Physical and chemical mechanisms involved in adhesion of orthodontic bonding composites: in vitro evaluations.

BACKGROUND: Bond strength of orthodontic composite is strongly influenced by molecular and structural mechanisms. Aim of this in vitro study was to compare bond strength of light-cure orthodontic composites by measuring debonding forces and evaluating locations of bond failure. Investigations on chemical compositions clarified adhesive behaviors and abilities, exploring effects of ageing processes in this junction materials. METHODS: Twelve enamel discs, from human premolars, were randomly coupled to one orthodontic adhesive system (Transbond XT™ 3 M UNITEK, USA, Light-Cure Orthodontic Paste, LEONE, Italy and Bisco Ortho Bracket Paste LC, BISCO, Illinois) and underwent to Shear Bond Strength test. Metallic brackets were bonded to twenty-seven human premolar, with one of the adhesive systems, to quantify, at FE-SEM magnifications, after debonding, the residual material on enamel and bracket base surfaces. Raman Spectroscopy analysis was performed on eight discs of each composites to investigate on chemical compositions, before and after accelerated aging procedures in human saliva and sugary drink. RESULTS: Orthodontic adhesive systems showed similar strength of adhesion to enamel. The breakage of adhesive-adherent bond occurs in TXT at enamel-adhesive interface while in Bisco and Leone at adhesive-bracket interface. Accelerated in vitro aging demonstrated good physical-chemical stability for all composites, Bisco only, was weakly contaminated with respect to the other materials. CONCLUSION: A similar, clinically adequate and acceptable bond strength to enamel for debonding maneuvers was recorded in all orthodontic adhesive systems under examination. No significant chemical alterations are recorded, even in highly critical situations, not altering the initial mechanical properties of materials.

Psychobiotics Regulate the Anxiety Symptoms in Carriers of Allele A of IL-1ß Gene: A Randomized, Placebo-Controlled Clinical Trial.

BACKGROUND: Probiotic oral intake, via modulation of the microbiota-gut-brain axis, can impact brain activity, mood, and behavior; therefore, it may be beneficial against psychological distress and anxiety disorders. Inflammatory cytokines can influence the onset and progression of several neurodegenerative mood disorders, and the IL-1ß rs16944 SNP is related to high cytokine levels and potentially affects mood disorders. The aim of this study was to examine the combined effect of IL-1ß polymorphism and probiotic administration in mood disorder phenotypes in the Italian population. METHODS: 150 subjects were randomized into two different groups, probiotic oral suspension group (POSG) and placebo control group (PCG), and received the relative treatment for 12 weeks. Psychological profile assessment by Hamilton Anxiety Rating Scale (HAM-A), Body Uneasiness Test (BUT), and Symptom Checklist 90-Revised (SCL90R) was administered to all volunteers. Genotyping was performed on DNA extracted from salivary samples. RESULTS: After 12 weeks of intervention, a significant reduction of HAM-A total score was detected in the POSG (p < 0.01), compared to the PCG. Furthermore, IL-1ß carriers have moderate risk to develop anxiety (OR = 5.90), and in POSG IL-1ß carriers, we observed a reduction of HAM-A score (p = 0.02). CONCLUSIONS: Consumption of probiotics mitigates anxiety symptoms, especially in healthy adults with the minor A allele of rs16944 as a risk factor. Our results encourage the use of probiotics in anxiety disorders and suggest genetic association studies for psychobiotic-personalized therapy.

Oral management of adult patients undergoing hematopoietic stem cell transplantation.

Chemotherapy and hematopoietic stem cell transplantation (HSCT) are the current treatments for patients with hematological diseases; they result in myelosuppression, and increase the susceptibility of patients to severe infections. The oral cavity is a potential site of complications in HSCT patients, because it is the entrance for agents that can cause systemic infections; it is one of the most frequent locations for side effects deriving from conditioning therapy. The importance of dental pre-chemotherapy and transplant prescription is often stressed, since both therapies depress the immune system and platelets, making each intervention at this stage a high risk. The aim of this article is to review the potential complications of HSCT, and to extrapolate from the scientific literature the treatments and timeframes in which dental therapies can be performed, avoiding important risks for patients.

