The Correlation between Mandibular Arch Shape and Vertical Skeletal Pattern.

Background and Objectives: The aim of this study was to evaluate the correlation between the mandibular arch shape and the vertical skeletal pattern in growing patients. Materials and Methods: A total of 73 Caucasian patients (33 males and 40 females; mean age 9.4) were retrospectively enrolled from a pool of patients treated in chronological order at the Department of Orthodontics, University of Foggia, Italy, from April 2018 to December 2021. Each patient received a laterolateral radiograph and a digital scan of the dental arch. Eight cephalometric parameters (lower gonial angle, intermaxillary angle, divergence angle, Wits index, Jarabak ratio, OP-MP angle, PP-OP angle, and ANB) and five dental measurements (posterior mandibular arch width, anterior mandibular arch width, mandibular occlusal angle, posterior width on distobuccal molar cusps, and molar angle) were analyzed and then compared. A Spearman's rho correlation test between the cephalometric measurements and the dental measurements was performed. Statistical significance was set at p < 0.05. Results: A negative statistically significant correlation was found between the Jarabak ratio and the intermolar angle; a statistically significant correlation was also observed between the Wits index, the posterior mandibular width, and the occlusal mandibular angle; the ANB angle and the occlusal mandibular angle; the intermaxillary angle (PP-PM) and the mandibular occlusal angle, posterior mandibular width on the disto-vestibular cusp, and the intermolar angle; and the OP-MP angle and mandibular occlusal angle and the posterior mandibular width on the disto-vestibular cusp. Conclusions: The mandibular arch form may be related to certain predisposing features in craniofacial morphology, such as jaw divergence, the Jarabak ratio, and the intermaxillary angle.

Treatment of Mandibular Impacted Canine in a Patient with Class II Division 1 Malocclusion with "Reverse Pin": A Case Report.

This case report presents an orthodontic treatment conducted on a 13-year-old girl with bilateral Class II malocclusion and a mandibular impacted canine. The presence of an impacted tooth necessitates careful consideration of the timing of orthodontic treatment, the appropriate surgical procedure to expose the tooth, the specific orthodontic mechanics involved, and the potential problems that may arise, all of which depend on the type and location of the canine impaction in the jaw. The treatment plan included a surgical procedure to expose the impacted tooth and orthodontic traction to guide it into position. Correction of the Class II Division 1 malocclusion utilized a specialized technique called the "reverse pin", reducing vertical side effects. The revised version maintains clarity and key information about the case report and treatment.

Temporomandibular Disorders and Oral Features in Idiopathic Inflammatory Myopathies (IIMs) Patients: An Observational Study.

Aim: Inflammatory idiopathic myopathies (IIMs) are inflammatory processes affecting skeletal musculature and extramuscular organs. Temporomandibular disorders (TMD) involve jaw muscles and temporomandibular joint. The aim of this observational study was to investigate the prevalence of the main TMD symptoms and signs as well as oral implications in IIM patients. Methods: The study group included 54 patients (42 women and 12 men), 22 of whom affected by dermatomyositis (DM), 29 by polymyositis (PM) and 3 by inclusion body myositis (IBM). A group of 54 patients not affected by this disease, served as CG. Oral and TMD signs and symptoms were evaluated by means of a questionnaire and through clinical examination. Results: About oral symptoms, the study group complained more frequently dysgeusia, with loss of taste or unpleasant taste (p<0.0001) and feeling of burning mouth (9.4% versus 0 controls). Xerostomia was more prevalent in the study group respect to the CG (p<0.0001). Dysphagia was reported by 48.1% of IIM patients while was absent in CG (p<0.0001). About oral signs, cheilitis (p<0.05) and oral ulcers (p<0.05) were significantly more frequent in CG. As regard to TMD symptoms, arthralgia and tinnitus didn't showed significant differences between the two groups, while neck/shoulders and masticatory muscle pain was significantly more referred in IIM patients than in the CG (p<0.05). About TMJ signs, sounds were overlapping in the two groups: click=11.1% in both IIM patients and CG (p>0.05), crepitation in 11.1% of IIM and 9.3% of controls (p>0.05). No significant difference was detected about deflection (9.3%, p>0.05), while deviation was wider in CG (p<0.05). Active opening and lateralities showed no significant differences, while endfeel was significantly increased in IIM group for a higher presence of muscular contracture. Bruxism was present only in CG. Conclusion: The data collected from this observational study seem to support the existence of a relationship between the prevalence of TMD symptoms and signs as well as oral features in patients with myositis. A remarkable reduction of salivary flow and dysphagia were more frequent and severe in IIM patients, as well as muscle contracture and myofacial pain evoked by palpation, this result being highly significant.

