Minimally invasive orthodontics: elastodontic therapy in a growing patient affected by Dentinogenesis Imperfecta

AIM: The aim of the study was to report the use of an elastodontic therapy in a growing patient affected by Dentinogenesis Imperfecta, second class malocclusion, deep bite and lower arch crowding from the deciduous dentition to permanent one. CASE REPORT: At first, the 5-year-old patient was treated with an elastodontic device known as "Nite-Guide". When the patient was 7 years old, during her first permanent molars and incisors eruption and after optimal house-practices, an Occlus-o-Guide Series G was placed at night and on daylight (two hours a day) performing exercises aimed to activate facial muscles and facilitate the deep bite reopening. At 9 years of age, with totally deep bite resolution, she used the Occluso-Guide only at night to hold down previous results and follow patient's dental growth. At 11 years of age, after successful teeth switching, we prescribed an Occlus-o-Guide Series N, which is functional for permanent dentition and guaranteed an eruptive guide for last dental elements. CONCLUSIONS: This clinic case could be considered an example of approach for all those patients with systemic and/or dental diseases that do not allow adequate dental retention, which is necessary for most orthodontic appliances; elastodontic devices do not require adequate dental retention and define a minimum intervention on the surfaces of the teeth

Healing environment in pediatric dentistry: strategies adopted by “Sapienza” University of Rome

Children’s dental anxiety has been of great worry for many years and it is still a barrier for dental care. According to recent guidelines for oral health prevention in childhood, additional strategies for a preventive care should be applied for pediatric patients. So it’s important to encourage pediatric dentists to develop a “child-friendly” environment for treating children. Environmental elements that produce positive feelings can reduce anxiety. The analysis of environmental design and features applied in Pediatric Dentistry Unit, Department of Oral and Maxillo-facial sciences, Sapienza University of Rome, highlighted special attention to the aspects supporting sensory conditions (colors, light, spatial organization); reassurance strategies (decorations, dental team attire, drawings); anxiety control strategies (playing area, TV, comics, toys); behavioral management strategies (positive reinforcement, modeling); in-formation (brochures, posters)

Prevention and early diagnosis of oral carcinoma in construction workers in Italy: a pilot project

Objectives: A research project on occupational exposure in relation to oral carcinoma was periodic compulsory check-ups, oral examinations were performed to detect pathologies and the prevalence of potentially neoplastic oral conditions and a selfassessment questionnaire was administered to all of the subjects. The questionnaire was structured to collect information regarding demographic and clinical characteristics, risk habits (tobacco and alcohol consumption) and oral health habits, and to allow an assessment of knowledge about oral cancer, related risk factors and early signs. Results: The study cohort included people with different ethnicities, and there were significant differences in clinical characteristics between Italians and other Europeans. The subjects showed a good knowledge about oral cancer and related risk factors (with correct answers provided to >50% of the questions) but insufficient knowledge about the early signs of oral carcinoma (correct-answer rates of 16–42%). There were high rates of habits that are potentially harmful to oral health, such as smoking (43.8%) and alcohol consumption (57%). The daily habit of brushing teeth was present in 92.6% of the subjects, but they had a low propensity to undergo regular dental examinations. The percentage of subjects with pathologies of the oral cavity was 18.6%. Conclusions: Despite the smallness of the sample, this pilot project could facilitate the acquisition of valid and cost-effective data for the primary prevention of oral cancer through information and educational campaigns on the related risk factors

Rapid maxillary expansion and upper airway morphology: a systematic review on the role of cone beam computed tomography

OBJECTIVE: This study aimed to investigate the quality of cone beam computed tomography (CBCT) studies evaluating the effects of rapid maxillary expansion on upper airway morphology. MATERIALS AND METHODS: A database search was conducted using PubMed, Ovid, and Cochrane Library up to December 2016. Studies in which CBCT was adopted to visualize the upper airway before and after rapid maxillary expansion were included. The population target was growing patients. Methodological quality assessment was performed. RESULTS: The screening process resulted in the exclusion of 1079 references, resulting in only 9 remaining papers that fulfilled the inclusion criteria. No randomized clinical trials were found. The quality scores ranged from 36% to 68% of the maximum achievable, and the mean quality score of the studies was 50%. No good quality studies were detected in our sample. CONCLUSIONS: Inconsistencies in the CBCT protocols utilized were detected between studies. Head posture, tongue position, and segmentation protocols were not consistent. These discrepancies were reflected in the different results obtained in the studies. A valid and consistent protocol with regard to head and tongue positioning, as well as nasal cavity volume segmentation, is required

