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During osteogenesis and bone modeling, high vascularity and osteoblastic/osteoclastic cell activity have been detected. A decrease in this activity is a sign of complete bone formation and maturation. Alveolar bone maturation seems to occur within weeks and months; however, the precise timing of the alveolar bone modeling is still unknown. The aim of this clinical pilot study was to investigate the bone modeling of neo-apposed tissue during orthodontic extrusive movements, through a histomorphometric analysis of human biopsies. This study was conducted on third mandibular molars sockets, and all teeth were extracted after orthodontic extrusion between 2010 and 2014. After different stabilization timings, extractions were performed, and a specimen of neo-deposed bone was harvested from each socket for the histomorphometric analysis. Histological parameters were evaluated to identify bone quantity and quality. This study included 12 teeth extracted from 9 patients. All specimens were composed of bone tissue. Bone samples taken after 1 and 1.5 months of stabilization presented remarkable percentages of woven bone, while after 2 months, a relevant decrease was observed. Histomorphometric analysis suggested that after orthodontic extrusion, a period of stabilization of 2 months allows the neo-deposed bone to mature.

The aim of the study was to test an information booklet containing suggestions to parents on how to prepare their child for the first dental visit. Forty-five children and one parent per included child took part in the trial. Children were randomized in two groups; the information booklet was e-mailed to the parents of the study group. At the end of the visit, the dentist and the parent evaluated the child’s behavior through the Frankl Behavior Rating Scale (FBRS) and the utility of the booklet through a Likert scale. The children evaluated the pleasantness of the visit and the perceived pain through the Wong–Baker FACES® Pain Rating Scale (WBFPRS). Parents evaluated the information booklet as highly understandable and useful. According to the dentist, informed children were more cooperative (FBRS median score: 4; IQR: 3.5–4) than the control group (median score 3; IQR: 2–4) (p = 0.013; Mann–Whitney U test). Children prepared with the booklet reported less pain (WBFPRS: 0.40 ± 0.82 vs. 1.42 ± 1.99; p = 0.034; t-test;) and tended to evaluate the visit as more enjoyable (WBFPRS: 1.1 ± 2.14 vs. 2.75 ± 3.43; p = 0.064; t-test) than unprepared children. The information booklet increases the child’s ability to cooperate during the visit and could represent a useful instrument for the clinical practice.

Background and Overview Severely molar-incisor hypomineralization (MIH)–affected teeth are prone to develop early posteruptive enamel breakdown (PEB) and caries. A novel conservative interim approach for the prevention of this complication is presented. Case Description A 6-year-old boy with strong hypersensitivity and extensive brown opacities in the partially erupted mandibular permanent first molars (PFMs) was diagnosed with MIH. Constant hygiene and dietary counseling were followed by the application of luted orthodontic bands and glass ionomer sealants to protect PFMs from caries and PEB until the complete eruption of the teeth. After 36 months, the PFMs were completely erupted, with no caries and PEB, and the cooperation of the child increased. Conclusions and Practical Implications Temporary strategies are useful to preserve MIH-affected PFMs. With the methodology described, the hypersensitivity decreased and the patient reached a good degree of cooperation, making possible definitive rehabilitative considerations.

Objectives: To evaluate the influence of the gingival contour on the smile esthetics. The influence of size, symmetry, teeth involved in apically shifted gingival margins, and the distance and clinical training of the observer were investigated. Materials and Methods: Two groups were identified: 33 first‐year dental students (inexperienced) and 40 last‐year students (trained). Each observer expressed four evaluations on four different images assigning a score from 0 to 10. Using a picture of an “ideal” female smile, 10 variants were virtually created by shifting (2 and 4 mm) the gingival contour apically at different sites of the upper incisors and canines. A total of 292 evaluations were collected. Results: Considering a score >6 for a “pleasant smile,” only one 4mm single alteration at the canine gingival contour obtained an insufficient score. “Observa- tional distance” and “clinical training” did not influence the final score, while size and symmetry of alterations displayed a significant role. Conclusions: The dental training of the observer and a close interpersonal distance seemed to be irrelevant in the esthetic perception of gingival margin alterations.

