Parental perceptions and acceptance of silver diamine fluoride staining in Italy.

BACKGROUND: Parental perceptions of staining due to silver diamine fluoride (SDF) could affect its utilization in paediatric dentistry. This study represents the second part of a wider project focused on SDF esthetic acceptability among Italian parents. AIM: To evaluate parental acceptance of SDF staining in Italy and to assess whether the parent's level of acceptance depends on location, child's behavior, or demographic background. DESIGN: A cross-sectional study was conducted among Italian parents of children attending two university dental clinics. We used a validated Italian version of the questionnaire "Parental Perceptions of Silver Diamine Fluoride Dental Color Changes." RESULTS: Two hundred and thirty-four parents took part in the survey. Of parents, 65.4% considered the staining on posterior teeth esthetically "acceptable" or "somewhat acceptable," and 19.3% on anterior teeth (p = .001). In a scenario of positive cooperation, 48.5% of parents were "somewhat likely" or "very likely" to choose SDF to treat posterior teeth, and 17.6% on anterior teeth (p = .001). Level of acceptance increased as the difficulty the child would experience to receive conventional treatment increased. CONCLUSION: Staining on posterior teeth is more acceptable to parents than staining on anterior teeth. Level of acceptance on anterior teeth increases when sedation or general anesthesia is the alternative for the child.

Development and validation of the Italian version of the 'Parental Perceptions of Silver Diamine Fluoride Dental Color Changes' questionnaire.

BACKGROUND: The original English version of the questionnaire 'Parental Perceptions of SDF Dental Color Changes' was used among parents in the New York City metropolitan area. AIM: To develop an Italian version of the questionnaire and to assess its validity. DESIGN: The construct validity and the internal consistency were assessed in a convenience sample of Italian parents of 251 young healthy children seen at the University of Bologna and Pisa. Forward-backward technique was carried out for the translation of the questionnaire. Kaiser-Meyer-Olkin measure of sampling adequacy was equal to 0.91, and Bartlett's test of sphericity was statistically significant (P = .001), so the items were treated with the exploratory principal component analysis (PCA). RESULTS: Cronbach's alpha ranged from 0.69 to 0.95. PCA demonstrates that all the items load on the first component (87% of explained variance). All the Spearman correlation coefficients between each subscale (positive scenario: 0.563; negative scenario: 0.665) and the general acceptability showed significant correlation (P = .0001). Different age, educational level, and family income of the parents did not produce statistically significant different scores on any of the subscales (P > .05; Mann-Whitney test). CONCLUSION: The Italian version of the questionnaire showed high internal consistency and construct validity and was appropriate to be used in an Italian population.

Craniofacial and occlusal features of children with Noonan syndrome.

Craniofacial features of 12 children with Noonan syndrome (NS) were compared with age and gender matched healthy children. Dental history, panoramic radiograph, dental casts, and cephalometric measurements were assessed. The palatal height was significantly increased in the study group compared with the control group (p = .009; paired t-test). The palatal width was significantly reduced in the study group compared with the control group (p = .006; paired t-test). The mean SNB was reduced in the study group compared with the control group (p = .02; paired t-test) and the ANB increased (p = .009; paired t-test). The mean Sum (NSAr + SArGo + ArgoMe) angle and SN-GoMe were increased in the study group compared with the control group (respectively, p = .015 and p = .002; paired t-test). The cephalometric analysis assessed a retruded position of the mandible, skeletal class II characteristics, and a vertical growth pattern. The mandibular hyperdivergency was associated to a positive overbite.

Assessment of impression material accuracy in complete-arch restorations on four implants.

