Maintaining Hygiene in Orthodontic Miniscrews: Patient Management and Protocols-A Literature Review.

BACKGROUND: Oral hygiene is crucial for the success of orthodontic therapy involving temporary anchoring devices like miniscrews. Plaque buildup, exacerbated by orthodontic appliances, causes inflammation that can undermine treatment outcomes. Individualized prevention plans based on patient risk factors are essential. This review emphasizes the importance of oral hygiene in orthodontic therapy with miniscrews, identifies optimal devices for ensuring long-term stability, and explores protocols for high-risk patients. MATERIALS AND METHODS: A comprehensive search was conducted on two primary databases, PubMed and Google Scholar, for relevant articles on oral hygiene and inflammation. Fourteen articles meeting the inclusion criteria were selected, covering topics such as "orthodontic miniscrew", "miniscrew and laser", "miniscrew and mouthwash", "electric toothbrush", and "GBT". RESULTS: Inflammation can compromise miniscrew stability by damaging surrounding bone. Miniscrews of 10 mm length have lower failure rates due to better bone contact and stability. Chlorhexidine reduces inflammation risk and inhibits epithelialization around the implant head. Laser therapy enhances miniscrew stability and reduces inflammation. Chitosan effectively suppresses inflammatory mediators and prevents microorganism adhesion. Both sonic and roto-oscillating electric toothbrushes remove plaque effectively, with roto-oscillating brushes showing superior results. The Guided Biofilm Therapy (GBT) protocol offers professional hygiene benefits similar to traditional methods, with improved patient engagement and motivation. CONCLUSIONS: Home oral hygiene maintenance is paramount for preventing inflammatory complications. Professional interventions such as diode laser usage, particularly in adult patients with a history of periodontitis or underlying systemic conditions, can mitigate orthodontic therapy failure risks. The GBT protocol fosters a more comfortable and participatory professional hygiene experience for patients, promoting better oral health awareness and compliance.

Dental bleaching: patient perception and satisfaction.

BACKGROUND: Teeth bleaching is a common practice performed by dental hygienists and dentists to correct aesthetic problems due to dental discoloration. Patients' opinions on this procedure may be different according to their personal experiences, expectations and individual sensitivities. The aim of this study is to assess the degree of satisfaction and related sensitivity of patients to professional and home bleaching treatment. METHODS: A questionnaire consisting of 12 multiple-choice questions was submitted to 625 subjects among general population. These were related to: 1) patient's age and whether the patient is a smoker; 2) personal satisfaction; and 3) post-treatment tooth sensitivity. Descriptive analyses of all variables in the questionnaire were performed, and statistical analyses between variables were carried out by Chi-square test and Fisher's Exact test. RESULTS: Of the people surveyed, 66% performed home bleaching, while the remaining performed the treatment in a dental office. Thirty-three percent of patients had previously undergone teeth bleaching and the 95.7% stated that they were satisfied with the treatment. Of these, only 36.4% reported experiencing postoperative hypersensitivity. Most patients (91.3%) received professional scaling before undergoing bleaching treatment. CONCLUSIONS: Patient satisfaction with tooth whitening treatment can vary from patient to patient and represents a strong indicator of treatment efficacy and suitability. A proper communication, careful management and individualized patient assessment are key to maximizing satisfaction and ensuring a positive and fulfilling patient experience.

Perception of the oral health risks of passive smoking from traditional cigarettes, electronic cigarettes, and heated tobacco products: A cross-sectional study.

INTRODUCTION: Tobacco smoke is a major health risk factor for smokers but also for non-smokers due to passive smoking. These risks come from conventional cigarette smoke but also from aerosol produced by electronic cigarettes and heated tobacco products (HTPs). The aim of this study was to investigate population knowledge about the adverse effects of passive smoking from traditional cigarettes, electronic cigarettes, and HTPs. METHODS: Between February and October 2023, 504 subjects among the general population responded to a questionnaire with 8 questions in Italian, via a link to the Google Forms platform. The questions related to the oral health effects of active and passive smoking. Descriptive analyses of all variables in the questionnaire were performed, and statistical analyses between variables were carried out using the chi-squared test and Fisher's exact test. RESULTS: A large subset of individuals interviewed stated that active smoking is harmful to health and consider active smoking more damaging compared with passive smoking (86.3%). The majority believed that passive smoking of cigarettes is more harmful to oral health than passive smoking of HTPs (79.4%) or electronic cigarettes (e-cigarettes) (84.9%). CONCLUSIONS: Results suggest that most people in this study had good knowledge about the adverse effects of active or passive smoking on health; however, knowledge regarding e-cigarettes and HTPs was poor and confused. These results reveal the complexity of perceptions regarding different types of smoking and the need for further research to fully understand the risks associated with each type of passive smoking.

