Impact of self-ligating orthodontic brackets on dental biofilm and periodontal pathogens in adolescents.

The aim of the present prospective study was to evaluate periodontal health and subgingival microbiological alterations in adolescents treated with fixed self ligating orthodontic brackets in comparison to subject without any orthodontic appliance. A total of 40 adolescents (23 females and 17 males; mean age: 13.2 ± 3.2 years) were included: 30 subjects with self ligating brackets (test group) and 10 patients without orthodontic appliances (control group). Follow-ups were as follows: T1 (1 month), T2 (3 months), T3 (6 months) from the beginning of the orthodontic therapy. Clinical parameters (plaque index, gingival index and clinical attachment level) were measured for every patient and a microbiological analysis was performed. Mann Whitney test was performed to evaluate clinical parameters between test and control group and Friedman test and Fisher test were adopted to evaluate intra group differences at different follow-ups. Student T-test was performed to compare clinical attachment level between the two groups. Significance level was set at p<0.05. No periodontal pathogens and no clinical attachment loss were found in the whole sample. A slightly higher plaque index and gingival inflammation were recorded in the test group in comparison to the controls.

Facial growth and morphology of cleft lip and/or palate patients after corrective surgery according to P.I.S.A. technique.

Cleft lip and/or palate patients (CLP) undergo corrective surgery that can affect facial growth. The aim of this study was to analyze facial growth and maxillary development of CLP subjects after surgery according to P.I.S.A. technique (Peri osteoplasty Improves Symmetry and Aesthetic). Cephalometric tracings of 55 patients were performed, thirty-three of which belonged to the test group, while the lasting twenty subjects were part of the control group. The test group was formed by cleft lip and/or palate patients after surgical repair according to P.I.S.A. technique. The control group included patients unaffected by this malformation, with an Angle's first class, selected from the Michigan Growth Study sample. Facial growth and upper maxilla development analysis was carried out by comparing the data obtained from the cephalometric traces of cleft patients who performed an early surgery, with the values of the same parameters measured in non-cleft subjects, providing the normal values. The results of this study showed, in the test group, a maxillary and mandibular bi-retrusion, a more negative facial convexity, the absence of a marked discrepancy in the skeletal relationships, a slight tendency towards hyper-divergence. .

Use of extra-oral scanner for the study of arch form in a sample of Italian adolescents with ideal occlusion.

The aim of this study was to evaluate the shape and the average size of the maxillary and mandibular arch in an Italian adolescents' sample with correct occlusion, using the digital technology. The study sample was composed, after the use of an extra-oral scanner and after the application of inclusion and exclusion criteria, by the digitized dental casts of 79 Italian adolescents (39 females and 40 males), aged 14±1 years, with correct occlusion. On each model, both upper and lower, the reference points of the dental arches (FA), of the alveolar bone (WALA ridges) and of the incisal edge of the central incisors were identified. With these points, using a software, fourteen parameters were evaluated for each cast: basal and dental intermolar and inter-canine width, basal and dental molar and canine depth, basal and dental molar and canine ratio, overjet, overbite. Finally, the shape of the arches was assessed, dividing it into ovoid, triangular or square. Chi-square test and Student's T-test for each parameter were adopted with a p<0,05 significance level. The results showed that the ovoid form was the most frequent, followed by the triangular one for the upper arch and by the rectangular one for the lower arch. On the canine level, both upper and lower, both for dental and for basal references, the triangular shape showed the lowest width and ratio values and the highest depth values in comparison with the other two groups. The square one showed the opposite situation, and the ovoid one presented in the intermediate value. On the molar level the trend is quite similar to the canine one. The results obtained maybe suggest that on a significant percentage of the patients of the sample is expected to use a preformed ovoid arch wire, and the data found could be useful to study the adequacy of the arch wires currently on the market or to design new ones. .

Longitudinal study on the effect of oral hygiene measures on the salivary count of microbial species with cariogenic potential.

