Aerosol transmission for SARS-CoV-2 in the dental practice. A review by SIdP Covid-19 task-force.

Current evidence suggests that SARS-CoV-2, the virus that causes COVID-19, is predominantly spread from person to person. Aim of this narrative review is to explore transmission modality of SARS-CoV-2 to provide appropriate advice to stakeholders, in order to support the implementation of effective public health measures and protect healthcare workers that primary face the disease. "In vivo" and "in vitro" studies from laboratories and hospitals confirmed the presence of surface contamination and provided insight of SARS-CoV-2 detection in the air, particularly in indoor settings with poor ventilation where aerosol-generating procedures were performed. Measures for aerosol reduction, in conjunction with other effective infection control strategies, are needed to prevent the spread of SARS-CoV-2 in dental setting.

Interdental Papillae Loss and Multiple RT2 and RT3 Gingival Recession Defects: A Case Report of a Combined Surgical Treatment Approach.

Modern dentistry is focused on patient needs, with the current trend shifting from merely restoring the loss of function to pursuing the esthetic satisfaction of patients and professional operators, as well as achieving optimal and stable results. Ideal smile esthetics depend on the balance between white and pink components, and therefore papilla reconstruction is one of the most challenging goals in periodontal plastic surgery and restorative procedures. The present case report proposes a surgical technique for the combined treatment of RT2 and RT3 recession defects and interdental papilla loss by means of a modified coronally advanced flap with an interdental subepithelial connective tissue graft.

Intrabony defects, open-flap debridement, and decortication: a randomized clinical trial.

BACKGROUND: Intramarrow penetration (IMP) is often incorporated in regenerative periodontal surgical procedures. However, the actual benefits of adding IMP to such a procedure remain undocumented. The purpose of this randomized controlled trial was to investigate the contribution of IMP to the outcomes of open-flap debridement (OFD) treatment of intrabony defects. METHODS: Forty-two chronic periodontitis patients, each contributing a 2-wall, 3-wall, or combined 2- to 3-wall intrabony defect, were treated. Sites were randomly assigned into one of two groups: control (OFD alone) or test (OFD + IMP). Papilla preservation flaps were raised, and defects were thoroughly debrided. In the control group, complete primary closure of flaps was ensured after debridement. In the test group, IMP was performed before flap closure, using a round bur to penetrate the cortical defect wall. Clinical and radiographic parameters were assessed at baseline and 12 months after treatment. RESULTS: At baseline, there were no statistically significant differences between groups. At 12 months, both groups experienced significant improvements, in terms of probing depth reduction, clinical attachment level (CAL) gain, and bone level (clinical and radiographic). The test group experienced significantly greater clinical bone gain (3.07 ± 1.74 mm) and prevalence of CAL gain ≥2 mm (93% of sites) compared with the control group (1.76 ± 2.71 mm, P <0.03; 62%, P = 0.024). The test treatment benefits were particularly evident in mandibular sites, in which OFD + IMP doubled the radiographic bone gain obtained by OFD alone. CONCLUSION: Addition of IMP to an OFD procedure used to treat intrabony defects results in statistically and clinically significant enhancement of both clinical and radiographic outcomes.

Surgical treatment options for grafting areas of gingival recession association with cervical lesions: a review.

STATEMENT OF THE PROBLEM: Gingival recession (GR) is a highly prevalent dental problem that may be associated with dentin hypersensitivity and aesthetic complaint. Furthermore, GR is often complicated by dental cervical wear of substance, such as erosion, abrasion, or abfraction lesions, as well as initial or more extensive carious involvement of the cervical area, which worsen the symptoms and make the treatment of this periodontal condition more challenging. THE PURPOSE OF THE STUDY: To provide an overview of surgical treatment options presented in the literature for sites affected by GR with carious cervical lesions (CCLs) or non-carious cervical lesions (NCCLs). METHODS: The Medline database was searched for items dealing with GR and its treatment options, especially on GR associated with CCLs or NCCLs. RESULTS: Several periodontal surgical techniques have shown good potential for treating GR over the years. Specifically, considering GR associated with CCL or NCCL, an assessment of both hard (dental) and soft (gingival) tissue characteristics of the involved site is recommended in selecting the surgical procedure. CONCLUSIONS: For GR associated with CCL or NCCL, hard and soft tissue characteristics of the involved site have to be carefully evaluated in order to choose the most appropriate surgical procedure. CLINICAL SIGNIFICANCE: A structured decision-making process, considering both hard and soft tissue characteristics of the involved site, is recommended in choosing the most appropriate surgical procedures to treat GR associated with CCL or NCCL defects. The restitutio ad integrum of the dento-periodontal unit is an essential condition to restore the tooth to its original function and esthetics.

Langerhans's cell histiocytosis in old subjects: two rare case reports and review of the literature.

BACKGROUND: Langerhans cell histiocytosis (LCH) is a proliferative disease of histiocyte-like cells that generally affects children; LCH onset is rare in adults; immunohistochemistry is essential to obtain the correct diagnosis, and treatment protocols are controversial. OBJECTIVE: To describe two new cases of adult onset oral LCH. CASE REPORTS: Case 1: a 71-year-old woman, complaining of diffuse oral pain, presented with erythematous mucosal lesions; the panoramic radiograph and CT scan showed multiple mandible radiolucent areas. Immunohistochemical assay for S-100, CD1a and langerin test was essential in reaching the correct diagnosis. Case 2: a 77-year-old female patient presented with a non-painful, non-bleeding, slightly elevated erythematous palatal lesion of 6 months duration, together with a genital vulvar lesion of uncertain nature. The pathology confirmed the diagnosis of LCH. Many therapies (etoposid, radiotherapy) could induce only a clinical partial remission; Cladribine induced a complete recovery. CONCLUSION: The first case was difficult to diagnose: the clinical presentation and course of the disease (LCH) in the elderly are multiple and unpredictable. An immunohistochemistry study is often essential to obtain the correct diagnosis. The second case required several therapeutic interventions: even though some cases regress spontaneously, others require systemic chemotherapy.