Background Oral breathing and downward tongue position are generally associated with transverse hypo-development of the upper maxilla. Rapid maxillary expansion aims to expand the upper maxilla transversely. This pilot retrospective clinical study evaluates the effects of rapid maxillary expansion therapy on the resting position of the tongue, on the position of the hyoid bone and on clinical respiratory pattern in a group of mouth breathing patients with mono- or bilateral cross-bites due to transversal deficits of the maxilla. Methods A total of 39 prepubertal oral breathing subjects with posterior cross-bite (mean age 8.5 year) have been studied. Before (T0) and after treatment (T1), changes in the position of the hyoid bone and tongue were evaluated by comparing latero-lateral radiographs (TLL), while the modification of respiratory patterns by a clinical and anamnestic assessment. Results After the treatment, the dorsum of tongue moved closer to the palatine vault, the position of the hyoid bone did not undergo significant variations and the respiratory pattern clinically improved in 64% of subjects. Conclusions In patients in early stages of oral respiratory development, rapid maxillary expansion promoted correct tongue position but did not produce significant changes in the position of the hyoid bone. It has been observed a general improvement of the breathing pattern.

Purpose: The aim of this preclinical study was to evaluate whether implant flossing could leave floss residues in three different implant-prosthetic conditions. Materials and methods: Using an anatomical model, three different conditions were studied: correct connection between the implant and abutment and complete insertion of the implant threads into the plaster (control group); misfit of approximately 220 to 230 μm between the implant platform and abutment in the absence of any thread exposure (misfit group); partial exposure of implant threads but absence of misfit (thread group). Twenty-one microstructured tapered threaded implants were divided among the three groups. Each sample was subjected to a flossing procedure using spongy floss, standardized in terms of movement, frequency, time, and pressure. Subsequently, a stereomicroscope examination with a standardized magnification of 10× was performed in order to highlight the possible presence of floss residues on the implant surface. Results: No floss residue was ever detected for the control group. Both misfit and thread groups showed floss residues that were discernible in two different types: microfilaments and amorphous particles. Statistical analysis showed a significant difference for the presence of floss remnants between the control group and the other two experimental groups (P = .005). No difference was observed between the misfit and thread groups. Conclusion: This study shows that exposed threads and misfit can induce the release of floss residues during maintenance procedures.

Craniofacial features of 12 children with Noonan syndrome (NS) were compared with age and gender matched healthy children. Dental history, panoramic radiograph, dental casts, and cephalometric measurements were assessed. The palatal height was significantly increased in the study group compared with the control group (p = .009; paired t-test). The palatal width was significantly reduced in the study group compared with the control group (p = .006; paired t-test). The mean SNB was reduced in the study group compared with the control group (p = .02; paired t-test) and the ANB increased (p = .009; paired t-test). The mean Sum (NSAr + SArGo + ArgoMe) angle and SN-GoMe were increased in the study group compared with the control group (respectively, p = .015 and p = .002; paired t-test). The cephalometric analysis assessed a retruded position of the mandible, skeletal class II characteristics, and a vertical growth pattern. The mandibular hyperdivergency was associated to a positive overbite.

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.

Background Audiovisual distraction using video eyeglasses is useful in managing distress and reducing fear and anxiety in healthy children during dental treatments. Aim To evaluate the effect of audiovisual distraction on behavior and self-reported pain of children with special healthcare needs (SHCN) without intellectual disability during dental restorations and its influence on the operator stress and the time of the appointment. Material and methods This randomized controlled crossover trial comprised 48 children with SHCN requiring at least two dental restorations. One restoration was done wearing the video eyeglasses and one wearing conventional behavior management techniques. Subjective and objective pain was evaluated using the Faces Pain Scale – Revised (FPS-R) and the revised Face, Leg, Activity, Cry, and Consolability scale (r-FLACC). The operator stress using a VAS, the time of the appointment, and the child satisfaction were recorded. Results The use of video eyeglasses significantly reduced the operator stress. The bivariate analysis showed that the mean FPS-R score and the mean r-FLACC score were significantly lower using the video eyeglasses only during the second clinical session. Conclusion Audiovisual distraction could be useful in managing distress in SHCN children without intellectual disability but cannot replace the conventional behavior management techniques.

