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The complexity of the use of antimicrobials for dental use (such as antibiotics) is directly related not only to the mode of onset of an oral infection (linked to numerous factors of local causality and comorbidity) but also to the predisposing risk for the general health of the patient with putative serious consequences related to the neck district. The abuse and misuse of antibiotics may lead to resistance to certain bacterial strains. In this regard, the evaluation of the risk/benefit of their use (especially in pregnant women) can be divided into two phases: risk analysis and subsequently risk management for the benefit of the patient for the oral pathology to be prevented or treated, respectively. This study seeks to focus on the issues and management of patients with certain antimicrobials during dental practice, placing special emphasis on new classes of antibiotics.Specific Aims:This study seeks to focus on the issues and management of patients with certain antimicrobials during dental practice, placing special emphasis on new classes of antibiotics.

Oral lichen planus usually occurs in adults; there are no clear data regarding the incidence and the clinical features of oral lichen planus in children. This paper reports clinical findings, treatments, and outcomes of 13 Italian patients with oral lichen planus in childhood diagnosed between 2001 and 2021. The most common finding was keratotic lesions with reticular or papular/plaque-like patterns, confined to the tongue in seven patients. Although oral lichen planus in childhood is rare and the malignant transformation index is unknown, specialists must be aware of its characteristics and oral mucosal lesions must be correctly diagnosed and managed.

Objectives To evaluate the quantitative effects of palatal Temporary Anchorage Device (TAD)-supported appliances for the distalisation of maxillary molars in Class II patients. Methods An electronic search was conducted in PubMed, CENTRAL, Scopus and the Web of Knowledge databases using specific key terms. The selection process was independently conducted by two researchers to identify relevant articles, published in English until January 2021. After the removal of duplicate articles and data extraction according to the PICOS scheme, the methodological quality of the included papers was ranked on a 9-point scale, from low to high quality. Results The initial search identified 14,830 articles, 536 of which were selected by title and abstract. After full-text reading, eleven articles were selected. The quality of evidence was moderate for ten studies, but high for one study. A total of 230 subjects in the permanent dentition were analysed. The mean molar distalisation values ranged from 3.0 millimetres (mm) to 5.3 mm. The mean molar distal tipping varied from −1.20° to 11.24°. The mean mesial movement of premolars showed negative values. Conclusions In Class II patients, palatally placed TAD-supported devices are more effective in maxillary molar distalisation compared to conventional appliances, thereby minimising molar distal tipping and preventing premolar anchorage loss during the distalisation mechanics.

Abstract: Under steady-state circumstances, the oral microbiota is in equilibrium with host tissues, thus contributing to local and systemic health. Any interruption of such equilibrium leads to a condition of dysbiosis with the proliferation of oral pathogens able to cause gingivitis and periodontal disease. The mechanisms of periodontitis will be described, mostly emphasizing the noxious effects exerted by oral pathogens on the periodontium either directly or indirectly via the release of an array of mediators, even including pro-inflammatory cytokines, chemokines, and enzymes. The persistence of local inflammation ultimately leads to systemic inflammation; therefore, the link between periodontitis and obesity, diabetes and cardiovascular disease will be elucidated. Some natural compounds, such as polyphenols, prebiotics, and probiotics, will be discussed for their ability to exert anti-inflammatory and anti-oxidant activities in the context of the inflamed buccal cavity and systemically, as well as for their modulation of the altered gum-gut microbiota.

The mandibular advancement device (MAD) is currently suggested in patients with mild to moderate obstructive sleep apnea (OSA). This study investigated the effects of a new fully customizable MAD-type device called, "It Makes You Sleep" (IMYS), in patients with mild to moderate OSA.Sixteen patients (14 men and 2 women; mean age 62; SD ± 11 years) were retrospectively enrolled. Each patient received home sleep apnea testing (HSAT) at baseline (T0) and after three months (T1) of IMYS treatment. The Apnea-Hypopnea Index (AHI), the Oxygen Desaturation Index (ODI), the Minimum Oxygen Saturation (minSO2) and the Medium Oxygen Saturation (medSO2) were analyzed.From T0 to T1, the IMYS treatment showed a significant reduction of AHI and ODI and a significant increase of minSO2 and medSO2.The IMYS appliance is an effective device for treating mild or moderate OSA.

