Reliability of the Italian version of the International Spinal Cord Injury Pain Basic Data Set.

STUDY DESIGN: Multicentric prospective psychometric study. OBJECTIVE: To provide a translation of the International Spinal Cord Injury Pain Basic Data Set (ISCIPBDS) for Italian persons and to evaluate the interrater reliability of the translated version. SETTING: Ten Italian rehabilitation centres specialized in spinal injury care. METHODS: The initial translation was performed by two medical doctors who had an in-depth knowledge of spinal cord injury (SCI), and then a back translation (from Italian to English) was given to an accredited agency. Sixty-six participants with SCI (53 men, 13 women; mean ± SD age: 53.4 ± 16.0 years) were evaluated by means of the Italian version of the ISCIPBDS by two different examiners. Intraclass correlation coefficient (ICC) or Cohen's Kappa (ĸ) was calculated to test the interrater agreement for the test-retest cases. RESULTS: All 66 participants had at least one pain problem and 34% of them had only one type of pain. A good interrater agreement was obtained in terms of number of pain (ICC = 0.781), type of pain (ĸ = 0.683), pain intensity (ICC = 0.798), correspondence of pain localization (ĸ = 0.750), and the value of the pain interference in day-to-day activities, overall mood and night's sleep (ICC = 0.827, ICC = 0.861 and ICC = 0.724, respectively). Eventually a prominent prevalence of neuropathic pain was recorded (64% from the first examiner and 62% from the second one). CONCLUSIONS: The authors propose the Italian version of ISCIPBDS that can be used for research and clinical evaluation of pain in SCI persons; it shows a significant interrater reliability.

Evaluation of three different manual techniques of sharpening curettes through a scanning electron microscope: a randomized controlled experimental study.

OBJECTIVE: The purpose of this study was to compare the effectiveness of three different techniques for manually sharpening of periodontal curettes (PCs) by examining the blades with the aid of scanning electron microscope (SEM). METHODS: Three groups were considered based on three sharpening methods used: group A (moving a PC over a stationary stone); group B (moving a stone over a stationary PC) and group C (moving a PC over a stone fixed, placed on a 'sharpening horse'). After the sharpening, the blades were examined using SEM. The SEM images were assessed independently by five different independent observers. An evaluation board was used to assign a value to each image. A preliminary pilot study was conducted to establish the number of samples. Pearson's correlation test was used to assess the correlations between measurements. anova test with Bonferroni's post hoc test was used to compare the three groups. RESULTS: Sixty PCs (20 PCs per group) were used in this study. Statistically significant differences emerged between the three groups (P-value = 0.001). Bonferroni's test showed that the difference between groups A and B was not statistically significant (P-value = 0.80), while it was significant for the comparisons between groups A and C (P-value = 0.005) and between groups B and C (P-value = 0.001). CONCLUSIONS: The sharpening technique used in group C, which involved the use of the sharpening horse, proved the most effective.

Experimental assessment of oral hygiene achieved by children wearing rapid palatal expanders, comparing manual and electric toothbrushes.

OBJECTIVES: The aim was to compare the efficacy of the electric versus the manual toothbrush in terms of the oral hygiene achieved by patients wearing rapid palatal expanders (RPEs). METHODS: Forty patients were randomly divided into two groups; one equipped with a manual toothbrush (Group A), the other with an electric toothbrush (Group B). Each child's plaque index (PI) and gingival index (GI) were calculated at banded molar level at times T0 (before banding), T1 (a month later), T2 (3 months later) and T3 (when the expander was removed). At each appointment, the PI and GI were recorded and the patient was remotivated. RESULTS: The level of oral hygiene achieved by the group using an electric toothbrush produced a greater improvement in the two indexes than in the group using the manual toothbrush that showed no statistically significant improvement (PI T0-T3: P = 0.309; GI T0-T3: P = 0.141). Both indexes dropped considerably in both groups from T0 to T2, but more so in the group B. From T2 to T3, although the electric toothbrush continued to be substantially more effective, Group B showed a statistically significant deterioration in the oral hygiene (PI +20%; GI +33%). Other assessments conducted on particular areas of the tooth showed improvements in the PI (-33%) for the vestibular region, and for the GI (-57%) in the palatal region among the patients in Group B, while there were no significant changes in these indexes in Group A. CONCLUSIONS: Our findings show that the electric toothbrush is statistically more efficient in performing an adequate level of oral hygiene in children wearing RPE.