Purpose: Self-induced soft-tissue injuries (SSI) are reported as local anesthesia complications, particularly in children. The purpose of the study was to evaluate the frequency of SSI following dental anesthesia in children with and without intellectual disability. Methods: 241 children receiving dental treatments with local anesthesia were divided into 2 groups: A, children without intellectual disability (159 individuals, 299 injections); B, children with intellectual disability (82 individuals, 165 injections). Each group was divided into subgroups according to age, injection technique and dental treatment. Two days after the dental procedure, a phone survey was conducted to determine the presence of SSI. Results: The frequency of SSI in group B was 19%, with no differences in relation to gender and age. In group A the frequency of SSI was significantly lower (9%; p = 0.002; Chi-square test); the children in the ≤ 6years-old subgroup experienced a higher frequency of SSI (p = 0.002). The lower arch was at major risk of SSI in both groups (p = 0.002). According to a multilevel approach group (p = 0.001) and injection technique (p = 0.0001) significantly influenced SSI; no influence of dental treatment is evidenced. Conclusions: SSI are common complications of local anesthesia in young children and individuals with intellectual disability.

Purpose The aim of this study was to compare the prevalence and bacterial load of 6 main periodontal pathogens between pairs of periodontal patients with and without type 2 diabetes mellitus. Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans genotypes were also investigated. Methods Twenty patients affected by chronic periodontitis and type 2 diabetes were retrospectively selected and matched to 20 patients without diabetes on the basis of the degree and severity of periodontal disease. Microbiological data of subgingival biofilms were analysed and compared for the examined pathogens: A. actinomycetemcomitans, P. gingivalis, Prevotella intermedia, Treponema denticola, Fusobacterium nucleatum, and Tannerella forsythia. Results The pairs were balanced in terms of demographic and clinical parameters, except for bleeding on probing and suppuration. In the microbiological test sites (4 for each patient), the mean probing pocket depth was 6.34±1.63 mm in patients with diabetes and 6.41±1.78 mm in patients without diabetes. No significant difference between pairs in the prevalence of P. gingivalis or the distribution of its genotypes was recorded. Patients with diabetes had a significantly greater amount of total bacterial load, P. gingivalis, T. denticola, T. forsythia, and F. nucleatum (P, Graphical Abstract

Objectives The aim of this study was to evaluate efficacy in children affected by Down syndrome of “Digital Brush” in terms of Plaque Index reduction added to the daily oral hygiene procedures. Methods A total of 56 patients with Down syndrome were recruited and randomly assigned in two groups: both control and test groups underwent standard hygiene procedures of tooth brushing twice a day followed by the intervention of Digital Brush, TNT gauze impregnated with chlorhexidine 0.12%, for the test group and by sterile gauze soaked in water for the control group. Initial plaque index was measured for all patients (T0), subsequently were instructed to use either Digital Brush or gauze soaked with water for 2 weeks. At last, patients were reevaluated (T1) and the plaque index measured. Results Plaque index improvement from T0 to T1 in control group was 11.7%, while in test group was 24.1%. The mean differences between test and control group was statistically significant (p < 0.001). Conclusions This study demonstrates how the Digital Brush, added to the daily oral hygiene procedures, obtains significant improvements in supragingival plaque control in children with Down syndrome.

Objectives Dental anxiety could impede dental treatment in children. Evidence shows that parents’ fear of dentists contributes to children's anxiety towards dentists. The aim of the present study was to determine whether and to what extent: a) parents’ anxiety and depression personality traits, b) parent's dental fear, and c) child personality traits can predict children's dental anxiety in an Italian population. Methods One hundred and four children (5–14 years old) and one of their parents participated in the study. Well-known and validated questionnaires were administered to children (MCDASf, CFSS-DS, TAD) and parents (FDPQ, STAI Y1, Y2, and BDI-II). Result Dental anxiety is significantly associated with the anxiety personality trait and depression of the child and with parental fear of dental pain. A hierarchical regression analysis showed that, regardless of age and gender, the best predictor of child dental anxiety is parent's fear of dental pain, rather than relatively stable temperaments of the child. Conclusions In line with the literature concerning adults, these findings highlight the children dental anxiety as a complex phenomena consisting of different components, including the child's personality traits (anxiety trait and depression) and parents’ dental fear. Clinical implications of this evidence are discussed.