Peek polymer in orthodontics : a pilot study on children

The purpose of the study has been making the orthodontic space maintainers in PEEK polymer (Polyetheretherketone) through a digital workflow. New digital technologies are taking hold in diagnosis, therapy and in dental laboratories. The digital world can help dentist in diagnosis and therapy: -diagnosis through the acquisition of radiographic images (CBCT) or scanners which allow the creation of 3D digital models ? about therapy thanks to dental CAD CAM system. It consists of design devices through an dedicated software CAD and then realize devices through CAM system. We used digital system to improve the quality of the treatment and reduce costs. Peek polymer, subject of studies in recent years, thanking to its characteristics, resulted useful for this study. According to a nine month- follow up the devices were found comfortable, satisfying, personalized and minimally visible for the patients. These devices were found suitable to maintain the space. About material, thanks to its dimensional stability, mechanical strength but specially, thanks to its biocompatibility, PEEK was found as a very good material to build space maintainers. The workflow allowed a simulation of the treatment plan with a better collaboration and acceptance of the patient. Digital system reduced the systematic mistakes during the various phases and the production time. The digital system saved space creating a virtual plaster casts collection

Malocclusion and rhinitis in children: an easy-going relationship or a yet to be resolved paradox? A systematic literature revision

Objective: The relation between nasal flow and malocclusion represents a practical concern to pediatricians, otorhinolaryngologists, orthodontists, allergists and speech therapists. If naso-respiratory function may influence craniofacial growth is still debated. Chronic mouth-breathing is reported to be associated also with a characteristic pattern of dental occlusion. On the other hand, also malocclusion may reduce nasal air flows promoting nasal obstruction. Hereby, the aim of this review was to describe the relationship between rhinitis and malocclusion in children. Methods: An electronic search was conducted using online database including Pubmed, Web of Science, Google Scholar and Embase. All studies published through to January 30, 2017 investigating the prevalence of malocclusion in children and adolescents (aged 0-20 years) affected by rhinitis and the prevalence of rhinitis in children with malocclusion were included. The protocol was registered at PROSPERO - International prospective register of systematic reviews under CRD42016053619. Results: Ten studies with 2733 patients were included in the analysis. The prevalence of malocclusion in children with rhinitis was specified in four of the studies ranging from as high as 78.2% to as low as 3%. Two out of the studies reported the prevalence of rhinitis in children with malocclusion with a rate ranging from 59.2 to 76.4%. Conclusion: The results of this review underline the importance of the diagnosis and treatment of the nasal obstruction at an early age to prevent an altered facial growth, but the data currently available on this topic do not allow to establish a possible causal relationship between rhinitis and malocclusion

Bioactive cements: from biological properties to clinical applications

Aim: Calcium silicate-based cements represent safe and predictable materials widely used in different fields of endodontics. They can be applied as pulp dressing agents during vital pulp therapy (VPT) of carious-affected deciduous or permanent teeth with immature roots as well as endodontic cements in case of root perforation or regenerative endodontic procedures. Therefore, it’s crucial to demonstrate biocompatible and antibiofilm properties of bioactive cements (i.e. MTA and Biodentine) in order to support their successful use in the clinical field. Materials and Methods: Biocompatibility of ProRootMTA and Biodentine specimens was assessed through cell culture of Saos-2 cells and both cement extracts by viability assay, oxidative stress analysis and immunofluorescence evaluation; on the other hand, antibiofilm efficacy was assessed by evaluating the biofilm forming ability of Streptococcus mutans onProRootMTA and Biodentine disks using Crystal Violet assay. Results: Cells exposed to ProRootMTA and Biodentine showed a good cell viability, slightly better in presence of the first; moreover, cells seeded on ProRootMTA presented a higher degree of biocompatibility compared to Biodentine. Accordingly, Biodentine demonstrated lightly fewer promising outcomes in terms of oxidative stress and focal adhesions of cells than ProRoot MTA, although the differences were not statistically significant. Inhibition of superficial colonization as well as biofilm forming ability of S. mutants were successfully obtained with both evaluated cements, even though ProRootMTA demonstrated a more efficient time-dependent antibiofilm effect than Biodentine. Conclusion: Bioactive cements proved to be biocompatible and to possess antibiofilm properties. When compared, MTA would seem to perform slightly better and could be considered as the gold standard material in the endodontic procedures