Gustatory dysfunction in COVID-19 patients: a rapid systematic review on 27,687 cases.

Objective: This is a rapid systematic review concerning taste alterations in 27,687 individuals infected with SARS-CoV-2, published in the worldwide literature.Material and methods: Of the 485 articles recovered, 67 eligible studies (27,687 confirmed COVID-19 cases) were included in this analysis. We analysed the prevalence of the taste alterations in patients considering the country of origin of the studies.Results: The results show strong important differences in the overall reported prevalence of taste alterations among the different countries (from 11% of Korea to 88.8% of Belgium).Conclusions: These data highlight that there is a different geographical distribution of taste alterations in COVID-19 patients. Gustatory dysfunction seems to be an understudied symptom of COVID-19 and this may explain the inconsistencies of diagnostic criteria for COVID-19 case definition. Furthermore, this diagnostic underestimation can lead to an increased risk of contagion for the whole population and for the working classes most at risk, including the dental one.

Correlation Between Maxillary Canine Impaction and Facial Biotype.

AIM: The etiology of teeth impaction is still not fully understood, despite that cofactors have been considered important to develop such a clinical picture. The aim of the authors' paper was to investigate about facial biotype, about the values of inclination of the upper cuspid axis to the perpendicular to Frankfort-horizontal plane and about the distance "d" of the canine cuspid to occlusal plane: each factor was statistically compared. The authors also performed a comparative analysis on the radicular length of the left and right lateral incisors of subjects with impacted maxillary canine. METHODS: The authors recruited with "cluster sampling" randomization more than 30 patients, then refined to 25 after the application of exclusion criteria. Specific values were carried out by x-rays: the authors calculated both the α and ß angles, the intermaxillary angle, the distance "d" and the inclination of upper cuspid axis to the perpendicular-to-Frankfort-horizontal plane. Spearman rank correlation coefficient or Spearman rho (ρ) was used as statistical methods. RESULTS: The authors' results assessed that the inclination of the upper cuspid axis to the perpendicular-to-Frankfort-horizontal plane showed a statistically significant inverse correlation with the intermaxillary angle. CONCLUSION: The authors' data clearly indicate that hyperdivergence is a key-factor that will certainly support the eruption path of canine cuspid: in this light, the treatment of tooth impaction in hyperdivergent subjects can be considered as predictive for a good prognosis.

Current Views About the Link between SARS-CoV-2 and the Liver: Friends or Foe?

The emergence of the novel coronavirus and the pandemic resulting from its spread have led to significant negative impacts on health, economy, relationships, and others. Particularly in the field of hospital care, the need for a greater number of patients has led to a breakdown of the system. Gastrointestinal manifestations are common in SARS-COV 2 patients, while 10% of those who are sick exhibit symptoms only from gastrointestinal without any manifestation on the part of the respiratory tract. The main manifestations are nausea, vomiting, diarrhoea, and anorexia. It is also interesting to note that biochemical liver disorder is a frequent finding and is associated with a worse prognosis and higher probability admission to intensive care. It was also observed that RNA from the virus was found in the stool several days after the tests came back negative pulmonary secretions, while rectal swab virus detection methods were used with a lower but comparable sensitivity to that of nasal swabs. Gastrointestinal symptoms in SARS-COV 2 infection are common and their search should be part of the initial diagnosis approach and have a connection with the gut microbiota dysbiosis and this can lead to an alteration of the gut/liver axis.

Correction of Midline Deviation and Unilateral Crossbite Treated with Fixed Appliance.

