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Abstract Objectives To estimate the economic costs of oral lichen planus (OLP) through a multicenter university hospital–based outpatient study conducted in Italy and Finland. Materials and methods A multicenter retrospective study was conducted on patients affected by OLP to evaluate the economic cost of managing the disease. Direct costs concerning diagnostic procedures, therapeutic management, and follow-up visits were obtained from clinical records. Statistics was performed with IBM SPSS Statistics. Results One hundred and eight patients with a confirmed diagnosis of OLP (81 women and 27 men), 58 Italians and 50 Finnish, were enrolled in this study. The mean annual cost was 1087.2 euros per patient. The mean annual cost was higher in Finnish than in Italian cohort (1558.7 euros vs. 680.7 euros—p p p Conclusions OLP-related costs are very similar to other chronic oral disorders (i.e., periodontitis) with differences between investigated countries. Moreover, patients with more severe clinical features, who need immunosuppressive therapy, are facing more expensive costs. Clinical relevance. In this multicenter cost of illness study, we estimated the direct health care costs of OLP and we found that patients with more severe clinical features, who therefore need symptomatic therapy, are facing more expensive costs.

Protective forests in the North Alps : general study context ; study of the structure of mountain resinous population ; assessment of mountain forest stability and sylvicultual consequences., Les forêts de protection dans les Alpes du Nord : contexte général de l'étude ; étude de la structure des peuplements résineux de montagne ; appréciation de la stabilité des forêts de montagne et conséquences sylvicoles.

Protection forests in the Northern Alps: general context, study of the structure of mountain softwood populations, appreciation of the mountain forest stability and silvicultural consequences., Les forêts de protection dans les Alpes du Nord : contexte général de l'étude ; étude de la structure des peuplements résineux de montagne ; appréciation de la stabilité des forêts de montagne et conséquences sylvicoles.

Various Norway spruce stands located in northern french Alps and playing an important role of protection are described in detail. A typology of the structures of these stands is proposed, using vertical cover stratification, basal area and microstructure. The different types are grouped in five families. The sensitivity of the stands in front of the different hazards (snow, wind, no natural regeneration) depends on their familly. The clear irregular type appears to be the most stable of all. Specific silvicultural actions are proposed aiming at leading each type towards this ideal structure., L'analyse dans les Alpes françaises, de pessières irrégulières à fort rôle de protection a permis de caractériser divers types de structures des peuplements. La stratification verticale du couvert, la densité (en surface terrière), la micro-structure sont les entrées de cette typologie qui regroupe ces types en cinq familles suivant l'état de maturité des arbres ou des bouquets. Cette typologie permet un diagnostic de la stabilité vis-à-vis de divers facteurs d'agression (neige, vent, non renouvellement naturel). Le type "futaie irrégulière claire" apparaît alors comme le plus stable. Pour chaque type sont proposées des règles sylvicoles permettant de se rapprocher de cette structure.

17 ref.; National audience

25 persons from four European countries participated in this international symposium, the objective of which was to lead scientists and managers of different alpine countries to develop a common opinion on the different approaches of stability, and to draw conclusions for a more adapted management. The description of the forestry structures characterized by data analysis, the diagnosis made for the studied site, and the materialization of the limited surfaces of " exemplary " interventions that will serve as references are detailed in this article., Ce colloque international a rassemblé 25 personnes représentant quatre pays européens. Son objectif était de réunir des chercheurs et gestionnaires de différents pays alpins, pour mener une réflexion commune sur les différentes approches de la stabilité et en tirer des enseignements pour une gestion plus adaptée. Une partie importante du colloque a été consacrée à des visites de terrain. La description de structures sylvicoles caractérisées par l'analyse des données , l'exposé du diagnostic réalisé à l'échelle du site étudié et la matérialisation sur des surfaces limitées d'interventions "exemplaires" destinées à servir de référence, sont détaillés dans cet article.

