Treatment of horizontal root fracture: a case report

Radicular fractures in permanent teeth are uncommon injuries among dental traumas, being only 0.5-7% of the cases. Traumatic dental injuries occur more frequently in young patients, and vary in severity from enamel fractures to avulsions

Sequence uniqueness as a molecular signature of HIV-1-derived B-cell epitopes.

The complex pathophysiology of human immunodeficiency virus (HIV) infection and the relatively high mutation rate of the retrovirus make it challenging to design effective anti-HIV vaccines. Several attempts have been made during the last decades to elucidate the enigmatic immunology of HIV infection and to predict potential immunogenic peptides for active vaccination using bioinformatic analysis methods. The results obtained to date to address this important problem are scarce. In this study, we exploit available HIV databases and analyse previously characterized HIV-encoded linear B-cell epitopes for their amino acid sequence similarity to the human or murine host proteome. We obtained further documentation that the HIV-derived antibody-targeted sequences mostly coincide with peptide areas rarely shared with the host proteins. In toto, our past and present data give clear-cut support to the statement that low-similarity to the host proteome is a major mechanism in defining viral peptide immunogenicity and indicate a possible way for inducing effective, high-titer, and non-cross-reactive antibodies to be used in anti-HIV vaccine therapy

Keratocystic odontogenic tumors as first clinical manifestation of nevoid basal cell carcinoma syndrome in pediatric age: our microinvasive surgical approach.

Keratocystic odontogenic tumors as first clinical manifestation of nevoid basal cell carcinoma syndrome in pediatric age: our microinvasive surgical approach. Aim. Nevoid Basal Cell Carcinoma Syndrome (NBCCS) is a rare genetic condition involving multiple organs; Keratocystic Odontogenic Tumors (KCOTs) are often the first clinical manifestation in pediatric age. The aim of this study was to describe the clinical and histopathological features of KCOTs as first clinical sign of NBCCS in pediatric patients allowing an early diagnosis, and their treatment with conservative microinvasive piezosurgery. Methods. Twenty pediatric patients affected by NBCCS showing 60 KCOTs came to our attention at the Complex Operating Unit of Odontostomatology, Policlinic of Bari, from 1996 to 2014. After clinical examination, OPT and computed tomography analysis, all patients underwent conservative micro-invasive surgical treatment under general anesthesia, consisting in enucleation of KCOTs, cavity ostectomy and osteoplasty with conventional rotative instruments and piezoelectric tools in order to remove damaged bone, epithelial remnants and satellite cysts with maximal teeth preservation in consideration of the young age of the patients, and to possibly minimize the recurrence risk. A sterile gel formulation of sodium hyaluronate and amino acids (Gly-Pro-Leu-Lys) was put into the bone defect, allowing for faster bone regeneration and healing of the surgical site. All the surgical specimens were sent for histopathological examination. The patients underwent clinical and radiological (OPT) follow-up after 7, 15 and 30 days, 2, 3, 6 and 12 months, and, then, once a year. The followup time ranged from 18 months to 8 years. Results. There were 10 males and 10 females, with an average age of 10,6 years. At the initial evaluation, 13 patients showed swelling, teeth agenesis, and dental inclusions or dislocations as first clinical manifestation of their disease; in the remaining cases, KCOTs were asymptomatic. Among the 20 patients, 11 had been previously diagnosed with NBCCS because of familiarity or presence of characteristic features of the syndrome, while KCOTs were the first clinical sign of NBCCS for the remaining 9 patients without familial history of the syndrome; subsequently, the genetic analysis showing PTCH1 mutations confirmed the diagnosis. 60 KCOTs were totally identified: 39 lesions were located in the mandible and 21 lesions were located on the upper jaw. The histopathological analyses highlighted thin connective tissue walls covered by para- and orthokeratotic stratified squamous epithelium, usually about 5-8 cell layers thick, around cystic lumens filled with desquamated keratin, thus confirming the diagnosis of KCOT. The epithelial lining included a well-defined, palisading basal layer of cuboidal to small columnar cells and a superficial layer with corrugated appearance. Satellite cysts could also be seen due to tissue budding of the basal cell layers into the adjacent connective tissue. The clinico-radiological follow-up of 53 lesions showed progressively decreased radiolucent areas up to complete healing within 12 months from the surgical treatment. Differently, OPT disclosed lack of decreasing radiolucency of 7 lesions after 12 months suggesting KCOTs recurrence, that is more frequent in syndromic KCOTs than in sporadic ones due to their higher dimensions and to the involvement of nobile structures such as teeth which should be preserved in these young patients as much as possible. Conclusion. KCOTs in pediatric patients require conservative approaches for permanent teeth preservation. While conventional enucleation leads up to 60% recurrence rates, cavity ostectomy with piezoelectric tools significantly reduced the recurrence risk allowing the preservation of permanent teeth

