the efficacy of endodontic sealers and endodontic medicaments: Aureoseal (OGNA), MTA (DENTSPLY), calcium hydroxide (CH) (Endoidrox OGNA) and iodoformic paste (OGNA) against Enterococcus faecalis. Thirty-six Biomeraux plates (18 MH and 18 DCO) were inoculated with the experimental suspensions. The E. faecalis broth culture suspensions were prepared and adjusted to no. 0.5-0.7 McFarland standard. In each agar plate, three cavities were created, each measuring 4mm in depth and 7mm in diameter, and then completely filled with the product to be tested. To investigate the root canal sealers' antimicrobial activity, the agar diffusion method is used. The diameters of the zones of microbial inhibition were measured in millimeters around the plate. The results showed that the antimicrobial activity of Aureoseal was superior to those of MTA, iodoformic paste and calcium hydroxide for the microorganisms tested. The study confirmed the resistance of Enterococcus faecalis to endodontic sealers. Aureoseal and Calcium hydroxide showed the best results in inhibition test suggesting to employ them in clinical cases., (Copyright 2019 Biolife Sas. www.biolifesas.org.)

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.

Aim: The aim of the study was to investigate how widespread is the use of the 2 x 4 appliance among Italian general dentists and specialists in orthodontics, as well as the type of treatment employed and length of use., Materials and Methods: We conducted a nationwide cross-sectional survey from July 14, 2016 to January 12, 2017 using an online questionnaire of 8 multiple choice questions, created by the SurveyMonkey® Company, on a population of Italian dentists and specialists in orthodontics affiliated with the Italian Society of Paediatric Dentistry (SIOI). This was made to assess how many clinicians knew and used this device in their clinical practice. We included 200 Italian dentists, 99 specialists in orthodontics and 101 general dentists of a mean age of 45 ± 15 years., Results: Results show that 93.94% of orthodontists have knowledge of and use this device in their clinical practice, while only 51.49% of the general dentists have knowledge of and use it (p<0.001). The 51.92% of dentists and the 52.13% of orthodontists used the 2x4 appliance to treat both space management and incorrect overjet. Most of general dentists and orthodontists combined the 2x4 appliance with pre-adjusted brackets and accessory components such as coil springs and power chains. While most of dentists (45.90%) used the 2x4 in association with appliances for space management, most of specialists (46.15%) applied the 2×4 in combination with both appliances for space management and high-pull headgear. Statistically significant differences were found also for the answers to the question "what is the average time of treatment?" among general dentists: the 32.79% used the 2 x 4 for less than 6 months of treatment, and the 67.21% used the 2 x 4 for more than 6 months of treatment. On the other hand 49.46% of orthodontists used the 2 x 4 for less than 6 months of treatment, and 50.54% of them for more than 6 months of treatment (p=0.041)., Conclusions: We conclude that the 2 x 4 appliance is widespread among orthodontists and about half of the general dentists, 93.94% and 51.49% (p<0.001) respectively. We found that 67.21% of general dentists used the 2 x 4 for a more than 6 months of treatment. As far as the orthodontists, 49.46% used the device for less than 6 months of treatment and 50.54% of them for more than 6 months of treatment. These differences were statistically significant (p=0.041).

Objective: This is a 6-month observational case-control study that aims to estimate plaque index (PI), salivary flow, buffering capacity of saliva, and specific Streptococcus mutans (S. mutans) and Lactobacillus rates in a mouth breathing late adolescents sample, after a professional oral hygiene procedure and home oral hygiene instructions., Subjects and Methods: A sample of 20 mouth breathing late adolescents/young adults (average: 19.2 ± 2.5; range: 18-23 years) and a matched control group of nose breathing subjects (average: 18.3 ± 3.2; range 18-23 years) were included in the study. All the participants were subjected to a professional oral hygiene procedure and appropriate home oral hygiene instructions (t0). After three months (t1) and six months (t2), the PI, salivary flow, buffering capacity of saliva, and S. mutans and Lactobacilli rates were recorded., Results: The mean buffering capacity of saliva and the salivary flow rate showed no significant difference between the two groups, all over the observational period. For PI, a significantly higher mode (score 1 of PI) was observed in the study group at t1 (score 0 = 35% of subjects; score 1 = 60%; score 2 = 5%) and t2 (score 1 = 65% of subjects, score 2 = 35%), with respect to control group. Furthermore, mouth breathing subjects show a significant 4 times higher risk to develop S. mutans CFU > 10 5 (CI lower limit: 0.95; CI upper limit: 9.48; chi-square: 4.28; p = 0.03), with respect to the control subjects., Conclusions: Mouth breathing late adolescents show a significantly higher risk to develop S. mutans CFU > 10 5 and an increased level of PI. Interceptive orthodontic treatments in growing subjects, like palatal expansion, are encouraged to improve the nasal air flow. In older subjects, orthodontic treatments should be performed with removable appliances like clear aligners, in order to allow a better oral hygiene level.