The effect of oral hygiene education measures and professional tooth cleaning on the salivary levels of microbial species with high cariogenic potential (i.e. Streptococcus mutans, Lactobacillus spp. and Candida albicans) was evaluated at different time points. At time 0, high salivary carriage rates were recorded in the study group (n=30). Fifty percent of the subjects harbored all three species in their saliva, 27% harbored 2 species, and 23% only one species. At 3 months after oral hygiene measures, a statistically significant reduction was observed in salivary count of S. mutans and Lactobacillus spp. The percentage of subjects harboring all three species was also highly reduced, along with an overall improvement of clinical and risk factors parameters. At 8 months after oral hygiene measures, S. mutans and Lactobacillus spp. load was still statistically lower than that recorded at time 0, although an increment in bacterial load and a partial worsening of clinical and risk factors parameters were observed. S. mutans count in saliva inversely correlated with salivary pH, while it positively correlated with C. albicans salivary levels. The results obtained suggest that strengthening of the motivation and administration of oral hygiene instructions and professional tooth cleaning every 6-8 months, might be necessary to control salivary levels of cariogenic species.

An educational intervention to promote healthy lifestyles in preschool children: a cluster-RCT.

OBJECTIVE: Promoting four healthy behaviours among preschool children:⩾4 servings of fruit and vegetables/day, ⩾2 h/day of active play, ⩽1 h per day of TV-watching and 0 sugar sweetened beverages/day. METHODS: We conducted a c-RCT on 425 3-year-old children at 16 childcare centres based in Cesena, Italy. We randomly allocated eight childcare centres (199 children) to the intervention group and eight childcare centres (226 children) to the control group. All the randomized childcare centres completed our study protocol. Parents recorded their children's target behaviours at home over 3 Saturdays, at baseline and at follow-up. Then trained nurses measured children's weight and height. We conducted a 6-month-long intervention trial in local health care centres where nurses and primary care pediatricians, respectively, conducted two subsequent motivational interviews with parents to encourage children's healthy behaviours at home. At the same time, teachers involved children in learning experiences about healthy behaviours. Our primary outcome is a children's combined health behaviour score (CHBS) at home. Our secondary outcomes measure the BMI z-score and the percentage of children that show a BMI trajectory crossing upward. After collecting the CHBS and BMI data at baseline as well as at 1- and 2-year follow-ups, we performed an Intent-to-Treat (ITT) analysis. RESULTS: After 2 years from baseline, 48.4% of intervention group children showed a low-risk CHBS in comparison with 28.0% of control group children. A multilevel analysis showed that they were by far more likely to achieve low-risk scores (adjusted OR: 3.41; 95% CI: 1.48-7.88; P=0.004). Our BMI outcomes showed no significant difference between groups. CONCLUSIONS: A multidimensional educational intervention, which consists of motivational interviews with parents and teacher-led learning experiences for children, improved preschool children's CHBS in the long term without influencing the outcomes of BMI z-score and BMI increase.

Craniofacial morphology in pediatric patients with Prader-Willi syndrome: a retrospective study.

OBJECTIVE: To investigate craniofacial characteristics in pediatric patients with Prader-Willi syndrome (PWS). SETTING AND SAMPLE POPULATION: A retrospective sample of 20 consecutive patients with PWS who had lateral and antero-posterior (AP) cephalograms (14 males and six females; average age 10.2 ± 3 years) was compared to 20 controls matched for age and sex (14 males and six females; average age 10.5 ± 3.7 years). MATERIALS AND METHODS: Cephalometric skeletal measurements were performed twice at a 1-week interval by one calibrated operator, and random error was calculated using Dahlberg's formula. Mean values and standard deviations were computed for all variables. Student's t-test for independent samples was used to determine significant differences between PWS and controls. The level of significance was set at p < 0.05. RESULTS: Cephalometric values for the length of the maxilla (p < 0.01), mandibular length (p < 0.05) at both the ramus (p < 0.05) and the mandibular body (p < 0.01), and posterior and anterior facial height (p < 0.01) were significantly lower in patients with PWS compared to controls. The AP cephalometric analysis revealed a significant reduction (p < 0.01) in maxillary skeletal width, mandibular skeletal width, and interzygomatic distance. CONCLUSIONS: Pediatric patients with PWS seem to have a general reduction in certain craniofacial skeletal parameters (i.e., maxillary and mandibular length) compared to controls, but this study did not assess the overall craniofacial characteristics.