Paedodontic preformed crowns in primary teeth and relative degree of dental wear.

AIM: Prosthetic rehabilitation of deciduous teeth in paediatric age using pre-formed crowns has been considered one of the best methods of dental restoration since their introduction. Their main advantages are related to durability, longevity and a low rate of recurrent cavities. Since stainless steel crowns do not coincide with aesthetic needs of parents and patients, preformed paedodontic crowns made of zirconia and nano-hybrid composite was introduced. The aim of the study is to evaluate the degree of wear on the enamel and on themselves of the different paedodontic crowns. MATERIALS: Nine bovine teeth and nine paedodontic crowns for deciduous molars were selected for the study, three of which in zirconia, three in nano-hybrid composite and three in stainless steel. Wear test was carried out on the Rtech™ Instruments tribometer applying a force of 50 N. After that, both the bovine teeth and the paedodontic crowns were observed using a stereo microscope (Zeiss Stemi C-500) and a scanning electron microscope (SEM, Cambridge Stereoscan 440). The areas of wear were calculated with a software [ImageJ, version 1x, Wayne Rasband, Maryland, USA]. CONCLUSION: Pre-formed paediatric crowns in zirconia, nano-hybrid composite and stainless steel are a valid aid for the restoration of deciduous teeth and do not compromise the physiological wear characteristic of the phases of the dental exchange. The stainless steel crown is preferable for the restorations in the posterior sectors as its behaviour is the most similar to that of a natural tooth. Zirconia and nano-hybrid composite crowns showed an inversely proportional behaviour between their wear volume and that of the opposing tooth.

In vitro comparison of the bond strength to the enamel of conventional and self-etching dental fissure sealants.

AIM: Dental caries in pits and fissures of molars is still very common in young people, despite a gradual reduction in their incidence and prevalence. Prevention with the aid of dental fissure sealants can help to reduce the onset of decay. In vitro tests were conducted to compare the bond strength to enamel of self-etching sealants versus those applied using the conventional procedure. METHODS: The lingual surface of 40 extracted, caries-free, mandibular third molars was milled to make them flat. The prepared teeth were randomly divided into two groups of 20 teeth each: those in Group A were treated with Clinpro (3M ESPE, St. Paul, MN, USA); those in Group B with Quick Seal (BJM Laboratories Ltd, Or-Yehuda, Israel). Cylinders of sealant were attached to the enamel of the flat surfaces of the samples using a polymerisation process treating the surfaces involved according to the type of material. All samples underwent load testing by means of a universal test machine. RESULTS: The results of the load testing, measured in MPa, were analysed using the Student's t-test for independent samples and the differences proved significant, indicating that the traditionally- applied sealant (mean strength 21.06 MPa) assured a significantly stronger bond (p <.05) than the self-etching sealant (mean strength 10.43 MPa) under our experimental conditions. CONCLUSION Conventional sealants generally provide a considerably higher bond strength than self-etching sealants.

Conscious sedation with diazepam and midazolam for dental patient: priority to diazepam.