Chewing Patterns and Muscular Activation in Deep Bite Malocclusion

Background: Deep bite, a frequent malocclusion with a high relapse rate, is associated with craniofacial features that need to be considered in the course of orthodontic treatment. Methods: This study included 81 patients with deep bite malocclusion (11.4 1.1 [yr.mo]; M = 32 and F = 49), and 14 age- and gender-matched controls (9.11 1 [yr.mo]; M = 5 and F = 9). The patients with deep bite malocclusion were treated with functional therapy. The chewing cycles and masticatory muscle EMG activity were recorded concomitantly before treatment in both groups (n = 95). Following correction of the malocclusion, a second recording took place (n = 25). Results: The kinematic variables showed the same dependency on bolus hardness in those with deep bite and in the controls. The masticatory muscle EMG activity was increased in those with deep bite, but decreased as a result of functional treatment. The chewing patterns showed a tendency towards a reduced lateral component, which significantly increased after treatment, indicating that functional therapy impacts the neuromuscular coordination of mastication, as well as dental positioning. Conclusions: Deep bite is a complex malocclusion, involving alterations in chewing and masticatory muscle activity. Orthognathodontic treatment should not only consider and correct the teeth position, but should also address muscular hyperactivity

Condylar Asymmetry in Children with Unilateral Posterior Crossbite Malocclusion: A Comparative Cross-Sectional Study

Unilateral posterior crossbite (UXB) is a common, severely asymmetric malocclusion, characterized by maxillary hypoplasia and masticatory dysfunction. The aim of this research is to evaluate the asymmetry of mandibular condyles and rami in children with UXB. This comparative cross-sectional study included 33 children with UXB (girls = 15, boys = 18; mean age ± SD = 8.0 ± 1.3 years.months]) and 33 age- and gender-matched controls (girls = 15, boys = 18; mean age ± SD = 8.4 ± 1.3 years.months]). Pre-treatment OPGs were analyzed by comparing the height of condyles and rami between the sides using the method by Habets et al. (1988); the result was considered significant if the degree of asymmetry was >6%. Children with UXB showed a significantly increased asymmetry of mandibular condyles (mean ± SD = 10.7% ± 9, p < 0.001), but not of rami (mean ± SD = 1.9% ± 2.3), compared to controls. The rami did not show significant asymmetry in either group. The presence of an increased condylar asymmetry index in a developing patient with unilateral posterior crossbite is a sign of altered skeletal growth and should be considered in the diagnostic process and treatment plan

Juvenile/Adolescent Idiopatic Scoliosis and Rapid Palatal Expansion. A Pilot Study.

The question of whether orthodontic therapy by means of rapid palatal expansion (RPE) affects the spine during development is important in clinical practice. RPE is an expansive, fixed therapy conducted with heavy forces to separate the midpalatal suture at a rate of 0.2-0.5 mm/day. The aim of the study was to evaluate the influence of RPE on the curves of the spine of juvenile/adolescent idiopathic scoliosis patients. Eighteen patients under orthopedic supervision for juvenile/adolescent idiopathic scoliosis and independently treated with RPE for orthodontic reasons were included in the study: Group A, 10 subjects (10.4 +/- 1.3 years), first spinal radiograph before the application of the RPE, second one during the orthodontic therapy with RPE; Group B, 8 patients (11.3 +/- 1.6 years), first radiograph during the use of RPE second one after the removal. Group A showed a significant worsening of the Cobb angle (p &lt;= 0.005) at the second radiograph after RPE. Group B showed a significant improvement of the Cobb angle (p = 0.01) at the second radiograph after removal of RPE. Based on the results, the use of RPE during adolescence might influence the spinal curves of patients with idiopathic scoliosis

Temporomandibular Disorders in Psoriasis Patients with and without Psoriatic Arthritis: An Observational Study