AIM: To evaluate the oral health status in Alzheimer's disease (AD) patients. MATERIALS AND METHODS: A descriptive study was performed on 120 AD patients (60 institutionalized in a public institute and 60 attended a daytime center), from September 2013 to January 2014. About 103 subjects formed the control group. The following medical and dental data were collected: dementia severity, pharmacological therapy, physical status (American Society of Anesthesiologists [ASA]), decayed (D), filled (F), and remaining natural teeth (T), DF/T ratio, community periodontal index (CPI), and gingival index (GI). A t-test for independent samples and the Spearman's correlation test were used to evaluate all variables. The significance level was set at 0.05. RESULTS: Statistically more AD patients (91.7%) were under pharmacological therapy and their physical status was more severe (ASA 2, ASA 3) compared with control subjects (p < 0.001). Moreover, they presented numbers of D, CPI, and GI significantly higher (p ≤ 0.005). In the institutionalized subgroup, statistically more moderate and severe AD cases were detected and more patients were edentulous (p < 0.001). Noninstitutionalized patients presented DF/T ratio, CPI, and GI significantly lower (p ≤ 0.024). A significant weak negative correlation (r = -0.121 to -0.372) between epidemiologic indices and AD severity was observed. CONCLUSION: Alzheimer's disease patients show a low oral health status that decreases progressively as the disease severity aggravates. Therefore, further studies are necessary to investigate oral health care interventions for AD patients. CLINICAL SIGNIFICANCE: It would be beneficial to introduce trained professional figures in specialized elderly institutions for regular follow-up visits and professional oral hygiene procedures. This task has to be coordinated with the treating physician, family members, and/or caregivers. Knowing that the severity of AD has a negative effect on the oral health status and the type of institutionalization exacerbates it.

The study aimed to assess the prevalence of Legionella spp. in dental unit waterlines of a dental clinic and to verify whether the microbiological parameters used as indicators of water quality were correlated with Legionella contamination. A risk management plan was subsequently implemented in the dental health care setting, in order to verify whether the adopted disinfection protocols were effective in preventing Legionella colonization. The water delivered from syringes and turbines of 63 dental units operating in a dental clinic, was monitored for counts of the heterotrophic bacteria P. aeruginosa and Legionella spp. (22 degrees C and 37 degrees C). At baseline, output water from dental units continuously treated with disinfection products was more compliant with the recommended standards than untreated and periodically treated water. However, continuous disinfection was still not able to prevent contamination by Legionella and P. aeruginosa. Legionella was isolated from 36.4%, 24.3% and 53.3% of samples from untreated, periodically and continuously treated waterlines, respectively. The standard microbiological parameters used as indicators of water quality proved to be unreliable as predictors of the presence of Legionella, whose source was identified as the tap water used to supply the dental units. The adoption of control measures, including the use of deionized water in supplying the dental unit waterlines and the application of a combined protocol of continuous and periodic disinfection, with different active products for the different devices, resulted in good control of Legionella contamination. The efficacy of the measures adopted was mainly linked to the strict adherence to the planned protocols, which placed particular stress on staff training and ongoing environmental monitoring.

Riasunto Obiettivi Questa revisione della letteratura scientifica riassume i principali aspetti coinvolti nei processi di adesione a smalto e dentina e focalizza l’attenzione sull’evoluzione dei sistemi self-etch, evidenziandone caratteristiche chimiche, di legame e l’impiego nella pratica clinica. Materiali e metodi E stata effettuata una revisione narrativa della letteratura scientifica utilizzando la banca dati PubMed per ricercare le principali pubblicazioni (reviews, original articles) degli ultimi anni. Risultati Numerosi studi di laboratorio e clinici descrivono il meccanismo di adesione della tecnica self-etch e ne sottolineano la validita nell’adesione al tessuto dentinale; minori sono le prestazioni a livello dello smalto, specie per gli adesivi a un passaggio. Conclusioni La tecnica self-etch costituisce una valido approccio nell’adesione ai tessuti dentali.