A Deep Morphological Characterization and Comparison of Different Dental Restorative Materials.

Giomer is a relatively new class of restorative material with aesthetics, handling and physical properties of composite resins, and benefits of glass ionomers: high radiopacity, antiplaque effect, fluoride release, and recharge. To verify the superior properties of Giomers, in this study, a deep morphological characterization has been performed with an in vitro comparative study among a Giomer (Beautifil® II by Shofu Dental Corporation, Osaka, Japan), a Compomer (Dyract Extra by Dentsply, Caulk, Germany), glass ionomer cement (Ketac fil plus by 3M ESPE), and a composite resin (Tetric Evoceram by Ivoclar). In particular, mechanical and optical properties and ageing effects have been compared to investigate materials similarities and differences. Indentation tests, UV-Visible spectroscopy, Raman spectroscopy, and weight loss after storage in saliva or sugary drink have been carried out to analyze materials behavior in real conditions. The results confirm the high quality of Giomer material and indicate possible improvements in their usage.

Dental unit wastewater, a current environmental problem: a sistematic review.

The dental unit waters are divided in two different groups, because of their chemical and microbial composition proprieties: in the first there is the "incoming dental unit water", drinking water that arrived directly in the dental chair unit through the municipal water system; in the second there is the "waste water", that represents the whole dental unit waste water. Regarding the lack of a complete systematic review on the quality of dental unit wastewater, the aim of the current research was to systematically study the incoming dental unit water and the waste one, focusing the attention on the problem of the wastewater contamination and its regulations. MATERIALS AND METHODS: A systematic literature review of the last 17 years was conducted on the topic of dental unit wastewater. Italian and English were the languages chosen for the papers research.Studies were searched in PubMed, Medline and Cochrane, with regard to inclusion criteria. RESULTS: The investigation and analysis of the two papers group revealed the presence of many information and scientific studies on the incoming dental unit water contamination, in contrast not much in literature about dental unit waste-water. CONCLUSIONS: The results revealed that dental unit wastewater is a problem underestimated by the scientific community, with the exception of dental amalgam wastes.In Italy there is a sentence of "Corte di Cassazione Penale, sez III, sentenza 17 gennaio 2013, n 2340" that regularized dental wastewaters as industrial ones, so they are inadequate to be disposed as domestic waters; but, at the same time, there isn't a specific law that regulates this king of waste.

Smart fusion vs. double scan: a comparison between two data-matching protocols for a computer guided implant planning.

AIM: To make a comparison between two different approaches of data matching during the preparation of a computer guided implant planning. MATERIAL AND METHODS: Electronic and manual literature searches were performed to collect information about the double-scan protocol and the smart fusion protocol. The two systems were then tested to identify or confirm their advantages and disadvantages. RESULTS: The double scan protocol is a reliable and well-known process to obtain a fusion between the anatomical data (CBCT) and the prosthetic data (radiographic template). It is possible to use this protocol both in dentate and edentulous patients. The newly developed smart fusion technique offers the possibility to superimpose the anatomical data (CBCT) onto the prosthetic data (cast + wax-up scan) without the production of a radiographic template. This system is still being tested by the clinicians even though dental manufacturers already consider it as the best solution for the dentate patients selected for a static computer guided implant surgery. CONCLUSIONS: Smart fusion protocol offers a reasonable time and cost reduction even though its application is limited to dentate patients. A noticeable drawback of the workflow is the matching step: often a manual intervention is necessary to obtain a correct alignment of the CBCT data with the lab scan of the cast. This issue is partially due to the use of non-volume stable materials during the preparation of the cast. Future improvements could be made by combining CBCT data with direct optical scans of patient dental arches in order to create the so-called 'virtual patient'.

Temporary anchorage devices (TADs) in orthodontics: review of the factors that influence the clinical success rate of the mini-implants.