Psoriasis is a chronic, remitting and relapsing inflammatory disorder, involving the skin, nails, scalp and mucous membranes, that impairs patients' quality of life to varying degrees. Psoriatic arthritis is a chronic seronegative, inflammatory arthritis, usually preceded by psoriasis. Temporomandibular disorders is a generic term referred to clinical conditions involving the jaw muscles and temporomandibular joint. The aim of this study was to assess symptoms and signs of temporomandibular disorders in psoriasis patients with and without psoriatic arthritis

Taxonomic Analysis of Oral Microbiome during Orthodontic Treatment

Background: Orthodontic appliances induce significant changes in the oral microbiome, but this shift in microbial composition has not been well established by the available evidence yet. Objectives: To perform a systematic review of existing literature in order to assess the taxonomic microbial changes in orthodontic patients during Fixed Appliance Treatment (FAT) and Clear Aligner Treatment (CAT), using next-generation sequencing (NGS) technique of the bacterial 16S rRNA gene. Search Methods and Selection Criteria. The search for articles was carried out in PubMed, including articles published in English until May 2021. They included every human study report potentially relevant to the review. Data Collection and Analysis. After duplicate study selection and data extraction procedures according to the PICOS scheme, the methodological quality of the included papers was assessed by the Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies (SBU) method. Results: The initial search identified 393 articles, 74 of which were selected by title and abstract. After full-text reading, six articles were selected according to inclusion criteria. The evidence quality for all the studies was moderate. Conclusions: Orthodontic treatment seems to transiently affect the composition of subgingival microbiome, although not salivary, maintaining a stable microbial diversity. Different results were found in the shift of microbiome between plaque and saliva, depending on the type of orthodontic treatment. This review should be interpreted with some caution because of the number, quality, and heterogeneity of the included studies

Which route of antibiotic administration should be used for third molar surgery? A split-mouth study to compare intramuscular and oral intake

Objectives. To compare the effectiveness of two different routes of antibiotic administration in preventing septic complications in patients undergoing third molar extraction. Materials and Methods. Twenty-four healthy patients requiring bilateral surgical removal of impacted mandibular third molars were successfully enrolled for this study. Depth of impaction, angulation, and relationship of the lower third molars with the mandibular branch had to be overlapping on both sides. A split-mouth design was chosen, so each patient underwent both the first and second surgeries, having for each extraction a different antibiotic route of administration. The second extraction was carried out 1 month later. To compare the effects of the two routes of antibiotic administration, inflammatory parameters, such as edema, trismus, pain, fever, dysphagia and lymphadenopathy were evaluated 2 and 7 days after surgery. Side effects of each therapy were evaluated 48h after surgery. Results. oral and intramuscular antibiotic therapies overlap in preventing post-operative complications in dental surgery (p>0.05), even if the oral intake, seems to promote the onset of significant gastrointestinal disorders (p=0.003). Conclusions. This study could help dentists in their ordinary practice to choose the right route of antibiotic administration in the third molar surgery. At the same effectiveness, the higher cost and the minor compliance of the patient seem not to justify a routine antibiotic intramuscular therapy, reserving it for patients with gastrointestinal disorders

Effect of Different Irrigating Solutions and Endodontic Sealers on Bond Strength of the Dentin - Post Interface with and without Defects.

Abstract Aims. To investigate how the interfacial shear strength of the dentin – post interface with and without defects changes for different combinations irrigant/sealer. Methods. In forty human decoronated and instrumented teeth, fibreglass posts were in-serted. The obtained root segments were randomly assigned to four different groups ac-cording to the irrigant adopted and the cement used to seal the root canal. The root segments were processed for metyl-methacrylate embedding. Serial sections were obtained and sub-mitted to histomorphometric analyses in order to observe any defect of adhesion at the dentin – post interface and to measure the defects’ dimension. The serial sections were also submitted to micro-push-out test. The measured shear strength values were subjected to statistical analysis by one-way ANOVA. The values of bond strength determined for the defective samples were correlated with the dimension of the defects. Finite element models were built to interpret and corroborate the experimental findings. Results. ANOVA showed that the generic combination irrigant/sealer does not affect the interfacial shear strength values. The bond strength of the samples without defects was av-eragely twice as large as that of the defective samples. The defects occupying more than 12 % of the total transverse section area of the endodontic cement layer led to a reduction of the bond strength of about 70 %. The predictions of the finite element models were in agreement with the experimental results. Conclusion. Defects occupying less than 2 % of the total transverse section area of the cement layer were shown to be acceptable as they have rather negligible effects on the shear strength values. Technologies/protocols should be developed to minimize the number and the size of the defects