Plastic surgery is gaining more and more popularity, while stigma and popular myths about it are gradually decreasing. Analyze My Face conjunctly deals with the two main problems of facial plastic surgery: the excessive rate of dissatisfaction, which results in high revision requests and negative psychological side-effects and the “diagnosis by procedure” approach, which leads to erroneous measurements. This new and innovative method of Digital Facial Analysis is a direct non-expensive online service that provides professional and documented in-depth consultation to patients before they decide to undergo any type of facial intervention. The paper thoroughly explains the scientific method with which professionals provide customers with a facial assessment based on specific parameters which will be discussed (height, width, proportions, direction of facial growth, the way they assess each facial area in detail (eyes, mouth, cartilage), and the motivations for which they suggest to correct eventual defects through precise measurements, indicators and suggested interventions. Long-term evaluation of stability of surgical results and patient satisfaction achieved with digital facial analysis has not yet been established and needs further research. However, it is important to underline that the AMF approach tends to consider exclusively possible and feasible procedures that do not compromise functionality and that do not put patients in danger of serious damage. Problems or deformities that cannot be treated are always indicated. AMF aims to maximize professionality by giving practitioners an additional tool to aid their work, give unbiased opinions and look at the overall picture. It also aims to help patients by soothing their way into the complicated world of aesthetic surgery.

Purpose: The aim of this in vitro study was to evaluate the mechanical reliability of a dental implant system by testing its maximum fracture load and mechanical performance under cyclic fatigue stress., Methods: An experimental study according to the international standards (UNI EN ISO 14801: 2008) was performed using 13 implants (3.80 mm in diameter and 12 mm in length) with straight titanium abutments tightened to 30 N. Five samples were subjected to compression stress at break. Based on the mean fracture load value obtained in this test, the levels of dynamic loading range were set and were carried on at a frequency of 15 Hz for 5 × 10 cycles., Results: The compression stress at break mean value of the tested implants was 430 N (SD ± 35.66 N). In the mechanical fatigue stress test, the fatigue limit for 5 × 10 load cycles was 172 N., Conclusions: The evaluated implant system proved to withstand considerable mechanical loads under the "worst-case" loading situation performed according to UNI EN ISO 14801 standard. The reliability of this test protocol makes it suitable to be accomplished for understanding and comparing mechanical properties of implant systems.

Background: The aim of this case report was to describe the surgical-orthodontic treatment of an unerupted mandibular canine tooth in a 9-year-old girl., Case Presentation: A 9-year-old white girl presented with an unerupted right mandibular canine tooth. Combined surgical-orthodontic treatment was performed to correct dental impaction and to achieve good aesthetic and functional results., Conclusion: Orthodontic treatment achieved all of the required objectives.

Objective: The aim of this study was to evaluate the beneficial effect of NeoHeal during laser-assisted oral surgery., Background Data: Laser-assisted surgery is a less invasive technique than conventional surgery using a blade; however, the heat produced by the laser can damage tissue proximal to the treated area. We hypothesized the hydrogel NeoHeal could be applied during oral surgery and have similar benefits as those already described for dermatological surgery., Methods: In our randomized controlled trial, we first selected 30 patients who were to undergo laser surgical intervention using a diode laser. Both at the end of intervention and at follow-up, each patient filled out a questionnaire comprising two questions. The answers to the questions were statistically analyzed with regard to frequency of each response, and validated by the Wilcoxon test with a p value <0.05 being considered significant., Results: The use of NeoHeal significantly reduced the pain experienced by patients both during the intervention and at the 7-day follow-up. NeoHeal clearly reduces surgery-related pain experienced by patients., Conclusions: The results show positive feedback from the patients, demonstrating how the hydrogel pads are necessary, useful, and effective as a cooling aid in laser-assisted dental surgery.