STATEMENT OF PROBLEM: New polyvinyl siloxane (PVS) materials with enhanced properties have been developed to improve and facilitate implant impression techniques. However, studies on their accuracy are lacking. PURPOSE: The purpose of this in vitro study was to determine the accuracy and precision of implant impressions made with some recently introduced materials on a simulated patient requiring an all-on-4 implant-supported prosthesis. Well-established polyether materials were also evaluated as a comparison. The variables considered were material type, consistency, splinting or not splinting techniques, and implant angulation. MATERIAL AND METHODS: A reference master model was made by inserting 4 implants at angles of 0, 5, and 10 degrees. Eighty impressions were made at 37 °C in wet conditions by using a standardized technique. Eight groups (n=10) were created using monophasic, single-viscosity materials (Hydrorise Implant Medium, HIM-ns; Hydrorise Implant Medium, HIM; Honigum Mono, HM; Impregum, IMP), and 2-viscosity materials (Hydrorise Implant Heavy+Light-ns, HIH+L-ns; Hydrorise Implant Heavy+Light, HIH+L; Honigum Heavy+Light, HH+L; and Permadyne and Garant [Heavy+Light, PeH+L]). Hydrorise materials were used with splinting and not splinting (ns) techniques. The reference points located on the connecting platforms of the transfer copings (TCP) were compared with the same points on the implant connecting platforms (ICP) located in the reference model. The accuracy and precision of the impressions were determined as linear 3D errors and standard deviation between each TCP-ICP couple by using an optical coordinate measuring machine (OCMM). RESULTS: PVS materials were generally better than polyether materials, with Hydrorise materials (HIM and HIH+L) showing significantly better accuracy and precision (30.9 ±14.4 µm and 28.7 ±15.5 µm, respectively) than IMP and PeH+L polyethers (44.2 ±16 µm and 43.8 ±17.6 µm, respectively; P<.001). Honigum materials were statistically similar to Hydrorise materials (P=.765). The values shown by Hydrorise nonsplinted groups (HIH+L-ns and HIM-ns) were not statistically different from those of the splinted polyether impressions (P=.386). The viscosities (monophasic or heavy+light) had no effect on accuracy, but monophasic material positively influenced precision (HIM and HIH+L, P=.001). No correlation was found between implant angulation and accuracy (multilevel analysis and Kendall rank correlation coefficient=-0.065; P=.133). CONCLUSIONS: Recently introduced materials designed for implant impressions showed significantly higher accuracy and precision; even with the unfavorable nonsplinting technique, the new materials performed similarly to, or better than, polyether materials. Although the transfer coping splinting technique generally improved the accuracy and precision of Hydrorise materials, the effect was significant only within HIH+L groups.

Stability of Periodontal Healing Distal to the Mandibular Second Molar After Third Molar Coronectomy: A 3-Year Follow-Up Study.

PURPOSE: The stability of the periodontal attachment distal to the mandibular second molar after coronectomy of the third molar is still unclear. This study addressed the question of whether periodontal measures are stable over time among patients undergoing coronectomy. MATERIALS AND METHODS: This prospective cohort study enrolled 30 patients treated at the Unit of Oral and Maxillofacial Surgery of the University of Bologna. The predictor variables were the probing pocket depth (PPD), distance between the marginal crest and the bottom of the osseous defect (BOD), and distance between the cementoenamel junction and the BOD. Three points on the distal surface of the second molar were recorded: distobuccal, distomedial, and distolingual sites. The distobuccal site was used as the statistical unit. The Wilcoxon test for paired data and Kendall τb were used to evaluate all variables. The significance level was set at P < .05. RESULTS: The 3-year follow-up was completed by 27 patients (7 male and 20 female patients; mean age, 28 ± 7 years) with 30 third molars. At 3 years, the PPD was 4 ± 1.25 mm; no significant changes in PPD were recorded for all sites from 9 months to 3 years. For the marginal crest-BOD distance and the cementoenamel junction-BOD distance, significant reductions were evident between preoperative values and those at 9 to 36 months (P = .001) and between values at 9 and 36 months (P = .02). CONCLUSIONS: A clinical healthy periodontium distal to the second molar was observed 36 months after coronectomy. However, further studies are necessary to confirm these preliminary clinical results.

