An Alternative Approach for the Treatment of Major Aphthosis: Case Report

An effective treatment for aphthous stomatitis is not still available and its treatment consists only of therapeutic measures to suppress its symptoms. We report a case of a 60-year caucasian woman presented a 16-year history of episodes of multiple major recurrent ulcers in the oral mucosa. Topical application of Oralmedic® caused an improvement of pain, discomfort and healing of the aphthous ulcer. No adverse events or side effects were recorded. Oralmedic® is an effective topical device for the major aphthous ulcers treatmen

Depth-specific fluctuations of gene expression and protein abundance modulate the photophysiology in the seagrass <i>Posidonia oceanica</i>

Here we present the results of a multiple organizational level analysis conceived to identify acclimative/adaptive strategies exhibited by the seagrass Posidonia oceanica to the daily fluctuations in the light environment, at contrasting depths. We assessed changes in photophysiological parameters, leaf respiration, pigments, and protein and mRNA expression levels. The results show that the diel oscillations of P. oceanica photophysiological and respiratory responses were related to transcripts and proteins expression of the genes involved in those processes and that there was a response asynchrony between shallow and deep plants probably caused by the strong differences in the light environment. The photochemical pathway of energy use was more effective in shallow plants due to higher light availability, but these plants needed more investment in photoprotection and photorepair, requiring higher translation and protein synthesis than deep plants. The genetic differentiation between deep and shallow stands suggests the existence of locally adapted genotypes to contrasting light environments. The depth-specific diel rhythms of photosynthetic and respiratory processes, from molecular to physiological levels, must be considered in the management and conservation of these key coastal ecosystems

Drug-induced gingival overgrowth: The effect of cyclosporin a and mycophenolate mophetil on human gingival fibroblasts

Drug-induced gingival overgrowth may occur after a chronic administration of three classes of systemic drugs: Anticonvulsants, immunosuppressants, and calcium channel blockers. This study aimed to investigate how cyclosporin A and mycophenolate mophetil (immunosuppressive drugs) could interfere with human gingival fibroblasts functions, leading to gingival enlargement. Human gingival fibroblasts derived fromthe tissue of a 60-year-old female were cultured in aDMEMEmedium. A stock solution with 1 mg/mL of mycophenolate and 1 mg/mL of cyclosporine were prepared and dissolved in a DMEM medium to prepare a serial dilution at the concentrations of 5000, 2000, 1000, 500, and 100 ng/mL, for both treatments. Cell viability was measured using the PrestoBlueTM Reagent Protocol. Quantitative real-time RT-PCR was performed in order to analyze the expression of 57 genes coding for gingival fibroblasts "Extracellular Matrix and Adhesion Molecules". Mycophenolate and cyclosporine had no effect on fibroblast cell viability at 1000 ng/mL. Both the treatments showed similar effects on the expression profiling of treated cells: Downregulation of most extracellular matrix metalloproteases genes (MMP8, MMP11, MMP15, MMP16, MMP24) was assessed, while CDH1, ITGA2, ITGA7, LAMB3, MMP12, and MMP13 were recorded to be upregulated in fibroblasts treated with immunosuppressive drugs. It has been demonstrated that gingival overgrowth can be caused by the chronic administration of cyclosporin A and mycophenolate mophetil. However, given the contrasting data of literature, further investigations are needed, making clear the possible effects of immunosuppressive drugs on fibroblasts

Conocimiento y actitud del odontólogo frente al manejo del tabaquismo: estudio comparativo entre España, Italia y Venezuela

