Effectiveness of elastodontic appliances in the treatment of malocclusions: a review of the literature.

AIM: This paper aims to verify the effectiveness of using elastodontic devices in the treatment of malocclusions in growing patients. An English-language literature search was conducted. The following electronic databases were selected for searching from 2020 to June 2023: PubMed, Web of Science, and Scopus. Eight articles were included based on the inclusion and exclusion criteria. The articles examined highlight the ability of elastodontic devices to act in cases of malocclusion in a safe, simple and more comfortable way for the young patient. However, there is a lack of knowledge about this technique, so this study aims to review the most recent literature to provide the scientific community with new knowledge.

Trigeminal electrical stimulation with ULFTENS of the dorsal anterior mucosal surface of the tongue: Effects on Heart Rate Variability (HRV).

BACKGROUND: Trigeminal electrical stimulation of the dorsal anterior mucosal surface of the tongue has demonstrated its efficacy in a variety of neurological disorders in which anatomical or functional alterations are present. The pathogenesis of such disorders is often linked to altered arousal circuits, and the benefits of tongue stimulation are attributed to the rebalancing of this system. Dental ULFTENS shows efficacy in acting on the muscular, autonomic system and control of the descending pathways that modulate pain. It is administered at the skin level in the area anterior to the tragus and not on the mucosal surface of the tongue. The use of this stimulation technique at the tongue level could have new applications and clinical results if it were able to reduce the activity of arousal circuits. MATERIAL AND METHOD: A new intraoral device allowed electrical stimulation of the dorsal anterior mucosa of the tongue in 32 healthy young women. The effects on HRV were monitored by photoplethysmographic wave (PPG) and compared with a control group. The HRV parameters studied were RMSSD, HF, LF, LF/HF, REC, DET. RESULTS: The group of stimulated subjects showed a significant change in some of the HRV parameters that was maintained even in the epoch after the end of electrical stimulation. This effect can be considered as a vagal activation and a change of HRV trend. The control group of unstimulated subjects showed an opposite trend. There were no undesirable or annoying effects of stimulation. CONCLUSION: Stimulation of the dorsal anterior (trigeminal) mucosal surface of the tongue with ULFTENS applied with an intraoral device was shown to be able to increase HRV.

AMASI epidemiological study on children living in L'Aquila.

AIM: The aim of the study is to observe the statistical relationship between children's habits, oral heath, pregnancy history and breastfeeding. METHODS: A cross-sectional study was carried out on the pupils of the first and second grades of the primary schools of the "Silvestro" and "Amiternum" school districts of L'Aquila (Italy). The study population consisted of 496 (244 females and 252 males) students. The data were collected through anamnesis carried out by qualified health personnel before dental examination. According to the WHO criteria clinical teething examination standard, the presence of caries was determined by the dmft index (decayed-filled-missing deciduous teeth). Shapiro-Wilk test, Chi-square test and t test used. P values below 0.05 were considered statistically significant. CONCLUSION: There is not enough evidence to advise against breastfeeding lasting more than one year due to the risk of tooth decay. Supportive practices need to be implemented to counteract risk factors. A larger sample is needed to study the role of human milk.

Bruxism in children: Use of the Functional Plane of Monaco (FPM).

BACKGROUND: Bruxism is a condition that results from hyperactivity in the central nervous system, and factors such as stress or other anxious conditions increase the frequency of episodes. When bruxism occurs at a young age, tooth wear can occur. The extent of wear can lead to the need for restorative dentistry and prosthetic treatments to restore the morphological and functional integrity of the teeth, with high costs associated with such treatments. CASE REPORT: A healthy 15-year-old boy presented to the orthodontist observation. His incisal ridges appeared thin, without mamelons, and with increased translucency. For treatment, the authors used only the Functional Plane of Monaco (FPM), a device which he had to wear 16 hours during the day. CONCLUSION: The orthodontist successfully treated an orthopaedic/orthodontic case with the FPM device.

Health status of Afro-Asian refugees in an Italian urban area: a cross-sectional monocentric study.

OBJECTIVES: The recent sociopolitical events in the Mediterranean and Middle Eastern areas have significantly impacted international migration flows. As disease prevalence and type are different among western and Afro-Asian countries, physicians dealing with refugees should be aware of their specific health needs. We aimed at evaluating the health status and disease history of refugees at their arrival in the urban area of L'Aquila (Italy). STUDY DESIGN: This is a monocentric cross-sectional study. METHODS: Refugees hosted at the local reception center in L'Aquila (Italy) between July 2014 and December 2014 were cross-sectionally evaluated for anamnestic, clinical, and laboratory features. A subset of randomly selected participants underwent further assessments (screening for tuberculosis, hepatitis B/C, human immunodeficiency virus, syphilis; ambulatory blood pressure measurement [ABPM]) to better define their health status. RESULTS: Ninety-three adult male refugees (27.34 ± 7.41 years) from Africa (76%) and Asia (24%) were enrolled. Overall, the most prevalent diseases according to the International Statistical Classification of Diseases and Related Health Problems 10th revision affected the digestive tract (15.6%) and musculoskeletal apparatus (14.4%). The analysis by continent of origin did not show significant differences in the distribution of diseases, although a trend toward some differences was observed. African refugees had a significantly greater prevalence of viral hepatitis (hepatitis B virus, P = 0.004; hepatitis C virus, P = 0.007) compared with Asians. Hypertension, as detected by ABPM, was uncommon. No written vaccination history was available. CONCLUSIONS: Health issues of our sample of Afro-Asian refugees span both non-communicable and communicable diseases, requiring attention for the safety of the individual and the community. National health systems should provide adequate information and shared guidelines for health professionals regarding identification and management of refugees' health needs.