INTRODUCTION: The mini-implant, temporary anchorage devices (TADS), are now a common method of treatment in Orthodontics with versatility, minimal invasiveness and the relationship between costs and benefits that they offer even today. Skeletal anchorage has, to a large degree, replaced conventional anchorage in situations where anchorage is considered either critical, insufficient, or likely to result in undesirable side effects such as vertical displacements generated by inter-maxillary force systems. OBJECTIVES: The objective of this study is to carry out a review about the factors that seem affect the success or failure rate of orthodontic mini-implants. A computerized literature review was performed by searching the MEDLINE database (Entrez PubMed, www.ncbi.nlm.nih.gov), Google Scholar, Scopus, Cochrane Central Register of Controlled Trials, Isi Web of Knowledge until March 2016 . The main subject heading "orthodontics" was combined with these keywords mini-implant, mini-screw, micro-implants, mini-implant success rate, mini-implant failure rate, skeletal anchorage, temporary anchorage device (TADS). In the selection process, abstracts were initially read independently by two researchers to identify potentially eligible full text papers which were then retrieved and assessed in order to decide on the final inclusion. CONCLUSIONS: The clinical success of orthodontic anchorage by mini-implants depends on the stability of the miniscrews used for fixation. For good stability, the application site must provide bone of good quantity and quality. We can reasonably assume that the stability of the anchorage of the mini-implants could be optimized by selecting a position with particular characteristics of quality and quantity of bone, in relation to cortical and total mandibular and jaw bone thickness. These expected informations are important because they indicates that the bone quality and quantity are significant when considering an implant placement site, but also that there are other confounding factors influencing the success rate.

Transcrestal guided sinus lift without grafting materials: a 36 months clinical prospective study.

PURPOSE: This study describes the ability to perform a technique for bone regeneration in maxillary posterior deficit (TGSL) without the use of bone grafting materials using a highly minimally invasive protocol. MATERIALS AND METHODS: Sixty six implants have been inserted in the sinus floor of a total of 39 patients through the transcrestal guided sinus lift technique (TGSL). All patients have been followed for at least three years in function. The drilling protocol was adapted on the basis of bone density of each implant site to achieve a torque between 45 and 55 Ncm. Healing titanium abutments tightened to 35 Ncm have been used. A CAD/CAM metal ceramics final prosthetic restoration has been generated a six months after the tissues healing and the provisional functionalization of the occlusion. Survival rate of implants and prostheses, biological and biomechanical complications, changes in marginal bone levels, and total height of alveolar crest bone before and after surgery have been evaluate and measured by the results obtained in this prospective study. It was also measured the periodontal parameters as well as levels of perception of pain by the patient during the entire recovery period. RESULTS: The result of the data of follow-up was 41.96 (24 to 36) months. Cumulative implant survival was 98.53% at 3 years. There were no biological and mechanical complications and there were no prosthetic failures during the whole period of follow-up. The Marginal Bone Loss (MBL) average during the first year of operation was from 0.33 to 0.36 mm, while the 3-year follow-up, the MBL average was 0.51 to 0.29 mm. The average of residual bone height of alveolar ridge before treatment was 6.7 to 1.6 mm (range 5.1 to 9.2 mm), while the average bone height was gained 6,4 - 1.6 mm (range 3.2 to 8.1 mm). All patients reported lower pain levels and found to have normal periodontal parameters. CONCLUSIONS: This study suggests that the use of guided surgery to perform transcrestal maxillary sinus lift to increase the sub-antral crestal height is a minimally invasive technique of success for the short and medium-term of follow-up, thus avoiding the extended treatment time and reducing the morbidity associated with the lifting of the floor of the maxillary sinus with traditional technique using bone grafting materials. Furthermore, this protocol without the use of graft materials does not vary the final outcome that have demonstrated the presence of newly formed bone around implants offering always predictable results, and giving a further reduction in the costs of the procedure rehabilitation.

Autologous blood preparations rich in platelets, fibrin and growth factors.