Treatment of Ankyloglossia: A Review.

AIM: The aim of this narrative review is to analyze and compare the current scientific evidence regarding the diagnosis and treatment of hypertrophic lingual frenulum in preschool and school-age children. The treatments considered in this review are traditional surgical therapy, laser-assisted surgical therapy, and functional rehabilitation therapy. MATERIALS AND METHODS: A comprehensive literature review was conducted using the PubMed and PubMed Central search engines, considering articles published in the English language between 1 January 2000 and 30 June 2022. The bibliographic search was performed using the following keywords as search strings: "lingual", "frenulectomy", "frenulotomy", "frenulum", "ankyloglossia", and "laser." RESULTS: A total of 14 articles were included in this review, including four prospective observational studies, one case-control study, three cross-sectional studies, four retrospective studies, and one randomized controlled trial. The data extracted from each article are summarized in a table. CONCLUSIONS: In the literature, there are still limited studies regarding the treatment of hypertrophic frenulum. No common indications for the treatment of ankyloglossia and universally used classification for lingual frenulum were found. Currently, clinicians prefer the use of a diode laser for treatment. This method offers several advantages over the use of a scalpel blade. Many studies agree on the usefulness of providing patients with myofunctional rehabilitation to improve lingual mobility, both prior to surgical therapy and in the postoperative period.

Assessment Methods for Marginal and Internal Fit of Partial Crown Restorations: A Systematic Review.

BACKGROUND: Different methods are used for the analysis of marginal and internal fit of partial crowns, but not all of them are applicable for in vivo studies. The aim of this review is to search the available methods, described in the current literature, to assess marginal and internal fit in partial crowns. METHODS: an electronic search was performed on Pubmed and Web of Science databases to find studies published from 1 January 2017 up to 2 March 2023, following PRISMA guidelines and Cochrane handbook for systematic reviews. The search strategy applied was: "(marginal) AND (fit OR gap OR adaptation OR discrepancy) AND (inlay OR onlay OR partial crown)". In vitro studies which evaluated marginal and internal fit on CAD CAM or 3D printed partial crowns were included in this review. Quality of the studies was assessed by using Quality Assessment Tool For In Vitro Studies (QUIN tool). RESULTS: 22 studies were included. Among conventional methods, direct view with microscope, indirect view on resin replicas, and silicone replica technique (SRT) were used. Considering new digital methods, micro-CT, SRT 3D and triple scan technique (TST) were applied. CONCLUSIONS: Among 2D methods, direct view technique is the most used marginal fit analysis. For a more comprehensive evaluation, a 3D digital analysis is suggested. SRT and indirect view are the only 2D methods available for in vivo analysis. A protocol for the application of TST for assessment in vivo is now available, but no studies are reported in literature yet.

Marginal and Para-Marginal Technique in Late Germectomy of Lower Third Molars.

INTRODUCTION: Third molar surgery can cause post-operative complications to the patient due to the presence of a wound from the incision. This study aimed to compare marginal flap with para-marginal flap on postoperative complications by the measurements on pre and post-surgical plaque index (PI), bleeding on probing (BoP), maximum opening of the mouth (MOM), pain perception (PP) and post-surgical tumefaction (PT). METHODS: In this double-blind randomized clinical trial, 40 patients were recruited and randomly allocated in two groups. In Group 1, third molar extraction was carried out after a marginal flap design was performed, while in Group 2 a para-marginal flap was performed. Plaque index, bleeding on probing, maximum mouth opening, and distal probing were assessed right before and one week after surgery, while post-operative pain perception and post-operative swelling were accounted one week following surgery. RESULTS: Statistically significant differences were reported between treatment groups, as the para-marginal flap led to better outcomes for all the measured indexes. CONCLUSIONS: The para-marginal flap design may decrease the occurrence of post-operative complications and discomforts after mandibular third molar surgery, compared to marginal flap design.