Aim. This study aimed to evaluate the reliability of 3D-TMT, previously used only for dynamic testing, in a static cephalometric evaluation. Material and Method. A group of 40 patients (20 males and 20 females; mean age 14.2 ± 1.2 years; 12-18 years old) was included in the study. The measurements obtained by the 3D-TMT cephalometric analysis with a conventional frontal cephalometric analysis were compared for each subject. Nine passive markers reflectors were positioned on the face skin for the detection of the profile of the patient. Through the acquisition of these points, corresponding plans for three-dimensional posterior-anterior cephalometric analysis were found. Results. The cephalometric results carried out with 3D-TMT and with traditional posterior-anterior cephalometric analysis showed the 3D-TMT system values are slightly higher than the values measured on radiographs but statistically significant; nevertheless their correlation is very high. Conclusion. The recorded values obtained using the 3D-TMT analysis were correlated to cephalometric analysis, with small but statistically significant differences. The Dahlberg errors resulted to be always lower than the mean difference between the 2D and 3D measurements. A clinician should use, during the clinical monitoring of a patient, always the same method, to avoid comparing different millimeter magnitudes., Competing Interests: The authors declare that they have no competing interests.

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<0.05). In the treated group, an increase in sEMG potentials was observed for the masseter muscle, from T0 to T2, during maximal voluntary clenching. During swallowing and kissing, the masseter and sub-mental muscles showed a significant increase in their sEMG potentials from T0 to T2. During the protrusion of the mandible, the masseter and anterior temporalis significantly decreased their sEMG activity, while the sub-mental area increased significantly. No significant change was observed in the control group during the follow-up. The sEMG potentials of treated patients at T2 reached about the same values as those of the control group at T2. At T0 and T1 the differences between the two groups were more diffused, suggesting a clinical improvement of muscular functions after treatment. Lingual frenulectomy and rehabilitation exercises seem to affect the function of the orofacial muscles. Improvement in muscle sEMG potentials after treatment was demonstrated by sEMG, which can be considered the correct method to monitor this intervention., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Purpose: The aim of the present in vitro study was to evaluate the leakage observed for 2 different microbial species at the level of the implant-abutment (I-A) interface, and the marginal fit and size of microgap at the I-A interface in 2 different implant connections., Methods: Ten specimens of each group were tested. The inner parts of 5 implants per group were inoculated with 0.1 μL of a viable Enterococcus faecalis suspension and 5 implants per group with Aggregatibacter actinomycetemcomitans. All of the vials containing the control specimens were incubated at 37°C under aerobic condition for E. faecalis and 37°C in presence of 5% CO2 for A. actinomycetemcomitans. They were maintained for 14 days, and the possible penetration of bacterial suspension into the surrounding solution was determined by the observation of turbidity of the broth. The I-A interface was evaluated for size of microgap and measured under SEM. Five implants of each group were evaluated. The marginal fit between implant and abutment was measured at 8 random locations in each assembly, under different magnifications at the interface., Results: No leakages through the I-A interface were demonstrated for either type of connection evaluated. The microgap values of all I-A interfaces ranged from 0.008 to 2.009 μm; the differences between the 2 systems were statistically significant., Conclusions: The present study demonstrated that a good marginal fit of implant components seemed to be able to prevent bacterial leakage.

Purpose: The aim of this in vitro study was to evaluate the maximum fracture load and the mechanical performance to cyclic fatigue stress of a dental implant system., Methods: An experimental study according to the international standards (UNI EN ISO 14801: 2008) was carried out using 15 implants (3.80 mm of diameter and 13 mm of length) with applied straight titanium abutment tightened to 30 N. Five samples were subjected to compression stress at break. Based on the mean fracture load value obtained in this test, the levels of dynamic loading range were set that were carried on at a frequency of 15 Hz for 5 × 10 cycles., Results: The compression stress at break mean value of the tested implants was 499.40 N (SD ±50.1 N). In the mechanical fatigue stress test, the fatigue limit for 5 × 10 load cycles for all tested samples was 250 N., Conclusions: The evaluated implant system proved to withstand considerable mechanical loads under the "worst-case" loading situation performed according to UNI EN ISO 14801 standard. The reliability of this test protocol makes it suitable to be accomplished for understanding and comparing mechanical properties of other implant systems.

