Er:YAG laser for brackets bonding: a SEM study after debonding.

BACKGROUND: The introduction of Er:YAG laser in dentistry for ablation of hard tissues advocated an alternative method of enamel etching for orthodontics purpose. MATERIALS AND METHODS: 55 extracted human third molars were inserted in acrylic resin blocks and divided into five groups of 11 teeth. Group 1 was treated with 37% orthophosphoric acid for 30 seconds. Group 2 was treated with laser irradiation (Er:YAG Fidelius III, Fotona, Slovenia) at 80 mJ and 4 Hz. Group 3 underwent laser treatment (80 mJ, 4 Hz), followed by 37% orthophosphoric acid for 30 seconds. The teeth in Group 4 were treated with laser at 40 mJ and 10 Hz. The teeth in Group 5 were treated with laser (40 mJ, 10 Hz), followed by 37% orthophosphoric acid for 30 seconds. The adhesive remnant index was determined after debonding. RESULTS: Kruskas-Wallis test showed that location parameters (median and mean) are significantly different between Groups 2 and 4 when compared with control group; on the contrary no significant difference was detected between Groups 3 and 5 with the controls. CONCLUSION: The use of Er:YAG laser alone, as in Groups 2 and 4, showed no significant advantages over phosphoric acid in the bonding procedure for orthodontics brackets.

Prevalence of molar incisor hypomineralization among school children in Rome, Italy.

Molar incisor hypomineralization (MIH) is a highly prevalent condition associated with increased caries experience, dental pain and treatment need. Aim of this study was to determine the prevalence and severity of MIH in a group of 7-8 years old primary school children living in Rome, Italy; and to assess the association with caries experience and possible perinatal risk factors. A survey has been conducted in the city of Rome, between April 2019 and March 2020 with a total of 49 primary schools and 176 2nd grade primary school classes and a total of 3611 children being involved. Of these, a subset of 346 children of 21 primary schools was selected for the epidemiological investigation. The prevalence of MIH was of 18.2%, with girls showing twice the probability of being subject to a mild-severe condition. Molar location was present in 71.4%, while location on both molar plus incisor was present in 28.6% of cases. The mean DMFT was 0.44 ± 0.78, "D" was 0.17 ± 0.58; the mean dmft was 1.7 ± 2.56, "d" was 1.32 ± 2.21. Female gender, caries experience, insufficient oral hygiene were risk factors. The incidence of MIH is increasing in the pediatric population. Knowledge about diagnosis and treatment options should be disseminated among dental professionals.

Knowledge of Emergency Management of Avulsed Teeth among Italian Dentists-Questionnaire Study and Next Future Perspectives.

(1) Background: In Italy, about one fourth of all schoolchildren experience a trauma to the permanent dentition. Management of avulsion trauma is challenging and requires adherence to clinical protocols. The aim of this study was to investigate the management knowledge of avulsed teeth among Italian dentists and to promote the guidelines' dissemination through the use of new social media. (2) Methods: The survey was carried out during the COVID-19 lockdown in Italy (March-May 2020). The questionnaire was sent anonymously to a total of 600 dentists. The questionnaire consisted of two parts. Part A-demographic and professional data and Part B-management of traumatic avulsion. (3) Results: The response rate was 50.6% and the mean fraction of correct responses was 0.524. Issues related to the therapeutic management of avulsed teeth were shown to be not well understood by the respondents. Professionals with qualifications in dentistry and those who declared to know the guidelines responded better, while other demographic and professional factors were insignificant. (4) Conclusions: Italian dentists' knowledge of the management of avulsion trauma should be improved. Educational programs and campaigns must be undertaken to improve their awareness and adherence to the Italian and international guidelines.

Electrochemical behaviour of titanium in ammine and stannous fluoride and chlorhexidine 0.2 percent mouthwashes.