A tree distance-dependent height growth model is prensented for multi-layered, monospecific Norway spruce (Picea abies) mountain forests. It can simulate step by step the growth of every tree in a plot, each tree being considered as a model subject and a potential competitor for all other trees in the plot. The past growth of 56 trees in a plot in the forest of Chamonix (Haute-Savoie, France) is reconstructed. When adjusted to these data, the model accounted for one third of inter-individual variability in this plot. Theoretical testing of the model demonstrated that it is capable of generating the diversity of the height-growth curves encountered in irregular forests, as well as modifications due to stand structure (e.g., forest gaps). Potential uses of such a model are discussed., Un modèle de croissance en hauteur des arbres en pessière pure irrégulière de montagne est présenté. De type "arbre dépendant de la distance", il permet de simuler pas à pas l'évolution d'une placette dans laquelle chaque arbre est considéré à la fois comme individu modélisé et comme compétiteur potentiel pour les autres arbres de la placette. Pour ajuster le modèle, l'histoire de la croissance d'une placette de 56 arbres située en forêt de Chamonix a été reconstituée. Le modèle de compétition a permis de représenter un tiers de la variabilité interindividuelle. Testé également de manière théorique, il s'est montré capable de reproduire la diversité des formes des courbes de croissance en hauteur rencontrée en forêt irrégulière et les évolutions de la structure d'une trouée forestière. Des perspectives d'utilisation de ce modèle sont présentées : simulation des modifications de la structure d'une placette et comparaison de différentes conditions de croissance.

General ageing as well as regular increase of windfallen wood observed for the past 50 years in softwood forests of the northern Alps raise questions on the possible consequences of a massive and relatively quick destabilization of weakened populations. The stability problem is particularly acute in forests playing in protection role against natural hazards. The main objective of this study is to propose and develop silvicultural policies to optimize and perpetuate this protection function. The results expected in this study, which could be directly used by the managers, would have to be extended within the framework of a more global analysis and oriented towards a better understanding of the biological mechanisms characterizing mountain forest ecosystems., Le vieillissement généralement constaté ainsi que l'augmentation régulière de la part prélevée en chablis, depuis 50 ans, dans les forêts résineuses des Alpes du Nord, conduisent à s'interroger sur les conséquences éventuelles d'une déstabilisation massive et relativement rapide de peuplements fragilisés. Le problème de la stabilité de ces peuplements se pose particulièrement dans les cadre des forêts jouant un rôle de protection vis-à-vis des risques naturels. L'objectif principal de cette étude est donc de proposer et de mettre en oeuvre des mesures sylvicoles destinées à optimiser et pérenniser cette fonction de protection. Les résultats attendus de cette recherche, qui se veulent être directement utilisables par les gestionnaires,devront être prologés dans le cadre d'une analyse plus globale ainsi que dans le sens d'une meilleure compréhension des mécanismes biologiques caratérisant les écosystèmes forestiers de montagne.

The authors study the weakening of mountain populations, the historical evolution of this phenomenon and of its understanding, the short, medium and long term predictions currently considered, and the study methodologies., Les auteurs étudient la fragilisation des peuplements de montagne, l'évolution historique du phénomène et de sa connaissance, les causes connues ou supposées, les prévisions à court, moyen et long termes actuellement retenues et les méthodologies d'étude.

Extensification of mountain management: definition of an extensive management. Historical evolution of the considered parameter and of its understanding. Problems related to the quantification of this parameter. Main known or guessed impacts., Extensification de la gestion en zone de montagne : définition d'une gestion extensive. Evolution historique du paramètre considéré et de sa connaissance. Problèmes liés à la quantification de ce paramètre. Principaux impacts connus ou supposés.