X-linked hypophosphatemia (XLH) is a genetic disorder related to alterations in bones and teeth formation, due to low levels of phosphate in blood. Oral findings in XLH have been enamel and dentine abnormalities, high pulp horns, large pulp chambers, and some cases of periapical abscesses related to teeth without caries or traumatic injuries. The aim of our study was to assess the presence of enamel alterations, such as microclefts and/or structure defects in patients with XLH and give guidelines of prevention of XLH dental complications. History taking, oral clinical and radiological examination in 10 young patients affected by XLH (average age of 9) and in 6 patients without XLH (average age of 8). Impressions were performed on the vestibular surfaces of teeth in order to obtain replicas. The replicas were analyzed using scanning electron microscope (SEM) and compared to replicas of control group. The images of replicas of XLH patients showed deep microclefts and irregular enamel surface structure compared to replicas of control group. The replica of a patient with spontaneous periapical abscesses showed numerous enamel crater-shaped depressions and deep microcleavages penetrating into the enamel thickness. In absence of caries or fractures, the abscesses pathogenesis may be related to microcleavages of the enamel and dentin, which allow bacterial invasion of the pulp. There could be a relationship between XLH disease and enamel abnormalities.

Pallister-Killian syndrome (PKS) is a rare sporadic multi-systemic developmental disorder caused by a mosaic tetrasomy of the short arm of chromosome 12. A wide range of clinical characteristics including intellectual disability, seizures, and congenital malformations has previously been described. Individuals with PKS show a characteristic facial phenotype with frontal bossing, alopecia, sparse eyebrows, depressed nasal bridge, long philtrum, telecanthus, and posteriorly rotated ears. Oro-dental features, such as "Pallister lip," macroglossia, delayed eruption of primary teeth, high arched-palate, prognathism, and cleft palate have been occasionally reported in the medical literature. The aim of the study was to assess the oro-dental phenotype of PKS and to describe the oral health status in a cohort participating in the First European Workshop on PKS. A clinical dental examination was performed in 21 Caucasian probands and data regarding medical and dental history collected. Twelve probands (57%) showed an atypical dental pattern, with multiple missing teeth (primarily the first permanent molars) and 2 (10%) a double teeth. The severity of gingivitis and dental caries increased with age and gingival overgrowth was a common finding. A characteristic occlusive phenotype was found: a high-arched palate with mandibular prognathism associated with an anterior openbite and crossbite and with posterior crossbite (unilateral or bilateral). The prevalence of oral habits (non-nutritive sucking, mouth breathing, bruxism) was high, even in older probands. This study suggests that individuals affected by PKS should be observed closely for oro-dental diseases and a multidisciplinary approach is needed to implement the right preventive measures. © 2016 Wiley Periodicals, Inc.

Objective: To analyze any differences in the orthodontic treatment between children belonging to a particular subgroup of subjects with special health care needs (SHCN), children with craniofacial anomalies (CFA), and children not diagnosed with SHCN (NO SHCN). Materials and Methods: The study sample consisted of 50 children with SHCN and a confirmed diagnosis of CFA (SHCN/CFA); the control group consisted of 50 NO SHCN children fully matched for age, gender, and type of appliance used. The differences between the two groups were analyzed retrospectively: pre-, posttreatment scores, and score reduction of the Peer Assessment Rating Index (PAR), dental health component (DHC), and aesthetic component (AC) of Orthodontic Treatment Need Index (IOTN), number of appointments, number of simple or complex chair-time appointments, overall treatment time, and age at treatment start and end. Results: There were no statistically significant differences between the SHCN/CFA and NO SHCN groups for number of appointments, overall treatment time, age at treatment start, and age at treatment end (P = .682, .458, .535, and .675, respectively). There were statistically significant differences between groups in PAR, DHC, AC pre- and posttreatment, and number of simple and complex chair-time appointments (P = .030 and .000; .020 and .023; .000 and .000; .043; and .037; respectively). The reduction of PAR, DHC, and AC scores was not significantly different between groups (P = .060, .765, and .825, respectively). Conclusion: The treatment of children with SHCN, in general, and with CFA, in particular, on the one hand involves a higher rate of using complex chair time appointments and an inferior treatment outcome, by the other side implies an overall treatment time and a reduction of PAR, DHC or AC scores similar to the treatment of children not diagnosed with SHCN.