Titanium (Ti) is widely used in dentistry. Fluorides at acid pH could destabilize Ti oxide and make it susceptible to corrosion. The behaviour of IV grade machined Ti disks in 5 electrolytic solutions: Fusayama artificial saliva (Fas), ammine fluoride-stannous fluoride (Am-SnF2), 0.2 percent Chlorexidine (CHX) 0.20 percent, Fas with 20 percent Am-SnF2, and Fas with 20 percent CHX, was evaluated. Open circuit potential Ecorr was determined by immersing Ti disks for 24 hours in an electrochemical cell containing the solutions, potential changes were measured until a stable value was obtained. Examination by Scanning Electronic Microscope and Energy Dispersive X-ray Analysis were then performed. One way ANOVA analysis showed a significant difference of Ecorr values regarding the 5 solutions (p less than 0.001). The highest values were observed for Fas (-37.6 mV), intermediate for Am-SnF2 (-81mV) and lowest for CHX (-87.6mV). SEM analysis of disks after polarization curve in CHX showed a marked localized corrosion, while the other solutions showed no considerable corrosive action on Ti surface. When considering corrosive potential range in oral cavity, Ti had an excellent behaviour on both antiseptics evaluated. The results obtained in this study will enable us to recommend the use of Am-SnF2 mouthwash for patients with dental implants.

The importance of immediately loaded immediate post-extractive implants in esthetical rehabilitation: case series.

The aim of this paper was to estimate, in a retrospective way, integration of hard and soft tissues in immediately loaded immediate postextractive implants. Benefits of this technique could be: single stage surgery, biological saving of tissues, aesthetic management of edentulism, good integration of both hard and soft tissues. Immediate loading of a postextractive implant seems also to produce a positive effect on the quality of perimplant soft tissues. The implants used in the present study have some advantages such as high auto-threading and auto-tapping ability, progressive increase of the thickness of the threads, at the apical and coronal level. All these features have helped to obtain a high primary stability.

Biomechanical evaluation of dental implants in D1 and D4 bone by Finite Element Analysis.

AIM: The aim of the present study was to analyze stress and strain distribution in dental implants with different abutment's inclination inserted in D1 and D4 bone. METHODS: The biomechanical behavior of 5 mm x 16 mm dental implants with straight, 15 degrees and 25 degrees angulated abutments subjected to static loads, in contact with D1 and D4 bone, was evaluated by Finite Element Analysis (FEA). RESULTS: The lowest stress and strain values were found in the system composed by implants with straight abutments loaded with a 200-N vertical strength, while the highest stress and strain values were found in implants with 15 degrees angulated abutment loaded with a tilted strength (FY=200 N and FZ=140 N). Stress value increased from D1 to D4 bone, while strain value decreased due to the effect of normal elasticity mode of biological tissues. CONCLUSION: The different stress and strain distribution in D1 and D4 bone tissue surrounding dental implants with a tapered neck could favor prosthetic load and play a role in implant long-term success.

Prevalence of oral disease and treatment types proposed to children affected by Autistic Spectrum Disorder in Pediatric Dentistry: a Systematic Review.

PURPOSE: To investigate the prevalence of dental caries and periodontal disease in children with ASD, and to analyse the necessity of treatment and the prevalence of using general anaesthesia in order to perform it. MATERIALS AND METHODS: A search was performed covering the last 10 years utilising the following databases: Pubmed, Scopus, Medline, BASE, Science Citation Index, Science Direct, Web of Science. Four reviewers evaluated each study. Review findings were summarised using the PRISMA Statement for reporting. Thirteen articles were included in this systematic review. RESULTS: When analysing the articles selected, the evidence turned out did not show a common DFMT and dmft for the groups of children affected by Autism Spectrum Disorder considered. When compared to group of unaffected children, groups of ASD children not always showed a higher prevalence of caries but always higher Periodontal Indexes (PI and GI), resulting in higher prevalence of periodontal disease. Where the treatment was performed and taken into consideration, there was a high incidence of necessity of General Anaesthesia due to the lack of collaboration of the children. CONCLUSION: The high prevalence of treatment under general anaesthesia and the often-reported negative behaviour evidence how there is a lack of protocols specifically designed for these patients, in order to better improve their collaboration and subsequently their oral health and so additional strategies for a preventive care should be applied for these patients.

Oral health in a cohort of individuals on a plant-based diet: a pilot study.

