The association between parent education level, oral health, and oral-related sleep disturbance. An observational crosssectional study.

AIM: To explore the relationship between parents' education levels, children obesity, children oral health and oral-related sleep disorders. BACKGROUND: Prevention of oral diseases in children is important for their long-term health. Parents play a crucial role in the health and wellness of their children. As such, it is important for parents to be well-informed about the importance of their children's oral health, as well as the steps they can take to ensure that their children receive the best possible care. METHODS: Observational cross-sectional study. At the time of enrollment data regarding parents' employment status and parents' education level were collected. We also collected BMI and anamnestic data regarding the presence or not of oral-related sleep disorders in the last 3 months: snoring, chronic mouth breathing, sleep bruxism. Oral health was also evaluated for each subject through the DMFT (decayed, missing and filled teeth) index. CONCLUSION: Parents' education levels influence several health outcomes, including oral health and the risk of obesity. In turn, obesity can represent a risk factor for oral-related sleep disturbances. Parents play a crucial role in the health and wellness of their children. As such, it is important for parents to be knowledgeable about the importance of their children's health, as well as the steps they can take to ensure that their children receive the best possible care.

Piezoelectric bone surgery for impacted lower third molar extraction compared with conventional rotary instruments: a systematic review, meta-analysis, and trial sequential analysis.

The aim of this study was to evaluate whether piezoelectric bone surgery (PBS) for impacted lower third molar extraction reduces the surgical time and risk of intra- and postoperative complications in comparison with conventional rotary instruments. This meta-analysis followed the PRISMA guidelines and was registered in the PROSPERO database. The PubMed, Embase, Scopus, and OpenGrey databases were screened for articles published from January 1, 1990 to December 31, 2018. Selection criteria included randomized controlled trials (RCTs) comparing PBS with conventional rotary instruments for impacted lower third molar extraction and reporting any of the clinical outcomes (intra- and postoperative complications and duration of surgery) for both groups. A risk of bias assessment was performed using the Cochrane Collaboration tool. A meta-analysis was performed, and the power of the meta-analytic findings was assessed by trial sequential analysis (TSA). Strong evidence suggests that PBS prolongs the duration of surgery and low evidence suggests that PBS reduces postoperative morbidity (pain and trismus) in comparison with rotary instruments. Data were insufficient to determine whether PBS reduces neurological complications and postoperative swelling in comparison with burs.

Accuracy of Periapical Radiography and CBCT in Endodontic Evaluation.

INTRODUCTION: A radiological evaluation is essential in endodontics, for diagnostic purposes, planning and execution of the treatment, and evaluation of the success of therapy. The periapical radiography is nowadays the main radiographic investigations used but presents some limits as 3D anatomic alteration, geometric compression, and possible anatomical structures overlapping that can obscure the area of interest. CBCT (cone beam computed tomography) in endodontics allows a detailed assessment of the teeth and surrounding alveolar anatomy for endodontic diagnosis, treatment planning, and follow-up. OBJECTIVE: The purpose of this study was to evaluate the accuracy of CBCT in comparison with conventional intraoral radiographs used in endodontic procedures. MATERIALS AND METHODS: Statistical analysis was performed on 101 patients with previous endodontic treatments with the relative radiographic documentation (preoperative, postoperative, and follow-up intraoral X-ray) that had underwent at CBCT screening for surgical reasons. The CBCT scans were evaluated independently by two operators and compared with the corresponding periapical images. RESULTS: Our analysis shows that the two radiological investigations statistically agree in 100% of cases in the group of patients without any endodontic sign. In the group of patients with an endodontic pathology, detected with CBCT, endodontic under extended treatments (30.6%), MB2 canals in nontreated maxillary molars (20.7%), second canals in nontreated mandibular incisors (9%), root fractures (2.7%), and root resorption (2.7%) were not always visible in intraoral X-ray. Otherwise, positivity in the intraoral X-ray was always confirmed in CBCT. A radiolucent area was detected in CBCT exam in 46%, while the intraoral X-ray exam was positive only in 18%. CONCLUSIONS: Our study shows that some important radiological signs acquired using CBCT are not always visible in periapical X-ray. Furthermore, CBCT is considered as a II level exam and could be used to solve diagnostic questions, essential to a proper management of the endodontic problems.

No Compliance Correction of Class II Malocclusion in Growing Patients Whit HERBST Appliance: A Case Report.