OBJECTIVES: Bone regeneration is often needed prior to dental implant treatment due to the lack of adequate quantity and quality after infectious diseases. The greatest regenerative power was obtained with autologous tissue, primarily the bone alive, taken from the same site or adjacent sites, up to the use centrifugation of blood with the selection of the parts with the greatest potential regenerative. In fact, various techniques and technologies were chronologically successive to cope with an ever better preparation of these concentrates of blood. Our aim is to review these advances and discuss the ways in which platelet concentrates may provide such unexpected beneficial therapeutic effects. METHODS: The research has been carried out in the MEDLINE and Cochrane Central Register of Controlled Trials database by choosing keywords as "platelet rich plasma", "platelet rich fibrin", "platelet growth factors", and "bone regeneration" and "dentistry". RESULTS: Autologous platelet rich plasma is a safe and low cost procedure to deliver growth factors for bone and soft tissue healing. CONCLUSION: The great heterogeneity of clinical outcomes can be explained by the different PRP products with qualitative and quantitative difference among substance.

The anti-transglutaminase auto-antibodies in children's saliva with a suspect coeliac disease: clinical study.

UNLABELLED: The coeliac disease is an immune-mediated enteropathy triggered by an ingestion of gluten in genetically susceptible individuals. Like some other systemic diseases (Crohn's disease, Sjögren's syndrome) the celiac disease is able to alter the oral ecosystem and the composition of the saliva. AIM: The aim of this retrospective study has been to examine the incidence of coeliac disease (CD) in paediatric population and to search the presence of anti-transglutaminase auto-antibodies (anti-tTG) in saliva, comparing and quantifying the concentration regard to the serum values of the anti-tTG auto-antibodies, before and after six months from the beginning of the free gluten diet. MATERIALS AND METHODS: 105 children (G0), aged between 5 and 13 years, belonging to the Paediatric Gastroenterology-Endoscopy Unit of PTV Hospital, University of Rome "Tor Vergata", have been examined for a diagnosis of suspected CD. RESULTS: Of a total of 105 pediatric patients (G0), only the 16.2% (G1) has showed to be positive. About the evaluation of the anti-tTG auto-antibodies in the serum, obtained from the second blood sample (T1), we can observe that 10 (G2) out of 17 children (G1) show positivity and for this reason they have been subjected to a sampling of intestinal villi to confirm the diagnosis of CD; in addition the 6.7% has been resulted positive at the first sampling of serum (T0), but negative to the second one (T1). The incidence of the CD has been resulted to be equal to 9.5%. About the evaluation of anti-tTG in the G1, we can observe that 58.8% of children are "definitely positive" to the salivary anti-tTG, while 11.8% appear to be weakly positive. About the correspondence of serum and salivary anti-tTG in Group G1, we can observe, that children positive to the anti-tTG in the serum have also the anti-tTG in the salivary fluid (sensibility 100%, specificity 71.4%). The results show that the anti-tTG salivary are present in children with CD, even though they have continued to follow the gluten free diet for 6 months. CONCLUSIONS: The presence of anti-tTG in the saliva may be considered, an additional and useful diagnostic dental marker for an initial, reproducible, non invasive, inexpensive and highly sensitive screening of CD having a predictive and precocious value compared to anti-tTG contained in the serum, as it has been already demonstrated.

Traditional elastic ligatures versus slide ligation system. A morphological evaluation.