INTRODUCTION: Plant-based diets are associated with a lower: (i) body mass index, (ii) rates of death from ischemic heart disease, (iii) serum cholesterol, (iv) incidence of high blood pressure, (v) type II diabetes mellitus and cancer, with an overall longer life expectancy. However, little data concerning the oral health in individuals on a plant-based diet are available. AIM: The aim of the present study was to investigate the general and clinical oral health status in a cohort of adults who had been following a plant-based diet for a minimum of 24 months. MATERIAL AND METHODS: For this purpose, individuals were administered two questionnaires (a.Questionnaire investigating risk areas for oral diseases; b. Italian version of the Oral Health Impact Profile -14 (IOHIP-14)) by a dental hygienist and clinical examination of the oral cavity was carried out. RESULTS: Seventy-seven adult individuals were enrolled. On average, they followed a plant-based diet for the last four years, had four meals a day and brushed their teeth twice a day. Fruit was the most frequently consumed food at breakfast by 48 of the participants. Thirty-four responders did not drink beer or wine, 65 did not drink spirits, 57 avoided carbonated beverages and 62 (80.5%) did not consume any highly-sugared beverages. Different dental therapies in the previous three years were reported in 36 of the responders. Overall, answers "never and almost never" to the IOHIP-14 questionnaire were observed in 87% to 100% of the individuals. Multiple logistic regression analysis revealed that fresh fruit consumption at lunch had a protective effect against caries (p<0.05). CONCLUSIONS: In conclusion, this study showed that individuals on a plant-based diet have good overall oral health conditions. These features are in agreement with the behavior of these subjects towards an overall healthy life style.

Computer-guided flapless surgery: immediately loaded implant-prosthetic rehabilitation.

The aim of this study was to show the operative procedure and the advantages coming from computer guided flapless surgery. This case report describes the use of stereolithographic surgiguides in order to insert 6 mandibular and 6 maxillary implants by a computer guided flapless surgery. These implants have been immediately loaded with cross arch screwed temporary prostheses. The definitive rehabilitation was realized with 2 fixed cross arch metal-ceramic prostheses that were cemented by AGC caps. The computer science technology allows to execute complex implant-prosthetic treatments in a shorter time, at low risk, with high esthetical and functional predictability and patient' satisfaction.

School-age dental screening: oral health and eating habits.

AIM: the study has the purpose to evaluate the association between clinical data collected from dental screening carried out on children and their eating habits. Materials and methods: The dental screening was carried out on a sample of eight-year-old children attending the third grade of the elementary schools of Gaeta (Latina). Clinical data and periodontal status indexes were recorded. The descriptive statistics (mean, standard deviation, frequency) of all data were calculated and anova analysis and chi square test have been performed. RESULTS: On the sample of 70 children the results showed an average of 1.4 decayed teeth per child (sd ± 2.3) with a slightly higher average in females. More than 68% of the sample had poor or insufficient oral hygiene conditions with plaque presence in 64% of cases. Moreover, 57% of children had class II malocclusion with increased overjet and oral breathing respectively in 37% and 30% of cases. Only 24% were breastfed in the first months of life and more than 40% maintained a bad habit for over two years of age. About eating habits, more than 80% of the sample consumed sweets or sweet drinks every day. The analysis of the data showed as children consume several snacks throughout the day, and 47% eat them watching TV. CONCLUSIONS: The results of this study showed how prevention program carried out through the School is more effective on children for learning of content especially when the acquisition of knowledge follows the application and verification of theoretical and practical skills in terms of oral health.

Using of modified rapid palate expander with miniscrews in a patient affected by ectodermic dysplasia.

OBJECTIVES: To show the orthodontic treatment in a 8-year-old patient affected by Ectodermal Dysplasia (hypohidrotic type) and presenting multiple agenesiae, contraction of the maxilla and skeletal Class III malocclusion. STUDY DESIGN: Because of both oligodontia of primary and secondary dentition and no good retention and anchoring, a hybrid modified rapid palatal expander (RPE) was used. It presented dental anchoring with two bands on first upper molars and skeletal anchoring with two miniscrews in the anterior palate. The project included the use of a CBTC for the bone examination and precise silicon dental impression for the insertion of miniscrews. RESULTS: The procedure was successful and the patient solved the expansion in few days, so RPE has been embedded throughout 6 months in order to develop the bone at the median suture. CONCLUSIONS: This case report can be considered as a valid example for approaching patients affected by Ectodermal Dysplasia with multiple agenesiae and palatal contraction because of the difficult retention.

