Pedagogia delle immagini e odontoiatria nei bambini con Disturbi Pervasivi dello Sviluppo

Scopo dello studio: è stato quello di verificare l’utilità del metodo educativo “per immagini” TEACH (Treatment and Education of Autistic and related Communication handicapped Children) in soggetti con disturbi pervasivi dello sviluppo (DPS), per facilitare il loro primo avvicinamento allo studio odontoiatrico. Materiali e metodi: sono stati scelti 2 gruppi: test e controllo. Entrambi i gruppi comprendono 11 pazienti con DPS tra i 5 ed i 14 anni con scarsa collaborazione alla prima visita. Il gruppo test è stato sottoposto al metodo TEACH. E’ stato quindi preparato per il gruppo test uno speciale album fotografico contenente le fotografie degli operatori e dell’ambulatorio odontoiatrico e una semplice descrizione delle stesse immagini. Una copia di tale album è stata inoltre consegnata ai genitori e/o ai riabilitatori almeno 15 giorni prima dell’appuntamento stabilito. Il gruppo controllo è stato sottoposto invece ad un normale approccio odontoiatrico. Risultati: Il metodo educativo TEACH ci ha permesso di poter far affrontare con serenità ad 8 dei nostri pazienti appartenenti al gruppo test la visita odontoiatrica e l’esecuzione di metodiche atte alla prevenzione. In particolare il livello di collaborazione è stato ottimo per 3 degli 8 pazienti e buono per gli altri 5. Per 3 pazienti la collaborazione si è dimostrata, nonostante il tipo di approccio, scarsa e comunque insufficiente per le cure odontoiatriche ambulatoriali. Nel gruppo di controllo la collaborazione si è dimostrata scarsa ed insufficiente per le cure ambulatoriali in 7 casi su 11.Conclusioni: L’approccio alle cure odontoiatriche con il metodo TEACH ha permesso l’accesso all’ambulatorio odontoiatrico per la visita e le cure preventive al 72% di un gruppo di pazienti con DPS, che erano risultati in precedenza non collaboranti. Invece, nel gruppo di controllo i pazienti selezionati per le cure ambulatoriali sono risultati essere solo il 36%. A nostro parere, il metodo di approccio proposto risulta efficace nel ridurre l’”ansia da esposizione e da rottura degli schemi” in pazienti con DP

Oral health care in patient with Williams Syndrome

William Syndrome is characterized by multiple anomalies including peculiar facial and oral features. A precocious maxillofacial and dental examination is mandatory in order to follow facial development and tooth eruption. The clinical examination often reveals dental anomalies in the form of amelogenesis imperfecta, morphology (microdontia) and number anomalies (dental agenesis). The risk of Early Childhood Caries is increased by gastroesophageous reflux, a frequent finding in the first year of life of this children. Orthopaedic-orthodontic treatment is often required to address bone growth and to correct the position of the teeth both for function and for aesthetic reasons. The cooperation level and the presence of systemic diseases have to be considered before the treatment planning. A correct psychological approach can ameliorate the compliance even in the patient with mental delay, but a certain degree of collaboration is required for positioning orthodontic devices. A careful analysis of the general health of the patient is necessary before dental therapy: antimicrobial prophylaxis, to prevent infective endocarditis is needed in patient with congenital heart diseases (75%); renal function and blood pressure have to be monitorized before administrating drugs (antibiotics, antiflogistics and sedative). A strict collaboration with the paediatrist and other specialists is needed to plan a safe and successful therapy. Parents must be involved in the planning of dental treatment and correctly informed and motivated about oral hygiene technique, as their collaboration is necessary to maintain oral health of their child after the treatment. In this presentation, the authors report their experience in dental treatment in children with Williams Syndrome describing their clinical approach from a complete anamnesis to the treatment plan, in order to propose guidelines for oral health care in this patients. References: Axelsson S., Bjornland T., Kjaer I., Heidberg A., Storhaug K., Dental characteristics in Williams syndrome: a clinical and radiographic evaluation, Acta Odontol Scand. 2003 Jun;61(3):129-36 Hertzberg J, Nakisbendi L, Needleman HL, Pober B Williams syndrome-oral presentation of 45 cases Pediatr Dent. 1994 Jul-Aug;16(4):262-7 Mass E, Belostoky L., Craniofacial morphology of children with Williams syndrome, Cleft Palate Craniofac J, 1993 May;30(3):343-9. Oncag V., Gumbay S., Parlar A., Williams Syndrome, J Clin Ped Dent, 1995; 19(4): 301-

A multi-stakeholder system for feasibility model of regeneration project with social impact. The field test of Vaiano Valle in Milan

Urban regeneration, as a multidimensional process to enhance built environment, is taking on an increasingly key role in meeting challenges of sustainable and inclusive city development. In Italy, regeneration interventions are increasingly being configured as multi-stakeholder processes. It is outcome of public-private and social private partnership which is carried out through co-design paths that combine actions on built environment - so-called "hardware" component - with actions that affect the "software" component of social infrastructure of cities by activation of welfare services aimed to the city and communities. There is a growing awareness that urban regeneration process that does not intentionally include an investment in social infrastructures and aspirations of citizens, transforming them into social entrepreneurship, will be unlikely to generate and maintain value over time. These "aspirations", which often prove to be the only possible source of value generation, translate into "a new science of understanding and making cities that start from the urban as a lived experience of its citizens" (La Cecla, 2015). The precondition for sustainable and inclusive development of territories lies in the definition of governance systems in which the plurality of stakeholders and assetholders have tools to cooperate and to give back to places a value in use, in order to jointly economic interest and production of social value. In this sense, third sector and cooperatives are strategic allies for Public Administration in pursuit of general interest, both for their aptitude to produce social value and impact, and also, for their statutory mission and ability to intercept need. The paper presents the results of a field test funded by the Ministry of Economic Development, which involved private investor, exponents of cooperative sector and University, to define a feasibility model for urban regeneration with social impact and based on a multi-stakeholder system and the cooperative's value system