Metodiche self-ligating versus metodiche convenzionali

Objectives

This study is based on a literature review in order to compare self-ligating brackets with conventional brackets.

Materials and methods

The literature review was conducted on the US National Library of Medicine database, using PubMed. The keywords used in PubMed research were: “active self-ligating brackets”, “passive self-ligating brackets”, “conventional brackets”, “dental movement”, “orthodontics”.

Results

We found a total of 209 articles, 38 of which were selected, as related to our research, and the full text version was evaluated.

Conclusions

Self-ligating brackets seem to give a significant benefit in terms of chair-time reduction and show a slightly lower proclination of mandibular incisors.     

Efficacy of systemic bisphosphonate delivery on osseointegration of implants under osteoporotic conditions: Lessons from animal studies

Background

The aim was to systematically review the role of systemic bisphosphonate (BP) delivery on osseointegration of implants under osteoporotic conditions.

Methods

The addressed focused question was “Does systemic BP delivery enhance osseointegration of implants under osteoporotic conditions?” PubMed/MEDLINE and Google-Scholar databases were searched from 1994 up to and including December 2013 using different combinations of the following keywords: “bone to implant contact”, “implant”, “bisphosphonate”, “osseointegration” and “osteoporosis”. Review articles, case-reports, commentaries, letters to the Editor, unpublished articles and articles published in languages other than English were excluded.

Results

Fifteen animal studies fulfilled our eligibility criteria. Osteoporotic conditions were induced via bilateral ovariectomy (OVX). BPs used in the studies were ibandronate, zoledronic acid and alendronate. Results from 12 studies showed that systemic BP delivery significantly increased bone volume and bone-to-implant contact under osteoporotic conditions. Two studies reported no significant difference in osseointegration among OVX animals with and without systemic BP delivery. In one study, systemic BP delivery negatively influenced implant osseointegration. Rough-surfaced and polished implants were used in 11 and one study respectively. In 3 studies implant surface characteristics remained unclear.

Conclusion

Within the limits of the present study, it is concluded that systemic BP delivery enhances implant osseointegration in animals with induced osteoporotic conditions. However, in a clinical scenario, the potential risk of BP related ONJ in osteoporotic patients undergoing dental implant therapy cannot be disregarded.     

Restorative dentistry and restorative materials over the next 20 years: A Delphi survey

Objectives

The aim of this study was to forecast trends in restorative dentistry over the next 20 years and to identify treatment goals and corresponding properties of restorative materials.

Methods

Using the Delphi method, a panel of 3 experts identified 8 key questions, which were sent to experts in restorative and preventive dentistry. In round 1 of this survey, 15 international experts devised a clearer semantic definition of the key questions and the completion of respective items for two additional rounds. In round 2, 125 experts from 35 countries rated the items developed in round 1 using a Likert scale. In round 3, the same 125 experts received the ratings of round 2 and were asked to agree or disagree to these ratings by re-voting on all key questions and items. A total of 105 experts re-voted and finally took part in the complete survey. Among the 8 key questions, two questions were selected for the present report: (Q1) “What will be the future role of restorative treatment?” and (Q6) “What will be the key qualities for clinical success of restorations?” For both questions and the respective items, the experts were asked to evaluate the importance and the feasibility for later calculation of the scientific value (i.e. the opportunity, where opportunity = importance + [importance − feasibility]).

Results

The three items of highest importance for Q1 were “preservation of existing enamel and dentin tissue,” “prevention of secondary caries,” and “maintenance of the pulp vitality,” and for Q6 they were “optimization of adhesion,” “biocompatibility,” and “minimizing technical sensitivity.”

Significance

Bioactivity toward the pulp-dentin complex and prevention of secondary caries were the items generally rated as having the highest opportunity.     

Le complicanze del piercing orale e il ruolo dell’odontoiatra nella loro prevenzione: revisione della letteratura

Objectives

The work reports about the complications of oral piercing and the role of dentist in their prevention.

Materials and methods

The authors conducted a systematic review of the literature through the Medline database by entering “oral piercing”, “piercing and complications”, “piercing and hygiene” as keywords. Articles published between 1988 and 2012 were considered.

Results

Oral piercing is linked to several potential complications. Many of them are due to scarce awareness of the risk, bad habits and inadequate oral care.

Conclusions

The dentist should motivate patients with oral piercing to maintain a good oral care, provide instructions and conduct periodic inspections to secure their understanding and implementation in order to prevent complications.     

