Cardiovascular risk and the COVID-19 pandemic: A retrospective observational study in a population of healthcare professionals.

BACKGROUND AND AIM: To contain the spread of COVID-19, many countries imposed several restrictive measures, leading to radical changes in daily life behaviors. Healthcare workers experienced additional stress due to the increased risk of contagion, possibly causing an increase in unhealthy habits. We investigated changes in cardiovascular (CV) risk assessed by the SCORE-2 in a healthy population of healthcare workers during the COVID-19 pandemic; an analysis by subgroups was also conducted (sportspeople vs sedentary subjects). METHODS AND RESULTS: We compared medical examination and blood tests in a population of 264 workers aged over 40, performed yearly before (T0) and during the pandemic (T1, T2). We found a significant increase in the average CV risk, according to SCORE-2, during the follow-up in our healthy population, with a shift from a mean low-moderate risk profile at T0 (2.35%) to a mean high-risk profile at T2 (2.80%). Furthermore, in sedentary subjects was observed a greater and early increase in SCORE-2 compared to sportspeople. CONCLUSIONS: Since 2019, we observed an increase in CV risk profile in a healthy population of healthcare workers, particularly in sedentary subjects, highlighting the need to reassess SCORE-2 every year to promptly treat high-risk subjects, according to the latest Guidelines.

'Study of the maxillary yaw on cone beam computed tomography: A preliminary report and comparison between two different dento-skeletal malocclusions'.

OBJECTIVES: To assess the skeletal and dental maxillary transverse compensation (yaw) on the cone beam computed tomography (CBCT) three-dimensional reconstructed image of the skull in two groups of patients, both clinically affected by a class III malocclusion with deviation of the lower midline. MATERIALS AND METHODS: An observational retrospective study was designed to analyse differences in two groups of patients, the first one was composed by patients affected by horizontal condylar hyperplasia, the second one by patients affected by dento-skeletal asymmetric class III malocclusion. Each group was composed by 15 patients. Transverse analysis was performed by measuring five landmarks (three bilateral and two uneven) with respect to a mid-sagittal plane; sagittal analysis was performed by measuring the sagittal distance on the mid-sagittal plane between bilateral points. Means were compared through inferential analysis. RESULTS: In the condylar hyperplasia group, all differences between the two sides were not statistically significant, nor for canines' difference (P = .0817), for molars (P = .1105) or for jugular points (.05871). In the class III group, the differences between the two sides were statistically significant for molars (P = .0019) and jugular points (P = .0031) but not for canines (P = .1158). Comparing the two groups, significant differences were found only for incisors' midline deviation (P = .0343) and canine (P = .0177). CONCLUSION: The study of the yaw on CBCT should be integrated into three-dimensional cephalometry and could help in differentiating the various malocclusion patterns.

Epidemiological characteristic of Orofacial clefts and its associated congenital anomalies: retrospective study.

BACKGROUND: To evaluate the relationship between gender, ethnicity/citizenship, clinical phenotype, total prevalence, and the various congenital malformations associated with oral clefts (OC) in Italy across the period 2001-2014. METHODS: A retrospective analysis (2001-2014) was conducted based on the National Congenital Malformation Registries network of Italy (Emilia-Romagna Registry of Birth Defects [IMER] and Registro Toscano Difetti Congeniti [RTDC]), which were analyzed to investigate time trends, geographical/ethnic clusters, topography, sex ratio, and associated congenital anomalies of OC phenotypes. RESULTS: Among 739 registered cases, 29.8% were syndromic or had multi-malformed associated anomalies, compared with 70.2% having isolated orofacial cleft. Cleft lip (CL) was observed in 22%, cleft palate (CP) in 40%, and cleft lip and palate (CLP) in 38% of live births, stillbirths, and terminations of pregnancy for fetal anomaly cases. Other associated conditions were major anomalies of cardiovascular defects (39%), followed by defects of the limbs (28%), neuroectodermal defects (23%), and urogenital malformations (10%). Male-to-female sex ratio was 1:1.14 in CP, 1.22:1 in CL, and 1.9:1 in CLP. Foreigners were represented by 29% from Southeast Asia, 25% from Balkans, 25% from North-Central Africa, 9% from the East, 7% from Western Europe, and 5% from South America. Total prevalence of OC cases ranged from 0.9 (RTDC) to 1.1 (IMER) of 1000 births. CONCLUSIONS: This retrospective study provides a population-based, clinical-epidemiological description of the orofacial cleft phenomenon. As a relatively frequent congenital malformation, its social and economic impact is worthy of further study. These abnormalities can cause significant problems that may be solved or minimized by early diagnosis and treatment.