BACKGROUND: Class II malocclusion is the most common sagittal skeletal discrepancy, with a prevalent skeletal pattern of mandibular retrusion. The correction of mandibular retrusion with functional removable appliance needs a good patient's compliance; for this reason, some clinicians prefer to use no compliance apparatus. OBJECTIVE: Objective of the present therapy note is to demonstrate that the use of no compliance apparatus can provide a good correction of skeletal class II malocclusion. METHODS: In the present study, authors report a therapy note referred to a 10 years old patient, woman, affected by Class II, with mandibular retrusion and deep bite, treated in 2013 at the Dep. of Orthodontics of Messina University. An orthodontic treatment has been planned with the aim of stimulating mandibular growth; an Herbst appliance with a cantilever design, bonded on first maxillary and mandibular molars, has been used. After eleven months of functional therapy a bilateral molar class I have been obtained. RESULTS: In the therapy note proposed, authors obtained a resolution of mandibular retrusion, a correction of overjet, overbite and dental crowding in both arches, and a bilateral molar and canine class I has been achieved. CONCLUSION: Herbst appliance seems to be efficient in the correction of II Class Malocclusion, independently from patient's cooperation; moreover , early correction of Class II malocclusion with functional appliances produces several clinical advantages.

Steam Sterilization of Equine Bone Block: Morphological and Collagen Analysis.

INTRODUCTION: The use of equine bone blocks is widely reported for bone augmentation techniques. The block must be shaped according to the form of the defect that should be regenerated. The shaping could be performed by hand before or during the surgery, in a sterile ambient, or using a CNC milling machine that could not be sterile. The aim of our study was to evaluate if a steam sterilization could provide a medical grade sterilization of the blocks and to evaluate if bone microstructure and collagen structures change after different steam sterilization protocols provided by mainstream autoclave. MATERIALS AND METHOD: Two blocks of equine bone were divided into 16 samples. 1 sample was used as control and not submitted to any treatment. 15 samples were infected with a Streptococcus faecalis bacterial culture. The samples were singularly packed, randomly divided into 3 groups, and submitted to autoclave sterilization on the same device. The groups were submitted to a sterilization cycle (Gr. A: 121°C, 1,16 bar for 20'; Gr. B:134°C, 2,16 bar for 4'; Gr. C: 134°C, 2,16 bar for 3.30 min.). 2 samples for each group were evaluated for the sterility. 3 samples for each group were observed at SEM to notice the macro- and microstructure modification and to confocal microscope to observe the collagen. RESULTS: All samples were sterile. The SEM evaluation showed, in all groups, a preserved morphological structure. Confocal microscope evaluation shows that the collagen structure appears to be more uniform and preserved in group C. CONCLUSION: Data show that autoclave steam sterilization could be reliable to obtain sterilization of equine bone blocks.

Traumatic Pseudoaneurysm of the Internal Maxillary Artery: A Rare Life-Threatening Hemorrhage as a Complication of Maxillofacial Fractures.

Pseudoaneurysm of the internal maxillary artery due to a traumatic event is a rare condition. Pseudoaneurysms are usually directly produced by arteries break with extravasation of blood. The compressed perivascular tissue forms the wall of aneurysmal sac. Then, this sac gradually expands and can be damaged. It is rare to see pseudoaneurysms of IMA. They are usually associated with fracture of the neck of the mandible. To the best of our knowledge the pseudoaneurysm of the internal maxillary artery related to maxillofacial trauma is an event extremely rare in the literature and if not quickly managed can lead to the patient's death. This case underlines how the close cooperation between surgeons and radiologists results in a quick diagnosis and management of such pathological events.

FEM Analysis of Mandibular Prosthetic Overdenture Supported by Dental Implants: Evaluation of Different Retention Methods.

Prosthetic rehabilitation of total edentulous jaws patients is today a common technique that clinicians approach in their daily practice. The use of dental implants for replacing missing teeth is going to be a safe technique and the implant-prosthetic materials give the possibility of having long-term clinical success. Aim of this work is to evaluate the mechanical features of three different prosthetic retention systems. By applying engineering systems of investigations like FEM and von Mises analyses, how the dental implant material holds out against the masticatory strength during the chewing cycles has been investigated. Three common dental implant overdenture retention systems have been investigated. The ball attachment system, the locator system, and the common dental abutment have been processed by Ansys Workbench 15.0 and underwent FEM and von Mises investigations. The elastic features of the materials used in the study have been taken from recent literature data. Results revealed different response for both types of device, although locator system showed better results for all conditions of loading. The data of this virtual model show all the features of different prosthetic retention systems under the masticatory load. Clinicians should find the better prosthetic solution related to the patients clinical condition in order to obtain long-term results.

Protein-Signaled Guided Bone Regeneration Using Titanium Mesh and Rh-BMP2 in Oral Surgery: A Case Report Involving Left Mandibular Reconstruction after Tumor Resection.