espanolIntroduccion: El Odontologo es capaz de ejercer un gran impacto en el tabaquismo a traves de su contacto con los pacientes y la deteccion precoz de lesiones bucales. El objetivo de este estudio fue determinar el conocimiento y la actitud de los odontologos frente al tabaquismo en tres paises distintos. Materiales y metodos: Se realizo una encuesta a 293 odontologos, 93 de ellos localizados en Caracas (OV), 90 con practica odontologica en Madrid (OE) y 110 en Milan (OI). Resultados: 46 OE y 22 OI indicaron ser fumadores, mientras que tan solo 10 OV admitieron ser fumadores. 80 (86,02%) OV, 66 (73,33%) OE y todos los OI refirieron registrar en la historia datos relacionados con tabaquismo en la primera consulta del paciente. La mayoria motiva a sus pacientes a dejar de fumar, sin embargo, 72,04% (67) OV, 55,55% (50) OE y 100% OI no recomiendan ninguna terapia de apoyo. Solo 7 odontologos (2,38%) (2 OV y 5 OE) reconocieron el medicamento Bupropion pero ningun odontologo lo ha indicado. Finalmente, 137 odontologos han diagnosticado cancer bucal, de los cuales 108 eran OI. Conclusiones: Los odontologos, independientemente del pais, tienen actitudes positivas para participar en el control del tabaquismo, pero no manejan la informacion relacionada ni ejercen un rol activo en la cesacion. Probablemente esta situacion se deba a la falta de entrenamiento durante sus estudios de pre y/o postgrado lo cual amerita una revision de los planes curriculares de Odontologia a nivel mundial. EnglishIntroduction: Health care professionals have an important role in tobacco control. Dentists are capable of having a great impact in smoking cessation due to their regular contact with patients and the rapid detection of oral signs produced by smoking. Unfortunately, there are few dentists actively involved in smoking control. The aim of this study was to investigate various aspects of dentists' beliefs and practices with respect to smoking cessation. Materials & Methods: A questionnaire about smoking cessation was filled in person by 293 dentists. 93 dentists were from Caracas-Venezuela (VD), 90 were from Madrid-Spain (SD) and 110 from Milan-Italy (ID). Results: 46 SD and 22 ID were smokers. Only 10 VD admitted to smoke. 80 (86.02%) VD, 66 (73.33%) SD and 100% of ID said that they recorded smoking status during the first consultation. However, none routinely update their records on smoking status. The majority of respondents encourage their patients to stop smoking, though, 72.04% (67) VD, 55.55% (50) SD and 100% ID do not recommend or prescribe any cessation therapy. Just 7 (2.38%) of all dentists had heard about the use of Bupropion, however, they had never indicated. Finally, 137 dentists (108 ID) have diagnosed oral cancer in their patients. Conclusions: Dentists have positive attitudes to being involved in smoking cessation interventions, but they do not manage all the information related to it. It is probably due to a lack of training or education during their undergraduate and postgraduate studies. Further studies should evaluate inclusion of smoking cessation instruction in Venezuelan, Spanish and Italian dentistry curriculum

Aging and oral care: An observational study of characteristics and prevalence of oral diseases in an Italian cohort

Background: Poor oral health is a common condition in patients suffering from dementia. Several aspects of this systemic pathology contribute to causing oral problems: cognitive impairment, behavior disorders, communication and, motor skills deterioration, low levels of cooperation and medical-nursing staff incompetency in the dental field. Objectives: The objectives of this study were to evaluate the prevalence and the characteristics of oral pathology in a demented elderly population, as well as to check the association between the different degree of dementia and the oral health condition of each patient. Materials and Methods: In this observational study (with cross-sectional design) two groups of elderly patients suffering from dementia, living in two different residential care institutions were recruited. The diagnosis of dementia of each included patient was performed using the Clinical Dementia Rating Scale. In order to evaluate the oral health condition of the included subjects, each patient underwent a physical examination of the oral cavity, during which different clinical parameters were analyzed (number of remaining teeth, oral mucosa, periodontal tissues, bone crests). To each parameter, a score was assigned. Spearman’s Rho test was used. Results: Regarding the prevalence of oral pathology in elderly suffering from dementia, it emerged that 20.58% of the included patients had mucosal lesions and/or new mucosal formations (in most cases undiagnosed and therefore untreated). The prevalence of periodontal disease was equal to 82.35% and a marked clinically detectable reabsorption of bone crests was found in almost all patients (88.23%). 24.13% of patients, who underwent the oral examination, had totally edentulous maxillae and/or with retained roots, without prosthetic rehabilitations. The correlation index r showed the presence of a linear correlation (inverse relationship) between the degree of dementia and the state of health of the oral cavity of each patient. Conclusions: Several factors contribute to poor oral health in the elderly suffering from dementia: cognitive functions deterioration, behavioral disorders and inadequate medical-staff nursing training on oral hygiene. This study also demonstrated that the lower the dementia degree is, the lower tends to be the oral health status. In order to guarantee a complete assistance to these patients, residential care institutions should include in their healthcare program specific dental protocols

The role of blood clot in guided bone regeneration: Biological considerations and clinical applications with titanium foil