AIM: The aim of this paper was to determine whether the use of midazolam is a better technique than the use of diazepam, in relation with the definition of conscious sedation in dentistry. METHODS: Eighty-eight patients undergoing oral surgery were divided into 2 groups in which the sedation was randomly achieved with equipotent cumulative doses of diazepam and midazolam, up to a maximum dose of 8 and 4 mg respectively. Patient's tranquillity was assessed after every dose, using a visual analogue score to ten points and the sedation was evaluated as mild, moderate or deep. Blood pressure, heart rate and SpO2 were also recorded. Psychomotor conditions, by Newman test, and the incidence of amnesia and the patient's satisfaction, by telephone interview, were both evaluated. RESULTS: The number of patients who reached maximum subjective tranquillity was greater already after the third dose of diazepam. The average scores of tranquillity were higher after diazepam. Patients treated with diazepam experienced a higher incidence of mild sedation, patients treated with midazolam a higher incidence of moderate and deep sedation. In patients treated with midazolam blood pressure, heart rate and SpO2 were lower. Postoperative recovery was similar in the 2 groups. After midazolam patients experienced greater amnesia for local anesthesia and drowsiness. Satisfaction was high with both treatments. CONCLUSION: The study shows that sedation with diazepam is more in line with the definition of conscious sedation in dentistry. Diazepam guarantees the persistence of consciousness and maximum subjective tranquillity levels. The recovery and satisfaction were comparable in the 2 groups.

Sugary and salty former food products in pig diets affect energy and nutrient digestibility, feeding behaviour but not the growth performance and carcass composition.

Former foodstuff products (FFPs) are promising alternative ingredients for reducing the waste of natural resources and the environmental impact of food production. This study investigates the effects of salty and sugary FFPs on growth performance, apparent total tract digestibility (ATTD), and growing-finishing pigs' empty body and carcass composition. Thirty-six Swiss Large White male castrated pigs were assigned to three growing (G) and finishing (F) diets: (1) standard diet (ST), 0% FFPs; (2) 30% conventional ingredients replaced by sugary FFPs (SU); and (3) 30% conventional ingredients replaced by salty FFPs (SA). Faecal samples from 24 selected pigs were collected to assess the ATTD of gross energy, crude fibres, and CP. The BW was measured weekly, while feed intake was determined daily. Average daily gain (ADG), average daily feed intake (ADFI), feed conversion ratio (FCR), and ATTD were calculated for both the growing and finishing periods. Pigs' body composition was determined at ≥20 and ≥98 kg using dual-energy X-ray absorptiometry. In the growing but not finishing period, the FCR was lower (P < 0.05) in ST compared to SA and SU pigs. Considering the entire growing and finishing period, neither the inclusion level nor the type of FFPs influenced (P > 0.05) ADG, ADFI, FCR, or BW at slaughter. In both the growing and finishing periods, the gross energy ATTD was higher (P < 0.05) in the SA than in the ST group, with intermediate values in the SU group. In the growing period, the CP ATTD was higher (P < 0.05) in the SA than in the SU and ST groups. In the finishing period, the crude fibre ATTD was lower (P < 0.05) in the SA and SU than in the ST group. Throughout the overall period, the average daily fat intake was higher (P < 0.05) in pigs fed an SU diet, even though both categories of FFPs had no (P > 0.05) effects on the parameters related to the pigs' body composition (e.g., average daily fat weight gain). Finally, the carcasses of the SU group had the thickest belly fat, even though the total fat content was similar among the groups. This study confirms that including FFPs has no detrimental effects on growth performance or live body/carcass composition in growing and finishing pigs.

A Decision Support System to Provide an Ongoing Prediction of Robot-Assisted Rehabilitation Outcome in Stroke Survivors.

Clinicians often deal with complex robotic platform and serious games in stroke patients rehabilitation contexts, and they face two main problems: 1) the interpretation of either the performance in game or measures of a robotic system from the motor recovery point of view, and 2) the duration and complexity of clinical scales administration that makes repetitive assessments during the therapy unpractical. In this paper, a Random Tree Forest based system was trained and tested to provide a prediction of different clinical outcomes (i.e. FMA, ARAT, and MI) along the whole therapy duration, having non-clinical measures only as inputs, acting as a simulated decision support system. The dataset includes 30 post-stroke patients, that underwent a 30-session robot-assisted rehabilitation treatment. Results have shown that the system is able to produce very accurate and reliable predictions about the motor recovery of the patient at the end of the therapy, already in the first phases of the rehabilitation (i40% of therapy execution), just using robotic platform measures. Such a tool would provide a great benefit in terms of rehabilitation objectives planning, as a decision support tool for highly personalized rehabilitation treatments.

