[The role of biopsy of the minor salivary glands in the diagnosis of Sjögren's syndrome]. / Il ruolo della biopsia delle ghiandole salivari minori nella diagnosi della sindrome di Sjögren.

After a short critical review of the latest literature, the authors evaluate the role of minor salivary gland biopsy in the diagnosis of Sjögren's syndrome. The histological factors typical of this syndrome are examined in this context.

[The oral health status in a sample of recruits form different regions of Italy]. / Stato di salute orale in un campione di reclute delle varie regioni d'Italia.

The present epidemiological study was carried out 700 national servicemen doing service at the barracks Carlo Alberto Dalla Chiesa of Fosano (Cuneo) in the period April-August 1989, for the purposes of determining the state of oral health in a large sample of the Italian young male population and the diffusion of actions aimed at caries prophylaxis. The DMF index of the group in question is 7.14. 83.44% of DMF teeth were subjected to conservative dental treatment, 5.58% were extracted and 10.98% presented ongoing processes of caries requiring treatment. The results obtained show that, although caries is still very widespread in Italy in relation to other European countries and the United States, considerable progress has been made compared to the past as regards the secondary prevention of the pathology. Nevertheless, much remains to be done for the primary prophylaxis of caries. These data were confirmed by those obtained on periodontopathies. Although, the serious forms of periodontal disease in youth are very rare, very few conscripts are aware of the most elementary principles of oral hygiene.

[The clinico-radiological assessment of dental anomalies with real and apparent numerical defects]. / Valutazione clinico-radiologica delle anomalie dentarie di numero in difetto reali ed apparenti.

Dental anomalies involving real shortfall in the number of teeth (agenesis) or apparent deficiency (impaction) have been studied in a population sample including 700 national servicemen aged between 19 and 26, in the period April-August 1989. The study was carried out by means of careful objective examination and the systematic performance of orthopantomography showed that 5.14% of the population examined is affected by dental agenesis. The tooth most often involved in agenesis is the lateral maxillary incisor followed by the third mandibular molar, the second mandibular premolar and the second maxillary premolar. As regards apparent agenesis, the upper and lower wisdom teeth were the most frequently involved in physiological or pathological bone impaction (this event occurs in almost 50% of third molars). The maxillary cuspid is also impacted with some frequency. The data obtained were compared with those in the world literature.

[An experimental verification of the thermal changes in the bone tissue during drilling for cavity preparation for an endosseous implant]. / Verifica sperimentale delle variazioni termiche del tessuto osseo durante la fresatura per la preparazione di cavità per impianto endosseo.

The local temperature increase of the bone following drilling procedures has been evaluated. Without any cooling device, and using a standard-speed drill, in few seconds the temperature reaches the necrosis-limit for living tissues (55 Celsius degrees). We compared the effectiveness of the most common cooling methods involving a forced flow of saline reaching the bone through an axial canal in the drill or just applied to the external surfaces of drill and bone with that of a device allowing a 100/1 reduction of the drill speed. With this method cooling was no more necessary and temperature control was quite good, as with cooling methods. We think the speed-reducing device can be recommended as safer, simpler to use and more comfortable for the patient.

Absence of significant bacteremia during urinary catheter manipulation in patients with chronic indwelling catheters.

The objective of this study was to quantify the microorganisms present in blood at urinary catheter removal and at reinsertion in patients with chronic indwelling urinary catheters. This was a prospective study during a 4-month period at a university-affiliated geriatric medical center. Our subjects were 33 patients with chronic indwelling urinary catheters and positive urinary cultures; the urinary catheter was usually changed once a month. A peripheral vein line was used for blood withdrawal and urinary cultures and quantitative blood cultures (Isolator) were performed during and shortly after urinary catheter removal and insertion. All patients had significant bacteriuria (greater than 10(5) cfu/mL) with an average of 2.3 microorganisms. Among the 46 sequential quantitative blood cultures performed, only two patients had bacteremia from the urinary source and at a very low concentration; one patient had 0.13 cfu/mL Str. faecalis in blood 5 minutes after removal of the urinary catheter, and the other 0.1 cfu/mL Proteus mirabilis 5 minutes after reinsertion of a new urinary catheter. None of the patients had any subjective or objective clinical problem during the 36 hours after the urinary manipulation. Clinical symptoms and bacteremia are rare events, and prophylactic antibiotics do not appear necessary during urinary catheter removal and reinsertion in elderly institutionalized patients. Further studies are necessary to identify risk factors in the rare instances of patients with bacteremia.

[Hemorrhagic cyst of the mandible. A case presentation]. / Le cisti emorragiche della mandibola. Presentazione di un caso.

Haemorrhagic mandibular cysts are quite rare and generally considered sequelae of an earlier trauma causing an overflow of blood into the bone, though a number of pathogenic theories have been put forward. Since few of these cysts involve subjective symptoms, most are discovered accidentally during radiography, while a sure diagnosis is only likely to be obtained during surgery on the discovery of a nonepithelialized cavity. The paper presents a typical case of haemorrhagic mandibular cyst which was treated by opening the cavity and scraping its walls in order to cause bleeding that would promote the growth of new bone tissue.

[Cystic lesions of the mucosa of the maxillary sinus. Clinical considerations and differential diagnosis]. / Lesioni cistiche della mucosa del seno mascellare. Considerazioni cliniche e diagnosi differenziale.

The various pathogenic, radiological and clinical aspects of cystic lesions of the maxillary sinus mucosa (pseudocysts, retention cysts, mucocells) are examined together with related problems of differential diagnosis. Such lesions are sometimes found accidentally in the course of routine X-rays or on the basis of clinical indications not directly attributable to the presence of a cyst. Often they are completely asymptomatic so that they are less often recognised than their true incidence and are sometimes confused with maxillary sinus lesions of a totally different origin. In the personal experience described sinusoscopy proved a valuable adjunct to clinical and radiological investigations for the purposes of differential diagnosis and may in some cases form the first stage of treatment. The value of sinusoscopy is also enhanced by the possibility it offers for targeted biopsies at the same time.

[Use of Lyodura in fractures of the orbital floor]. / L'uso della Lyodura nelle fratture del pavimento orbitario.

After a brief review of reported techniques for the reconstruction of substance losses of slight or modest proportions at the orbital floor using autogenic, homogeneous, heterogeneous and alloplastic grafts, personal experience with this type of surgery employing lyophilised human dura mater is reported. It is considered that Lyodura can be considered the material of choice by virtue of its strength, handiness and the absence of tissue reactions. 38 fractures of the orbital floor were treated from 1980 to 1986 with osteosynthesis of the border and insertion of lyophilised dura mater to make up for bone loss. In the immediate postoperative period and in later controls, there was no evidence of complications or phenomena of intolerance to the material. The patients treated were followed up a short time later. Clinical and X-ray data confirmed the validity in time of the technique and material employed long-term.