In Guided Bone Regeneration (GBR) materials and techniques are essential to achieve the expected results. Thanks to their properties, blood clots induce bone healing, maturation, differenti-ation and organization. The preferred material to protect the clot in Guided Bone Regeneration is the titanium foil, as it can be shaped according to the bone defect. Furthermore, its exposition in the oral cavity does not impair the procedure. We report on five clinical cases in order to explain the management of blood clots in combination with titanium foil barriers in different clinical settings. Besides being the best choice to protect the clot, the titanium foil represents an excellent barrier that is useful in GBR due to its biocompatibility, handling, and mechanical strength properties. The clot alone is the best natural scaffold to obtain the ideal bone quality and avoid the persistence of not-resorbed granules of filler materials in the newly regenerated bone. Even though clot contraction still needs to be improved, as it impacts the volume of the regenerated bone, future studies in GBR should be inspired by the clot and its fundamental properties

Oral health status and need for oral care in an aging population: A systematic review

Background. The world population is aging. This phenomenon is accompanied by an increase in the number of elderly with dementia, whose oral hygiene care is a challenge. Objective. This paper presents a literature review of oral health status and the need for oral care in people with dementia, as compared to people without dementia and also of the relationship between periodontal disease and cognitive impairment. Methods. A systematic review was conducted in PubMed, CINAHL, and the Cochrane Library. Fifty-six articles met the inclusion criteria and were consequently included for quality assessment and data extraction. Results. No significant differences were found between both groups with regard to the number of present teeth, DMFT Index, edentulousness/use of denture, and orofacial pain. Coronal/root caries and retained roots were more common in people with dementia than in those without dementia. Most of the participants with dementia presented gingival bleeding or inflammation and they suffered from the periodontal disease more than people without dementia. Conclusions. Poor oral health is a common condition among the elderly with dementia. The education process of caregivers might improve the oral health status of people with dementia. Finally, periodontal disease might contribute to the onset or progression of dementia

Hemifacial microsomia: Case report and literature review

Hemifacial microsomia (HFM) is a sporadic congenital malformation of the craniofacial structures derived from the first and second branchial arches. The incidence of HFM has been reported to range from 1 in 3,0001 to 1 in 26,0002 live births, making HFM the second most common congenital malformation in the face after cleft lip and/or palate. An 11-year-old girl came at Galeazzi Institute (Milan) in January 2017. She presented left hemifacial microsomia with absence of the left ramus of mandible and the left temporomandibular joint (tmj), part of the zygomatic arch, hypoplasia of the lateral and inferior orbital bone and of the zygomatic bone. She also presented a medial canthal dystopia. She underwent to costochondral bone graft and calvaria bone graft for reconstruction of part of the mandible and the TMJ. An emi-Le Fort I, emi-Le Fort III, and sagittal segmental osteotomy of the right mandible were performed to improve the correct occlusion. Traditionally, the costochondral graft has been considered the gold standard for ramus-condyle reconstruction in the pediatric mandible when appropriate. Some studies cite growth unpredictability and ankylosis as concerns with rib. Further studies examining carefully the factors predicting graft growth, such as size of cartilage cap, surgical technique, and postoperative physiotherapy, are warranted

Oral health status among migrants from middle-and low-income countries to europe: A systematic review

Introduction. Economic inequality, political instability and globalization have contributed to the constant growth of the migration phenomenon in recent years. In particular, a total of 4.2 million people migrated to Europe during 2019 and most of them settled in Germany, France and Italy. Objectives. The objective of this study was to conduct a systematic review of studies analyzing the oral health condition among migrants from middle-and low-income countries to Europe and assessing the eventual association between their sociodemographic and socioeconomic characteristics and oral health status. Materials and Methods. A systematic review was conducted in PubMed, Cochrane Library, Scopus and Science Direct databases. After titles, abstracts and full-text exami-nation, only 27 articles were selected on the basis of inclusion criteria and consequently included for quality assessments and data extraction. Results. Most of the studies reported a higher prevalence of caries experience, a poorer periodontal health and more difficulties in accessing dentalcare services among migrant groups compared with the non-migrant population. Inequalities were mostly associated with ethnic background, economic condition and social grade. Conclusion. Our review demonstrates the lack of dental health among migrants, underlining that their cultural beliefs and their social and economic living conditions could influence their oral health