Recombinant human bone morphogenetic protein-2 (rhBMP-2) is an osteoinductive protein approved for use in oral and maxillofacial defect reconstruction. Growth factors act as mediators of cellular growth on morphogenesis and mythogenesis phases. Utilized as recombinant proteins, these growth factors need the presence of local target cells capable of obtaining the required results. This cell population may be present at the wound site or added to scaffolding material before implantation at the surgical site.The aim of this study is to evaluate the clinical and radiographic results of a reported case with a large bone defect, treated with an absorbable collagen sponge, rhBMP-2 and a titanium plate and mesh. The Authors want to report a case which shows the resulting effectiveness of the rhBMP2 action regarding a large, mandibular defect reconstruction. This case also shows how the removal of a rare tumor such as a ghost cell tumor of the jaw may be treated without harvesting bone from another body site. A quick diagnosis of the lesions is important in order to perform the most suitable treatment. The Authors also underline the clinical and histological steps to insure the correct treatment is carried out to solve the case.Moreover, from results obtained from this case, it is possible to highlight several clinical benefits for the patient by adding rhBMP-2 to the common allograft to not only have alveolar reconstruction defects and sinus floor augmentation, but also to have alveolar cleft reconstruction and to treat segmental defects.

Flowable resin and marginal gap on tooth third medial cavity involving enamel and radicular cementum: a SEM evaluation of two restoration techniques.

PURPOSE: The aim of this study is to investigate the presence and the extent of a possible marginal gap after the interposition of a flowable composite between the composite restoration and the dental structures (enamel and cementum). This technique is also used to eliminate the infiltration in a zone of the cavity preparation that is frequently at a risk of secondary decay. MATERIALS AND METHODS: Fifteen human premolars extracted for orthodontic reasons were used for the study. A cavity with mesial and distal margin in enamel and cementum was realized in every tooth. The cavities were then restored with an adhesive system (ScotchBond 3MÔ) and composite (Filtek Supreme 3MÔ); and, a fine layer of flowable composite was applied in the distal margin of each cavity. Scanning electron microscopy (SEM) in secondary electron imaging (S.E.I.) modality was used for the study and identifying the marginal gaps in the composite restorations. Data was investigated on the mesial and distal margin of each cavity at the restoration-enamel interface, and at the restoration-cementum interface. The interfaces were divided in four groups: Group A (enamel/composite); Group B (enamel/flow/composite); Group C (cementum/composite); and, Group D (cementum/flow/composite). RESULTS: By the comparison of the gap's average width found in each group, it is evidenced that the average width of the gap increases when the interface moves from the coronal to the radicular end (Group A 0,1 ± 0,4 µm Vs Group C 12,3 ± 11,6 µm; Group B 0,2 ± 0,8 µm Vs Group D 2,8 ± 6,6 µm). Correlating the measurements of the marginal gap's average width among the Group A and Group B, no significant variations were obtained; and instead, on comparing Group C with Group D, the gap's average width decreases. CONCLUSION: The interposition of a low elastic modulus composite between the adhesive layer and the composite resin allows an improvement of the cementum-restoration interface by the means of a lower shrinkage stress during polymerization.

Miomas sintomáticos: ¿miomectomía o embolización de las arterias uterinas? / Symptomatic uterine leiomyoma: myomectomy or uterine artery embolization?

Objetivo: Evaluar las complicaciones asociadas a la miomectomía laparotómica y a la embolización de las arterias uterinas en mujeres con miomas sintomáticos. Métodos: Estudio descriptivo restrospectivo efectuado en el Complejo Hospitalario Universitario de Vigo desde el año 2008 al 2010. La población en estudio la conformaron aquellas mujeres sometidas a una miomectomía laparotómica o a una embolización de las arterias uterinas. Se recopilaron las complicaciones registradas en las historias clínicas de las pacientes tras las técnicas. Resultados: La tasa de complicaciones en el grupo de las pacientes sometidas a miomectomía fue de 15,2 por ciento; las más frecuentes fueron fiebre, anemia, necesidad de trasfusión y hematoma subcutáneo. La tasa de complicaciones en el grupo de embolización fue de 4,5 por ciento recogiéndose casos de síndrome postembolización, mioma parido y un caso de histerectomía. Conclusión: La adecuada indicación de cada técnica es fundamental para tener una baja tasa de complicaciones. Se debe tener en cuenta la sintomatología, tipo y número de miomas, edad y deseo genésico de cada paciente.

Objective: This study was undertaken to evaluate the complications after laparotomy myomectomy and uterine artery embolization in women with symptomatic uterine leiomyoma. Methods: This was a descriptive and retrospective study of patients who were treated with embolization and myomectomy for leiomyomas from 2008-2010. Complications were measured. Results: The rate of complications collected in the myo-mectomy group was 15.2 percent; there were cases of fever, anemia, need for transfusion and subcutaneous hematoma. The rate of complications collected in the embolization group was 4.5 percent; there were cases of embolization syndrome, transcervical fibroid expulsion and a case of hysterectomy. Conclusion: The suitable indication of every tecnic is fundamental to have a low rate of complications. It is necessary to bear in mind the symptomatology, type and number of myomas and age and reproductive desire of each patient.