Three-dimensional (3D) printing technologies commonly used for trial complete dentures use photopolymerizing resins. Although effective, some clinical, process-related, and practical issues associated with them are still unclear. The option of using alternative printing technologies may help in overcoming limitations.The purpose of this in vitro study was to evaluate the trueness of trial dentures fabricated by using 3D-printing fused deposition modeling (FDM).Ten maxillary and 10 mandibular digital complete trial dentures designed from intraoral scans were fabricated from polylactic acid by using a FDM 3D-printer. Each denture was scanned, and the scans were compared with the digital file of the designed denture by means of a surface-matching software program. The mean distance (both signed and absolute) was measured and recorded for the intaglio surface, as well as for the entire denture surface. Statistical analysis was performed to investigate the significance of the extent of measured distances, as well as differences between intaglio and global deviations; subgroup analysis for arch type was also performed (α=.05).Mean values of the intaglio distance were not significantly different from zero (P=.223). The manufacturing accuracy of the intaglio surface was higher than that measured for the entire denture (P.001), confirmed both by the averaged signed (0 mm and -0.028 mm, respectively) and the absolute mean deviations (0.06 mm and 0.08 mm, respectively). No significant differences were found between maxillary and mandibular trial dentures.3D-printing may constitute a valid and practical option for accurate and affordable digital trial dentures.

Digital workflows for removable partial dentures have enabled new machinable framework materials, including polyetheretherketone (PEEK). In addition, all denture components can be designed and manufactured digitally. Nonetheless, physical casts are still required for assembly of the components. The adoption of a cast-free fabrication procedure may enhance benefits, including a reduced number of procedures, faster processing, and reduced material waste. The purpose of this technical report was to demonstrate a workflow for the fabrication of a removable partial denture with a PEEK framework, milled teeth, and milled flanges, which uses intraoral scanning and no physical casts.

Statement of problem Denture tooth displacement may have a significant impact on denture occlusion. This aspect has seldom been investigated, especially for digital denture processing techniques. Purpose The purpose of this clinical study was to evaluate the accuracy of tooth position with milled digital dentures processed without physical casts. Material and methods Ten maxillary and 10 mandibular dentures designed from intraoral scans, milled, and processed without physical casts were investigated. The standard tessellation language (STL) files of the digitally designed dentures were compared with the scan of the dentures after processing (milling the denture base, milling teeth in a complete arch, and then bonding teeth into the base). The STL files were superimposed by using a surface-matching software program. After a preliminary alignment, the STL meshes were trimmed and reoriented; then, the final alignment was carried out by using the cameo surface. Six reference points (the mesiobuccal cusp on the most distal molar, the canine cusp, the middle of the incisal edge of the central incisor on both the left and the right side) were selected to measure tooth displacements along the X-, Y-, and Z-axes, corresponding (from the preliminary reorientation) to anteroposterior, mediolateral, and occlusal displacement, respectively. Tooth position accuracy was assessed by using median and interquartile range values. Univariate and multivariate statistical analyses were used to investigate the significance of the extent of displacements, as well as differences among displacement directions, reference teeth, side, and denture arch type (α=.05). Results Only the median (0.2 mm; interquartile range: 0.27 mm) occlusal displacement was significantly different from zero. A generalized estimated equation model addressing occlusal displacement as a dependent variable showed no significant effect of tooth type, side, or denture arch type, either alone or in combination. Conclusions The tooth position of both maxillary and mandibular milled digital dentures processed without physical casts was accurate in the anteroposterior and mediolateral directions. Occlusal displacement seemed to be within the range of clinical acceptability; its consistency throughout the arch allowed optimization or compensation at the design or manufacturing step.

