Perceived Orthodontic Needs and Attitudes towards Early Evaluation and Interventions: A Survey-Based Study among Parents of Italian School-Aged Children.

(1) Background: Parents' awareness of malocclusion and their attitude towards early evaluation and interventions influence children's orthodontic management. This cross-sectional study investigates factors that affect the perceived orthodontic needs and the attitude towards interceptive orthodontics among a sample of one-thousand eight-hundred and six (1806) parents of children aged between 6 and 11 years. (2) Methods: The investigation was carried out thought a 18-items online questionnaire divided as follows: characteristics of respondents; perceived child's orthodontic needs; attitude toward early orthodontic evaluation and interventions. The associations between responses were assessed with a Chi-square test. (3) Results: Two-thirds of the respondents referred to having consulted an orthodontist for their child, and more than half of them initiated the required orthodontic treatment. In 44% of cases, the orthodontic consultation occurred after the age of 7 years. Parents' higher education and history of orthodontic treatment were associated with a greater awareness of orthodontic needs. Parents' perception of the impact of teeth on their child's personality was significantly associated with the decision to start the orthodontic treatment (p < 0.001). (4) Conclusions: Although the parents' level of awareness of their child's orthodontic needs was generally satisfactory, the results of the present study pointed out the need for a better education regarding the importance of an early orthodontic assessment.

Preformed Elastodontic Appliances: Awareness and Attitude of Orthodontists and General Dental Practitioners.

BACKGROUND: Preformed elastodontic appliances (EAs) have been described as safe, cost-effective, and easy-to-use devices for interceptive orthodontic treatment in growing patients. This study aimed to assess the knowledge and the attitude of dentists toward the use of EAs and to compare the behaviors of orthodontists (Os) with those of general dental practitioners (GDPs). METHODS: An anonymous survey was distributed among dentists through social media. Twenty-two items were divided as follows: characteristics of respondents; general knowledge about EAs; section for EA-users; and section for EA non-users. Chi-squared tests were used to analyze differences in responses between groups. RESULTS: Participants included 226 Os and 168 GDPs. The majority in both groups reported having adequate knowledge about EAs and utilizing them in their practice. GDPs usually use EAs to treat children during the early phase of growth, while Os also use EAs to address orthodontic problems in different stages of dentition, experiencing a chair time reduction compared with traditional appliances. Regarding EA non-users, GDPs seem not to find an application among their patients, whereas Os reported not having enough patient compliance during treatment. CONCLUSIONS: Although treatment with EAs is common among all dentists, differences exist between Os and GDPs in the awareness and application, as well as in the reasons provided for not using EAs.

Attitude of Italian dental practitioners toward bruxism assessment and management: A survey-based study.

INTRODUCTION: Bruxism is a spectrum of masticatory muscles activities. According to the recent evidence and international consensus, there is no indication to treat bruxism unless clinical consequences are present. The aim of the present study was to investigate the approach of Italian dentists to bruxism in their clinical practice. METHODS: An anonymous online survey was developed, composed by 26 items grouped into five sections: (1) Characteristics of the respondent (Q1-Q6); (2) Bruxism frequencies (Q7-Q11); (3) Bruxism assessment (Q12-Q15); (4) Bruxism management (Q16-Q20); (5) Occlusal splints therapy (Q21-Q26). RESULTS: A total of 384 practitioners, including specialists and non-specialists, participated in this survey. The majority of the respondents reported that 1-3 out of ten patients presented with bruxism. The diagnosis is mainly performed with non-instrumental methods, and facial pain and dental wear are the major clinical consequence associated with bruxism. Almost the entire sample of respondents report to offer occlusal splints to bruxism patients, and 41% refer to perform occlusal adjustments. Almost half of the respondents have never proposed any form of cognitive-behavioural therapy. CONCLUSION: The results of the current survey highlighted several inconsistencies in Italian dentists' approaches to bruxism, suggesting the need for better education of practitioners and for the development of a standardized protocol to assess and manage bruxism in dental practices.

Lower Incisor-Pg: A New Cephalometric Parameter to Evaluate the Anterior Limit of Dentition.