The following case report describes the treatment of a 20-year-old man with dental and facial asymmetry. Patient presented upper dental midline shifted 3 mm to right side and the lower one 1 mm to left side, skeletal class I, molar class I and canine class III on the right side, molar class I and canine class II on the left side, and upper and lower crowding on teeth #12, #15, #22, #24, #34, and #35 in crossbite. The treatment plan provided four extractions: in the superior arch the right second and the left first premolar and in the lower arch first premolars on the left and right sides. Wire-fixed orthodontic device was used in combinations with coils to correct the midline deviation and to close post-extractive spaces, avoiding miniscrew implants. At the end of the treatment, optimal functional and aesthetic results were obtained: realignment of the midline improved facial symmetry, correction of the crossbite on both sides, and a good occlusal relationship.

The efficacy of a modified mandibular advancement device for OSA treatment in a group of adult patients.

OBJECTIVE: The Mandibular Advancement Device (MAD) is actually recommended for the treatment of Obstructive Sleep Apnea (OSA) with mild or moderate severity. The present study evaluated the effects of a fully customizable MAD-type device (It Makes You Sleep, IMYS), in patients with moderate-to-severe OSA. METHODS: Twenty-nine patients (15 men and 14 women; mean age 62, SD ±10 years) were retrospectively enrolled. Home Sleep Apnea Testing ;(HSAT) was performed for all patients at baseline (T0) and after three months (T1) of IMYS therapy. The analyzed respiratory parameters were: Apnea-Hypopnea Index (AHI), Oxygen Desaturation Index (ODI), Minimum Oxygen Saturation (minSO2) and Medium Oxygen Saturation (medSO2). RESULTS: From T0 to T1, a significant reduction of AHI and ODI was reported, as well as a significant increase of minSO2 and medSO2. CONCLUSION: The IMYS device could be an effective MAD appliance for treating moderate-to-severe OSA.

Craniofacial morphology in Obstructive Sleep Apnea patients.

Background: To evaluate the correlation between cephalometric skeletal parameters and Obstructive Sleep Apnea syndrome (OSAs) severity, in adult patients with OSAs. Material and Methods: One hundred patients (94 males,6 females mean age 59,3) with diagnosis of OSAs were retrospectively enrolled. Each patient received Home Sleep Apnea Testing (HSAT) and latero-lateral radiograph. Eight cephalometric parameters (cranial deflection angle, saddle angle, articular angle, divergence angle, cranial base angle, skull base length, mandibular length, maxilla length) were analyzed and then related to Apnea/Hypopnea Index (AHI) and to the Oxygen Desaturation Index (ODI), recorded by HSAT. A Spearman's rho correlation test between cephalometric measurements and HSAT indices was performed. Statistical significance was set at p< 0.05. Results: A negative statistically significant correlation was found between mandibular length (Condilion-Gnathion distance) and AHI (rho= -0,2022; p<0,05) and between maxilla length (Ans-Pns) and AHI (rho= -0,2984; p<0,01) and ODI (rho= -0,2443; p<0,05). A statistically significant correlation was also observed between the divergence angle (S-N^Go-Me) and AHI (rho=0,2263; p<0,05) and between cranial deflection angle (Fh^NBa) and AHI (rho=0,2212; p<0,05) and ODI (rho=0,1970; p<0,05). Conclusions: The OSAs severity may be related to certain predisposing features in craniofacial morphology, such as maxillary and mandibular length, divergence and cranial deflection. Key words:OSAs, Home Sleep Apnea Testing, AHI, ODI, Cephalometry, Airway.

Evaluation of qualitative and quantitative taste alterations in COVID-19.

A large percentage of coronavirus disease 2019 (COVID-19) patients have taste dysfunction. Interleukin 6 (IL-6) levels in mild and moderate COVID-19 patients with the type (quantitative or qualitative) of taste disorders were compared in this observational study. The 208 COVID-19 patients (118 men and 90 women) revealing only taste dysfunctions as prodromic symptoms were classified as mild and moderate patients. Survey results were used to evaluate the taste disorder. The IL-6 levels were measured using a chemiluminescence assay. Statistical analysis was conducted using the Wilcoxon rank, Welch's, and Mann-Whitney tests. The findings revealed that neither the presence of dysgeusia or phantogeusia nor the perception of sour and salty, differed statistically significantly between moderate and mild patients (P > 0.05). But between moderate and mild patients, there were statistically significant differences in how umami, bitter, sweet, and parageusia were perceived (P < 0.05). There was an impairment of multiple tastes up to ageusia in patients with high IL-6 levels. The findings demonstrated that parageusia and dysfunctions in umami, bitter, and sweet taste perception can be indicators of more severe forms of COVID-19.