Eziopatogenesi e manifestazioni cliniche della sindrome di Crouzon: revisione della letteratura

Objectives

The term Craniofacial dysostosis (CFD) is used to describe familiar forms of synostosis involving different sutures of the cranial base and midface. The aim of this work consists in a systematic review of literature on aetiology, etiopathogenesis, epidemiology, diagnosis, clinical, systemic, and oral manifestations and therapeutic options of Crouzon syndrome.

Materials and methods

A systematic review of literature through Medline data bank [www.ncbi.nim.nih.gov/pubmed] was done using “Craniofacial Dysostosis”, “Craniosynostosis”, and “Crouzon Syndrome” as keywords.

Results

Crouzon syndrome is the most common craniosynostosis. It develops after an early fusion of superior and posterior sutures of the maxilla with orbital ones, with consequent underdevelopment of the midface and ocular proptosis. Oral manifestations are maxillary hypoplasia, maxillary dental crowding, ogival palatus, and relative mandibular prognathism. Diagnosis can be done either through the evaluation of clinical phenotypes or DNA analysis with polymerase chain reaction (PCR). Treatment is mainly surgical. Orthodontic therapy is performed during the early skeletal maturation.

Conclusions

Thanks to the important innovations in surgical techniques and to a muldisciplinary approach, patients affected by this syndrome may aspire to normal cerebral development, physical status, and social relationships.     

Oxygen Saturation in the Dental Pulp of Permanent Teeth: A Critical Review

Introduction

Pulse oximetry is a noninvasive method for assessing vascular health based on oxygen saturation level. The method has recently also been used to assess dental pulp vitality, but a median oxygen saturation level suggestive of normal pulp physiology has not been determined. The objective of this study was to make a critical analysis of the published research to establish the median oxygen saturation for the diagnosis of normal dental pulps in maxillary anterior permanent teeth using pulse oximetry.

Methods

Studies reporting on the use of pulse oximeters to determine oxygen saturation in dental pulps were retrieved using the MEDLINE, Scientific Electronic Library Online, and Cochrane Central Register of Controlled Trials databases plus a manual search of relevant references cited by selected articles. Different combinations of the terms “oximetry,” “oximeter,” “pulp,” “dental,” and “dentistry” were used in the search. Statistical analysis was performed for each group of teeth (central incisors, lateral incisors, and canines) using R statistical software (US EPA ORD NHEERL, Corvallis, OR) and a random effects model (P < .0001) with an I² of 99%.

Results

Of the 295 articles found, only 6 met the inclusion criteria (472 teeth). Of these, the number of articles included in each analysis (according to tooth group) was as follows: all 6 studies (288 teeth) for central incisors at a median oxygen saturation of 87.73%, 3 studies (90 teeth) for lateral incisors at a median oxygen saturation of 87.24%, and 4 studies (94 teeth) for canines at a median oxygen saturation of 87.26%.

Conclusions

The median oxygen saturation in normal dental pulps of permanent central incisors, lateral incisors, and canines was higher than 87%.     

Colonisation of gingival epithelia by subgingival biofilms in vitro: Role of “red complex” bacteria

Objectives

Biofilm formation on tooth surface results in colonisation and invasion of the juxtaposed gingival tissue, eliciting strong inflammatory responses that lead to periodontal disease. This in vitro study investigated the colonisation of human gingival multi-layered epithelium by multi-species subgingival biofilms, and evaluated the relative effects of the “red complex” species (Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola).

Methods

The grown biofilm consisted of Fusobacterium nucleatum, Campylobacter rectus, Veillonella dispar, P. gingivalis, Prevotella intermedia, T. forsythia, T. denticola, Actinomyces oris, Streptococcus anginosus and Streptococcus oralis, or its variant lacking the “red complex”. After 48 h in co-culture with the gingival epithelia, the bacterial species in the biofilm were quantified, whereas their localisation on the cell surface was investigated by combining confocal-laser scanning microscopy (CLSM) and fluorescence in situ hybridisation (FISH), as well as by scanning electron microscopy (SEM).

Results

Exclusion of the “red complex” quantitatively affected S. oralis, but not other species. The “red-complex” species were all able to colonise the gingival epithelial cells. A co-localisation trend was observed between P. gingivalis and T. denticola, as determined by FISH. However, in the absence of all three “red complex” bacteria from the biofilm, an immense colonisation of streptococci (potentially S. oralis) was observed on the gingival epithelia, as confirmed by both CLSM and SEM.

Conclusions

While the “red complex” species synergise in colonizing gingival epithelia, their absence from the biofilm enhances streptococcal colonisation. This antagonism with streptococci reveals that the “red complex” may regulate biofilm virulence, with potential implications in periodontal pathogenesis.     