Aim: 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., Materials and Methods: 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., Results: 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)., Conclusion: 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.

Introduction: The retrieval of unerupted teeth in pedodontics is always significant to preserve the trophism of adjacent tissues, establish the correct space, provide adequate function and maintain good esthetics for the patient. The treatment plan is based on radiographic examinations and measurements, and on an accurate clinical evaluation; it aims to achieve the best treatment possible depending on the complexity of the specific case.In the most difficult clinical cases it is very important to have an early diagnosis, which is essential to plan the treatment and achieve success. In these cases, the pediatrician is in a strategic position to give an early diagnosis through a child's medical history and by counting the child's teeth., Case Presentation: This article presents two different difficult clinical cases of impacted teeth diagnosed during pediatric age, with a radiological analysis, and successfully treated with orthodontic devices designed for these specific cases. Clinical case 1 describes a 13-year-old Italian girl; clinical case 2 describes a 9-year-old Italian girl. The use of these devices achieved the desired treatment goals. The problems associated with impacted teeth and the biomechanical interventions used for these patients are discussed., Conclusions: An early and careful diagnosis followed by an accurate treatment plan for the individual cases can lead to retrieval of the impacted teeth without affecting other anatomic structures and adjacent teeth. In these cases, the pediatrician is in a strategic position to give an early diagnosis through a child's medical history and by counting the child's teeth.

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.

Patients with cognitive deficit have poor oral health and fewer teeth than cognitive normal elderly. The aim of the study was to investigate potential differences in masticatory function between elderly with dementia and those with normal cognitive function. Fifty-five patients (age >61; 82.05 ± 3.53) were enrolled in the study. Twenty-five subjects cognitively normal (10 females/15 males; 81.04 ± 4.89 years), were randomly selected and were assigned to Control Group. Thirty subjects (15 females/15 males; 83.16 ± 6.017 with cognitive impairments were randomly selected from hospitalized patients (Medically Assisted Residences RSA) and were assigned to Test Group. MMSE test, B-ADL and number of teeth were evaluated for each subject. The number of teeth in relation to levels of schooling is not resulted significative. In the cognitively impaired group 26 subjects had fewer than 20 teeth (86.6%); in the cognitively normal group 9 subjects had fewer than 20 teeth (36%). The correlation between number of teeth and age in both groups is significative (p<0.05). There is also a significative correlation between subjects with renal diseases and type II diabetes and number of teeth (p<0.05). Finally a significative correlation is present between number of teeth and sex of the patients (p<0.05) (Table 1). The results of the Wilcoxon's test revealed a significative correlation between MMSE in the two groups (p<0.01). There is also a significative correlation between the two groups and the educational background (p<0.01). The results of the study shows a clear correlation between tooth loss and cognitive function in elderly of L'Aquila.

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.

Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors that include obesity, impaired glucose tolerance or diabetes, hyperinsulinemia, hypertension, and dyslipidemia. Recently, more attention has been reserved to the correlation between periodontitis and systemic health. MetS is characterized by oxidative stress, a condition in which the equilibrium between the production and the inactivation of reactive oxygen species (ROS) becomes disrupted. ROS have an essential role in a variety of physiological systems, but under a condition of oxidative stress, they contribute to cellular dysfunction and damage. Oxidative stress may act as a common link to explain the relationship between each component of MetS and periodontitis. All those conditions show increased serum levels of products derived from oxidative damage, promoting a proinflammatory state. Moreover, adipocytokines, produced by the fat cells of fat tissue, might modulate the balance between oxidant and antioxidant activities. An increased caloric intake involves a higher metabolic activity, which results in an increased production of ROS, inducing insulin resistance. At the same time, obese patients require more insulin to maintain blood glucose homeostasis - a state known as hyperinsulinemia, a condition that can evolve into type 2 diabetes. Oxidation products can increase neutrophil adhesion and chemotaxis, thus favoring oxidative damage. Hyperglycemia and an oxidizing state promote the genesis of advanced glycation end-products, which could also be implicated in the degeneration and damage of periodontal tissue. Thus, MetS, the whole of interconnected factors, presents systemic and local manifestations, such as cardiovascular disease and periodontitis, related by a common factor known as oxidative stress.