Coronectomy: A Surgical Option for Impacted Third Molars in Close Proximity to the Inferior Alveolar Nerve-A 5-Year Follow-Up Study.

PURPOSE: The extraction of third molars is the most common surgical procedure performed in the oral cavity. Coronectomy is a surgical protocol to reduce the risk of neurologic lesions to the inferior alveolar nerve (IAN). We evaluated early (up to 1 month) and late (from 2 to 60 months) postoperative complications. MATERIALS AND METHODS: This prospective cohort study enrolled patients treated at the Unit of Oral and Maxillofacial Surgery, University of Bologna. The predictor variable was the time after coronectomy with up to 5 years' follow-up. To assess the rate of postoperative complications, the outcome variables were neurologic injuries, postoperative pain, swelling, fever, alveolitis, pulpitis, and root exposure. The success rate, need for a second surgical procedure, probing pocket depth, and bleeding on probing also were investigated. Univariate and bivariate descriptive statistics, Kaplan-Meier analysis, and Cox hazards modeling were performed to evaluate the variables. RESULTS: We performed 116 coronectomies in 94 healthy patients (37 men and 57 women; mean age, 28.99 ± 8.9 years). At 5 years' follow-up, we re-evaluated 63 patients with 76 coronectomies. In total, 30 complications were verified. No cases of neurologic lesions to the IAN or lingual nerve were observed after surgery. In the first 3 years, the surgeons extracted migrated roots in 5 cases (6%) without any neurologic lesions to the IAN. No complications were observed from the third to fifth year. CONCLUSIONS: This prospective study on coronectomy of third molars in a close relationship with the mandibular canal found no cases of neurologic lesions, no cases of late infection of the retained roots at 5 years, and a low rate of immediate postoperative complications. Further investigations should include a follow-up study at 10 years and more research about the mechanism of pulp healing.

Correction to: The fate of root canals obturated with Thermafil: 10-year data for patients treated in a master's program.

The author names in the original version of this article were inadvertently interchange. Correct presentation of author names is reflected here.

The fate of root canals obturated with Thermafil: 10-year data for patients treated in a master's program.

OBJECTIVES: Retrospective description of the 10-year success rate of endodontic treatments with Thermafil (TF). MATERIALS AND METHODS: Patients treated by postgraduate students in an Endodontics Master's Program (2006-2008) were enrolled. All treated root canals were filled with TF and AH Plus. Teeth satisfying the inclusion criteria (206 teeth in 89 patients) were reexamined clinically and radiographically to estimate a 10-year survival and periapical health. Demographic and medical data were registered; collected information included pre-, intra-, and postoperative variables. Teeth were classified as "healthy" (PAI ≤ 2 in absence of signs/symptoms), "endodontically diseased" (presenting at least one of the following: PAI ≥ 3, signs/symptoms, retreated in the course of the follow-up, or extracted for endodontic reasons), or "non-endodontically diseased" (extracted for non-restorable fractures or periodontal disease). For teeth lost during the 10-year follow-up, details and reason of extraction were analyzed. Two PAI-calibrated examiners assessed outcomes blinded to preoperative status. Bivariate and multilevel analyses were performed (α level set at 0.05). RESULTS: At 10 years, 179 (87%) teeth survived and 27 were extracted: 20 for non-endodontic reasons (excluded from success analysis) and 7 for endodontic reasons (considered "endodontically diseased"). Multilevel analysis revealed that the probability of extraction was increased by the presence of preoperative pain (odds ratio = 6.720; 95% confidence interval, 1.483-30.448) and by maxillary location (odds ratio = 2.950; 95% confidence interval, 1.043-8.347). Concerning periapical status, 159/186 teeth (85%) were assessed as "healthy." Multilevel analysis confirmed that maxillary location (odds ratio = 3.908; 95% confidence interval, 1.370-11.146), presence of flare up (odds ratio = 9.914; 95% confidence interval, 2.388-41.163), and fracture occurrence (odds ratio = 35.412; 95% confidence interval, 3.366-372.555) decreased the odds of healing, respectively. CONCLUSIONS: After 10 years, teeth filled with Thermafil in a specialist master's program presented a survival and a periapical health comparable to cohorts where root canals were filled with other obturation techniques. CLINICAL RELEVANCE: Carrier-based techniques provide time savings for clinicians while satisfying clinical quality criteria for the root filling and consequently the clinical outcome.