Is non-cavitated proximal lesion sealing an effective method for caries control in primary and permanent teeth? A systematic review and meta-analysis

Objectives

The aim of this study was to perform a systematic review and meta-analysis on the effectiveness of sealing non-cavitated proximal caries lesions in primary and permanent teeth.

Data

Only controlled clinical trials and randomized controlled clinical trials that evaluated the effectiveness of sealing on non-cavitated proximal caries with a minimum follow-up of 12 months were included in the study. The primary outcome should be arrestment/progression of proximal caries evaluated by bitewing radiographs. A risk of bias evaluation based on the Cochrane Collaboration common scheme for bias was carried out for each study. The meta-analysis was performed on the studies considered low risk of bias and with pair-wise visual reading results through RevMan software.

Sources

A comprehensive search was performed in the Systematic Electronic Databases: Pubmed, Cochrane Library, Scopus, IBI Web of Science, Lilacs, SIGLE, and on website Clinical trials.gov, through until June 2013.

Study selection

From 967 studies identified, 10 articles and 3 studies with partial results were assessed for eligibility. However three articles were excluded and our final sample included 10 studies. According to the risk of bias evaluation, six studies were considered “high” risk of bias, and four “low” risk of bias. The forest plot of the meta-analysis showed low heterogeneity (I² = 29%) and a favourable outcome for the Infiltrant. The chance of caries progression when this technique was used was significantly lower (p = 0.002) compared with Placebo.

Conclusion

Our results suggest that the technique of sealing non-cavitated proximal caries seems to be effective in controlling proximal caries in the short and medium term. Further long-term randomized clinical trials are still necessary to increase this evidence.

Clinical significance

Contemporary dentistry is focused in minimally invasive approaches that prevent the destruction of sound dental tissues next to carious lesions. This paper searches for evidence of the efficacy of sealing/infiltrating non-cavitated proximal caries in arresting caries progression both in permanent and primary teeth.     

Assessment of endpoints in studies on peri-implantitis treatment—A systematic review

Background

Endpoints are normally used to assess the efficacy of clinical treatment. In studies of peri-implantitis therapy, “true” endpoints are preferred to “surrogate”, because they can capture a substantial proportion of the effect of treatment on an outcome of interest, for example implant failure.

Objective

To assess the type of endpoints reported in the literature on peri-implantitis therapy, and their frequency of use.

Materials and methods

An extensive literature search was conducted (Pubmed, Cochrane, and Lilacs databases up to and including October 2009) to retrieve randomised controlled trials and non-randomised studies. Grey literature and major dental journals were also searched for potential studies. A variable was regarded as an endpoint only when it was clearly stated as the objective of an investigation.

Results

Fourteen studies are included in this review. Data on implant failure are presented solely as a consequence of peri-implantitis therapy, and not as an objective of an investigation. No true endpoint was described in any study on peri-implantitis. Mean pocket probing depth at implant, mean clinical attachment level at implant, and mean bleeding on probing (after pocket depth assessment) at implant were the three surrogate endpoints cited most often in the studies. More than 20 different clinical endpoints were described in the studies selected.

Conclusions

Reports did not reveal whether or not the therapy for peri-implantitis is useful for reducing the risk of implant failure. A consensus should be reached among dental researchers to standardise surrogate endpoints, and efforts should be made to validate these endpoints.     

Nuovo dispositivo per l’espansione rapida del palato in dentatura mista

Objective

To present a new device that allows palatal expansion with a main skeletal component and a reduced vestibular tipping of supporting teeth.

Methods

The sample consisted of a group of 100 children aged between 5 and 12. The new device “New REP” was cemented on second primary molars. The clinical protocol was 1/4 turn of screw three times a day for a maximum of 12 days.

Results

In this group the opening of palatal suture was obtained with high predictability after four days; the expansion was completed within 12 days and the initial occlusal problem was solved in all patients.

Conclusions

The “New REP” developed by the authors according to the biomechanical principles involved allows to open the palatal suture after four days in a highly predictable way and to solve dental basal discrepancies within 12 days using the second primary molars as anchorage teeth.     

Therapeutic polymers for dental adhesives: Loading resins with bio-active components

Objectives

Many recent adhesives on the market exhibit reasonable clinical performance. Future innovations in adhesive materials should therefore seek out novel properties rather than simply modifying existing technologies. It is proposed that adhesive materials that are “bio-active” could contribute to better prognosis of restorative treatments.