OBJECTIVE: Elastomeric materials play an important role in the orthodontic practice, including the retraction force to move teeth into extraction sites, closing diastemas, selective shifting of the midline and generalized space closure. Frictional resistance and ligating strength of archwire-bracket-ligature complex occurs during utilization of elastomeric and metallic ligatures when orthodontic forces are applicated. The aim of this study was to analyze elastic deformation of three types of elastomeric ligatures, after clinical use. MATERIAL AND METHODS: ELASTOMERIC LIGATURES: ring-shape, transparent, latex ligatures (Leone® S.p.A.), ring-shape, grey, polyurethane ligatures (Micerium® S.p.A.) and grey, polyurethane, Slide low-friction ligatures (Leone® S.p.A.). A total of 9 orthodontic patients undergoing fixed orthodontic therapy were selected. Three specimens were applied, one for each types of ligature, inside the oral cavity of each subject. Samples were kept in the oral cavity for 28 days, ligating 0.16 X 0.22 inches stainless steel archwires to stainless steel premolars brackets (Leone® S.p.A., Sesto Fiorentino, FI, Italy) for Bidimensional technique. After the pre-established time, the systems of ligature were removed and washed. Control group consisted of 9 unused specimens of each ligation type. Each elastomeric ligature was observed under the scanning electron microscope (SEM) to determine variations in size. The archwire-bracket-ligature complex was also analyzed. RESULTS: Transparent O-ring ligatures showed significant volumetric and structural changes. The external rounded shape was rather maintained, while the internal shape tended to appear square. Both external and internal diameter significantly increased (p<0.005 and p<0.0001 respectively) while the thickness decreased ( p<0,005) when analyzed with t-test. Polyurethane ring-shape ligatures retained the initial ring design. Both external and internal diameter increased (p<0.0001), while the thickness remained almost unchanged. The internal border was more squared, and showed jagged edges with continuous and irregular extroversions. Grey, polyurethane Slide low-friction ligatures showed a reduced dimensional change. There was a slight increase in two dimensions, length and width, (14-16%) (p<0.05 and p<0.001) while there was a not significant decrease in thickness (10%). CONCLUSION: From SEM analysis of ligature morphology it emerges that latex and polyurethane O-ring ligatures endure significant volumetric and structural changes, after clinical use, index of a greater degree of friction and early loss in functionality. Grey, polyurethane Slide low-friction ligatures presented limited variation in size after clinical use.

Occurrence of Candida species colonization in a population of denture-wearing immigrants.

Infection of the oral cavity and dentures by Candida species are frequent in denture wearers. C. albicans is the most common pathogen; however, other emerging Candida species are also responsible for this condition. Few data are available about the occurrence of Candida species in the oral cavities of denture-wearing immigrants to Italy. In this study, we compare the Candida species found in the oral mucosa and on dentures from a population of denture wearing immigrants to Italy to a matched Italian group. Oral swabs were collected from dentures and the underlying mucosa of patients enrolled in the study and were then cultured to test for the presence of Candida species in each sample. Out of 168 patients enrolled (73 Italians and 95 immigrants), 51 Italians (69.8 percent) and 75 immigrants (78.9 percent) tested positive for the presence of Candida. Candida albicans was the most frequently observed species overall; however, we found a higher occurrence of C. glabrata among immigrants than among Italians. In addition, immigrants displayed a higher incidence of Candida – associated stomatitis and a lower mean age than Candida-positive individuals from the Italian group. Immigrants are more prone to longer colonization of the oral mucosa and dentures by Candida. In these patients, dentures must be checked periodically to prevent the presence of Candida.

Sealants in dentistry: a systematic review of the literature.

UNLABELLED: The occlusal surface is the most affected area by dental caries and the sealing of the pits and of the fissures has been found, in time, the preventive method most effective trying to counteract the onset. Currently, the WHO considers it as a primary preventive measure, in other words one of the most effective and least invasive available to ensure the complete protection and the total preservation of the occlusal carious by the phenomenon. PURPOSE: THE AIM OF THIS WORK HAS BEEN TO PERFORM A SYSTEMATIC REVIEW OF THE LITERATURE ON CLINICAL TRIALS OF DIFFERENT SEALING MATERIALS, IN ORDER TO: compare their individual characteristics, highlight the reliability and the long-term efficacy and identify the most significant variables, both technological and clinics, in order to declare whether or not the success of this method prior. MATERIALS AND METHODS: The research has been carried out in the MEDLINE database by choosing keywords as "sealants" and "follow up". Only studies published in the last thirteen years have been considered and have been evaluated only types of scientific articles that fall within the definition of Anglo-Saxon "Clinical Trial" and "Controlled Clinical Trial", excluding all experimental works in vitro, case-reports, meta-analyzes and literature reviews. Have been also considered only scientific papers on patients between the ages of 0 and 18 years. RESULTS: Out of 29 studies, evaluating a total of 2900 individuals (aged between 2.5 and 17 years), 7411 seals made by using resin-based sealants (RB Sealants), modified glass ionomer sealants (RMGI) and compomer sealants have been analyzed. The best retention capacity of the material in time has been obtained from the use of RB Sealants compared to RMGI, demonstrating retention values much lower with partial loss of material at a distance of one year from the clinic. The compomers demonstrate retention values intermediates. The incidence of caries in a year is negligible for all sealants application. CONCLUSIONS: In terms of retention, resin-based sealants (RB Sealants) are the materials that give more guarantees of success at 12 months, while in the same period there haven't been significant differences in caries prevention of disease among the various classes sealing materials analyzed.