Survey on Oral Health Education Knowledge of Family Members and Health Workers Dedicated to Patients with Disabilities.

OBJECTIVE: Over a billion people in the world live with some form of disability and this figure is destined to grow due to the increase in life expectancy. As consequence, the caregiver is taking on an increasingly important role that gains relevance also in the field of oral-dental prevention, being able to promptly identify needs for medical treatment. In some cases, however, the caregiver can be an obstacle to consider in case of a lack of adequate knowledge and commitment. The aim of this study is to evaluate the caregiver level of oral education comparing family members and health workers dedicated to people with disabilities knowledge. MATERIALS AND METHODS: Anonymous questionnaires were distributed in five disability service centers and filled alternatively by family members of patients with disability and disability service centers health workers. RESULTS: Two-hundred fifty questionnaires were collected, of which 100 were filled in by family members and 150 by health workers. Data were analyzed by applying the chi-squared (X2) independence test and the pairwise method for missing data. CONCLUSION: Family members oral education appears better in terms of brushing frequency, toothbrush replacement, and number of dental visits.

Patient's perception of hygiene in the dental practice after COVID-19.

BACKGROUND: The COVID-19 pandemic has significantly impacted various sectors, including healthcare. The dental profession has faced unprecedented challenges in providing care while minimizing the risk of transmission. The aim of the study is to assess how patient's perception of hygiene in the dental field has changed since COVID-19. In detail, it has been analyzed patient's attention to hygiene and how in his opinion the dental practice changed its procedures after COVID-19. METHODS: A questionnaire consisting of 10 multiple-choice questions was submitted to 509 subjects, patients of several dental practices. These were related to: 1) change in their perception of hygiene after COVID-19; 2) how the office they usually go to has changed and what hygiene standards it has adopted; 3) vaccination against COVID-19. Descriptive analyses of all variables in the questionnaire were performed, and statistical analyses between variables were carried out by Chi-square test and Fisher's Exact Test. RESULTS: Most patients (75.8%) stated that they had changed their perception of hygiene after the onset of COVID-19. They reported that they had experienced changes in hygiene procedures at their usual dental practice (70.7%), including rinsing with chlorhexidine mouthwash, continuous air and water disinfection and use of personal protective equipment (PPE). Vaccination of practitioners was considered to be important by 73.5% of participants. CONCLUSIONS: In the present study it was analyzed how emergence of the new Coronavirus has considerably changed the perception of patient hygiene within the dental practice. As a result of the awareness implemented to prevent virus transmission, patients are paying more attention to hygiene and preventive procedures to protect their health.

Correlation between consumption of sugared beverages and caries incidence in the pediatric patient.

BACKGROUND: Dental caries still represents a major public health problem, as it is the most widespread noncommunicable disease. The enamel of deciduous teeth is less resistant than permanent dentition and for this reason demineralization, and consequent caries formation, progresses more rapidly. The purpose of this study is to investigate the correlation between the incidence of caries and intake of sugary drinks in pediatric patients. METHODS: The study included 526 subjects (295 males, 231 females) between the ages of 2 and 15 years old. Several variables were examined, including: gender, age, separate values of the decay missing filled teeth (DMFT) epidemiological index (for both deciduous and permanent dentition), quantity and quality of sugary drinks taken daily, daily brushing frequency, parental nationality and socio-economic status. A multivariate analysis conducted (using a simple linear regression model) to verify the association between soft drink consumption and DMF, including a series of confounding variables (namely, sex, brushing frequency and parents' nationality). RESULTS: From the results of the statistical analysis of the variables examined, a correlation between the incidence of caries in children aged between 2 and 14 years and brushing frequency, consumption of sugary drinks and parents' nationality was found. CONCLUSIONS: It is important to raise awareness and properly inform patients and healthcare colleagues about the importance of oral health. Taking good care of our oral health represents part of implementation of the lifestyle and the quality of life of the future generations.

Early Childhood Caries and Oral Health-Related Quality of Life: Evaluation of the Effectiveness of Single-Session Therapy Under General Anesthesia.