"All on short" prosthetic-implant supported rehabilitations.

OBJECTIVES: Short implants are increasing their popularity among clinicians who want to fulfill the constant demanding of fixed prosthetic solutions in edentulous jaws. The aim of this report was to propose a new possibility to project and realize an occlusal guided implant cross-arch prosthesis supported by ultra-short implants, describing it presented an edentulous mandible case report. METHODS: A 61-year-old, Caucasian, female patient who attended the dental clinic of the University of L'Aquila presented with edentulous posterior inferior jaw and periodontitis and periimplantitis processes in the anterior mandible. The remaining tooth and the affected implant were removed. Six 4-mm-long implants were placed to support a cross-arch metal-resin prosthesis. RESULTS: At 1-year follow-up clinical and radiological assessment showed a good osseointegration of the fixtures and the patient was satisfied with the prosthesis solution. CONCLUSION: The method, even if it requires further validation, seems to be a valid aid in solving lower edentulous clinical cases, and appears less complex and with more indications of other proposals presented in the current clinical literature. Our case report differs from the current technique All-on-Four, which uses four implants in the mandible to support over-denture prosthesis, assuring a very promising clinical result.

TENS effects on salivary stress markers: A pilot study.

Transcutaneous electrical nerve stimulation (TENS) is extensively used as pain relief through endorphins release. Moreover, recent findings showed a role in the activation of the autonomic nervous system (ANS); it was evidenced by modification in the heart rate variability and ANS-related marker. The objective of this pilot study is to evaluate salivary alpha amylase (sAA) as a marker of stress in two groups of healthy subjects, one receiving ultra-low frequency transcutaneous electrical nerve stimulation (ULF-TENS) and one without stimulation. Sixty healthy people were enrolled. The test group consisted of 30 participants (15 men, 15 women). The control group consisted of 30 participants (15 men, 15 women). Statistical analysis showed that sAA levels were statistically different between men and women independently from TENS; we hypothesize that treatment could influence sAA levels because it is thought to activate µ opioid receptors. The results of this study seem to indicate that the analysis of sAA, through a non-invasive saliva sample, could be an efficient aid for understanding the functions of the autonomic nervous system.

Advanced glycation end products: possible link between metabolic syndrome and periodontal diseases.

On a planetary scale, Metabolic Syndrome (MetS)is the third cause of inability after malnutrition and nicotinism, even higher than water shortage and sedentariness. In the USA, the prevalence is estimated at over 25 percent of the population; in Italy, it involves approximately 25 percent of men and even 27 percent of women. These are very high figures, corresponding to approximately 14 million affected individuals. The prevalence is alarming and must not be underestimated, particularly in the dental field, where more than one patient out of four sitting in a dentist chair is affected. The etiology of periodontal disease has not yet been clarified, and recently the idea to consider it as a multifactor pathology has been developed. Cofactors such as the formation of free radicals of oxygen (ROS), oxidative stress, lipid peroxidation, and formation of glycation end-products (AGEs) probably play an important role in the onset of periodontal disease. The AGEs are compounds physiologically produced by the cells. However, they accumulate and cause pro-inflammatory conditions, when the cellular clearance fails, or in hyperglycemic and oxidative states. All these conditions can be clinically summarized as Metabolic Syndrome. The purpose of this literature review is to establish a relationship between two pathologies with very high prevalence: Metabolic Syndrome and Periodontal Disorder. The literature seems to have clarified that MetS involves a pro-oxidation status, which induces AGE formation. AGEs play a very important role in the course and severity of periodontal diseases.

Possible involvement of advanced glycation end products in periodontal diseases.

Periodontal diseases are considered as multifactorial conditions initiated by infection with pathogenic bacteria, promoted by inflammation and immune response against bacteria and modified by different environmental and genetic factors. Recently, interest in periodontal diseases has been increasing due to the awareness that the hyperinflammatory status associated with this disorder could impose a significant increase of reactive oxygen species (ROS) relevant to numerous systemic diseases driven by a pro-oxidant profile. A highly complex interplay occurs between oxidative stress and AGEs (Advanced Glycation End products), a group of heterogeneous compounds that form constantly under physiologic conditions, although their rate of formation is markedly increased in hyperglycemia and oxidizing conditions. Starting from the most relevant hypotheses on the pathogenesis of periodontal diseases, the present review outlines its relationship with oxidative stress and inflammation response in order to make a critical evaluation of the potential role of AGEs in periodontal deterioration. Although direct evidence for the presence of AGEs in the periodontal ligament is still lacking, valuable approaches based on the use of periodontal cells along with genetic and biochemical studies in animal models and chronic periodontal patients support a potential role for protein glycation in the aetiology and severity of this disease. Following a review of the current literature, the present study highlights the need for further investigation on the presence of AGEs in the periodontal ligament as a means for the comprehension of the pathogenic mechanisms underlying periodontal diseases in order to develop prevention and treatment modalities for this dysfunction.