Prevalence of craniomandibular disorders in orthodontic pediatric population and possible interactions with anxiety and stress.

AIM: To analyse the presence and prevalence of gnathologic problems in a sample of children, candidate for orthodontic treatment, and evaluate the relationship between psychological factors and gnathological problems. The purpose of this study was also to evaluate a simple protocol with specific psychological test and a questionnaire for the rapid diagnosis of gnathologic problems, useful for possible screening studies on a wider population. MATERIALS AND METHODS: Study Design: Observational, cross-sectional study. Among the patients coming for a first orthodontic evaluation 106 children, aged between 8 and 16 years, were examined. A complete orthodontic evaluation was performed in all patients; the RCMAS (Revised Children's Manifest Anxiety Scale) was used in the study to test the psychological condition, while the selected test for the diagnosis of gnathologic problems was the Fonseca Test. The prevalence of temporomandibular disorders (TMD) was evaluated with descriptive statistical analysis, and the eventually present correlation with a positive psycological test for anxiety has been evaluated with correlation parameters: c2 test of Pearson, and Cramer's V index. RESULTS: The mean age of the children was 10.74 years. Females accounted for 55.66% of the total compared to 44.34% males. Signs and symptoms of TMD were present on average in 82% and 32% respectively. A remarkable amount of children also showed signs of psychological problems, mostly represented by anxiety. Positive correlation resulted between TMD (Fonseca scores) and increased overbite. Cross-correlations have been obtained, tested with Pearson c2 test and Cramer's V index, between level of anxiety, muscle pain on palpation, bad habits, and headache. The Class II subdivision molar class and altered canine relationship have been related to the presence of articular noise. CONCLUSION: The protocol largely respected the need for speed of administration, comprehensiveness and reliability that we set out to achieve. Limited correlations have been assessed between occlusal conditions and positivity to the administrated tests. Further studies are desirable to increase the sample population.

Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

BACKGROUND: The prevalence of impacted maxillary canine is reported to be between 1% and 3%. The lack of monitoring and the delay in the treatment of the impacted canine can cause different complications such as: displacement of adjacent teeth, loss of vitality of neighbouring teeth, shortening of the dental arch, follicular cysts, canine ankylosis, recurrent infections, recurrent pain, internal resorption of the canine and the adjacent teeth, external resorption of the canine and the adjacent teeth, combination of these factors. An appropriate diagnosis, accurate predictive analysis and early intervention are likely to prevent such undesirable effects. The objective is to evaluate, by means of a retrospective observational study, the possibility of carrying out a predictive analysis of root resorption adjacent to the impacted canines by means of orthopantomographs, so as to limit the prescription of additional 3D radiography. MATERIAL AND METHODS: 120 subjects with unilateral or bilateral maxillary impacted canine were examined and 50 patients with 69 impacted maxillary canine (22 male, 28 female; mean age: 11.7 years) satisfied the inclusion criteria of the study. These patients were subjected to a basic clinical and radiographic investigation (orthopantomographs and computerized tomography). All panoramic films were viewed under standardized conditions for the evaluation of two main variables: maxillary canine angulations (a, b, g angles) and the overlapping between the impacted teeth and the lateral incisor (Analysis of Lindauer). Binary logistic regression was used to estimate the likelihood of resorbed lateral incisors depending on sector location and angle measurements. RESULTS: Results indicated that b angle has the greatest influence on the prediction of root resorption (predictive value of b angle = 76%). If ß angle <18° and Lindauer = I, the probability of resorption is 0.06. CONCLUSIONS: Evaluation of b angle and superimposition lateral incisor/impacted canine analysed on orthopantomographs could be one of the evaluation criteria for prescribing second level examination (CT and CTCB) and for detecting root resorption of impacted maxillary canine adjacent teeth.