Manufacturing of Metal Frameworks for Full-Arch Dental Restoration on Implants: A Comparison between Milling and a Novel Hybrid Technology.

PURPOSE: To determine the trueness and precision of frameworks manufactured with a selective laser melting/milling hybrid technique (SLM/m) and conventional milling by comparing the implant-platform/framework interface with those of the original computer-aided design (CAD). MATERIALS AND METHODS: Using a virtual 6-implant-supported full-arch framework CAD drawing, 27 titanium replicas were manufactured by 3 independent manufacturing centers (n = 9/center) using a hybrid SLM/m technology (labs 1 and 2) or the conventional milling technique (lab 3). Using an opto-mechanical coordinate measuring machine, the frameworks' misfit distribution and patterns were analyzed, and the position error between paired platform positions within each framework was evaluated to calculate the misfit tendency for each group. A multilevel analysis using a mixed-effects model was conducted (α = 0.05). The trueness was evaluated as the dimensional difference from the original, while the precision as the dimensional difference from a repeated scan. RESULTS: The 3 dimensional misfits differed significantly among the 3 groups, with the milled group exhibiting the least accurate outcome (p = 0.005). The mean 3D positioning errors ranged from 8 to 16 µm and from 9 to 22 µm for the SLM/m technique (labs 1 and 2, respectively), and from 20 to 35 µm for conventional milling (lab 3). Regarding the misfit distribution pattern, the misfit increased with the distance between paired platform positions in all groups. CONCLUSIONS: All groups had 3D misfits well within the error limits reported in the literature. The 3D misfits of new hybrid (SLM/milling) and conventional (milling) procedures differed significantly among them, with the milling technique the less accurate and precise. The largest errors in all groups were found between the most distant implants, resulting in a correlation between the framework span and the inaccuracies.

Outcome of secondary root canal treatment filled with Thermafil: a 5-year follow-up of retrospective cohort study.

OBJECTIVES: The aim of the present retrospective cohort study was to assess the 5-year outcome and survival of secondary root canal treatments (2°RCT), exploring the influence of pre-, intra-, and post-operative variables. MATERIALS AND METHODS: One hundred thirty-two endodontically retreated teeth were radiographically and clinically re-examined after 5 years. 2°RCT had been performed during a Masters program following standardized protocols and filled with AH Plus/Thermafil (TF). Pre-, intra-, and post-operative data were collected. The 5-year outcome was blindly evaluated and categorized as healed/diseased on the basis of the periapical index. Bivariate analysis and chi-square test evaluated the association between outcome and 31 demographic/clinical parameters. Multilevel analysis was performed at both patient and tooth level. Statistical significance was calculated at 5% level. RESULTS: At 5-year evaluation, survival rate was 80% with 7.5% lost for endodontic reasons. Eighty-three percent of the teeth were classified as healed. Multilevel analysis identified significant predictors of increased survival: female gender (p = 0.012), absence of a pre-operative metal post (p = 0.017), conservative apical preparation (diameter size < #35) (p = 0.039), teeth restored with a crown (p = 0.009), and final PAI (after 5 years) ≤ 2 (p = 0.001). Multilevel analysis identified as predictor healing: not being a smoker (p = 0.048) and conservative apical preparation < size #35 (p = 0.037). CONCLUSIONS: Outcome of 2°RCT filled with Thermafil was successful at 5 years, showing a high rate of survived and healed teeth comparable to that reported previously for other obturation techniques. CLINICAL RELEVANCE: Present findings confirm 2°RCT as a valid therapeutic option to retain natural teeth.