Black Stains: a microbiological analysis and a view on familiarity and susceptibility to tooth decay of patients in childhood.

AIM: Assess prevalence, familial predisposition and susceptibility to caries of Black Stains (BS). Evaluate the microbiological composition of BS, saliva and subgingival plaque. MATERIALS AND METHODS: Sixty nine subjects with BS (test group) and 120 subjects without BS (control group) were analysed for oral status. For each BS-patient, a BS-deposit, 1 ml of saliva and subgingival plaque were collected and microbiologically analysed. Five deciduous teeth with BS were observed under SEM. RESULTS: This study showed a BS prevalence similar to that of the Mediterranean area and a familiality. The microbiological origin of BS was confirmed by SEM and culture method and the BS flora differ from that of supragingival plaque. CONCLUSIONS: Predominance in BS and saliva of Actinomycetes and the low salivary prevalence of S. mutans and L. acidophilus may be related with low caries incidence in BS patients. The high presence of Actinomyces spp can be a causative factor for BS.

The process of mineralisation in the development of human tooth.

AIM: Tooth development and mineralisation are processes that derive from different tissues interactions, in particular ectodermal and mesenchymal layers. These interactions are responsible for the formation of unique structures with a particular chemical composition. Despite differences, mineralised tissues are similar and they derive by highly concerted extracellular processes that involve matrix proteins, proteases, and mineral ion fluxes that collectively regulate the nucleation, growth and organisation of forming mineral crystals. This review aims at explaining mineralisation, its stages and when damage occurs and alters the hard tissues structure.

Comparison of salivary antioxidant enzyme activity between ex-smokers and subjects who had never smoked.

Smoke contains oxidants such as oxygen-free radicals which are probably the major cause of damage to biomolecules. A decrease of salivary antioxidant enzymes was detected in habitual smokers. However, the effects of cigarette smoke on salivary antioxidant enzymes may persist after withdrawal from smoking. The objective of this study was to assess salivary superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activity in ex-smokers in comparison with that of subjects who had never smoked. The test group included 25 ex-smokers (13 males and 12 females; mean age: 48 ± 8 years) who had given up smoking for at least one year but for no more than 2 years, and a control group consisting of 25 subjects (14 males and 11 females; mean age: 50 ± 12 years) who had never smoked. Salivary samples were collected and SOD and GSH-Px activity was measured. Student’s t-test was used to evaluate differences between groups and significant differences were observed for p < 0.05. A significant decrease (p < 0.05) of GSH-Px (14.5 ± 2) was observed in the test group compared to the control group (30 ± 4). However, SOD was very similar in the two groups: 0.9 ± 0.3 in the test group and 0.8 ± 0.3 in the controls and no significant difference was detected (p> 0.05). Detoxification of hydrogen peroxide by the GSHPx was altered even after withdrawal from smoking, while the production of hydrogen peroxide, that is mediated by SOD, was not modified.

Investigation of periodontal status in type 1 diabetic adolescents.