Effective radiation doses associated with non-invasive versus invasive assessment of coronary anatomy and physiology.

OBJECTIVES: To compare the effective radiation dose (ERD) needed to obtain information on coronary anatomy and physiology by a non-invasive versus an invasive diagnostic strategy. BACKGROUND: Knowledge of anatomy and physiology is needed for management of patients with coronary artery disease (CAD). There is, however, a growing concern about detrimental long-term effects of radiation associated with diagnostic procedures. METHODS: In a total of 671 patients with suspected CAD, we compared the ERD needed to obtain anatomical and physiological information through a non-invasive strategy or an invasive strategy. The non-invasive strategy consisted of coronary computed tomography angiography (CCTA) and single photon emission computed tomography (SPECT). The invasive strategy included coronary angiography (CA) and fractional flow reserve (FFR) measurement. In 464 patients, the data were acquired in Period 2009 and in 207 the data were acquired in Period 2011 (after each period, the CCTA- and the CA-equipment had been upgraded). RESULTS: For the Period 2009 total ERD of the non-invasive approach was significantly larger compared to the invasive approach (28.45 ± 5.37 mSv versus 15.79 ± 7.95 mSv, respectively; P < 0.0001). For Period 2011, despite the significant decrease in ERD for both groups (P<0.0001 for both), the ERD remained higher for the non-invasive approach compared to the invasive approach (16.67 ± 10.45 mSv vs. 10.36 ± 5.87 mSv, respectively; P < 0.0001). Simulation of various diagnostic scenarios showed cumulative radiation dose is the lowest when a first positive test is followed by an invasive strategy. CONCLUSION: To obtain anatomic and physiologic information in patients with suspected CAD, the combination of CA and FFR is associated with lower ERD than the combination of CCTA and SPECT.

Alkaline phosphatase level in gingival crevicular fluid during treatment with Quad-Helix.

The aim of this work is to assess the level of the human alkaline phosphatase enzyme (ALP) during palatal expansion with Quad-Helix (QH) appliance. A total of twenty-two orthodontic patients characterized by contraction of the upper jaw, that needed application of a QH in order to treat their condition, were included in this study. Gingival crevicular fluid (GCF) was collected at four different times: before cementation (T0), after two weeks (T1), after four weeks (T2) and after one year (T3) from application of QH. In each patient maxillary first molars, right (UM-right) and left (UM-left), which were connected with bands to QH, were used for testing; first lower molars were used as Controls (LM-right, LM-left). Data show that ALP level in tension sites was proportional to the average increase of the inter-molar distance; on the contrary, the enzymatic level in compression sites was characterized by an inverse trend. The only exception to this phenomenon was recorded after one year (T3), when the increase of ALP level in both sites of tension and compression was ascribed to a mild inflammation due to bacterial plaque accumulation. The level of ALP in control sites was constant for the whole period of observation. The described ALP fluctuations in accordance with the inter-molar distance increment, shows that the main action of QH on bone remodelling was exerted during the fourth week (T2); for this reason, the monitoring of this enzyme could be used as a marker of effective function of the QH appliance.

The mandibular permanent second molars and their risk of impaction: a retrospective study.