Background: The wellbeing of oral lichen planus patients (OLPs) may be strongly influenced by a poor quality of sleep (QoS) and psychological impairment. The aims were to analyze the prevalence of sleep disturbance, anxiety, and depression in OLPs and to validate the Pittsburgh Sleep Quality Index (PSQI) in OLPs. Methods: Three hundred keratotic OLPs (K-OLPs), 300 with predominant non-keratotic OLP (nK-OLPs), and 300 controls were recruited in 15 Italian universities. The PSQI, Epworth Sleepiness Scale (ESS), Hamilton Rating Scales for Depression and Anxiety (HAM-D and HAM-A), Numeric Rating Scale (NRS), and Total Pain Rating Index (T-PRI) were administered. Results: Oral lichen planus patients had statistically higher scores than the controls in the majority of the PSQI sub-items (p-values5) in K-OLPs and nK-OLPs, respectively. The PSQI’s validation demonstrated good internal consistency and reliability of both the total and subscale of the PSQI. Conclusions: The OLPs reported an overall impaired QoS, which seemed to be an independent parameter according to the regression analysis. Hence, clinicians should assess QoS in OLPs and treat sleep disturbances in order to improve OLPs management.

Abstract: Oral candidiasis is an opportunistic infection of the oral mucosa sustained by fungi of the genus Candida. Various Candida species, with a predominance of C. albicans, normally a saprophyte of the oral cavity, may become virulent and infect the oral mucosa with variegated clinical presentation, in case of imbalance of the oral microbiota, the presence of local predisposing factors and systemic conditions that weaken the immune system. Conventionally, oral candidiasis eradication is done with the help of antifungal drugs. However, the growing phenomena of drug resistance and the increase in infections sustained by non-albicans species being less responsive to common antifungals have orientied researches towards the experimentation of alternative therapies. The present review considered the most promising alternative therapeutic proposals. The use of plant derivatives with phytotherapy is a promising option, such as probiotics, to rebalance the oral microbiota in case of dysbiosis. Finally, antimicrobial photodynamic therapy (aPDT), with highly selective fungicidal activity and free of side effects, is also being studied as a powerful alternative to drug administration. All these therapies are alternatives or supportive to the conventional treatment of recurrent and non-drug-responsive forms of oral candidiasis. However, further studies are needed to define the most active compounds, the efficacy of the therapies compared with the conventional ones, and the planning of regulated and standardized protocols.

Objectives: The aim of this systematic review was to estimate the osteoradionecrosis rate in patients with head and neck cancer due to teeth extraction performed before radiotherapy and to identify possible risk factors. Material and Methods: PRISMA protocol was used to evaluate and present the results. PubMed, Scopus and Web of Science were used as search engines: English full-length papers of clinical studies, in peer-reviewed journals, were investigated. Cumulative meta-analysis was performed with a random effects model (PROSPERO registration code: CRD42018079986). Results: Among 2,020 records screened, 8 were included in this review. Sixteen of 494 patients who underwent tooth extraction before radiotherapy developed osteoradionecrosis, with an osteoradionecrosis incidence of 2.2% (95% Confidence of Interval=0.6–3.9, p&nbsp

Objective The purpose of this study was to describe an unusual case of intraoral juvenile xanthogranuloma (JXG) and to perform a systematic review to investigate the available literature regarding oral JXGs. Study design We present a new case of oral JXG arising in a 36-year-old Italian woman and conducted a systematic literature review in PubMed, Web of Science and Scopus, according to the PRISMA guidelines. Results Our review of the English-language literature yielded 34 cases of oral JXG, which are included in our case report. Conclusions JXG is a non-Langerhans cell histiocytosis. Oral JXG has been reported, but it is a rare manifestation. Because of the rarity of oral lesions and possible variations in the clinical and histological presentation, the correct diagnosis can be challenging, requiring a careful clinical and histopathological evaluation with adjuvant immunohistochemical studies.