OBJECTIVE: The aim of this study is to evaluate whether the treatment of ECC, performed in a single-session dental treatment under general anesthesia, can affect the quality of life of pediatric patients. It was assessed whether risks and discomforts involved in SSGA are outweighed by its effectiveness and reliability in improving oral health-related quality of life. MATERIALS AND METHODS: The quality of life that was assessed in this prospective study was oral health-related quality of life (OHRQL). Pediatric patients aged between 3 and 6 years with ECC undergoing dental treatment in SSGA were asked to fill in the Early Childhood Oral Health Impact Scale (ECOHIS) form both before and 1 month after the intervention. The data obtained were then statistically elaborated and analyzed to evaluate the actual significance of the differences found between the values before and after treatment and between the two sexes. RESULTS: Mean ECOHIS score before treatment was 30.58, following a large decrease after treatment, with a mean score of 2.94. Most parameters show a significant improvement between pre- and post-SSGA treatments, mainly those related to oral-dental pain, daytime irritability, and impact on family environment. Average ECOHIS scores for males and females are 31.72 and 29.76 before treatment and 3.55 and 2.52 1 month after treatment, respectively, showing no statistically significant differences. CONCLUSION: The dental treatment of young children under SSGA is associated with considerable improvement in their OHRQL. It can be considered an effective and reliable way of managing cases that cannot be dealt with by alternative methods.

Mothers' Awareness of the Correlation between Their Own and Their Children's Oral Health.

Pregnancy is a critical time for a woman since it involves a series of changes in the body due to hormonal fluctuations and changes that can also influence the oral cavity and can lead to certain pathologies, such as carious lesions. Furthermore, it has been demonstrated over the years that having poor dental health during pregnancy might have a significant impact on the child's oral health. The aim of the study is to analyze the level of knowledge and information of mothers on the importance of oral health care before, during, and after pregnancy as a preventive factor for the future oral health of the child. A questionnaire of 13 multiple choice questions was formulated and delivered from 24 February 2022 to 13 July 2022, aimed at women with at least one child. The Department of Pediatric Dentistry of the Borgo Cavalli Clinic in Treviso and the Maxillofacial Surgery Department of Santa Maria di Ca' Foncello Hospital in Treviso were the data collection centers. Crosstabs with dependency variables were used to statistically analyze the results. The study cohort consists of 411 women, whose responses showed that the majority did not have dental visits before and during pregnancy, which is why 74% of the whole sample did not request or receive information from professionals. Most mothers knew that they had to cleanse their child's mouth and, among them, those who responded more correctly, that is, who started before the eruption of the teeth, had received instructions from professionals. However, the low frequency of mothers performing dental checks during pregnancy did not allow mothers to become aware of the possibility of transmitting the carious lesions to their child, as conscious mothers represent 21%. Education from dentist and dental hygienists, gynecologists, and pediatricians is essential since they have an impact on mothers' habits and behaviors and ensure favorable oral health for both the mother and the child.

Soft drinks and dental erosion during pediatric age: a clinical investigation.

BACKGROUND: Dental erosion is an irreversible condition of loss of teeth hard tissues caused by intrinsic or extrinsic acids attack, without bacterial involvement. Common soft drinks have an acid pH and they release hydrogen ions and act as chelating agents, dissolving teeth mineral component. The aim of the study was to investigate the correlation between the consumption of soft drinks in children and the degree of dental erosion. METHODS: A questionnaire of 15 multiple choice questions was addressed to the parents of the 231 children needing different dental treatments. Responses were compared with the level of dental erosion of their child, that was clinically investigated using the Basic Erosive Wear Examination (BEWE) index. RESULTS: About 26.8% of subjects fall into a high-risk category of dental erosion while 24.2% in a low risk level. Socioeconomic status and oral hygiene habits are able to affect the degree of dental erosion. Toothpastes containing fluoride have not proved effective in preventing this phenomenon and no significant correlations were found between the type of toothbrush used and its frequency of use. CONCLUSIONS: It is necessary to apply preventive measures such as information on the processes and causes of erosion, instruction about right home oral hygiene maneuvers and the possible use of specific products, to avoid the development of problems related to severe dental wear.

Impact of breastfeeding and bottle-feeding comparison on children between 2- and 6-year-old caries development.