Atypical deglutition: diagnosis and interceptive treatment. A clinical study.

AIM: The aim of this study was to evaluate the early treatment of atypical deglutition, by analysing the efficacy of the eruptive guide appliance Habit Corrector™. MATERIALS AND METHODS: The pre- and post-treatment (T1 and T2) cephalometric data of 2 groups of patients (G1 and G2), both consisting of 25 patients each and treated with Habit Corrector™, were compared. The first group included 10 males and 15 females, aged between 4 and 7 years old, with average age 6.17 years, and therefore undergoing the last phase of primary dentition and the first phase of mixed dentition. The second group included 12 males and 13 females, aged between 8 and 12 years old, with average age 9.19 years old, undergoing the second phase of mixed dentition. The overall duration of the treatment was 12 months. RESULTS: The results showed significant differences between the two groups, with respect to overbite, overjet, molar relation, inclination of the upper and lower incisors, position of the jaw. A significant variation between the two groups at T2 was registered for the maxillomandibular relationships: the increase in the growth and degree of mandibular protrusion was of 4.66° in G1 and 2.44° in G2. Significant changes were registered for the position or growth of the upper jaw; the upper facial height almost remained unaltered, with 53.34° for G1 and with 53.96° for G2. A significant variation occurred with the increase in the sagittal relationship between the molars, improved in G1 by 3.14 mm and in G2 by 2.61 mm. A significant decrease of overjet was registered in G1 by 1.94 mm and in G2 by 0.76 m and an increase of overbite in G1 by 3.14 mm and in G2 by 0.88 mm. The inclination of the maxillary and mandibular incisors improved, with an inter-incisive angle of 123° in G1 and 124.2° in G2. CONCLUSION: The clinical results obtained suggest that early intervention in atypical deglutition with Habit Corrector™ is able to produce significant results in primary dentition and in the first phase of mixed dentition, rather than in the late phase of mixed dentition.

Childhood obesity and skeletal-dental maturity.

AIM: The aim of this cross-sectional study was to evaluate the skeletal maturation assessed through cervical vertebral maturation (CVM) and dental age, in normal weight, pre-obese and obese patients, using the Body Mass Index (BMI) and the Dual energy X-ray Absorptiometry (DXA). MATERIALS AND METHODS: A group of 107 healthy patients, aged between 6 and 12 years (mean age 8.77∓1.79), underwent anthropometric measurements, BMI calculation, and DXA exam at the Department of Neuroscience, Human Nutrition Unit, University of Rome "Tor Vergata" and the assessment of skeletal and dental age at the Paediatric Dentistry Unit of PTV Hospital, University of Rome "Tor Vergata". The subjects were classified as underweight, normal weight, pre-obese and obese according to FM% McCarthy cut-offs classification and BMI classification. STATISTICS: The analyses were performed using the SPSS software (version 16; SPSS Inc., Chicago IL, USA). The assessment of differences through the means of continuous variables among the different groups were analysed using the One-Way-Anova test. The Student's t test was also applied for each group of children (using McCarthy and BMI classifications) between chronological and skeletal-dental age; the Fisher's exact test was performed between the gender categorical variable and McCarthy cut-offs classification, and between McCarthy and BMI classifications. Besides, to evaluate the association between skeletal and dental age, a Pearson correlation coefficient was calculated. In all the assessments a significant level of alpha = 0.05 was considered. RESULTS: The comparison between BMI and DXA data shows statistically significant differences between BMI- FM% (McCarthy cut-offs) classifications (p≤0.001). According to FM% (McCarthy cut-offs) classification, from the Anova analysis among the groups a statistically significant difference between skeletal age (p=0.03) and dental age (p=0.02) was observed, while the difference related to the chronological age (p=0.22) among the groups, was not significant. The correlation between dental and skeletal age is almost the highest (Pearson correlation coefficient=0.994) and statistically significant (p=0.01). According to FM% McCarthy classification, it is observed that with an increase in the FM% , that is passing from normal weight to obese children, the skeletal-dental age always increases with respect to the chronological age. The difference between chronological and skeletal-dental age is statistically significant for pre-obese (p=0.01) and obese (p<0.001) children, while it is not significant for underweight (p=0.46) and normal weight (p=0.33) children. According to the BMI classification, from the Anova analysis no statistically significant differences were observed among the groups as for chronological, dental and skeletal age. Applying the same inferential analyses and taking into account the BMI classification, in the obese subjects were observed not statistically significant differences as for chronological and skeletal-dental age (p=0.09). CONCLUSION: The results highlighted a relation between skeletal-dental age acceleration and body fat percentage measured by DXA.

