Is Stevia rebaudiana Bertoni a Non Cariogenic Sweetener? A Review

Stevia rebaudiana Bertoni is a small perennial shrub of the Asteraceae (Compositae) family that is native to South America, particularly Brazil and Paraguay, where it is known as "stevia" or "honey leaf" for its powerful sweetness. Several studies have suggested that in addition to their sweetness, steviosides and their related compounds, including rebaudioside A and isosteviol, may offer additional therapeutic benefits. These benefits include anti-hyperglycaemic, anti-hypertensive, anti-inflammatory, anti-tumor, anti-diarrheal, diuretic, and immunomodulatory actions. Additionally, critical analysis of the literature supports the anti-bacterial role of steviosides on oral bacteria flora. The aim of this review is to show the emerging results regarding the anti-cariogenic properties of S. rebaudiana Bertoni. Data shown in the present paper provide evidence that stevioside extracts from S. rebaudiana are not cariogenic. Future research should be focused on in vivo studies to evaluate the effects on dental caries of regular consumption of S. rebaudiana extract-based products

Oral Mucosa and Nails in Genodermatoses: A Diagnostic Challenge

Genodermatoses represent a group of uncommon, hereditary, single-gene skin disorders, characterized by multisystem involvement, heterogeneous clinical manifestations and different degrees of morbidity and mortality. Some genodermatoses may have oral mucosa and nail involvement, since the oral cavity and cutaneous organ system, including nails, share a close embryologic origin. Nail disorders can manifest with nail hypoplasia or nail hypertrophy. Clinical pictures of affected oral mucosa can be extremely heterogeneous, ranging from asymptomatic papules to painful blisters, leukokeratosis, oral papillomas and fibromas to oral potentially malignant disorders and cancerous lesions. Oral mucosa and nails pathological features may occur synchronously or not and are usually associated with other systemic and skin manifestations. In some cases, oral mucosa and nails diseases may be distinct and constitute the principal sign of the genetic disorder, in other cases they represent only a part of the puzzle for the confirmation of the diagnosis. Continued awareness of the correlation between oral mucosa and nails findings can help physicians to diagnose genodermatosis in a timely manner, allowing more effective clinical management and prevention and/or early detection of complications. This article provides an overview of all specific genodermatoses affecting both oral mucosa and nails. Moreover, the correlation between teeth and nails is summarized in tabular form

A BIOLOGICAL WAY IN CARIES PREVENTION

The intent of this research program was to determine a new way in caries prevention. The score was the valuation of anti-caries effects of bio-active molecules of natural origin (derived from animals), in order to elaborate a new preventive methodology. The under discussion molecules were casein phosphopeptides (CPPs) of dairy origin. For this aim, this research project has been divided in 5 part. Part 1: in vitro evaluation of the effectiveness of synthetic CPPs in dental caries prevention; Part 2: in vitro evaluation of the effectiveness of natural CPPs in dental caries prevention; Part 3: in vivo evaluation of the effectiveness of synthetic and natural CPPs in dental caries prevention; Part 4: in vivo evaluation of the antibacterial power of commercial yogurt against oral cariogenic microflora; Part 5: in vitro effectiveness of TMR (transverse micro-radiography) in assessing dental enamel demineralisation and remineralisation. The final score will be the creation of a new preventive methodology against dental caries. In fact, on the basis of the results obtained from this research, the protection against tooth decay could be done in different ways. First of all, people could protect their self simply by eating food containing CPPs , then these active principles could be exploited by nutritional and pharmacological industries by adding these bio-molecules both in food and in commercial products used for oral hygiene (mouth-rinse, toothpaste)

COVID-19 Disease in Children: What Dentists Should Know and Do to Prevent Viral Spread. The Italian Point of View

Coronavirus disease 2019 (COVID-19) has spread rapidly across the globe, becoming a major public health challenge not for China only, but also for countries around the world. Despite worldwide efforts to contain viral spread, the outbreak has not been stopped yet. Among healthcare personnel, dentists seem to be at elevated risk of exposure to COVID-19. This risk is even more serious in pediatric dentistry, since affected children, frequently, present an asymptomatic, mild or moderate clinical viral infection and, therefore, they may play a major role in community-based COVID-19 transmission. To date, despite no universal guidelines are available for dental procedures in pediatric dentistry during COVID-19 outbreak, routine dental practice should be postponed and only severe dental emergencies must be treated. In the case of a dental emergency, involving a pediatric patient, dentists should be aware of which recommended management protocol can be adopted during the practice to protect patient health, to safeguard their-self and to prevent viral transmission. The aim of this paper is to provide clinical recommendations, presenting a needed tool for dentists to allow a valid and safe how-to-do protocol. Pediatric dentists should keep a high level of awareness to help patients, minimize risk and prevent viral spread

New approach in paediatric dentistry: ultrasonic nondestructive evaluation of restorative dental materials. Experimental study

The ultrasonic inspection is a non invasive method which is very developed in the industrial field, for the non-destructive evaluation of materials, and in the medical field, for the ultrasound diagnostic analysis. In paediatric dentistry the most widely used non- destructive evaluation is the X-ray technique. Radiographs are valuable aids in the oral health care of infants, children, adolescents, allowing dentists to diagnose and treat oral diseases that cannot be detected during a visual clinical examination. The aim of this in vitro study was to analyse the ultrasonic non-destructive evaluation (UT-NDE) technique to inspect both dental materials internal structure and the form and position of internal defects in order to obtain a diagnostic method, free of ionising radiations, in paediatric dentistry. Moreover the ultrasonic inspection (UT) could be a rapid method of diagnosis in uncooperative paediatric patients