Review: Pig-based bioconversion: the use of former food products to keep nutrients in the food chain.

The primary challenge of agriculture and livestock production is to face the growing competition between food, feed, fibre, and fuel, converting them from resource-intensive to resource-efficient. A circular economy approach, using agricultural by-products/co-products, in the livestock production system would allow to reduce, reuse, and redistribute the resources. Former food products (FFPs), also named ex-foods, could represent a valid option in strengthening resilience in animal nutrition. FFPs have a promising potential to be included regularly in animal diets due to their nutritive value, although their potential in animal nutrition remains understudied. A thorough investigation of the compositional and dietary features, thus, is essential to provide new and fundamental insights to effectively reuse FFPs as upgraded products for swine nutrition. Safety aspects, such as the microbial load or the presence of packaging remnants, should be considered with caution. Here, with a holistic approach, we review several aspects of FFPs and their use as feed ingredients: the nutritional and functional evaluation, the impact of the inclusion of FFPs in pigs' diet on growth performance and welfare, and further aspects related to safety and sustainability of FFPs.

Maternal mental health and children oral health: a literature review.

AIM: Recently, serious considerations regarding mental health conditions and their impact on the whole organism have been made. This area is still quite unknown within the dental community, despite the potential impact these conditions can have on both oral care and health. Previous studies have concluded that both pregnant women and mothers have been found to be particularly sensitive to the risk of developing mental disorders such as anxiety and major depression. There is a very high possibility for the children of these mothers to experience neglect and disregard due to of the development of these conditions, which will negatively affect their behavioural and physical growth as a result. This impact stretches into oral health as well, as these children have been reported to be more inclined to develop early childhood caries, bruxism, and after-birth enamel defects, in addition to illnesses like diabetes and disabilities. MATERIALS: A literature search was conducted in Pubmed, Medline, and Scopus for the keywords 'maternal depression', 'oral health' and 'children', combined with 'AND' or 'OR' Boolean Operators. CONCLUSION: The results of the present literature suggest a strong connection between maternal mental disorders and poor children's oral care, and as a result, dental professionals should be extremely careful when treating and communicating with these patients.

Age limit for infiltration anaesthesia for the conservative treatment of mandibular first molars. A clinical study on a paediatric population.

AIM: The aims of this study were to assess the age limit for infiltration anaesthesia as an effective technique in treating carious lesions of first permanent molars in the paediatric age and if differences exist between males and females. MATERIALS AND METHODS: A total of 51 teeth from 48 different patients aged between 6 and 14 years were included in the study. The anaesthetic solution used was 1.8 ml of 2% mepivacaine with 1:100000 epinephrine. The effectiveness of anaesthesia was assessed by electrical pulp test after 3, 5, 7 and 10 minutes. RESULTS: In 56.9% of the treated cases a single mandibular infiltration was sufficient to induce complete pulpal anaesthesia of the tooth to be treated. Under 10 years of age, the infiltration technique was effective in 85.2% of cases. The success rate of anaesthesia also decreased significantly and not linearly in function of age. The success of infiltration anaesthesia was not related to gender. CONCLUSION: Mandibular infiltration anaesthesia is a successful technique for most patients under 10 years (success rate: 85.2%) especially for the younger ones, with no differences between males and females. After this age that success rate dramatically drops.

Experimental evaluation of two methodologies for the restoration of crown fracture in permanent anterior teeth.