Periodontal Healing Distally to Second Mandibular Molar After Third Molar Coronectomy.

PURPOSE: Coronectomy of mandibular third molars is a procedure that still raises a number of questions. The aim of the present study was to answer one unsolved question: the periodontal healing distal to the mandibular second molar after third molar coronectomy. MATERIALS AND METHODS: A prospective cohort study was performed of 30 patients treated at the Unit of Oral and Maxillofacial Surgery of the Department of Biomedical and Neuromotor Science of the University of Bologna. The predictor variables were the probing pocket depth (PPD), the distance between the marginal crest (MC) and the bottom of the osseous defect (BOD), and the distance between the cementum enamel junction (CEJ) and the BOD. These clinical indexes were recorded on 3 points of the distal surface of second molar: the distobuccal (DB), distomedial (DM), and distolingual (DL) sites. The other variables evaluated included root migration and postoperative complications. The Wilcoxon test for paired data and Kendall's tau-b correlation coefficient was used to evaluate all variables. The significance level was set at P = .05. RESULTS: The cohort was composed of 30 patients with 34 high-risk mandibular third molars (9 men and 21 women), with a mean age of 28 ± 7 years. At 9 months, a statistically significant reduction in the PPD of 2 ± 3, 1 ± 2, and 2 ± 2 mm and a statistically significant reduction in the MC-BOD distance of 4 ± 4, 4 ± 4, and 4 ± 5 mm for the DB, DM, and DL sites, respectively, was observed (P = .001). Also, the intraoperative CEJ-BOD distance showed a statistically significant reduction for the DB, DM, and DL sites. CONCLUSIONS: After coronectomy, restoration of a clinical healthy periodontium distal to the second molar was observed. However, further studies are necessary to confirm these preliminary clinical results and to compare periodontal healing between coronectomy and complete extraction.

Immediate Early and Delayed Implants: A 2-Year Prospective Cohort Study of 131 Transmucosal Flapless Implants Placed in Sites With Different Pre-extractive Endodontic Infections.

INTRODUCTION: To evaluate clinical outcome of early, immediate, and delayed transmucosal implants placed in patients affected by acute/chronic endodontic lesions. MATERIALS AND METHODS: Eighty-five consecutive patients received 131 titanium implants with zirconium-oxide blasted surface. Pre-extractive diagnosis represented the main criteria for implant placement timing, following "best treatment" criteria. Implants were placed with flapless transmucosal technique. Hopeless teeth with chronic periapical lesions received atraumatic extraction, and an implant was immediately placed (Immediate Group, n = 29). Teeth with acute periapical lesion/abscess were extracted and implants placed after 8 to 12 weeks (Early Group, n = 29). Implants placed 10- to 12-month after extraction constituted the control group (delayed group, n = 73). Implants were loaded 3 months after insertion with provisional resin crowns and after approximately 15 days with definitive ceramic crowns. Marginal bone loss (MBL) was measured in a single-blind manner on periapical radiographs at 1, 3, 6, 12, and 24 months. RESULTS: Multilevel analysis described exploring factors associated with MBL. Survival rate was 100%. MBL after 24 months was 0.78 ± 0.70 (95% confidence interval [CI]: 0.20 to -1.37) at immediate, 0.48 ± 0.70 at early (95% CI: -0.006 to -0.961), and 1.02 ± 1.01 (95% CI: 0.61 to -1.43) at delayed groups. Implant groups (immediate/early/delayed) and location (maxillary/mandibular) showed statistically significant results. Early group showed the lowest MBL values. The immediate group demonstrated less MBL than the delayed group. CONCLUSION: Early implant placement technique preserves periimplant marginal bone level more than immediate and delayed techniques.

Microbiological Distribution of Six Periodontal Pathogens Between Untreated Italian and Dutch Periodontal Patients.