Identificazione, caratterizzazione ed efficacia di molecole bioattive nella prevenzione della patologia cariosa

I caseino fosfopeptidi (CPP), prodotti dalla proteolisi della caseina, proteina del latte bovino, da parte della tripsina, hanno la capacità di legare il fosfato di calcio amorfo (APC) e di stabilizzarlo all’interno della placca dentaria in condizioni di pH neutro o alcalino, formando soluzioni stabili che sono supersature in relazione all’ ACP. In condizioni di pH acido, invece, l’ACP, essendo una molecola instabile, rilascia in soluzione ioni calcio, fosfato e CaHPO40 che sono, così, disponibili in elevate concentrazioni per la remineralizzazione della lesione cariosa, riuscendo a diffondere, sotto gradiente, nel corpo dello smalto demineralizzato . I caseino fosfopeptidi più importanti sono: beta-CN(1-25), alfas1–CN(59-79), alfas2-CN(46-70) e alfas2-CN(1-21). Tutti i peptidi contengono la sequenza cluster-(Ser(P)-)3(Glu)2 con tre contigue fosfoserine . E’ stato dimostrato sperimentalmente che il peptide che lega in modo migliore l’ACP, in un range di pH compreso tra 7 e 9 , è alfas1-CN(59-79). A pH 8, infatti, alfas1-CN(59-79) lega 6.84 +/- 0.45 moli di calcio per mole di peptide, beta-CN(1-25) lega 4.64 +/- 0.17 moli di calcio per mole di peptide, il peptide più piccolo alfas1-CN(63-70) lega 3.52+/-0.13 moli di calcio per mole di peptidi. Il numero di siti leganti i complessi di fosfato di calcio dipende dalla sequenza fosforilata-Ser(P)-Ser(P)-Ser(P)-Glu-Glu-, richiesta per iniziare il legame. Dopo che il peptide si è legato all’ACP, deboli interazioni permettono ai rimanenti residui polari di interagire con le particelle core dell’ACP. Confrontando quattro diverse fasi di fosfato di calcio, idrossiapatite (HA), calcio fosfato diidrato (DCPD), octacalcio fosfato (OCP) ed un fosfato di calcio amorfo avente la composizione Ca3+ z(PO4)2(OH)2z, dove z=0.0877, si è visto che la fase che meglio si lega con alfas1-CN(59-79) è la quarta. Dato che alfas1-CN(59-79) lega al massimo 14 ioni fosfato, la composizione del complesso alfas1-CN(59-79)-ACP è approssimativamente (alfas1-CN(59-79)-(ACP)7)n, dove n è un piccolo numero intero. E’ stato dimostrato, inoltre, in vivo, che l’utilizzo di una soluzione contenente CPP-ACP all’1.0%, due volte al giorno, determina un incremento dei livelli calcio e fosfato, rispettivamente, del 144% e del 160% su una sezione di smalto applicata ad un apparecchio intra-orale . Ulteriori esperimenti in vitro hanno provato che una soluzione di CPP-ACP all’1.0% produce una remineralizzazione della superficie dello smalto del 63.9 +/- 20.1% in dieci giorni . Soluzioni contenenti CPP a concentrazioni comprese tra 0.5 e 1.0% determinano una riduzione della carie in maniera simile ad una soluzione contenente 500 ppm di fluoro. I caseino fosfopeptidi ed il fluoro svolgono, infatti, un’azione sinergica contro la patologia cariosa. E’ stato, poi, dimostrato che gomme da masticare a base di sorbitolo e xilitolo, contenenti 0.19, 10, 18.8, 56.4 mg di CPP-ACP, determinano un incremento nella remineralizzazione dello smalto, rispettivamente, del 9, 63, 102, e 152% rispetto a gomme non contenenti CPP-ACP, usate come controllo. Le superfici smaltee remineralizzate risultano, inoltre, più resistenti a successivi attacchi acidi . L’utilizzo di un collutorio contenente CPP-ACP aumenta in maniera significativa i livelli di calcio e fosfato inorganico della placca e i CPP risultano incorporati nella placca sopragengivale grazie al legame con la superficie delle cellule batteriche. L’incorporazione di caseinofosfopeptidi e caseinomacropeptidi all’interno della pellicola salivare, inoltre, inibisce l’aderenza di Streptococco mutans e Streptococco sobrinus. In particolare, in presenza di CGMP, CPP, CGMP + CPP l’aderenza dello S. sobrinus viene ridotta, rispettivamente, del 49 %, 75% e 81%, mentre quella dello S. mutans è ridotta del 64%, 83% e 84% . I caseinomacropeptidi (Kappacin), infine, mostrano un’attività inibitoria nei confronti della crescita dello Streptococco mutans, Porphyromonas gingivalis ed Escherichia coli . I dati presenti in letteratura dimostrano, quindi, chiaramente la capacità dei CPP sintetici di inibire la demineralizzazione dello smalto dentario, tanto che in alcuni paesi (Australia) l’industria alimentare ha immesso sul mercato numerosi prodotti arricchiti di CPP (chewing-gum, caramelle, biscotti, puree...etc.)