AIM: The aim of this retrospective study is promote a better understanding of the impaction of teeth 37 and 47 by means of clinical and statistical data from the point of view of early interceptive treatment. STUDY DESIGN: 478 patients of the Orthodontic School of "La Sapienza" University of Rome (Italy) were studied to assess the eruption of teeth 37 and 47 on at least two good-quality panorex using angular measurements and Nolla's index from January 2008 to December 2013. Data were analysed using ANOVA and Tukey HSD test (P < 0.05). RESULTS: The data obtained on the possible correlations between the examined teeth and the four reference angles show that at t0, the angular variation of teeth 36 or 46 is constant when the teeth are at the end of their eruptive process, while for teeth 37 and 47, this variation is always constant. At t0, the first and the second molars of both quadrants, during eruption showed a similar behaviour. At t1, the four teeth examined in the patients sample showed a model of development analogous to that exhibited at t0. STATISTICS: a constant variation (t0-t1) is present among the differences in the development of the 36 and the two angular values, while difference in development of the 37 and that of the angular value is constant only in relationship to the difference in development of the mandibular first molar of the same quadrant. The variations between the difference in development of the 47 and in angular value (t0-t1) are constant only when related to the developing 46. The analytic variance of gradience (vargrad) data confirm peculiar behaviour of the first one, according to both mandibular molars, during their eruptive development. CONCLUSIONS: Adoption of universally recognised radiographic predictive methods allows assessment of the case and allows the specialist to plan a suitable treatment to prevent or intercept the molar impaction, with a perspective of a less invasive and shorter therapy. Although rare, impaction of teeth 37 and 47 often requires a complex, multidisciplinary approach.

The accuracy of CBCT in measuring jaws bone density.

BACKGROUND: The cone-beam computerized tomography (CBCT) has become widely used for oral and maxillofacial imaging, providing a good spatial resolution, gray density range, and contrast, as well as a good pixel/noise ratio. In the CBCT the dimensional accuracy is also comparable with Computer Tomography (CT), but in contrast to the CT, the gray density values of the CBCT images (voxel value [VV]) are not absolute. AIM: The aim of the study was to evaluate if there is a statistically significant difference in bone density values, defined as gray density values (VV), using two different CBCT exposure radiation (8 mAs or 15 mAs). MATERIALS AND METHODS: 10 dry mandibles were CBCT scanned using two different exposure radiation (8 mAs or 15 mAs). Using software and a radiographic template, the CBCT-scan images were overlapped and two datasets were created, each one giving the respective gray values (VV), of the same area with the same spatial coordinates. The quantified gray density values of the planned volume were measured and expressed as VV in two different exposure radiation scans Groups (Group A: 8 mAs; Group B: 15 mAs). For the statistical analysis, t-test was used. RESULTS: The differences between the CBCT gray density values (VV) of the Groups (Group A: 8 mAs; Group B: 15 mAs) were statistically significant (p <= .05). CONCLUSIONS: This study demonstrated that the use of a CBCT to evaluate the bone density of jaws is not useful when the values are taken as absolute values. In spite of the lower radiation dose and costs of CBCT, this new technique does not allow an accurate assessment of bone density.

The impact of osteotomy technique for corticotomy-assisted orthodontic treatment (CAOT) on oral health-related quality of life.

BACKGROUND: Corticotomy in accelerating orthodontic tooth movement, also defined as corticotomy-assisted orthodontic treatment (CAOT), is a promising technique that recently had many applications in orthodontics. AIM: The purpose of this study was to compare the use of piezoelectric surgery and conventional rotatory osteotomy technique for CAOT, determining the duration of surgery and oral health-related quality of life (OHRQoL). PATIENTS AND METHODS: CAOT was performed in a sample of subjects, randomly choosing piezoelectric surgery (PS Group) or conventional rotary osteotomy technique (RT Group). The duration of surgery was recorded and the oral health-related quality of life evaluated using the short form Oral Health Impact Profile (OHIP-14) preoperatively, 3 and 7 days after surgery. t-test and Cronbach's alpha were used for statistical analysis. RESULTS: 12 patients (mean age 14; range: 13-17) were enrolled. The time needed to complete the osteotomy cuts was greater (p = 0.1) for the piezoelectric surgery group (mean 34.3 minutes; range 35.3-32.6) than for the rotator group(mean 28.2 minutes; range 27.1-29.2). Oral health-related quality of life deteriorated from baseline (OHIP-14 mean: 6.33) to first follow-up, 3 day after surgery, in both groups (PS Group: 22.67 OHIP-14; RT Group: 21.33 OHIP-14). At 7 days follow-up there was a nearly complete recovery of the original OHIP-14 values , even faster with the conventional rotary osteotomy technique; however, no statistically significant differences were recorded between the two methods (p = 0.35). Cronbach's alpha values indicated an excellent internal consistency reliability. CONCLUSIONS: In clinical decision-making regarding the use of corticotomy-assisted orthodontic treatment, it should be aware of the expected decrease in oral health-related quality of life both using piezoelectric surgery or rotary osteotomy technique. In addition, the piezoelectric osteotomy requires a longer surgical time.