(1) Background: Gingival cancer has a significant incidence and is often diagnosed at advanced stages. The aim of this paper is to highlight its clinical aspects on the basis of a case series analysis in order to promote awareness and improve the diagnosis process. (2) Methods: Oral cancers diagnosed and treated at three Italian University Hospitals over ten years were retrospectively investigated. Cancer location on the gingiva, edentulous ridge, and retromolar pad was addressed. Data regarding clinical features, stage at the diagnosis, and time from presenting symptoms to first medical consultation were retrieved. (3) Results: Thirty-three cancers located on the gingiva, edentulous ridge, and retromolar pad were retrieved from 276 total oral cancer cases (11.9%). A median of 50 days (range 2–300) passed for the patient to seek for a medical evaluation. At the time of diagnosis, 63.3% were advanced stage cancers, mainly located at the mandible (91%), especially in the retromolar pad (48.5%) and the edentulous alveolar ridge (24.2%). Lesions were red (45.5%), red and white (45.4%), or white (9.1%), appearing as an ulcer (69.7%), exophytic mass (12.1%) or flat lesion (12.1%). Sixty-six percent of cancers were completely asymptomatic, regardless their clinical appearance. A statistically significant association between the time from the presentation of symptoms to the first medical consultation and the cancers stage was found. (4) Conclusions: The clinical appearance of gingival cancer is very polymorphous, its understanding may be significant to improve patient education and early medical consultation.

Objectives To evaluate the influence of Fixed (FOA) and Removable Orthodontic Appliances (ROA) on oral Candida colonisation. Methods A search for articles published in the English language until September 2021, was carried out using Pubmed, Scopus and Web of Knowledge databases and by applying the search terms “orthodontic” OR “orthodontics” OR “fixed appliance” OR “removable appliance” OR “bracket” OR “removable aligner” AND “Candida” OR “Candidiasis” OR “Candidosis” to identify all potentially relevant human studies. After the removal of duplicate articles and data extraction according to the PICOS scheme, the methodological quality of the included papers was assessed by applying the Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies (SBU). Results The initial search identified 533 articles, 157 of which were selected by title and abstract. After full-text reading, sixteen articles were selected. The evidence quality for all the studies was moderate. Conclusions ROA induced a temporary increase of Candida counts from the early stage of treatment but which returned to the pre-treatment level after ROA removal. Contrasting results were reported for FOA treatment which promoted the oral colonisation of non-albicans species, although the most prevalent species was Candida albicans in both groups. This review should be interpreted with caution because of the number, quality, and heterogeneity of the included studies.

Reinfection with SARS-CoV-2 seems to be a rare phenomenon. The objective of this study is to carry out a systematic search of literature on the SARS-CoV-2 reinfection in order to understand the success of the global vaccine campaigns. A systematic search was performed. Inclusion criteria included a positive RT-PCR test of more than 90 days after the initial test and the confirmed recovery or a positive RT-PCR test of more than 45 days after the initial test that is accompanied by compatible symptoms or epidemiological exposure, naturally after the confirmed recovery. Only 117 articles were included in the final review with 260 confirmed cases. The severity of the reinfection episode was more severe in 92/260 (35.3%) with death only in 14 cases. The observation that many reinfection cases were less severe than initial cases is interesting because it may suggest partial protection from disease. Another interesting line of data is the detection of different clades or lineages by genome sequencing between initial infection and reinfection in 52/260 cases (20%). The findings are useful and contribute towards the role of vaccination in response to the COVID-19 infections. Due to the reinfection cases with SARS-CoV-2, it is evident that the level of immunity is not 100% for all individuals. These data highlight how it is necessary to continue to observe all the prescriptions recently indicated in the literature in order to avoid new contagion for all people after healing from COVID-19 or becoming asymptomatic positive.