To assess (i) the prevalence of oral colonization by Candida spp. in patients with psoriasis and (ii) the prevalence of oral lesions associated with Candida spp. in patients with psoriasis and identify the risk factors for oral lesions. A systematic review was conducted in accordance with PRISMA criteria. The PROSPERO registration code is CRD42019127178. PubMed, Scopus and Web of Science were used as search engines. Meta-analyses and trial sequential analyses were performed. Among the 5805 retrieved records, nine articles were included. Among 530 psoriatic patients, 255 patients had an oral Candida spp. colonisation with an odds ratio (OR) = 3.44 (95% CI:2.38-5.00). Among 490 psoriatic patients, 43 patients developed oral Candida spp. lesions with an OR = 5.31 (95% CI:1.04-27.23). Among the patients without the main predisposing factors for infections, psoriatic patients had a higher OR (3.48, 95% CI: 2.0-6.0) for Candida spp. colonization, but not for Candida spp. infection, when compared with healthy controls (p-value > 0.05). Meta-analysis showed a higher risk of Candida spp. colonisation in patients with psoriasis. Patients who received immunosuppressive therapies were also at higher risk of developing oral lesions. Further studies are needed to understand these associations.

Objective: The aim of this study was to evaluate the postoperative course in patients undergoing oral mucosal biopsies, considering clinical and patient’s perception variables potentially correlated to poor healing. Subjects and methods: Eighty patients underwent oral biopsies. All the variables connected with the surgery were recorded, and the harvested volume was calculated through image software (ImageJ, NIH, Betesda, USA). To evaluate the postoperative discomfort, the OHIP-14 and the numeric rating scale of pain (NRS) were administered at 6 h, 7 days and 21 days after biopsy. Results: Six hours after the biopsy, 22 (OHIP-14 ≥ 20) and 24 (NRS ≥ 4) patients experienced a troublesome or painful healing, respectively. A significant statistical correlation between poor healing and high scores of NRS and OHIP was detected (Pearson’s correlation test p < 0.05). Higher values of OHIP-14 were correlated to the type of lesion (OR = 1.165; p < 0.05), whereas high values of NRS were correlated to the use of systemic drugs (p < 0.05). No surgical variable had a significant statistical correlation with any of the outcomes. Conclusions: The clinical evaluation was correlated with the patient’s perception of pain and discomfort. This finding could be suggestive of the fact that wound healing can be reliably monitored with the help of these tools. Clinical relevance: Patient perception can be a predictor of the healing of biopsied tissues.

Nowadays, there is a considerable interest to study the biological and microbiological changes that accompany orthodontic treatment. Growing knowledge on oral microbiota allows, day after day, to identify and characterize the microbial arrangements specifically associated with oral and extra-oral conditions. The aim of the present work is to highlight any further correlations between orthodontic appliances and the qualitative and quantitative modifications of the oral microbiota, such as predisposing factors for the onset of caries, periodontal diseases, and other infections, which can impact the oral and systemic health of the orthodontic patients. When compared with subjects without orthodontic appliances, orthodontic patients reported significant qualitative and quantitative differences in supra- and subgingival plaque during the entire treatment period. Certain components of fixed appliances (mainly bonded molar brackets, ceramic brackets, and elastomeric ligatures) showed high risks of periodontal disease and tooth decay for patients. An unclear prevalence of Candida spp. and the paucity of studies on viruses and protozoas in the oral microbiota of orthodontic patients need to be further investigated. The evidence emerging from this study could guide clinicians in modulating the timing of controls and enhance patient motivation to prevent the formation of mature plaque, thus reducing the risks of oral-plaque-related diseases.

Osteoradionecrosis (ORN) of the jaw is considered the most severe long-term adverse effect that can occur in radiation therapy patients. Teeth extractions and dental diseases are the main risk factors for ORN in irradiated patients. The aim of this case series was to evaluate the outcome of primary root canal treatments performed on patients who underwent head and neck radiotherapy and to evaluate any ORN related to the endodontic treatment. In this case series, primary root canal therapies (absence of radiolucency) were performed on 10 teeth of 8 patients who underwent radiotherapy for head and neck cancers. Radiation doses to the periapical area were calculated using the radiotherapy planning computed tomographic scan. After a 277-day mean follow-up, all patients were asymptomatic, no teeth showed periapical radiolucency, and no ORN was observed. Even if a limitation of buccal opening occurred after radiotherapy and complicated the endodontic procedures, root canal therapy seemed to be safe and a valid alternative to tooth extraction.