AIM: The purpose of this study is to compare, by means of mechanical tests, the resistance of two types of dental restoration in the uncomplicated crown fracture of human permanent maxillary central incisor: rebonding of the fractured tooth fragment and application of ceramic veneers. MATERIALS AND METHODS: Thirty human maxillary central incisors were divided into three groups of ten teeth each. The teeth of the first group (Group A) were kept intact and used as controls, while the remaining teeth were sectioned, in order to simulate a crown fracture, and restored respectively with either the rebonding of the fragment (Group B) or with the use of ceramic veneers (Group C). All samples underwent mechanical tests by means of a universal test machine. RESULTS: The mean resistance to fracture recorded is respectively 425.2N for Group A, 233.3N for Group B, and 347.3N for Group C. One-way ANOVA analysis demonstrates statistical significance for at least one couple of values (Group B compared to Group A). The group of restorations with rebonding of fractured fragments has a mean value of resistance to fracture that is lower than both intact teeth and teeth restored with ceramic veneers. The resistance of teeth with rebonded restorations is 54.9% of that of, intact teeth, and resistance increases for teeth restored with ceramic veneers (81.8% of that of intact teeth). CONCLUSION: Ceramic veneers showed a higher resistance than rebonding and resulted to be more reliable in case of further trauma.

Sugary vs salty food industry leftovers in postweaning piglets: effects on gut microbiota and intestinal volatile fatty acid production.

Awareness of the need to improve the sustainability of livestock by reducing the loss of natural resources has increased significantly. This study investigated the effects of two categories of food industry leftovers, also referred to as former foodstuff products (FFPs), on pig gut microbiota and intestinal volatile fatty acid (VFA) production. Thirty-six female postweaning piglets (28 days old, Large White × Landrace, 6.5 ±â€¯1.1 kg) were separated into three groups and fed a conventional diet (CTR), and diets in which cereals were partially replaced (30% w/w) by sugary confectionery products (FFPs-C) or salty bakery products (FFPs-B), respectively. After 42 days of dietary treatments, faeces were collected from the rectal ampulla, snap-frozen, and used for next-generation sequencing to analyse the composition and the alpha and beta diversity indexes of the microbial population. The concentration of VFAs in the intestinal content collected at the slaughterhouse was also analysed. The study demonstrated that balanced diets can be obtained by the inclusion of both FFPs-C and FFPs-B, with a similar chemical composition compared to traditional diets. Neither the FFPs-C nor FFPs-B diets affected the abundance and biodiversity indexes of the microbial community. Only a few taxa, normally attributed to a healthy gut, increased with FFPs-C and FFPs-B compared to the CTR. The experimental diets had no impact on the production of the VFAs in the faeces. Lastly, the inclusion at 30% (w/w) of both categories of FFP diets slightly affected the faecal microbiota. FFPs could thus be used as a promising alternative to traditional ingredients in pig diets; however, additional analyses are needed to further investigate the presence of potentially pathogenic bacteria. The effects of such ingredients on other markers of gut health, and on product quality when used in the fattening period also need to be investigated.

A Random Tree Forest decision support system to personalize upper extremity robot-assisted rehabilitation in stroke: a pilot study.

Robotic-based rehabilitation administered by means of serious games certainly represents the frontier of rehabilitation treatments, offering a high degree of customization of therapy, to meet individual patients' needs and to tailor a proper rehabilitation therapy. Despite the rush on developing complex rehabilitation systems, they often do not provide clinicians with long-term information about the outcome of rehabilitation, thus, not supporting them in the initial set-up phase of the therapy. In this paper, a Random-Forest based system was trained and tested to provide a prediction at discharge of several clinical scales outcomes (i.e. FMA, ARAT, and MI), having clinical scale scores and measures from the robotic system at the enrollment as inputs. The dataset includes 25 post-stroke patients from different clinics, that underwent a variable number of days of rehabilitation with a robotic treatment. Results have shown that the system is able to predict the final outcome with an accuracy ranging from 60% to 73% on the selected scales. Also results provide information on which variables are more relevant for the prediction of outcome of therapy, in particular clinical scales scores such as FMA, ARAT, MI, NRS, PCS, and MCS and robotic automatically extracted measurements related to patient's work expenditure and time. This supports the idea of using such a system in a clinical environment in a decision support tool for clinicians.

Preventive oral hygiene and ventilator-associated pneumonia in paediatric intensive care unit.