PURPOSE: To compare prevalence and microbial load of six periodontal pathogens between Italian and Dutch patients affected by chronic periodontitis, using oligonucleotide probe technology. MATERIALS AND METHODS: Subgingival plaque samples data from 352 Italians and 115 Dutch periodontal patients were analysed and compared. Bleeding on probing, suppuration, probing pocket depth, clinical attachment level, age, gender, ethnicities and smoking habits were recorded. Presence and level of bacterial species were determined by realtime polymerase chain reaction under the identical microbiological protocol. Statistical analysis was performed using the chi-square test, Mann-Whitney U-test and binary unconditional logistic regression (α = 0.05). RESULTS: Between populations, only Treponema denticola and Porphyromonas gingivalis differed significantly, being more prevalent in the Italian group (p = 0.0001). Except for Tannerella forsythia, all bacterial loads differed significantly: Treponema denticola (p = 0.0001) and Prevotella intermedia (p = 0.001) were higher in Italians, while Porphyromonas gingivalis (p = 0.001), Fusobacterium nucleatum (p = 0.03) and Aggregatibacter actinomycetemcomitans (p = 0.001) were higher in Dutch patients. CONCLUSIONS: Significant differences in prevalence and bacterial load of periodontal pathogens exist between Italian and Dutch patients affected by chronic periodontitis. The microbiological profile, and particularly the bacterial load of pathogens, varied significantly between populations.

Maxillary first premolar inclination in 8- to 11-year-old children: An observational cross-sectional study on panoramic radiographs.

INTRODUCTION: In this study, we examined first premolar inclination in a large sample. METHODS: First premolar inclination, canine inclination, and mesiodistal location were measured on 797 panoramic radiographs of orthodontically untreated children (ages, 8-11 years; 381 boys, 416 girls). The sample comprised 1496 premolars and 1496 canines. A linear mixed-effects model was used to determine the contribution of age, sex, canine inclination, canine sector location, second molar maturational stage (D-G), and dental arch side on premolar inclination. RESULTS: First premolar inclination values (medians and interquartile ranges) were 12.76° (8.12°-19.05°) at 8 years, 11.82° (7.87°-16.04°) at 9 years, 10.40° (6.38°-15.46°) at 10 years, and 9.03° (5.42°-12.81°) at 11 years; 13.86° (8.60°-18.78°) at stage D, 10.56° (7.39°-14.77°) at stage E, 10.43° (6.08°-15.09°) at stage F, and 8.00° (4.62°-10.74°) at stage G. The following equation was selected (Akaike information criteria = 424.99): first premolar inclination (°) = -2.211 + 2.240 (8 years) + 1.363 (9 years) + 0.955 (10 years) + 0.387 (canine inclination) + 0.902 (right side) + 2.320 (stage D) + 6.320 (sector 1) + 5.446 (sector 2) + 3.803 (sector 3). There was no difference between percentiles constructed by age and maturational stage. CONCLUSIONS: First premolar inclination decreases during the mixed dentition and is moderately correlated with canine inclination.

What Are the Types and Frequencies of Complications Associated With Mandibular Third Molar Coronectomy? A Follow-Up Study.