Natural Bioactive Compounds against Oxidative Stress: Dietary Polyphenols Strike Back.

Oxidative stress is a major cellular and metabolic burden that can really alter cell life and become the base for disease onset and development. Many widespread pathologies can develop from an unresolved oxidative stress situation; thus, addressing this state is paramount for human health. Our antioxidant enzymes sometimes are not just enough. Fortifying our defense and the antioxidant and anti-inflammatory system can make a difference in our health: if this is attainable with our dietary habits, it could be a dream come true. Polyphenols are a fantastic tool indeed in the fight against oxidative stress: they are easy to obtain, with little cost, no side effects, and have a multitude of metabolic actions. This perspective review would shed light on polyphenol's metabolic and molecular action regarding oxidative stress to help preserve our health.

Oral microbiota in human health and disease: A perspective.

The evolution of medical knowledge about oral microbiota has increased awareness of its important role for the entire human body health. A wide range of microbial species colonizing the oral cavity interact both with each other and with their host through complex pathways. Usually, these interactions lead to a harmonious coexistence (i.e. eubiosis). However, several factors - including diet, poor oral hygiene, tobacco smoking, and certain medications, among others - can disrupt this weak homeostatic balance (i.e. dysbiosis) with potential implications on both oral (i.e. development of caries and periodontal disease) and systemic health. This article is thus aimed at providing an overview on the importance of oral microbiota in mediating several physiological and pathological conditions affecting human health. In this context, strategies based on oral hygiene and diet as well as the role of probiotics supplementation are discussed.

Occlusal Plane Modification in Clear Aligners Treatment: Three Dimensional Retrospective Longitudinal Study.

The purpose of the present study was to evaluate: (i) maxillary occlusal plane changes after clear aligners therapy with a 3D measurement technique; and (ii) as a secondary outcome, if such changes were correlated to the patient's 1axilla-mandibular divergence. 3D maxillary models of 32 patients (7 males and 25 females; mean age 22.3 +/− 3.4 year) treated with clear aligners were analyzed. The angle (α) between a reference palatine plane and a maxillary occlusal plane was measured. Five angular cephalometric measurements (NSL/MP; PP-OP; OP-MP; PP-MP; PFH/AFH%) were performed and related to Δα. The subjects were further divided into three groups according to facial divergence. After aligner treatment, Δα increased in hyperdivergent patients and decreased in hypodivergent patients (p < 0.05). Δα showed a significant positive correlation with NSL/MP (rho = 0.44) and negative correlation with PFH/AFH% (rho = −0.53). Aligners treatment produced a counterlockwise rotation of the maxillary occlusal plane, even if this rotation occurs differently depending on divergence.

Application of the Extracts of Punica granatum in Oral Cancer: Scoping Review.

The Punica granatum L. is an ancient fruit plant native to south-western Asia. It belongs to the Litraceae family and of its genus we have only one other Punica protopunic species. The fruit is rich in polyphenols, whose extract is consumed as a food and is considered safe. In medicine, it is used for its antioxidant properties; it has a rich component of tannic polyphenols among which the most bioactive are: punicalagin (flavonoids) and anthocyanins (delphinidin, cyanidin, pelargonidin), which are found mainly in the skins and in the pericarp; however, all the parts of the Punica granatum are used for therapeutic purposes as anti-inflammatories and analgesics and in diabetes and cardio-vascular disease. Punica granatum extracts also show interesting anticancer activities in influencing tumorgenesis and angiogenesis and cell transformation and proliferation. The purpose of this scoping review is to summarize all the scientific evidence on the possible applications of Punica granatum extracts in the treatment and prevention of oral cavity tumors to investigate the anticancer properties of the active ingredients extracted from Punica granatum. Methods: The scoping review was carried out following the PRISMA-ScR checklist; the search was performed on three databases (Scopus, Science direct and PubMed) and one registry (Cochrane library). Results: The search produced a number of bibliographic sources equal to 11,403; with the removal of duplicates, 670 potentially admissible articles were obtained, from 24 of which only 7 in vitro studies on OSCC cell lines were included. Conclusions: From the preliminary data on the cellular lines of OSCC, it emerges that for oral cancer there are conditions for which the extracts of Punic granatum are effective at least from a prevention perspective.