AIM: The purpose of this study was to evaluate the effects of type 1 diabetes and the possible role of metabolic control on the periodontal status of diabetic adolescents. MATERIALS AND METHODS: Three groups of 40 patients each were examined: diabetic subjects with a good metabolic control (well controlled WC) (glycated haemoglobin HbA1c ≤ 7%) (20 males and 20 females; mean age: 14.1 ± 1.5 years); diabetic subjects with poor metabolic control (poorly controlled PC) (glycated haemoglobin HbA1c> 7%) (20 males and 20 females; mean age: 14.5 ± 1.3 years); and patients in good general health, which constituted the control group (20 males and 20 females; mean age: 14.1 ± 1.2 years). For each subject, a periodontal evaluation was performed and the following parameters were assessed: Plaque Index (PI), Gingival Index (GI), Bleeding on probing (BOP), Probing Depth (PD), Clinical Attachment Level (CAL). Chi-square was used to compare categorical variables. Kruskal-Wallis one-way ANOVA by ranks was used to compare the quantitative variables (GBI, PD) among the 3 groups. Post-hoc comparison between pairs of groups was assessed by Wilcoxon's rank sum test, with a downward adjustment of the alpha level to compensate for multiple comparisons. RESULTS: The levels of PI in WC subjects (1.9 ± 0.8) and in PC subjects (2.1 ± 0.6) were significantly higher compared to healthy subjects in the control group (0.8 ± 0.7) (p <0.0001). Similarly, the GI in both PC (1.9 ± 0.8) and WC subjetcs (1.7 ± 0.9) was significantly higher (p <0.05) compared to controls (0.9 ± 0.8). GBI in the PC (60.2 ± 23.6%) and the WC (57.4 ± 22.5%) groups was significantly higher compared to healthy subjects (35.9 ± 18.7%) (p <0.05). The PD parameter was found significantly higher (p <0.05) in the PC group (26.7 ± 12.6) and WC group (23.5 ± 11.3%) compared with controls (8.3 ± 6.2%). Regarding the CAL, no significant differences were found between the groups (p> 0.05). In addition, the comparisons between groups PC and WC were not statistically significant (p> 0.05). CONCLUSIONS: Adolescents affected with type 1 diabetes show a higher level of bacterial plaque, gingival inflammation with bleeding on probing and probing depth, compared to healthy subjects. There were no significant changes with regard to the accumulation of plaque and periodontal status among diabetic patients both with good control and with poor metabolic control.

Evaluation of cephalometric, hormonal and enzymatic parameters in young obese subjects.

AIM: The aim of the present investigation was to analyse cephalometric skeletal structures and hormonal and enzymatic parameters in young obese subjects in comparison with those of normal weight subjects. MATERIALS AND METHODS: The whole sample consisted of 50 Caucasian patients (28 males and 22 females) whose lateral radiographs, laboratory hormonal and enzymatic analyses were already available. The test group included 25 obese patients (11 females and 14 males, average age: 9.8 +/- 2.11 years old), while the control group included 25 normal weight subjects matched for age and sex (11 females and 14 males, 9.9 +/- 2.5 years old). Data were statistically analysed: Student's t-test for independent samples was adopted and the level of significance was set at: p < 0.05. RESULTS: As regards cephalometric records, the anterior cranial base length was significantly greater in the test group (S-N: 69.9 +/- 4 mm) compared to the controls (S-N: 68.1 +/-2.7 mm). Moreover, the maxillary lenght was higher in the test group (Pm-A: 48.5 +/- 2.5 mm) in comparison to the control group (Pm-A: 46.1 +/- 1.9 mm). As regards skeletal class and vertical dimension, no significant differences were found between the two groups, with the exception of the intermaxillary plane angle, which was significantly lower in the obese subjects in comparison to the controls. Laboratory analysis showed significant (p < 0.05) higher levels of leptin and insulin in the test group in comparison with control subjects. Furthermore, LH, FSH, IGF-1 values were significantly (p < 0.05) lower in the test group in comparison with the control group. CONCLUSION: Obese subjects exhibited an increase of some craniofacial parameters and alteration of some laboratory parameters that may be involved in the process of skeletal maturation, in comparison to normal weight subjects. These findings may be of interest in orthodontics, as young obese subjects may need a different orthodontic treatment plan in comparison to normal weight subjects of the same age.

Association between obesity and periodontal disease in children.