AIM: Data indicate a tendency towards an increased incidence through the last decades of various forms of pneumonia. Among these, nosocomial pneumonia in patients who have been on mechanical ventilation support (increased after the Covid-19 pandemic) is a condition that must be addressed as soon as possible to avoid complications. Current literature lacks an in-depth analysis of the potential correlation between ventilator-associated pneumonia and poor oral hygiene, especially in children. The aim of this literature review is to investigate if improving oral hygiene could affect the onset of nosocomial pneumonia in children. METHODS: A search was performed in Pubmed, Medline, and Scopus for the keywords: oral care, children, neonates, ventilator-associated pneumonia, combined with 'AND' or 'OR' Boolean Operators. CONCLUSION: The relevant papers retrieved in the scientific literature emphasised the importante of good oral care bundles to mitigate the bacteria proliferation in the bloodstream, and to prevent the development of ventilator-associated pneumonia.

Pain perception in paediatric patients: evaluation of computerised anaesthesia delivery system vs conventional infiltration anaesthesia in paediatric patients.

Aim: The aim of the present study is to compare the effectiveness of a computerised system (QuickSleeper) compared to traditional syringe in injection of local anaesthetic focusing on the perception of anxiety and pain in paediatric patients. Methods: Study design: 100 children aged between 3 and 15 years in need of two dental treatments that required local anaesthesia were selected and treated randomly but alternately with computerised and traditional local anaesthesia. After each anaesthetic injection, patient's anxiety was measured using the Venham test. Results: Electronic anaesthesia showed statistically significant better results than traditional anaesthesia according to the Venham pain scale, in both mandibular and maxillary sites. Statistics: Data were analysed using the paired Wilcoxon test. Conclusion: The computer-assisted anaesthesia system resulted in a significantly lower pain perception score and yielded to helpful, cooperative behaviour. For this reason, it is an advantageous alternative to traditional injection anaesthesia and can avoid invasive treatments and trauma for young patients.

Social differences in tooth decay occurrence in a sample of children aged 3 to 5 in north-east Italy.

OBJECTIVE: To correlate the occurrence of tooth decay with a social class indicator (occupational level) and the immigrant status in a sample of pre-school children in Veneto region. BASIC RESEARCH DESIGN: Cross-sectional survey. CLINICAL SETTING: Twenty nursery schools in the area of Health District n.15. PARTICIPANTS: A total of 1,410 children aged 3 to 5 years old visited between September 2005-May 2006. OUTCOMES: Occurrence of dental caries into dentine threshold was made visually and confirmed with a probe when necessary by two calibrated examiners. Information on immigrant status and occupational level of parents was obtained by a questionnaire. Children were categorized as immigrant or non-immigrant on the basis of their mother's country of origin. Means and standard deviation were calculated for continuous variables; for categorical variables the results were provided as proportions. Comparisons between groups were made using Pearson chi-square test. The association between caries occurrence and the independent variables gender, age, immigrant status and family social class was evaluated by means of a logistic regression model. RESULTS: Caries occurrence was higher among children from lower social class families (1.7 +/- 3.2) than among children from higher social class (0.8 +/- 2.1). The prevalence of dental caries in immigrant preschool children was significantly higher than in indigenous ones (15% vs 40%; p = 0.000) while the severity in immigrants was almost 4 times higher (2.2 +/- 3.6 vs 0.6 +/- 1.8). CONCLUSIONS: Our data on preschoolers confirm the worldwide literature shared statement that social class as well as immigration status are determinants of oral health.

Tooth fragment reattachment through the use of a nanofilled composite resin.