MIH: epidemiologic clinic study in paediatric patient.

The Molar Incisor Hypomineralization (MIH) is a qualitative and quantitative defect of the enamel structure of the first permanent molars, which may vary from 1 to 4 with involvement of maxillary and jaw permanent incisors. AIM.: Aim of this study is that to evaluate, among 1500 paediatric patients chosen at random aged between 0 and 14 years, afferent by the Paediatric Dentistry of the Azienda Ospedialiera Policlinico Tor Vergata of Rome from 1996 to 2011, the incidents and the prevalence of the MIH distribution, and furthermore to ascertain the possible relationship with the data described in the literature. RESULTS AND DISCUSSION.: From the sample of 1500 paediatric patients, the number of those affections from MIH has turned out to be pairs to 110 (7.3%) aged between 4 and 15 years, and an average age equal to 9.7. The incidence of the hypoplastic defects is greater in the elements of the permanents series in which the functional class mainly interested is that of the first molars, with a percentage of 39.8%. Regarding the elements of the deciduous series affections from hypoplasia, they turn out to be in all in number of 20 represented in 80% of the cases from the seconds molars while in the remaining 20% of the cases the items involved are the central incisors. About the percentage of elements involved in the MIH: the molars, involved with a frequency of 56%, turn out to be more hit regarding incisors (44%). As reported in the literature, it can be asserted that the MIH can hit in equal measure both the male sex that feminine one. CONCLUSIONS.: MIH represents a condition quite frequent in the paediatric population. In managing this anomaly takes an essential role in the early diagnosis and in the differential one. The study done underlined the importance of a correct application of the therapeutic protocol which, starting from a careful diagnosis and articulating themselves in the execution of preventive treatments and in severe cases restorative and prosthetic, has the aim to certify the functionality and the aesthetic of the dental elements affected by MIH.

Plaque retention on elastomeric ligatures. An in vivo study.