OSA Wellness Scale (OWS): A New Health-Related Quality of Life Test in Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Device.

Objectives: To present a new short self-test, called the OSA wellness scale (OWS), for assessing the health-related quality of life (HRQoL) changes in obstructive apnea syndrome (OSA) patients treated with mandibular advancement device (MAD). Methods: 51 OSA patients (8 women and 43 men, mean age 52.3) treated with a fully customizable MAD device (Protrusor) were retrospectively enrolled. Each patient received a home sleep apnea testing (HSAT) at baseline (T0) and after three months of MAD treatment (T1). Two self-test evaluations, the Epworth sleepiness scale (ESS), and OWS were also submitted at T0 and T1. The OWS was a short self-test of 8 questions for evaluating the daytime HRQoL. Patients gave an assessment from 0 to 3 for each question. At the end of the questionnaire, the patients had a score from 0 to 24, resulting from the sum of all 8 scores. The higher the score, the greater the patient's perceived state of discomfort. Results: At T1, a significant decrease in the oxygen desaturation index (ODI) and apnea-hypopnea index (AHI) was shown (p < 0.0001), while no significant changes in body mass index (BMI) were found. Both the ESS and the OWS records showed a significant reduction in daytime sleepiness and HRQoL (p < 0.0001). Conclusion: The OWS could be a useful method to verify and numerically compare the perceived quality of life in OSA patients, before and after MAD therapy.

Effects of Contact Sports on Temporomandibular Disorders: An Observational Study.

The study investigated the prevalence of temporomandibular disorders in 100 competitive athletes in contact sports, equally grouped by the practiced game: Soccer (SoG), Rugby (RG), American Football (AFG), Boxing (BoG), Basketball (BaG), compared to a randomly control group of 20 non-athletes (CG). Symptoms and signs were examined according to the standardized Diagnostic Criteria for Temporomandibular Disorders through a questionnaire and clinical evaluation. Arthralgia showed significant differences between RG and CG and between AFG and CG (p < 0.05). Study groups reported masticatory muscle pain during function, neck and shoulder pain more frequently than CG, except for BoG. Closing click was significantly more present in study groups than CG, while crepitation was significantly higher only in RG and AFG. The deviation was wider in SoG, RG and AFG compared to CG (p < 0.05). Tukey's multiple comparisons test showed a statistically significant reduction in right laterotrusion in RG vs. CG (p < 0.05); the comparison showed a decrease in right laterotrusion in RG vs. SoG and BoG (p < 0.05), a decrease in endfeel in RG vs. CG, BaG and AFG (p < 0.05). The data seem to support a relationship between the prevalence of TMD symptoms and signs in competitive athletes in contact sports, especially in RG and AFG compared to CG.

Biological Prognostic Value of miR-155 for Survival Outcome in Head and Neck Squamous Cell Carcinomas: Systematic Review, Meta-Analysis and Trial Sequential Analysis.

Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers worldwide; in fact, it is among the top six neoplasms, with an incidence of about 370,000 new cases per year. The 5-year survival rate, despite chemotherapy, radiotherapy, and surgery for stages 3 and 4 of the disease, is low. MicroRNAs (miRNAs) are a large group of small single-stranded non-coding endogenous RNAs, approximately 18-25 nucleotides in length, that play a significant role in the post-transcriptional regulation of genes. Recent studies investigated the tissue expression of miR-155 as a prognostic biomarker of survival in HNSCC. The purpose of this systematic review is, therefore, to investigate and summarize the current findings in the literature concerning the potential prognostic expression of tissue miR-155 in patients with HNSCC. The revision was performed according to PRISMA indications: three databases (PubMed, Scopus, and the Cochrane Register) were consulted through the use of keywords relevant to the revision topic. Totally, eight studies were included and meta-analyzed. The main results report for the aggregate HR values of 1.40 for OS, 1.36 for DFS, and 1.09 for DPS. Finally, a trial sequencing analysis was also conducted to test the robustness of the proposed meta-analysis.

The Prognostic Role of miR-31 in Head and Neck Squamous Cell Carcinoma: Systematic Review and Meta-Analysis with Trial Sequential Analysis.

BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide with high recurrence, metastasis, and poor treatment outcome. Prognostic survival biomarkers can be a valid tool for assessing a patient's life expectancy and directing therapy toward specific targets. Recent studies have reported microRNA (miR) might play a critical role in regulating different types of cancer. The main miR used as a diagnostic and prognostic biomarker and reported in the scientific literature for HNSCC is miR-21. Other miRs have been investigated to a lesser extent (miR-99a, miR-99b, miR-100, miR-143, miR-155, miR-7, miR-424, miR-183), but among these, the one that has attracted major interest is the miR-31. METHODS: The systematic review was conducted following the PRISMA guidelines using electronic databases, such as PubMed, Scopus, and the Cochrane Central Register of Controlled Trials, with the use of combinations of keywords, such as miR-31 AND HNSCC, microRNA AND HNSCC, and miR-31. The meta-analysis was performed using the RevMan 5.41 software (Cochrane Collaboration, Copenhagen, Denmark). RESULTS: This search produced 721 records, which, after the elimination of duplicates and the application of the inclusion and exclusion criteria, led to 4 articles. The meta-analysis was conducted by applying fixed-effects models, given the low rate of heterogeneity (I2 = 40%). The results of the meta-analysis report an aggregate hazard ratio (HR) for the overall survival (OS), between the highest and lowest miR-31 expression, of 1.59, with the relative intervals of confidence (1.22 2.07). Heterogeneity was evaluated through Chi2 = 5.04 df = 3 (p = 0.17) and the Higgins index I2 = 40; testing for the overall effect was Z = 3.44 (p = 0.00006). The forest plot shows us a worsening HR value of OS, in relation to the elevated expression of miR-31. CONCLUSIONS: In conclusion, the data resulting from the current meta-analysis suggest that miR-31 is associated with the prognosis of patients with HNSCC and that elevated miR-31 expression could predict a poor prognosis in patients with this type of neoplasm.

Parathyroid Hormone-Related Peptide (PTHrP): Evaluation of Pediatric, Covariate-Stratified Reference Intervals.

Parathyroid hormone-related peptide (PTHrP) is expressed at a wide range of sites in the body and performs different functions including vasodilation, relaxation of smooth muscle cells, and regulation of bone development. PTHrP also mediates hypercalcemia related to neoplastic diseases. However, reference ranges specific method and age were not evaluated. We establish PTHrP reference ranges in apparently healthy, normocalcemic, normophosphatemic pediatric individuals. In this observational prospective, study we measured PTHrP in serum from 178 samples (55.06% male 44.94% female) from apparently healthy pediatric subjects [median age 10 years (range 1-18)] subunit ELISA method The statistical analysis performed provided for the calculation of the 95% reference interval, right-sided, with a non-parametric percentile method (CLSI C28-A3). Upper reference limits (URL) for PTHrP was 2.89 ng/mL (2.60 to 3.18; 90% CI). No significant differences were found between the median PTHrP concentrations in males vs females and in the age range categories selected. Comprehensive normal values for PTHrP are indispensable to the assessment of calcium phosphorus dysfunction in children. Severe hypercalcemia is a rare, but clinically significant condition, in infancy and childhood. PTHrP values higher than the reference value may help to distinguish the hypercalcemic product of a malignancy, paraneoplastic syndromes mediated by PTHrP, from other causes.

Axenfeld-Rieger syndrome: orthopedic and orthodontic management in a pediatric patient: a case report.

Axenfeld-Rieger Syndrome (ARS) is a rare autosomal dominant genetic disease with considerable expressive variability, characterized by ocular and non-ocular manifestations, cardiovascular, mild craniofacial abnormalities and dental malformations. Current data report an incidence of Xenfeld-Rieger syndrome in the population of 1: 200,000.The case described is that of a 14-year-old female patient whose ARS is suspected and investigated following a dental specialist visit for orthodontic reasons, acquired the patient's family and clinical data following a medical approach multidisciplinary, we proceed to the orthodontic involved the use of the Rapid Palatal Expander (RPE) and a fixed orthodontic treatment.The aim of this study is to report the case of the orthopaedic and orthodontic treatment in a patient affected by ARS and with facial dysmorphism and teeth anomalies associated to ocular anomalies.