AIM: The purpose of this study is to evaluate resistance to fracture with static tests of dental fragments reattached through the use of different light-curing composite resins. For this purpose 40 bovine inferior incisors were utilised, which were randomised into 4 groups; one control group and 3 experimental groups. MATERIALS AND METHODS: All teeth of the 3 experimental groups were sawed at 3 mm from the incisal margin, and the respective fragments were then reattached utilizing different composite resins: in group 2_EI the hybrid composite Tetric EvoCeram (Ivoclar Vivadent AG) was used, in group 3_ZI the hybrid composite FiltekTM Z250 (3M ESPE) was used, and in group 4_SN the nanofilled composite FiltekTM Supreme (3M ESPE) was used. After reattachment, on each tooth were performed a chamfer on the buccal surface and an overcontour on the lingual surface along the fracture line, which were then filled with the composite resin corresponding to the respective group. Finally, all teeth were embedded in plaster blocks, and a force was applied on the buccal surface. RESULTS: All teeth in groups 2, 3, and 4 showed a significant loss of resistance to fracture compared to the teeth of the control group (P<0.0001). Resistance to fracture of the teeth belonging to groups 2_EI and 3_ZI was 37.35% and 47.35% of that of intact teeth respectively; in group 4_SN resistance to fracture reached 60.05%. Teeth of group 2 exhibited values of resistance to fracture statistically significant from those of group 4 (P=0.024), but no difference was found between group 2 and group 3 (P=0.298). The difference in resistance between group 3 and group 4 was not statistically significant (P=0.199). CONCLUSION: Static test showed that reattachment of coronal fragments do not restore resistance to fracture to the value of intact teeth. Resistance to fracture in in vitro studies is influenced by the type of composite resin utilised.

Patients appreciation for information on anesthesia and anxiolysis in dentistry.

AIM: The research regards information on anesthesia to patients undergoing oral surgery. Every patient evaluated the information received at the end of the preoperative visit and in the postoperative period. METHODS: One hundred-fifty dental patients were asked about the most appreciated information received in the preoperative visit on the anxiolytic technique, local anesthesia and treatment of the perioperative pain. Afterwards the patients had to report on their reaction to the content of the preoperative visit and information quality. On a phone interview they had to evaluate their appreciation of the anxiolytic technique, their perception during loco-regional anesthesia and incidence of pain and edema. RESULTS: The most appreciated details were those on the intervention, pharmacologic treatment, postoperative complicances, postoperative pain and operative competence; less appreciated were those on loco-regional anesthesia, duration of the intervention, anxiolytic techniques, hospital reception and permanence in the hospital. Ninety-eight percent of the patients considered to have been adequately informed on a context judged to be extraordinary (99.3%), 96.6% indicated the information as necessary, 98.6% appreciated the treatment of the intraoperative and postoperative (99.3%) pain and 99.3% the anxiolytic treatment. On the telephone interview, 100% of patients expressed satisfaction for the experienced intraoperative tranquillity, 91.3% complained for not having received in the past a similar preoperative visit, 99.3% wished a diffused application of the information. The loco-regional anesthesia was associated to psychological detachment in 84% of the cases and the incidence of postoperative pain was of 36%. CONCLUSION: The information on the anxiolytic techniques, loco-regional anesthesia, treatment of perioperative pain and postoperative distress was enthusiastically accepted and albeit initially induced feelings of astonishment resulted to be appreciated and preferred in the whole of the patients.

Solitary neurofibroma of the palate. A case report.

The neurofibroma is a benign tumor of neuronal origin not frequently located in the oral cavity. The possible association of this neoplasia with systemic pathologies, such as Von Recklinghausen's disease and multiple endocrine neoplasia, makes its diagnosis fundamental. The diagnosis is, in most cases, quite complex, because of the neurofibroma's strong similarities with a great number of benign neoformations of the connective tissue, of the epithelium, and of the bone. The histology represents, therefore, the fundamental diagnostic criterion, in particular, through the use of appropriate immunohistochemical analysis. This articles presents the case of a solitary neurofibroma, subtype I (common Schwann cell type), detected on the left-hand side of the posterior region of the palate in a 56-year-old woman, which presented itself as an otherwise non-symptomatic ulcerated mass. After a careful anamnesis, an incisional biopsy was performed in order to establish the histological nature of the neoformation. The immunohistochemical test, which resulted positive for S-100 and negative for the epithelial membrane antigen and keratin, allowed the diagnosis of a presumably benign lesion deriving from a neural differentiation. The surgical excision of the entire mass was accompanied by the extraction of the upper left-hand second molar, which was attached to the mass through its palatal root.