UNLABELLED: Fixed orthodontic appliances make it difficult to maintain the oral hygiene, resulting in plaque accumulation. Retention of bacterial plaque, represents a risk for white spot lesions and development of periodontal disease. AIM: Purpose of this study was to determine in vivo the retention of plaque on three different elastic ligatures, in comparison with stainless steel ligature, to determine a possible association between type of ligatures and accumulation of microorganisms. MATERIAL AND METHODS: THREE ELASTIC LIGATION SYSTEMS WERE ANALYZED FOR PLAQUE RETENTION: ring-shape, clear, latex ligatures (Leone® Spa), ring-shape, grey, polyurethane ligatures (Micerium® Spa) and grey, polyurethane, Slide low-friction ligatures (Leone® Spa), compared with stainless steel ligatures (Leone® Spa) used as control. Forthy orthodontic patients undergoing fixed orthodontic therapy were selected. A sample for each type of ligature were applied inside the oral cavity of each subject. Samples were kept in the oral cavity for 28 days, ligating 0.16 X 0.22 stainless steel archwire to stainless steel orthodontic premolars brackets. The presence of bacterical slime was quantified by spectrophotometric method (crystal violet-Bouin's fixative) and morphological observations was evaluated by Scanning Electron Microscopy (SEM). RESULTS: From analysis of bacterical slime emerges that all the elastics showed a low plaque retention, especially if compared to the group of steinless steel ligatures, that presented a greater plaque adhesion, statistically significant compared to the Slide group (r<0.0002) and the two elastic groups (r<0.0001). This study reported no significant difference between the Slide ligatures and the traditional elastic ligatures as regards the retention of plaque. SEM images showed presence of cocci, rods and few filamentous organisms and an interbacterial matrix in all observed samples. CONCLUSION: Elastomeric ligatures showed a significant lower susceptibility to plaque adhesion, in comparison to the stainless steel of the metallic ligatures. No statistically significant difference was observed among the elastic devices.

The dental age in the child with coeliac disease.

AIM: The coeliac disease deprives affected individual of the main nutritive factors, which are essential to promote body development: coeliac children are often subject to weight loss and have a lower somatic growth rate compared to healthy children. In addition, it is proven that prolonged malnutrition can have irreversible effects on dental eruption: teeth development also suffers a delay or it is slowed down in coeliac children. The purpose of this study was to evaluate and quantify the persistence of a delay in the dental age in children with coeliac disease and the presence of a possible constant relationship between the estimated delay in skeletal development and that referred to the dental age. MATERIALS AND METHODS: Seventy children (24 males and 46 females) were selected, all affected by coeliac disease, aged between 5.3 and 13.8 years, with a mean age of 9 years +/- 22 months SD. Through teleradiography of the skull in latero-lateral projection and orthopantomography of the dental arches, the estimate of the skeletal development and dental age was carried out for each patient, applying two specific methods extensively described in the literature. RESULTS AND CONCLUSION: The results obtained, in agreement with the literature, show how the dental age, which is delayed in children affected by coeliac disease, may be considered as a reliable indicator of somatic growth and also of biological age. Furthermore, a gluten-free diet has considerable beneficial effects on skeletal development in relation to the dental age, in agreement with the hypothesis that dental development is controlled by different regulatory mechanisms, totally independent from those that influence skeletal development and the somatic and sexual development of the individual, even if the delay of dental development decreases progressively from the time of diagnosis of coeliac disease to introduction of a gluten-free diet.

Oral lesions in paediatric patients with graft-versus-host disease.

AIM: This work aims at assessing and describing the most frequent clinical manifestations of the Graft-versus- Host Disease (GvHD) in the oral and maxillofacial region in paediatric patients affected by neoplastic or non neoplastic haematologic disorders who undergo specific haematopoietic stem cell transplantation (HSCT) protocols, with a view to detecting the potential pathological modifications that are recognised as the cause of a possible altered harmonious development of the child. MATERIALS AND METHODS: Thirty-eight paediatric patients aged between 3 and 13 years, coming from the haematological department of Tor Vergata University (Roma, Italy) and affected by GvHD, assessed on the basis of their medical history and accurate clinical and instrumental exams, after having received haematopoietic stem cell transplantation for neoplastic or non neoplastic haematologic disorders, were enrolled in this study. The aim of this work was to assess oral conditions, detect possible oral pathological manifestations and evaluate their incidence both locally and in terms of clinical severity, as well as to mitigate associated symptoms. This was done to prevent and eliminate any oral interference in the systemic treatment protocol. DISCUSSION AND CONCLUSION: In line with the data presented in the literature, clinical GvHD manifestations seem to mainly involve the oral and maxillofacial region from an early phase also in paediatric patients. As a consequence, a timely diagnosis and a multidisciplinary treatment programme are essential for the early detection of the oral signs of potential systemic complications, to improve the quality of life of these young patients, as well as to prevent any potential alterations of dentoskeletal development and growth in the child.