AIM: The objective of this study was to analyse the relationship between obesity and periodontal disease in children. The null hypothesis is that obese and normal weight children show no different degree of periodontal status. MATERIALS AND METHODS: The sample for this case control study consisted of 20 males and 24 females with a mean age of 9.43±2.05 years old and mean body mass index standard deviation score (BMI-SDS) of 2.16±0.37 in the test group, and 33 males and 26 females with a mean age of 9.67±1.46 years old and BMI-SDS of 0.22±1.79 in the control group. The periodontal status was assessed using plaque accumulation, bleeding on probing (BOP) index, probing depth (PD) and clinical attachment level (CAL). RESULTS: The test group showed higher plaque deposits and BOP and the difference between the two groups was statistically significant (p< 0.05). No significant difference between the two groups was found regarding the loss of clinical attachment, though it was worse in obese children. Categorical variables described as frequency and percentage were compared using the Fisher's exact test or test chi square. Continuous variables were analysed using the Mann-Whitney test. CONCLUSION: The study showed an association between obesity and periodontal risk indicators in children that in the long term may lead to oral conditions. The oral health of overweight/obese subjects should be more carefully supervised and checked in order to prevent oral alterations.

BIoecology of Oncideres cervina Thomson (Coleoptera: Cerambycidae) on Persea americana Mill. (Lauraceae).

Cerambycidae beetles limit production and establishment of forest and fruit trees. Oncideres cervina Thomson, 1868 (Coleoptera: Cerambycidae) is one of the most important species. The objective was to record O. cervina girdling branches of Persea americana Mill. (Lauraceae) for the first time, check the number of oviposition incisions (Noi) as a function of the diameter of branch sections, period of emergence, and describe the larval-pupal chamber. Individuals of O. cervina were observed, for the first time, in P. americana orchards in Santa Maria, Rio Grande do Sul, Brazil. The middle section of branches (40-60 cm interval) had higher number of incisions. Girdled branches with a diameter of 40-50 mm had higher number of them. Adults emerged from November through January. Larval-pupal boreholes had diameters between 9 and 11 mm, and average tunnel length was 28 mm, with a mean volume of consumed wood of 4.3 mL. This information is useful for establishing integrated pest management practices against O. cervina in P. americana since this crop has a high added value and can be significantly compromised by attack by Cerambycidae beetles.

Dental and periodontal complications of labial and tongue piercing.

Piercing is the practice of puncturing some parts of the body to apply ornamental objects. The presence of oral and perioral piercings are a risk factor for many acute and chronic complications, such as chipping of the dental enamel, periodontal lesions and infection. The aim of this study is to assess the prevalence of lip and tongue piercing complications in the dental and periodontal tissues in a sample of young adults. Twenty-five adult patients were examined (test group: 11 males and 14 females with an average age of 23.4+/-3.6 years) who had had a minimum of one labial or tongue piercing for at least 1 year and were compared with 25 subjects (control group: 11 males - 44 percent, and 14 females - 56 percent) without any lingual or labial piercing. A questionnaire was compiled for each patient and a clinical examination was performed. The following parameters were examined by the same operator: abnormal toothwear, tooth chipping or cracking, clinical attachment loss (CAL), probing pocket depth (PD) and gingival recession (GR, classified by using Miller s classification). The data were analyzed using X2 or Fisher s exact test for small numbers and non-parametric Mann-Whitney or Kruskal-Wallis tests to examine for differences in continuity; the level of significance was p less than 0.05. According to the results found in the present study the prevalence of abnormal tooth wear and tooth chipping was higher in the subjects with labial or lingual piercing. Moreover, patients with tongue or labial piercing exhibited a higher GR in comparison to control subjects without any oral piercing. No differences were observed between the two groups as regards CAL and PD. A significant association between the duration of piercing and dental defects was found in the group of patients with piercings with greater prevalence of tooth and periodontal defects in the group of 13 subjects who had had the piercings for a period less than or equal to 4 years.

Spatial distribution and sample size to estimate Lycosa erythrognatha (Araneae: Lycosidae) population density overwintering.