Pediatric patients tolerance: a comparative study about using of Er:YAG laser and self-adhesive flowable composite for treatment of primary decayed teeth

Aim. To verify the tolerance of children aged between 3 and 8 years, having class I caries and treated with Er:YAG laser in association with a new self-adhesive flowable resin in comparison with a highspeed diamond bur and a conventional flowable resin treatment. Methods. A group of 80 healthy children (43 males and 37 females) ranging in age from 3 to 8 years, who had been diagnosed with at least one active occlusal non-cavitated superficial carious lesions in first or second deciduous molars, were selected for the present study. They were divided in 4 groups: group A: Class I occlusal cavities prepared using an Er: YAG laser and a self-adhesive flowable resin; Group B: Class I occlusal cavities prepared using an Er: YAG laser and a conventional flowable resin; Group C: Class I occlusal cavities prepared using a high-speed diamond bur and a self-adhesive flowable resin; Group D: Class I occlusal cavities prepared using a high-speed diamond bur and a conventional flowable resin. Before and after the treatments the patient tolerance was tested with the modified Wong-Baker pain level scale. Results. In the first group, the tolerance rate was 95% with 0 score (no hurt) for 19 patients; in Group D, the tolerance rate was 75%. Just one child of group D experienced hurting worst because of non cooperative patient. Conclusion. From these results it emerged that, although the limits of the study, Er:Yag laser in association with self-adhering composite, is very effective in pediatric dentistry and is a good treatment option especially for non cooperative patients

Prevalence of maxillary canine impaction in skeletal Class III malocclusions compared to Class I malocclusions

The aim of the present investigation was to evaluate if an orthodontic population of Class III malocclusion patients shows a different prevalence of maxillary canine impaction than Class I subjects. Fifty-eight subjects were retrospectively selected and assigned to the Class I group (n= 32) or the Class III group (n= 26), depending on the ANB and WITS values. Lateral cephalograms were used to collect angular and linear measurements that described the skeletal and dental maxillary features of the subjects, while orthopantomography was used to assess the impaction or the correct eruption of the maxillary canines. An independent samples T-test or a Mann?Whitney U-test was used to compare the cephalometric values between the two groups, while a chi-squared test was used to evaluate the distribution of maxillary canine impaction between the two groups. No statistically significant difference was found for the cephalometric variables, and the frequency of canine impaction showed no difference between the Class III and Class I subjects. Patients with skeletal Class III malocclusions did not show a different prevalence of canine impaction; therefore, such skeletal features cannot be used as a diagnostic aid for assessment of the risk of maxillary canine impaction

New 3D cone beam CT imaging parameters to assist the dentist in treating patients with Osteogenesis Imperfecta

(1) Background: The aim of the work is to identify some imaging parameters in osteogenesis imperfecta to assist the dentist in the diagnosis, planning, and orthodontic treatment of Osteogenesis Imperfecta (OI) using 3D cone beam Computed Tomography (CBCT) and the Double Energy X-ray Absorptiometry (DEXA) technique. (2) Methods: 14 patients (9 males and 5 females; aged mean ± SD 15 ± 1.5) with a clinical-radiological diagnosis of OI were analyzed and divided into mild and moderate to severe forms. The patients’ samples were compared with a control group of 14 patients (8 males and 6 females; aged mean ± SD 15 ± 1.7), free from osteoporotic pathologies. (3) Results: The statistical analysis allowed us to collect four datasets: in the first dataset (C1 sick population vs. C1 healthy population), the t-test showed a p-value < 0.0001; in the second dataset (C2 sick population vs. C2 healthy population), the t-test showed a p-value < 0.0001; in the third dataset (parameter X of the sick population vs. parameter X of the healthy population), the t-test showed a p-value < 0.0001; in the fourth dataset the bone mineralometry (BMD) value detected by the DEXA technique compared to the C2 value of the OI affected population only) the Welch–Satterthwaite test showed a p-value < 0.0001. (4) Conclusions: The research has produced specific imaging parameters that assist the dentist in making diagnostic decisions in OI patients. This study shows that patients with OI have a characteristic chin-bearing symphysis, thinned, and narrowed towards the center, configuring it with a constant “hourglass” appearance, not reported so far in the literature by any author