PURPOSE: Coronectomy has been proposed for impacted third molars in close proximity to the inferior alveolar nerve (IAN) to avoid neurologic injury. Immediate (up to 1 month) and late (2 to 36 months) postoperative complications were investigated. MATERIALS AND METHODS: A prospective cohort study was performed on healthy patients treated in the dental clinic of the Department of Oral Surgery, University of Bologna. The predictor variables examined were experience of the surgeon (<10 vs ≥10 yr), length of surgery, type of mandibular third molar inclusion, and patient age. To assess the rate of postoperative complications, outcome variables were neurologic injuries, postoperative pain, swelling, fever, alveolitis, pulpitis, and root exposure. The success rate and need for a second surgery also were investigated. Univariate and bivariate descriptive statistics, Kaplan-Meier analysis, and Cox hazards modeling were performed to evaluate the variables. RESULTS: The study involved 94 healthy patients (mean age, 28.99 ± 8.9 yr; range, 17 to 56 yr; 37 men and 57 women) who had 116 third mandibular molars treated with coronectomy. During the 3-year follow-up period, 28 patients (29 coronectomy procedures) dropped out of the study. There was no case of neurologic injury to the inferior alveolar nerve (IAN) or to the lingual nerve (LN). In total, 30 complications were observed (25 within 1 month; 5 at 2 to 12 months). Surgeons with less than 10 years of training exposed patients to a greater risk of complications (hazard ratio = 2.069; 95% confidence interval, 1.004-4.263). An overall success rate of 74% at 6 months was estimated, and a second surgery was needed in 6% of cases. Of the retained roots analyzed, 80% showed postoperative root migration. CONCLUSIONS: In this study, coronectomy of mandibular third molars did not result in temporary or permanent injury to the IAN or LN. Coronectomy showed a low rate of postoperative complications. However, within the first year, a second surgery was needed in 6% of coronectomy procedures to remove migrated root fragments. Additional studies with larger patient samples are recommended to further investigate differences in postoperative complications in relation to patient age.

The effect of diode superpulsed low-level laser therapy on experimental orthodontic pain caused by elastomeric separators: a randomized controlled clinical trial.

The aim of this study was to evaluate the efficacy of diode superpulsed low-level laser therapy (SLLLT) in reducing experimentally induced orthodontic pain. Overall, 120 subjects (23.01 ± 1.39 years) were enrolled for a clinical trial. Subjects were randomly assigned to upper (U, N = 60) or lower (L, N = 60) jaw groups. All subjects received 4 elastomeric separators mesial and distal to the upper (U group) or lower (L group) right first molar and bicuspids. Each subject of the U and L groups was randomly assigned to laser (Ul, N = 20 and Ll, N = 20), placebo (Up, N = 20 and Lp, N = 20) or control (Uc, N = 20 and Lc, N = 20) sub-groups. Subjects in laser groups received a single GaAs diode SLLLT application (910 nm, 160 mW, beam diameter of 8 mm, applied for 340 s) immediately after placing orthodontic separators. Placebo groups received a simulated SLLLT and controls did not receive any therapy. All participants compiled a survey on pain duration and a 100-mm visual analogue scale immediately after the separators placement and after 12, 24, 36, 48, 72, and 96 h. Pain intensity of laser groups was significantly lower compared to placebo and control groups (p = 0.0001). In the laser group, 70% of subjects felt pain, while in the placebo and control groups all subjects felt pain (p = 0.0001). The end of pain occurred earlier in laser compared to placebo and control groups (p = 0.021). A single-diode SLLLT application appeared to be effective in reducing the intensity and duration of experimentally induced orthodontic pain and could be used in daily orthodontic practice.

Evaluation of clinical effectiveness and subjective satisfaction of a new toothbrush for postsurgical hygiene care: a randomized split-mouth double-blind clinical trial.

The aim of this RCT was to evaluate plaque control and gingival health promotion effectiveness of a new toothbrush with extra-soft filaments in postsurgical sets. Ten consecutive patients with at least two scheduled symmetrical periodontal surgeries were selected. Following the first periodontal surgery, a test (TB1) or control (TB2) toothbrush was randomly assigned. After the second surgery, the remaining toothbrush was given. Patients were asked to gently wipe the surgical area from days 3 to 7 postoperatively and to gently brush using a roll technique from day 7 till the end of the study. Baseline evaluation took place on the day of surgery and follow-ups were performed at days 7, 14, and 30 postoperatively. A more evident PI reduction was recorded for test toothbrush where a regular decrease was observed till day 14; then, this parameter tended to stabilize, remaining however lower than that recorded for the control toothbrush. There were no statistical differences in the GI between test and control toothbrushes. All patients introduced the test toothbrush at surgical site at third day; the control toothbrush was introduced within a mean of 9 days. The introduction of the test toothbrush 3 days after periodontal surgery may be recommended.