Objectives The aim of this study was to evaluate efficacy in children affected by Down syndrome of "Digital Brush" in terms of Plaque Index reduction added to the daily oral hygiene procedures. Methods A total of 56 patients with Down syndrome were recruited and randomly assigned in two groups: both control and test groups underwent standard hygiene procedures of tooth brushing twice a day followed by the intervention of Digital Brush, TNT gauze impregnated with chlorhexidine 0.12%, for the test group and by sterile gauze soaked in water for the control group. Initial plaque index was measured for all patients (T0), subsequently were instructed to use either Digital Brush or gauze soaked with water for 2 weeks. At last, patients were reevaluated (T1) and the plaque index measured. Results Plaque index improvement from T0 to T1 in control group was 11.7%, while in test group was 24.1%. The mean differences between test and control group was statistically significant (p < 0.001). Conclusions This study demonstrates how the Digital Brush, added to the daily oral hygiene procedures, obtains significant improvements in supragingival plaque control in children with Down syndrome.

Evaluation of the effects of rapid maxillary expansion and mandibular advancement using Propulsor Universal Light appliance on the upper airways in Marfan's syndrome children through home sleep studies, Epworth Sleepiness Scale questionnaire, and cephalometric analysis of the upper airways on lateral radiographs. METHODS: The study sample consisted of 30 children with Marfan's syndrome, and the control group consisted of 30 untreated and matched children. For Marfan subjects, data were taken at different time points compared to treatment: at T0 (before treatment), T1 (after rapid maxillary expansion), and T2 (after mandibular advancement). For control subjects, data were taken at similar intervals, at three follow-up visits: at T0 (as a starting screening tool), T1 (after approximately 2 years), and T2 (in proximity of the peak skeletal growth). RESULTS: Apnea-hypopnea and oxygen desaturations were significantly higher in the study group at T0 and T1 compared with control children. At T2, the values were not significant (p value 0.442 for both apnea-hypopnea index (AHI) and oxygen desaturation index (ODI)). Horizontal airway dimensions were significantly reduced, and vertical airway values were significantly increased in Marfan's syndrome at T0 and T1 but not at T2 (p values at T2: 0.071 for Phw1-Psp, 0.106 for Phw1-Psp', 0.101 for Phw2-Tb, 0.559 for UAL in male and 0.560 for UAL in female). CONCLUSIONS: Early rapid maxillary expansion and mandibular advancement using Propulsor Universal Light appliance significantly improved airway patency of Marfan's syndrome children and are strongly encouraged as a routine treatment for both correction of class II malocclusions and prevention of obstructive sleep apnea.

Introduction Ectodermal dysplasia syndromes are a heterogeneous group of inherited diseases characterised by abnormal development of tissues of ectodermal origin. The most common form of ectodermal dysplasia syndromesis X-linked hypohidrotic ectodermal dysplasia characterised by abnormalities of the skin, teeth, hair and sweat glands. The intraoral abnormalities include hypodontia, malformed teeth (conically shaped) and reduced alveolar ridge height. It causes severe impairment of chewing, swallowing, speech, aesthetics and affects social relation. Early dental treatment at 2-3 years is essential to improve oral function and reduce the social impairment. This may include resin bonded restorations to conventional prosthetic treatment. In some cases suffering from severe hypodontia, however, conventional prostheses are inadequate due to lack of retention and instability. The replacement of teeth by implants is usually restricted to patients with completed craniofacial growth; however, implants can be used as abutments for overdentures.This study reports a 9-year follow-up case of a child affected with X-linked hypohidrotic ectodermal dysplasiaaccompanied by anodontia. Case report At the age of 2 years, conventional upper and lower removable prostheses were fabricated. Subsequently, at the age of 11 years and 11 months; the patient was treated with a lower implant supported overdenture placed on two tapered implants (3.8 × 10 mm) in the anterior mandible. Cone beam computer tomography of the mandible was done and Dicom data used to obtain a rapid stereolithographic model. Conclusion Implants can be successfully placed, restored and loaded in growing patients with ectodermal dysplasia