Correlation between generalised joint hypermobility and temporomandibular joint disc displacement in adolescent patients: Magnetic Resonance Imaging study.

AIM: Temporomandibular disorders (TMD), in particular disc displacement, are recognised to have a multifactorial aetiology. Ligamentous laxity has been suggested as a potential risk factor for TMD. Ligamentous laxity can lead to generalised joint hypermobility (GJH) involving multiple joints, including the temporomandibular joint (TMJ). The aim of this work is to evaluate the correlation between GJH and disc displacement (DD) assessed on magnetic resonance images (MRI) of the TMJ in adolescent patients. MATERIALS: The study was included 40 adolescent patients (10-16 years), divided into two groups, a Study Group (SG), composed of 20 subjects with GJH, and a Control Group (CG), composed of 20 subjects without GJH. The GJH was assessed by the Beighton test with a threshold value of ≥ 4. The severity of the TMD was determined using the Fonseca Questionnaire and a clinical evaluation of the type of TMD. The condylar-discal relationship and the condylar mobility of the TMJ were evaluated by MRI. Pearson's χ2 Test was performed for the analysis of the statistical correlation. CONCLUSION: This study suggests that adolescents with GJH have a greater risk of developing TMJ disc displacement, especially disc displacement without reduction.

Physiological and angiographic outcomes of PCI in calcified lesions after rotational atherectomy or intravascular lithotripsy.

BACKGROUND: Percutaneous coronary interventions (PCI) in calcified coronary artery lesions are associated with impaired stent expansion, higher rate of periprocedural complications and cardiac mortality. Lesion preparation using calcium modifying techniques such as Rotational Atherectomy (RA) or Intravascular Lithotripsy (IVL) has been advocated. Studies comparing these technologies are lacking. We aimed to compare in-stent pressure gradients, evaluated by vessel fractional flow reserve (vFFR), in calcific lesions treated using either RA or IVL. METHODS: Patients undergoing either RA- or IVL-assisted PCI from two European centers were included. Propensity score matching (1:2) was performed to control for potential bias. Primary outcome was post-PCI in-stent pressure gradients calculated by vFFR (vFFRgrad). Secondary outcomes included the proportion of patients with complete functional revascularization defined as distal vFFR post-PCI (vFFRpost) ≥ 0.90. RESULTS: From a cohort of 210 patients, 105 matched patients (70 RA and 35 IVL) were included. Pre-PCI vFFR did not differ between groups (0.65 ± 0.13 RA and 0.67 ± 0.11 IVL). After PCI, in-stent pressure gradients were significantly lower in the IVL group (0.032 ± 0.026 vs 0.043 ± 0.026 in the RA group, p = 0.024). The proportions of vessels with functional complete revascularization was similar between the two groups (32.9% vs. 37.1% in the RA and IVL group, respectively; p = 0.669). CONCLUSIONS: Calcific lesions preparation with IVL is effective and resulted in lower in-stent pressure gradients compared to RA. Approximately one third of the patients undergoing PCI for a severely calcified lesion achieved functional revascularization with no difference between rotational RA and IVL.

The role of fractional flow reserve to guide stent implantation.

In routine clinical practice, a sizeable proportion of patients with suspected coronary artery disease (CAD) undergo coronary angiography without prior non-invasive functional evaluation. In this situation, the decision wheter to perform revascularization is taken solely on the basis of angiographic parameters, which are often limited in assessing the lesions that are functionally significant and ultimately responsible for patients' symptoms. Fractional flow reserve (FFR) is a validated method for assessing hemodynamic significance of coronary stenoses based on the use of pressure wires and assessment of hyperemic pressure gradients across coronary lesions. FFR can guide clinical decision making in several anatomical settings: e.g. intermediate stenosis, left main stenoses, multivessel disease, bifurcation lesions. Treatment strategies guided by FFR have been shown to be equally safe and more efficacious than angiography-guided PCI. FFR is readily available in the catheterization laboratory, and can be easily measured during coronary angiography. FFR represents a unique tool for interventional cardiologists to combine anatomical and functional information, allowing the selection of optimal revascularization strategy in patients with CAD.