Lycosa erythrognatha Lucas, 1833 (Araneae: Lycosidae) is a predatory arthropod with potential for conservation biological control. In addition to being considered a bioindicator of environmental quality, this arthropod provides an important service for agriculture by reducing insect-pest populations. In this work we seek to understand how the plants Andropogon bicornis L., Saccharum angustifolium Nees and Eustachys retusa Lag (Poales: Poaceae) and their different clump sizes affect the population density, spatial distribution and determination of the minimum number of samples to estimate its population density during the winter. Among the evaluated host plants, S. angustifolium and A. bicornis presented higher population density than E. retusa, but we observed that the clump diameter significantly influences the population density and the minimum number of samples. We observed a gregarious behavior in plants of A. bicornis and E. retusa. For S. angustifolium, a uniform distribution was observed.

Effects of cigarette smoke on salivary superoxide dismutase and glutathione peroxidase activity.

Cigarette smoke contains oxidants such as oxygen-free radicals and volatile aldehydes, which are probably the major causes of damage to biomolecules exposed to cigarette smoke. However, saliva has an antioxidant defense system able to counter toxic activities of radical species that is formed by antioxidant enzymes, including superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px). The purpose of this study is to verify the possible effects of cigarette smoke on SOD and GSH-Px. Forty-four patients (25 males and 19 females) were enrolled in this study. The participants were 20 smokers (12 males and 8 females) and 24 non-smokers (13 males and 11 females). Furthermore, 10 subjects of the control group were ex-smokers (9 males and 1 female). Their mean age plus or minus standard deviation (SD) was 58.8 plus or minus 15.9 years for the case group and 73.8 plus or minus 10.6 years for the control group. All patients were underwent a careful anamnestic investigation and examination of the oral cavity. After rinsing the mouth with water, each subject put 3 cc of non-stimulated saliva inside a test tube. The saliva was centrifuged and oral peroxidase and superoxide dismutase activity was measured according to a specific assay. Statistical analysis was performed to evaluate differences between the groups and significant differences were observed for p less than 0.05. A significant decrease of GSH-Px activity was detected in the smoking group (p less than 0.05), while the SOD activity was similar in the control and case groups. According to the sex, a significant decrease of GSH-Px activity was noted in males of the smoker group (p less than 0.05), while in the sample of females no significant difference of the enzymatic activity was found. Moreover, among ex-smokers, there was a significant difference in the values of GSH-Px between those who had not smoked for less than ten years and those who had not smoked for more than ten years. Cigarette smoke may alter the detoxification of hydrogen peroxide through a decrease of GSH-Px activity. The overproduction of H2O2 may lead to an oxidative stress that is involved in a large number of diseases, including precancerous and neoplastic lesions of the oral cavity. The effects of cigarette smoke on salivary antioxidant enzymes decrease after withdrawal from smoking and the benefits become more evident with the passage of time.

Sjögren's syndrome: correlation between histopathologic result and clinical and serologic parameters.

AIM: Sjögren's syndrome (SS) represents a challenging illness to diagnose properly and, because of the serious complications such as lymphoma, it is important to reach a correct diagnosis in early stages. Aim of this retrospective study was to evaluate the correlation between histopathologic result of minor salivary gland biopsy and clinical and serologic parameters for the diagnosis of SS. METHODS: We evaluated 360 biopsies, taken from the lower lip, of 360 patients (18 males) on suspicion that they were suffering from SS. The Chisolm and Mason classification was used to state the diagnosis of SS. For each patient, the medical history and the symptoms were evaluated, and diagnostic tests were performed. The revised rules of the American-European Consensus Group Criteria were used to diagnose primary and secondary SS. For the statistical analysis we used the Chi(2) test; a difference of P<0.05 was considered significant. RESULTS: Considering the statistical correlation between a focal score > or =1 and the serological data, it was noted that a positive score was significantly correlated to all serological parameters examined (P<0.0001). A significant correlation was also found between a positive biopsy score and Schirmer's test and Rose Bengal test (P<0.0001). However, with regard to the clinical data, a significant correlation was found only for two parameters: xerostomia (P<0.0001) and parotid swelling (P<0.05). CONCLUSION: Minor salivary gland biopsies are of great diagnostic value in detecting SS. However, for the diagnosis of SS both clinical and serologic parameters should be considered. The data obtained from the present survey reveal that the serologic markers are more predictive than clinical parameters for a positive biopsy score.