Methods

This review examines the recent approaches used to achieve therapeutic polymers for dental adhesives by incorporating bio-active components. A strategy to maintain adhesive restorations is the focus of this paper.

Results

Major trials on therapeutic dental adhesives have looked at adding antibacterial activities or remineralization effects. Applications of antibacterial resin monomers based on quaternary ammonium compounds have received much research attention, and the loading of nano-sized bioactive particles or multiple ion-releasing glass fillers have been perceived as advantageous since they are not expected to influence the mechanical properties of the carrier polymer.

Significance

The therapeutic polymer approaches described here have the potential to provide clinical benefits. However, not many technological applications in this category have been successfully commercialized. Clinical evidence as well as further advancement of these technologies can be a driving force to make these new types of materials clinically available.     

Deficit trasversale del mascellare superiore e problematiche relative all’orecchio medio

Objectives

Restriction of the maxillary dental arch frequently results in decreased nasal canal patency with mouth breathing, and this situation may also be associated with conductive hearing loss. The aim of this paper is to review some of the literature on this condition and to advance several hypotheses regarding the changes observed in conductive hearing loss following orthodontic-orthopedic treatment.

Materials and methods

A literature review was carried out to critically analyze the relationship between “rapid maxillary expansion” and “improvement in conductive hearing loss”.

Results

The limited data in the literature on this specific topic suggest that hearing levels can be improved by correction of the palatal anatomy.

Conclusions

The positive effect on conductive hearing levels can be considered a possible additional benefit of rapid maxillary expansion, but this does not mean that rapid maxillary expansion should be proposed as a treatment for conductive hearing loss that is not associated with maxillary restriction.     

Una pratica classificazione psicologica del paziente odontoiatrico

Objectives

A clear understanding of the patient's needs is demanded for a proper dental management. The objective of this work is to relaunch the so-called “psychological classification of House”.

Mat erials and methods

Starting from the clinical setting for which it was realized, the removable denture, this work emphasizes its comprehensive suitability to the whole dental therapy. Clinical viability and scarce scientific reliability are discussed.

Results and conclusions

Retracing the bibliographic path, this contribute highlights the need for a review of the commonly known authorship. The research for a scientific validation being necessary, this work calls for a redefinition of this classification, able to identify the one who published the very first intuition.     

Effect of Ibuprofen on Masking Endodontic Diagnosis

Introduction

An accurate diagnosis is of upmost importance before initiating endodontic treatment; yet, there are occasions when the practitioner cannot reproduce the patient's chief complaint because the patient has become asymptomatic. Ibuprofen taken beforehand may “mask” or eliminate the patient's symptoms. In fact, 64%–83% of patients with dental pain take analgesics before seeing a dentist. The purpose of this study was to examine the possible “masking” effect of ibuprofen on endodontic diagnostic tests.

Methods

Forty-two patients with endodontic pain underwent testing (cold, percussion, palpation, and bite force measurement) and then received either placebo or 800 mg ibuprofen. Both patients and operators were blinded to the medication received. One hour later, diagnostic testing was repeated and compared with pretreatment testing.

Results

Ibuprofen affected testing values for vital teeth by masking palpation 40%, percussion 25%, and cold 25% on affected teeth with symptomatic irreversible pulpitis and symptomatic apical periodontitis. There was no observed masking effect in the placebo group on palpation, percussion, or cold values. When nonvital teeth were included, the masking effect of ibuprofen was decreased. However, little masking occurred with the bite force measurement differences.

Conclusions

Analgesics taken before the dental appointment can affect endodontic diagnostic testing results. Bite force measurements can assist in identifying the offending tooth in cases in which analgesics “mask” the endodontic diagnosis     

Valutazione delle caratteristiche cranio-facciali in pazienti affetti da patologie neuromuscolari

Objectives

The objective of this study was to perform an epidemiological survey of craniofacial features in patients affected by neuromuscular diseases.

Materials and Methods

67 patients, aged 6 to 18 years (57 males and 10 females), affected by different neuromuscular diseases (Duchenne muscular dystrophy, Becker muscular dystrophy, spinal muscular atrophy, congenital myopathy, limb-girdle muscular dystrophy, congenital muscular dystrophy, congenital myotonic dystrophy, facioscapulohumeral dystrophy) were evaluated.

Results

High prevalence of particular craniofacial features (hyperdivergent facial morphology, increased lower third facial height, lip incompetence, asymmetry) and occlusal features (Class II or III dental occlusion, crossbite) was observed. Moreover, atypical swallowing, macroglossia, mouth breathing and phonological disorders were frequently evidenced.