Heart failure with preserved ejection fraction or non-cardiac dyspnea in paroxysmal atrial fibrillation: The role of left atrial strain.

BACKGROUND: Diagnosis of heart failure with preserved ejection fraction (HFpEF) in patients with dyspnea and paroxysmal atrial fibrillation (AF) is challenging. Speckle tracking-derived left atrial strain (LAS) provides an accurate estimate of left ventricular (LV) filling pressures and left atrial (LA) phasic function. However, data on clinical utility of LAS in patients with dyspnea and AF are scarce. OBJECTIVE: To assess relationship between the LAS and the probability of HFpEF in patients with dyspnea and paroxysmal AF. METHODS: The study included 205 consecutive patients (62 ± 10 years, 58% males) with dyspnea (NYHA≥II), paroxysmal AF and preserved LV ejection fraction (≥50%), who underwent speckle tracking echocardiography during sinus rhythm. Probability of HFpEF was estimated using H2FPEF and HFA-PEFF scores, which combine clinical characteristics, echocardiographic parameters and natriuretic peptides. RESULTS: Patients with high probability of HFpEF were significantly older, had higher body mass index, NT-proBNP, E/e', pulmonary artery pressure and larger LA volume index than patients in low-to-intermediate probability groups (all p < 0.05). All components of LAS and LA strain rate showed proportional impairment with increasing probability of HFpEF (all p < 0.05). Out of the speckle tracking-derived parameters, reservoir LAS showed the largest area under the curve (AUC = 0.78, p < 0.001) and the strongest independent predictive value (OR: 1.22, 95% CI 1.08-1.38) to identify patients with high probability of HFpEF. CONCLUSIONS: Reservoir LAS shows a high diagnostic performance to distinguish HFpEF from non-cardiac causes of dyspnea in symptomatic patients with paroxysmal AF.

Short-term effects of the activator in skeletal class II division 1 patients with different vertical skeletal pattern. A retrospective study.

AIM: The aim of this retrospective study was to analyse the effectiveness of Andresen appliance in inducing an increased mandibular dimension and, above all, to test the "null" hypotesis that the patients' vertical skelettofacial morfology could influence this increase using the Ricketts' method of VERT. METHODS: Cephalometric records of 42 skeletal class II patients treated at the Orthodontic Department of Catania University were randomly selected. The sample was divided for vertical facial patterns, according to the facial classification method of Ricketts (VERT), into three groups: brachyfacial, mesiofacial and dolicofacial. Ten landmarks were located on the lateral cephalometric radiographs; growth in the horizontal-sagittal direction and in the vertical direction was evaluated using the measurements of total mandibular length (Co-Gn, Co-Pg, Ar-Pg, Ar-Gn), mandibular sagittal position (SNB, ANB) and mandibular ramus height (S-Go, Ar-Go, Co-Go). The intragroup comparisons were made using two tailed t-tests, while the intergroup comparisons were analyzed statistically using the Kruskal-Wallis test. RESULTS: The cephalometric values before (T0) and after (T1) treatment showed significant changes for the majority of the cephalometric variables in each group. Our findings demonstrated a statistically significant greater increase of mandibular dimension in the brachyfacial group, while similar results were found for mesiofacial and dolichofacial groups. CONCLUSION: The "null" hypothesis, that the skeletal pattern of subjects could influence the increase of mandibular dimension after Andresen treatment, had to be accepted: the brachyfacial patients showed a greater anterior mandibular displacement when compared to mesiofacial or dolichofacial group.

Dental Monitoring Application: it is a valid innovation in the Orthodontics Practice?