OBJECTIVE: The purpose of the study was to evaluate the effect of water storage, adhesive system and root canal region on the hydrolytic degradation of dentin bonds to carbon fiber posts. STUDY DESIGN: Fiber posts were bonded to the root canals using different adhesive systems and composites: SB1 XT group (Scotchbond 1 XT/RelyX ARC), OBF group (One Up Bond F Plus/Ionotite F), and AB2 group (All Bond 2/C&B) After water storage (10 days), all roots were sectioned into 1 mm beams and divided into coronal or apical group. The specimens were stored in water at 22-26 °C temperature for 15 or 60 days and tested for microtensile bond strength at a crosshead speed of 0.9 mm/min after the calculation of the bonding area. Statistical analysis was performed with ANOVA followed by Tukey test to detect differences between groups (α=0.05). SEM investigation was performed to determine the mode of fracture. RESULTS: Bond strength at coronal and apical half showed significant differences between experimental groups both after 15 and 60 days of water storage. Premature failures were observed in 16-20% of specimens before storage in water. CONCLUSIONS: For the bonding systems tested, clinicians should consider that bond strength inside the root canal at apical half is lower than at coronal half irrespective of the adhesive system. The adhesion within the root canal is possible for SB1 XT and OBF groups unlike the AB2 group where adhesion to root canal dentine is not reliable. Nevertheless, apical half represents the worst scenario in which is possible to obtain a durable adhesion.

Treponema denticola is an oral spirochete that is associated with periodontal disease and detected occasionally in extraoral lesions associated with systemic disorders such as cardiovascular diseases. The effect of specific bacterial products from oral treponemes on endothelium is poorly investigated. This study analyzed the ability of components of the outer membrane of T. denticola (OMT) to induce apoptosis and heat shock proteins (HO-1 and Hsp70) in porcine aortic endothelial cells (pAECs), compared with results obtained with classical pro-inflammatory lipopolysaccharide (LPS) treatment. Cellular apoptosis was detected when pAECs were treated with either OMT or LPS, suggesting that OMT can damage endothelium integrity by reducing endothelial cell vitality. Stimulation with OMT, similarly to LPS response, increased HO-1 and Hsp-70 protein expression in a time-dependent manner, correlating with a rise in HO-1 and Hsp-70 mRNA. Collectively, these results support the hypothesis that T. denticola alters endothelial cell function. Moreover, our in vitro experiments represent a preliminary investigation to further in vivo study using a pig model to elucidate how T. denticola leaves the initial endodontic site and participates in the development of several systemic diseases.

Introduction This study evaluated the root canal wall morphology under scanning electron microscopy magnification after removal of 2 types of root canal fillings by using ultrasonic tips, nickel-titanium (NiTi) rotary instruments, and hand K-files. Methods Thirty-six extracted roots were filled by using AH Plus (DeTrey-Dentsply, Konstanz, Germany) as a sealer with Thermafil (Tulsa Dental Products, Tulsa, OK) (18 roots) or warm vertically condensed gutta-percha (18 roots). All fillings were removed up to the middle third by using Gates Glidden drills. The retreatment was completed by using K-files (group 1), M-Two NiTi rotary instruments (group 2), or ESI ultrasonic tips (group 3) in 12 roots each. Root canals were irrigated by using 10% ethylenediaminetetraacetic acid and 2.5% NaOCl. The samples were split longitudinally and observed by scanning electron microscopy (100–2000×). The presence of smear layer, filling debris, and the surface profile was evaluated in each picture. Kruskal-Wallis (analysis of variance) and Mann-Whitney tests were used to evaluate the differences between the obturation techniques, the 3 retreatment methods, and the canal thirds (P Results Resin sealer tags were observed inside dentinal tubules. No statistical differences (P > .05) were found among the 3 retreatment methods. No statistical differences were observed between Thermafil and vertically compacted warm gutta-percha for each group or between the coronal third used as control, middle, and apical thirds. Conclusions All retreatment techniques showed similar performances in terms of smear layer morphology, debris, and surface profile. None of them completely removed filling debris from dentinal tubules of apical third.

Summary Objective The aim of this study was to evaluate the fluoride release (release-tests) from two glass-ionomer cements (GIC), before and after NaF solution treatment (fluoride treatment) in different pH environments. Materials and methods After 21 days, every second sample was submitted to fluoride treatment to simulate a fluoride recharge. After fluoride treatment every second sample was submitted to a further three days of long release-tests. Sample surfaces were analyzed by SEM before and after the release-tests in all pH solutions studied. Results The present study showed that GICs released fluoride ions for the duration of the examination period. For both materials the amount of F− released at low pH was considerably greater than at higher pH. The massive superficial breaking up observed by SEM probably promoted the releasing processes. Recharge is possible at different pH levels using NaF solution. Conclusions Fluoride release may depend on GICs surface degradation caused by pH in the solution. The use of this kind of material may be an important issue in patients with with low pH saliva and with a high risks caries.