Immediate loading on single NobelDirect implant. Case report.

A problem associated with implant-prosthetic rehabilitation on single implant is the unscrewing or fracture of the connecting screw. In this study the authors evaluate clinical results of the immediate loading on single NobelDirect implant. This innovative implant introduced by NobelBiocare is a single-piece implant including fixture and abutment in a single piece of Titanium in order to eliminate the problem of unscrewing or fracture of the connecting screw.

Allergy and desensitization to latex. Clinical study on 50 dentistry subjects.

AIM: Nowadays latex allergy represents a relevant social and occupational problem because this substance constitutes the first material to realise many dental and non dental products; then, there is a cross-reactivity between latex allergens and proteins present in many vegetal foods. The aim of our research was to find latex allergy cases experimenting a percutaneous desensitization protocol. METHODS: Among 50 examined subjects, those patients resulting positive to thiuram-mix by patch test have been submitted to desensitization after removal of all latex products and substances giving cross-allergy (kiwi, celery, chestnuts, tomato, banana etc.). Desensitization has been carried out by using latex glove from 10 s progressively to 1 h after 1-year treatment. RESULTS: In 7 patients out of 11 (63.6%) regression of symptoms has been verified; 2 patients (18.2%) have declined treatment and 2 patients (18.2%) have showed no regression. CONCLUSIONS: Apart immunotherapy and DNA-vaccines, nowadays percutaneous desensitization is the most efficacious, safe and easy treatment for latex allergic patients; it has no collateral effects during its execution and no symptoms coming back to work, but it needs further verifications.

Study on the frequency of protozoa and mycetes in the oral cavity.

The importance of a good knowledge in microbiology of the oral cavity is every day more and more indispensable in order to propose proper therapeutic treatments. In this study, the most frequent protozoa and mycetes present in the oral cavity are described, distinguishing the different species and their pathologies.

Dental anomalies associated with genetic factors.

The article reviews the association between dental anomalies and genetic diseases. Knowledge of these hereditary diseases will enable the dentist to make a more extensive analysis of the families in which such diseases occur, and above all to evaluate more precisely the dental aspects that such conditions favour. This will lead to better management of diseases linked to malocclusion, congenital absence of teeth and anomalous development of dental tissues. Hereditary diseases are caused either by a single mutant gene, inherited from 1 parent and acting as dominant gene, or from a pair of mutant genes, inherited from both parents and acting recessively. Autosomal-dominant and autosomal-recessive inherited diseases are described, together with hereditary sex-linked conditions and those of multi-factorial origin. The purpose is to review such diseases so that the dentist can make an early diagnosis in clinical practice, check the predisposition toward such diseases and put in place preventive measures.

Awareness of complications and maintenance mode of oral piercing in a group of adolescents and young Italian adults with intraoral piercing

BACKGROUND: The aim of the study was to focus the awareness of complications of oral piercing among a group of adolescents and young Italian adults with intraoral piercings. MATERIAL AND METHODS: A total of 225 teenagers were asked to complete a questionnaire on the awareness of complications of oral piercing. An additional questionnaire was administered in case of oral piercing worn, based on site piercing, knowledge about piercer license, oral and systemic risks due to oral piercing, disinfection and sterilization of the material pierced, information by the piercer about piercing hygiene maintenance and post-piercing dentist check-up. After questionnaire all partecipants received a brochure with some information about risks and maintenance mode of piercing. RESULTS: Data revealed that more than 50% of teens surveyed was found to wear a piercing. Only 25.3% was aware of the risk of HCV cross-infection and only 17.3% reported of knowledge about risk of endocarditis. Only 17% checked the piercer license and only 18% sterilization and disinfection of the materials used. 53.7% did not received explanations about the risks associated with piercing. With regard to the maintenance mode of the piercing, it has been suggested to brush the piercing bar in 17% of cases. The post piercing specialist visits have been suggested only in 7% of cases. CONCLUSIONS: The general lack of awareness of complications and maintenance mode related to oral piercing needs to be addressed by some education programs performed at school and by dentists

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