AIM: The aim of research is to show the effectiveness of 0.014X0.025 CuNiTi wires in self-ligating straight-wire appliance in the working time of 10 weeks, the treatments are monitored with the Dental Monitoring® Applications. A statistical significance analysis of the correspondence between the results of the first phase of fixed orthodontic treatment (alignment), according to the type of wires used, compared to the time (about 8 weeks) suggested by the manufactory house is therefore useful to fully understand the power of these arches in the orthodontic treatment. MATERIAL AND METHODS: The study provides for the recruitment of 35 cooperating patients with different degrees of crowding, all treated with Damon System(ORMCO), monitoring them through pictures, taken in the Dental Monitoring(DM®) sequence technique, as follows: Time0: Arch-Wire Insertion (0.014x0.025CuNiTi), Time1: Four Weeks, Time2: Eight Weeks, Time3: Ten Weeks. RESULT: The results obtained will be compared with records reported by manufactory house. Our results showed that the manufacture information does not correspond to the real efficiency of the device tested. Statistical Analyses performed by T test student. CONCLUSIONS: In Our experience, applying DM Application with self-ligating technique has reduced in term of number of appointments for each patient from 3 appointments in 10 weeks to 2 appointments, when the indirect bonding was effectuated and when we have inserted a 014X025 CuNiTi. This means that there is a reduction in the mean period of chair time, of material 'costs, number of visits; moreover, there is an increase in term of frequency of patient' s monitoring, resulting in a more precise evaluation of treatment by orthodontist. The limits of the present study are presented by the variable patient's compliance and by the small number of patients. This device is an instrument advantageous for the orthodontist's work. In literature, there are few articles inherent to Digital application Mobile, we will hope that this our experience represents a valid support to a major use of this application in the clinical practice.

Oral health and malocclusion in 10-to-11 years-old children in southern Italy.

AIM: This study had two main goals: the evaluation of caries experience in permanent teeth and the analysis of malocclusion prevalence. STUDY DESIGN: Observational cross-sectional survey. METHODS: The sample consisted of all the 5th graders of 'Gio Leonardo di Bona', the only Public School in Cutro, a small urban area in Southern Italy (10,000 inhabitants). The clinical examination was performed by a trained dentist at the school infirmary, and no radiographs, study casts, or previous written records of the children were available. DMFS-DMFT and Index of Orthodontic Treatment Need (IOTN) were used to fulfil the study objectives. After the examination, parents received a report on presence/absence of dental caries and possible orthodontic treatment need. Statistics All data were analysed with StatView and Stata 8.0 software. The Chi-square test was applied to compare prevalence rates. The Chi-square linearity was used to evaluate whether caries and malocclusion prevalence changed with a steady trend with reference to sex. RESULTS: The 94% (n. 97) of the whole sample gave a positive consent to the screening. The overall mean of DFS was 4.30 (4.74 SD) while the mean of DFT was 2.60 (2.03 SD). The 22.7% of the sample had DFS/T = 0. Statistically significant difference between genders according to DFS (p = 0.017) and DFT (p = 0.002) distribution was found, being females' significantly lower than males'. Using the DHC-IOTN, 51.6% of the children were assigned to the no/little need, 26.8% to borderline need and 21.6% to a great need for orthodontic treatment. There was no statistically significant difference by gender according to distribution of occlusal traits (p> 0.05), except in the anterior cross bite, being males significantly more affected (p = 0.030). CONCLUSIONS: We believe that oral health and orthodontic surveys performed on a higher number of patients at an early age are critical in order to enhance early treatment, thus avoiding severe malocclusions and progression of dental caries. The results of our study indicate that 21.6% of the sample had an objective orthodontic treatment need (grades 4-5 DHC-IOTN). The single Aesthetic Component (AC) score of the IOTN failed to identify orthodontic treatment needs in our sample: only 13% rated themselves as being in categories 5-10 (great aesthetic need for treatment). With reference to dental caries, males had a mean DFT (3.20) higher than the WHO's 2000 Oral Health Goal for 12-years-olds (DFT = 3) while females (DFT = 1.96) were significantly under this target. The children were advised to undergo regular examinations and to change their lifestyle habits.