The purpose of this study was to investigate the effect on enamel surface morphology of two commercially available bleaching products (AZ Whitestrips 6% hydrogen peroxide - ProcterGamble; Platinum TWS 10% carbamide - Colgate Oral Pharmaceuticals) and their ability to prevent enamel demineralization in the presence of cariogenic solution, with or without saliva.Forty sound teeth were used to obtain 90 enamel fragments. Lactic acid (pH = 4.4) was used as a demineralizing cariogenic solution. The specimens were randomized into eight groups: Group A: product A + cariogenic solution; Group B: product B + cariogenic solution; Group C: cariogenic solution; Group D: (control group) stored in deionized water; Group E: product A + deionized water; Group F: product B + deionized water; Group G: product A + saliva; Group H: product B + saliva. Scanning electron microscope (SEM) analysis was performed to detect the type of lesions induced by the treatments. A score rating system was used to perform a non-parametric statistical analysis.Our study confirms that enamel alterations (i.e. removal of intraprismatic core and presence of deep porosities and pits) occur as a result of the application of a cariogenic solution (lactic acid). The enamel surface presented a honeycomb surface only in untreated samples previously stored in lactic acid solution. Conversely, both products were able to prevent enamel alterations caused by exposure to lactic acid. Saliva treatment reduced the degree of enamel lesions of both treated and untreated groups. Treatment with product A achieved better preservation of enamel integrity.Whitening treatment conducted with two 'home' bleaching agents had no adverse effects on enamel surface morphology. Several morphological aspects suggest that the tested products may even prevent demineralization of the enamel surface after exposure to lactic acid.

This study tested the hypothesis that hybridization of intraradicular dentin eliminates interfacial gaps, thereby improving the coronal seal and retention of teeth restored with fiber posts. Post spaces were bonded with two types of fiber posts, using the corresponding etch-and-rinse adhesives and dual-cured resin cements. Longitudinal sections of the interfaces were examined for dentin hybridization in the coronal- and middle-thirds of the root canals. Resin replicas of these sections were evaluated for interfacial gap formation. Although intraradicular dentin hybridization was not compromised irrespective of whether the adhesives were light-cured before cementation, the universal occurrence of interfacial gaps along the hybrid layer surface or the post-cement interface reflects the challenge in bonding to post spaces with low compliance and high C-factors. The clinical success associated with bonded fiber posts is probably due predominantly to frictional retention.

The aim of this study was to define from a morpho-structural point of view, using scanning electron microscopy, the features of various types of disposable latex gloves commonly used in Italian dental practice (Biogel D, Trend, Pagni, JJ, Latechnics, Pehasoft, Bantex). None of the brands examined was free from morphological flaws; however, while in some of these only slight depressions were found (Biogel D, Trend), in others (Latechnics, Bantex) there was a marked lack of homogeneity in the latex structure or real holes (Pehasoft). This study emphasizes the current difficulties faced by dentists in the search for safe working conditions.

The aim of this study was to describe the clinical treatment of young patients, affected by ectodermal dysplasia (ED), and to possibly establish clinical guidelines. The study design was case series. ED syndromes (EDs) are a heterogeneous group of inherited diseases characterised by abnormal development of tissues of ectodermal origin. The most common form of EDs is X linked hypohidrotic ED (HED). Characteristic triad of HED is oligo-anodontia, hypotricosis, hypo-anhydrosis. Oligo-anodontia is one of the most severe impairment, since it affects chewing, swallowing, speech, esthetics and social relation. Early prosthetic rehabilitation (at 2-3 years of age), with partial or complete dentures, is essential to improve oral function and reduce the social impairment.

Ectodermal Dysplasias (ED) are a heterogeneous group of inherited disorders characterized by dysplasia of tissues of ectodermal origin. Complete or partial anodontia are the most frequent dental findings. Prosthetic rehabilitation is recommended from functional, esthetic, and psychological points of view. Because of the anatomical abnormalities of existing teeth and alveolar ridges, conventional prosthetic rehabilitation in young patient is often difficult.