Background: The aim of this study was to evaluate the antiplaque effect of a new alcohol free essential oil mouthwash with respect to a control of an essential oil with alcohol mouthwash, using an in vivo plaque regrowth model of 3-days., Methods: The study was designed as a double-masked, randomized, crossover clinical trial, involving 30 volunteers to compare two different essential oil containing mouthwashes, during a 3-day plaque accumulation model. After receiving a thorough professional prophylaxis at the baseline, over the next 3-days each volunteer refrained from all oral hygiene measures and had two daily rinses with 20 ml of the test mouthwash (alcohol free essential oil) or the control mouthwash (essential oil with alcohol). At the end of the each experimental period, plaque was assessed and the panelists filled out a questionnaire. Each subject underwent a 14 days washout period and there was a second allocation., Results: The essential oil mouthwash with ethanol shows a better inhibitory effect of plaque regrowth in 3-days than the mouthwash test with only essential oil in the whole mouth (plaque index = 2.18 against 2.46, respectively, p < 0.05); for the lower jaw (plaque index = 2.28 against 2.57, respectively, p < 0.05); for the upper jaw (plaque index = 2.08 against 2.35, respectively, p < 0.05); for the incisors (plaque index = 1.93 against 2.27, respectively, p < 0.05); and the canines (plaque index = 1.99 against 2.47, respectively, p < 0.05)., Conclusion: The essential oil containing mouthwash without alcohol seems to have a less inhibiting effect on the plaque regrowth than the traditional alcoholic solution.

Background: Currently, there are no suitable assays available to evaluate the embryotoxicity of leached components from restorative dental materials., Methods: The effect of the medium conditioned by composites and amalgam on mouse blastocysts in vitro was tested. The materials were also subcutaneously implanted, and the effect of the medium supplemented with serum from the host blood was evaluated in the embryotoxicity assay. The embryo implantation rate in the material-transplanted mothers was also evaluated., Results: The results show that while the culture in media conditioned by amalgams did not affect blastocyst development, the medium conditioned by composites caused blastocyst degeneration and apoptosis. The development of blastocysts in a medium containing serum obtained from animals after transplantation was, however, without effect. Finally, inconsistent reduction in the implantation rate in transplanted mothers was observed., Conclusions: In this study, we provide examples of in vitro and in vivo tests that may be used to evaluate embryotoxicity for dental materials. Our results show that leached components from our composite-material induced embryotoxicity in vitro, however, no toxicity was observed when subcutaneously implanted in vivo. This highlights the necessity of integrated in vitro and in vivo tests for valuable predictive estimation of embryotoxicity for complex materials.

Background: Idiopathic scoliosis is a deformity without clear etiology. It is unclear wether there is an association between malocclusion and scoliosis. Several types of occlusion were described in subjects with scoliosis, mostly case-reports., Objectives: The aim of this review was to evaluate the type of occluslins more prevalent in subjects with scoliosis, Search Strategy: All randomised and controlled clinical trials identified from the Cochrane Oral Health Group Trials Register, a MEDLINE search using the Mesh term scoliosis, malocclusion, and relevant free text words, and the bibliographies of papers and review articles which reported the outcome of orthodontic treatment in subjects with scoliosis that were published as abstracts or papers between 1970 and 2010., Selection Criteria: All randomised and controlled clinical trials published as full papers or abstracts which reported quantitative data on the outcomes malocclusion in subjects with scoliosis., Data Collection and Analysis: Data were extracted without blinding to the authors, age of patients or type of occlusion., Main Results: Using the search strategy eleven observational longitudinal studies were identified. No randomized clinical trials were recorded. Twenty-three cross-sectional studies were recorderd, and the others studies were reviews, editorials, case-reports, or opinions. The clinical trials were often not controlled and were about the cephalometric evaluation after treatment with the modified Milwuakee brace, followed by the orthodontic treatment of the class II relationship with a functional appliance. Clinical trials also included the study of the associations between scoliosis and unilateral crossbite, in children with asymmetry of the upper cervical spine. This association was also investigated in rats, pigs and rabbits in clinical trials. The other associations between scoliosis and occlusion seems to be based only on cross-sectional studies, case-reports, opinions., Authors' Conclusions: Based on selected studies, this review concludes that there is plausible evidence for an increased prevalence of unilateral Angle Class II malocclusions associated with scoliosis, and an increased risk of lateral crossbite, midline deviation in children affected by scoliosis. Also, documentation of associations between reduced range of lateral movements and scoliosis seem convincing. Data are also mentioned about the association between plagiocephaly and scoliosis.