Conclusions

Patients affected by neuromuscular diseases present with particular dysmorphic craniofacial features and dental malocclusion.     

Differenti procedure di profilassi nel paziente in trattamento ortodontico

Objectives

The aim of this work was to compare the use of two different powders, one composed of sodium bicarbonate and the other made of glycine, applied with “Prophy-Jet” in orthodontic patients suffering from gum disease.

Materials

Fifteen patients aged 13–18 nearly to orthodontic were selected on the bases of a plaque index VPI ? 35% (O’Leary et al.) and gingival bleeding index GBI (Ainamo and Bay) ?30%. Some patients were selected and subjected to:

•

periodontal treatment of all four squares;

•

treatment of the first square with “Prophy-Jet” and sodium bicarbonate;

•

treatment of the second square with “Prophy-Jet” and glycine.

Results

The comparison between starting and last values showed a reduction, in the shortest time, of VPI and GBI in second square with Prophy-Jet” and glycine.

Conclusions

Clinical results demonstrated that Prophy-Jet associated to traditional periodontal therapy reduce significantly periodontal index. The application of glicine powder has also displayed multiple uses in the healing process.     

Prevascularization of biofunctional calcium phosphate cement for dental and craniofacial repairs

Objectives

Calcium phosphate cement (CPC) is promising for dental and craniofacial repairs. Vascularization in bone tissue engineering constructs is currently a major challenge. The objectives of this study were to investigate the prevascularization of macroporous CPC via coculturing human umbilical vein endothelial cells (HUVEC) and human osteoblasts (HOB), and determine the effect of RGD in CPC on microcapillary formation for the first time.

Methods

Macroporous CPC scaffold was prepared using CPC powder, chitosan liquid and gas-foaming porogen. Chitosan was grafted with Arg-Gly-Asp (RGD) to biofunctionalize the CPC. HUVEC and HOB were cocultured on macroporous CPC-RGD and CPC control without RGD for up to 42 d. The osteogenic and angiogenic differentiation, bone matrix mineral synthesis, and formation of microcapillary-like structures were measured.

Results

RGD-grafting in CPC increased the gene expressions of osteogenic and angiogenic differentiation markers than those of CPC control without RGD. Cell-synthesized bone mineral content also increased on CPC-RGD, compared to CPC control (p < 0.05). Immunostaining with endothelial marker showed that the amount of microcapillary-like structures on CPC scaffolds increased with time. At 42 d, the cumulative vessel length for CPC-RGD scaffold was 1.69-fold that of CPC control. SEM examination confirmed the morphology of self-assembled microcapillary-like structures on CPC scaffolds.

Significance

HUVEC + HOB coculture on macroporous CPC scaffold successfully achieved prevascularization. RGD incorporation in CPC enhanced osteogenic differentiation, bone mineral synthesis, and microcapillary-like structure formation. The novel prevascularized CPC-RGD constructs are promising for dental, craniofacial and orthopedic applications.     

Mapping the spatial and temporal progression of human dental enamel biomineralization using synchrotron X-ray diffraction

Objective

The complex biological, physicochemical process of human dental enamel formation begins in utero and for most teeth takes several years to complete. Lost enamel tissue cannot regenerate, therefore a better understanding of the spatial and temporal progression of mineralization of this tissue is needed in order to design improved in vivo mineral growth processes for regenerative dentistry and allow the possibility to grow a synthetic whole or partial tooth.

Method

Human dental enamel samples across a range of developmental stages available through archaeological collections have been used to explore the spatial and temporal progression of enamel biomineralization. Position sensitive synchrotron X-ray diffraction was used to quantify spatial and temporal variations in crystallite organization, lattice parameters and crystallite thickness at three different stages in enamel maturation. In addition X-ray microtomography was used to study mineral content distributions.

Results

An inverse correlation was found between the spatial variation in mineral content and the distribution of crystallite organization and thickness as a function of time during enamel maturation. Combined X-ray microtomography and synchrotron X-ray diffraction results show that as enamel matures the mineral content increases and the mineral density distribution becomes more homogeneous. Starting concurrently but proceeding at a slower rate, the enamel crystallites become more oriented and larger; and the crystallite organization becomes spatially more complex and heterogeneous.

Conclusion

During the mineralization of human dental enamel, the rate of mineral formation and mineral organization are not identical. Whilst the processes start simultaneously, full mineral content is achieved earlier, and crystallite organization is slower and continues for longer. These findings provide detailed insights into mineral development in human dental enamel which can inform synthetic biomimetic approaches for the benefit of clinical dentistry.