Background: This present retrospective study aimed to introduce Lower Incisor-Pg and to assess how this new parameter varies with the skeletal sagittal and vertical relationships. Methods: A total of 1256 cephalometric analyses were performed using lateral cephalometric radiographs of a sample of subjects divided according to SN^Go-Gn, ANPg^, and IMPA measurements. The differences in Lower Incisor-Pg between the groups were assessed through ANOVA tests and posthoc analyses, while Pearson's correlation analysis was used to assess the correlations between the measurements. Results: The mesofacial growth pattern (61.0%) was more common than dolichofacial (30.0%) and brachyfacial (8.6%) ones in the sampled population. Regarding skeletal sagittal relationships, Class I was more frequent (70.9%) than Class II (19.3%) and Class III (9.8%). The mean value of the Lower Incisor-Pg was 3.2 ± 4.0 mm. Linear regression showed that the ß coefficient was 0.45 and 0.36 for ANPg^ and SnGoGn^, respectively. Conclusions: Lower Incisor-Pg is a linear cephalometric measurement to evaluate the lower incisor sagittal position. For each degree of increase in ANPg^ and SNGoGn^, the Lower Incisor-Pg increased 0.45 mm and 0.36 mm, respectively.

Maxillary Impacted Canine and Upper Lateral Incisor Agenesis Treatment with "Canine First Technique" and Clear Aligners: A Case Report.

The aim of this study was to show a case of an impacted canine in an adult patient with agenesis of the maxillary lateral incisor treated with clear aligners (CA). A 19-year-old male with a persistence of 5.3 and absence of 1.2 came to our department of the School of Orthodontics at the University of Federico II in Naples and asked for an aesthetic treatment. The Canine First approach was used to surgically expose the canine and pull it into the dental arch. In order to ensure long-term aesthetic, periodontal, and occlusal results, a treatment with CAs to close the space through the mesial placement of the canine and the enameloplasty of the tooth crown was performed. At the end of the treatment, the occlusal objectives were achieved.

Multiple-Drugs-Related Osteonecrosis of the Jaw in a Patient Affected by Multiple Myeloma: A Case Report.

A 60-year-old woman suffering from multiple myeloma (MM) was treated with zoledronic acid (bisphosphonate), dexamethasone (corticosteroid), bortezomib (a chemotherapeutic agent), and lenalidomide (thalidomide analog) for about a year and with lenalidomide alone as maintenance therapy for almost two years and developed stage three medication-related osteonecrosis of the jaws (MRONJ) in the upper left dental arch approximately two weeks after tooth extraction, which was treated with a medical nonoperative conservative approach until reversion to stage one. The present case report describing the development of multi-drug-related osteonecrosis of the jaws during the pharmacologic MM maintenance phase draws attention to the complex multidisciplinary and multistage management of MM subjects and also that during disease remission, crucially involving oral healthcare providers for MRONJ prevention and pharmacovigilance. To prevent similar cases, cancer patient management should ensure proper dental care not only before starting but also throughout therapy duration and ensure continuous interdisciplinary consensus between oncologists and dentists. Moreover, also considering the independent negative and potentially synergistic effect on bone metabolism and mucosal healing processes of employed medicaments, additionally combined with the cumulative one of previous intravenous bisphosphonates, further studies should highlight the polypharmacy effect and hopefully aid in patient-specific MRONJ risk assessment in cancer patients.

Infection Control in Dental Practice during the COVID-19 Pandemic: What Is Changed?

The COVID-19 pandemic has profoundly changed our lives. Since the SARS-CoV-2 was discovered, many studies have been done on the transmission mode, its replication within humans, and its survival even in the outside environment and on inanimate surfaces. Undoubtedly, health care workers have faced the greatest risks because of their close contact with potentially infected patients. Of these, dental health care professionals are certainly among the most vulnerable categories, precisely because infection occurs with the airborne virus. The treatment of patients within the dental office has changed profoundly, respecting all preventive measures towards the patient and the practitioners themselves. The aim of this paper is to understand whether the protocols changed for the prevention of SARS-CoV-2 infection among dentists remained even after the most acute phase of the pandemic. In particular, this study analyzed habits, protocols, preventive measures, and any costs incurred in the COVID-19 era for the prevention of SARS-CoV-2 infection among dental workers and patients.