The clinical case of an unusual ameloblastic fibro-odontoma (AFO) was reported. The patient's clinical chart as well as preoperative and postoperative radiographs and histological findings of a 20-year old man that addressed Dental Clinic at University of L'Aquila were thoroughly reviewed. The patient showed a swelling in the oral cavity and radiographic feature of a radiolucent lesion at left second premolar maxillary site. Histologic examination made diagnosis of AFO. AFO is a rare mixed odontogenic tumor with similarities to the ameloblastic fibroma (AF) and ameloblastic dentinoma. The nature and the relationships between mixed odontogenic tumours and related lesions are still controversial. Moreover is not clear if these lesions are separate pathologies or if they are different development stages of the same pathology.

Aim: The aim of the study is to analyse the prevalence of anomalous function of the orofacial muscles and their aetiological factors in a small sample of paediatric patients, to evaluate the correlation between anomalous functions of the orofacial muscles and malocclusions, and finally to verify the effects of a myofunctional protocol, composed of a series of exercises aimed at correcting the anomalous function and position of the tongue., Methods: The protocol that has been used in this research is a re-elaboration of the diagnostic and therapeutic methods set by two authors, Daniel Garliner and Aurelio Levrini. A group of 57 children (aged 5 to 13, mean age 8.2) with atypical swallowing diagnosis, has been treated for almost 3 years., Results: Physiologic swallowing was achieved in 47% of the children treated., Conclusion: The results show the benefits of the myofunctional therapy in the treatment of children with abnormal swallowing.

Aim: The aim of the study was to compare two methods of treatment for aggressive periodontitis: traditional surgical and Nd:YAG laser, evaluating their possible objective clinical advantages., Materials and Methods: A total of 36 hemiarches of 18 patients were analysed, 10 males and 8 females of average age of 14, selected according to predefined criteria. Overall we examined 70 radicular surfaces (sites) of 50 teeth. Each hemiarch to treat was randomly assigned to one of two treatment groups., Results and Conclusion: The results, analysed using the Friedman's test, showed a clinically appreciable validity both for the surgical and the laser treatment, while the Wilcoxon signed-rank test didn't highlight any statistically significant difference between the two types of treatment. The laser itself appears as a valid alternative to conventional therapy, in relation to the young age of the patients and for individuals at increased anaesthesiological risk and/or with coagulation and platelet function disorders.

Research into the monitoring and control of oral malodor has nowadays received new stimulus from the importance gained by this phenomenon as a medical and social problem. In this paper the performance of an electronic nose to detect this manifestation has been investigated in order to explore the possibility of using this instrument as a complement to those already existing for the assessment of oral malodor. In particular, a breath sampling procedure has been optimized to maximize the transfer to the sensors of those molecules that are known to be associated with the malodor. The sensitivity of electronic nose sensors to hydrogen sulfide, butyric acid and valeric acid-three compounds known to play a major role in halitosis-has been measured and the results indicate that the threshold limits are compatible with halitosis detection. An experiment with real and artificial samples indicates the possibility of identifying halitosis-affected individuals and of discriminating them according to breath composition.

Aim: This was the radiographic evaluation of 15 maxillary incisors apexification treatment carried out on 7-9 years old patients with periapical pathology due to pulpal necrosis after dental trauma., Materials and Methods: The treatment consisted of two phases. The aim of first phase was the formation of a calcified apical barrier through calcium hydroxide medications repeated twice with a three months interval. The aim of the second phase was the obturation of the root canal system once achieved a radiographic evidence of the formation of an apical barrier. The treated teeth were radiographed at six months and then periodically once a year for a period of 7 and 13 years., Results: The radiographic analysis allowed to underline three different kinds of apical formation: a physiological development of the apical portion with a final root length equal to the contralateral tooth; the formation of a cap tissue and an apical development with the final root length slightly shorter than the contralateral tooth; or the formation of different layers of mineralised tissue that aggregate together trough the years., Conclusion: Apexification is not a static phenomenon and the apexified area undergoes through the years to a conspicuous readjustment involving bone, apical root tissues and root filling material.