Pressure pain threshold of the cervico-facial muscles in healthy elderly people: the role of gender, age and dominance.

OBJECTIVE: The aim of this study was to assess the impact of age on pressure pain threshold (PPT) of cervico-facial muscles in healthy geriatric subjects and to investigate the role of gender and dominance on nociception. BACKGROUND: Musculo-skeletal pain is common in the elderly, but being subjective, it risks to be underdiagnosed and undertreated. A useful method for assessment of local pain is determining PPT through pressure algometry. Ageing process seems to increase PPTs, but reference values for the assessment of pain in geriatric subjects are lacking. METHODS: In this study, PPTs in temporal muscle, masseter, sternocleidomastoid, occipital and splenius capitis of 97 healthy elderly subjects were measured using Fischer algometer. Participants were divided by age in four classes (years 65-69; 70-74; 75-79; ≥80). RESULTS: Women had lower PPTs in all muscles compared with men. Comparing PPTs obtained from the right and the left side, no significant differences were recorded neither in men nor in women. When dividing subjects by age class and education, in both genders no significant differences were observed in PPTs among the groups, neither in the right nor in the left sides. CONCLUSION: In conclusion, the present study reports reference PPT values for the cervico-facial muscles that can be applied to a population of healthy elderly subjects. After 65 years of age, further ageing does not influence PPTs in cervico-facial muscles whereas female gender has lower PPTs.

Prevalence of six periodontal pathogens in subgingival samples of Italian patients with chronic periodontitis.

The aim of this study was to investigate the subgingival prevalence of six periodontal pathogens in 352 Italian patients with chronic periodontitis. Possible correlations with clinical parameters, age, gender and smoking status were also investigated. At first visit a pooled subgingival plaque sample was obtained for each subject by using the paper-point method. The samples were processed and analysed according to a commercially available quantitative real time polymerase chain reaction assay (Meridol® Perio Diagnostics, GABA International, Switzerland). Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn) and Aggregatibacter actinomycetemcomitans (Aa) were investigated. Fn resulted the most frequently detected (95%) while Tf showed the highest load (12x105 cells/plaque sample). Aa was the less represented bacteria for load and presence. Bacterial load of Pg, Td, Tf and Fn showed a direct correlation to Bleeding On Probing (BOP) and presence of suppuration (p=0.0001). The bacterial load was always directly correlated to Probing Pocket Depth (PPD) (p=0.0001). Among the investigated variables, PPD resulted the most important risk indicator for periodontal pathogens. BOP appeared as a risk indicator for Td, Tf, Pg detection. Few studies have described the microbiological pattern of chronic periodontal disease in the Italian population. Considering the different forms of periodontitis, similar investigations in other countries are needed to disclose any microbiological differences among populations, which may lead to more specific approaches to prevention and therapy.

A laboratory based investigation of a new elastic toothbrush head.

PURPOSE: To demonstrate the noninferiority of a new toothbrush head with retractile bristles compared to traditional toothbrush heads on dental models. METHODS: The new toothbrush head, mounted on manual and electrical handles, presents retractile bristle groups that can singularly retract over its entire length and offer calibrated resistance. Fourteen gypsum models of dental arches, twelve with and two without anatomical impairments, were spread with a "plaque simulator." Each arch was brushed twice with each of the four toothbrushes, one minute by the same operator, blinded to the study. The plaque index (PI) was recorded at the end of each brushing session. GLM for repeated measures analysed the data. RESULTS: On all the casts, the manual prototype and the electric prototype, removed 11% and 14% more "plaque simulator" compared to the standard toothbrush. In presence of dental anomalies, the prototypes removed 13% and 16% more plaque, respectively, compared to standard toothbrushes (P = 0.04). In both situations, the 95% confidence intervals of PI did not include -10% (the minimal margin of clinical relevance). CONCLUSIONS: The prototype is more effective in removing plaque from the casts with anomalies. The noninferiority of the prototype with respect to the standard toothbrushes was demonstrated.