BACKGROUND: Caries is a multifactorial degenerative disease, and it is the most common chronic disease during childhood. Few studies have assessed the effects of breastfeeding and bottle feeding on children's dental caries, also taking into account the duration of both options. We investigated whether the infant feeding duration and feeding methods (breast, bottle or both) are risk factors for dental caries in childhood. METHODS: Our study included 210 children from 2 to 6 years old and it was carried out in the Department of Pediatric Dentistry of Borgo Cavalli (Treviso, Italy). The average number of decayed, missing, and filled primary tooth surfaces (DMFT) were investigated by analyzing the medical histories. Data collection was conducted from September 2021 to July 2022. Data analysis was performed using the statistical program R (R Foundation for Statistical Computing, Vienna, Austria). First, an analysis was performed to verify the database using a graph. We used the negative Poisson and Binomial count model for the data. Next, the verification of which covariables were significant was performed, finally the conclusions were obtained. RESULTS: By dividing the population according to the type of feeding, we saw that most of the children participating in the study had between 3 and 7 cavities. By analyzing the length of feeding, we saw that the average duration was between 10 and 20 months. Due to the P values, we concluded that the total duration of feeding variable was not significant in explaining the event of interest and, therefore, only the variable type of feeding (artificial and natural) was significant because the P value was below the 5% significance level. Finally, we concluded that natural type breastfeeding increases the average amount of caries by 1.29 times, or 29% more than artificial feeding. CONCLUSIONS: Compared to bottle-feeding, breastfeeding increases the risk of caries at an early age; however, there is no correlation between duration and occurrence of caries. Meanwhile, considering health benefits, dental professionals should not discourage breastfeeding; as a matter of fact, promoting breastfeeding has many benefits for infants and mothers, provided that it is associated with proper oral hygiene.

The Role of Information in Dental Traumatology in Patients during Developmental Age: A Cognitive Investigation.

OBJECTIVES: The gestation period involves a series of changes in all maternal organs and systems, due to hormonal fluctuations that also affect the oral cavity, leading to possible development of diseases such as gingivitis, oral pregnancy tumor, or periodontitis. Over the years, the positive correlation between poor oral health and adverse outcomes in pregnancy, such as fetal changes, low birth weight, preterm birth, or preeclampsia, has also been highlighted. The aim of this study is to analyze and understand the levels of knowledge and information of pregnant women about the possible repercussions that they may have on the oral cavity, caused by hormonal alterations. MATERIALS AND METHODS: A questionnaire of 17 multiple choice questions was formulated and published online from 01/02/2020 to 31/08/2020, aimed at pregnant women and new mothers. The Google Forms platform was used to collect the data that were then statistically analyzed by creating crosstabs with multiple dependency variables. RESULTS: The study cohort was represented by 1,191 women, whose responses first showed that about half were unaware of the predisposition to develop infections and periodontal problems during the gestation period. The same noticed bleeding and gum swelling during brushing and despite this, only 21% visited their dentist to resolve the situation. Furthermore, 88.2% of all women did not know that problems in the oral cavity can lead to adverse pregnancy outcomes. CONCLUSION: Primary prevention is essential and must be implemented with the collaboration of the various professional figures who follow the woman during gestation.

Rational diagnostic and therapeutic management of deep neck infections: analysis of 233 consecutive cases.

OBJECTIVES: Although deep neck infections are less common nowadays because of the widespread use of antibiotics, they continue to carry significant morbidity and mortality rates. METHODS: Between 2000 and 2008, deep neck infections were treated in 233 patients at the University of Padova. Cases of peritonsillar abscess, superficial infections, infections due to external neck injuries, and infections in head and neck tumors were excluded. Clinical, radiologic, laboratory, and microbiological assessments were analyzed. RESULTS: The site of origin was identified in 189 of the 233 cases (81.1%), and the most common cause of deep neck infection was dental infection (39.5%). Intravenous antibiotic therapy was given to 78 patients, and 155 required both medical and surgical procedures. The bacteria most often isolated were gram-positive anaerobic cocci. None of our patients died of the deep neck infection or its complications. CONCLUSIONS: It is worth emphasizing that airway support is the priority in patients with deep neck infections. Empirical antibiotic treatments must cover gram-positive and gram-negative aerobic and anaerobic pathogens. Surgical exploration and drainage may be mandatory in selected cases at presentation or in cases that fail to respond to parenteral antibiotics within the first 24 to 48 hours. It is important to perform cultures during operation to establish the pathogen(s) involved and to obtain an antibiogram to tailor the antibiotic treatment.