Treatment of recurrent aphthous stomatitis (RAS; aphthae; canker sores) with a barrier forming mouth rinse or topical gel formulation containing hyaluronic acid: a retrospective clinical study

BackgroundUse of hyaluronic acid-based products has become a valuable alternative to drug-based approaches in the treatment of recurrent aphthous stomatitis (RAS). The presented study aimed to investigate the effect of a barrier forming hyaluronic acid containing mouth wash or a topical gel formulation on the healing of RAS and patient's quality of life.MethodsFor this single-center retrospective study, medical records of the Dental School of the University of Brescia were screened for adult and systemically health patients suffering from minor recurrent aphthous stomatitis (RAS) and treated with either a barrier forming, hyaluronic acid containing mouth wash (GUM (R) AftaClear (R) rinse) or a topical gel (GUM (R) AftaClear (R) gel) in 2015. All patients fulfilling the in-/exclusion criteria and presenting full data sets on lesion diameter, lesion color, as well as pain perception for baseline (day 0) and 4 and 7days after treatment were enrolled into the presented study.ResultsOut of 60 screened patients, a total of 20 patients treated with the Rinse formulation and 25 treated with the Gel formulation were eligible for the enrollment into this study. Both groups showed equal distribution in patient's age, sex and presented a similar mean lesion size (3.01.0mm), lesion color distribution as well as pain perception at baseline. All patients showed significant normalization of lesion color, reduction of pain, and lesion dimension within the course of their treatment. After 7days, the mean percentage of lesion reduction was highly significant for both groups attaining 77.4 +/- 30.1% in the Rinse group and 81.2 +/- 23.1% in the Gel group with a complete lesion closure obtained in 60 and 56% of the cases, respectively. However, a significant (p<0.05) higher percentage of lesions in the Gel group (72%) compared to the Rinse group (40%) showed an improvement in lesion size already after 3days.ConclusionsWithin the limitation of retrospective design, it can be concluded that both the barrier forming hyaluronic acid containing mouth rinse as well as the topical gel formulation are effective in the treatment of minor recurrent aphthous stomatitis (RAS), with a trend for an earlier healing onset for the topical Gel formulation

Advantages of cone beam computed tomography (CBCT) in the orthodontic treatment planning of cleidocranial dysplasia patients: a case report

Our aim was to discuss, by presenting a case, the possibilities connected to the use of a CBCT exam in the dental evaluation of patients with Cleidocranial Dysplasia (CCD), an autosomal dominant skeletal dysplasia with delayed exfoliation of deciduous and eruption of permanent teeth and multiple supernumeraries, often impacted. We think that CBCT in this patient was adequate to accurately evaluate impacted teeth position and anatomy, resulting thus useful both in the diagnostic process and in the treatment planning, with an important reduction in the radiation dose absorbed by the patient

The adolescent patient: parental responsibility, the right to be informed and the right to be heard

The increasing emphasis placed on patients’ rights, in dentistry as in other areas, is also having repercussions for the structure of the relationship between health care staff, the under-age patient and his/ her parents. The Authors reflect about the decision-making process when the patient is a minor in the field of dentistry and underline the role of the parties involved (dentist, parents, under-age patient) in different circumstances (e.g. ordinary care or non-routine care; urgent situations; conflict between parents; refusal of the parents; disagreement between the parents and the child, refusal of the under –age patient; etc.).. The Law must first ensure that the minors’ needs for protection are met by awarding their parents the power and duty to care for them and, thus, also to take health care decisions in their interest. At the same time, domestic legislation and international legislation supports the need to give greater weight to minors’ opinions as they approach the age of majority and thus as they acquire a certain degree of maturity. The rights of under-age patients are safeguarded by actively involving them in the decision-making process, with particular reference to their right to information and right to be heard, to the extent that their age and understanding allow, with due consideration to the specific situation

Consent in dentistry: Ethical and deontological issues

In Italy, consent for health treatment, aside from being an ethical and deontological obligation, constitutes an essential requirement for any medical treatment according to articles 13 and 32 of the National Constitution and also in accordance with the Council of Europe's 'Convention on Human Rights and Biomedicine'. An essential requirement for the validity of consent is that clear, exhaustive and adequate information be provided to the patient himself: the practice of informed consent is a communicative relationship in which the patient can express doubts, perplexities and clarification requests to the dentist. Furthermore, dental treatment has specific peculiarities: the relationship between dentistry and aesthetics, the concomitant presence of pathologies requiring different treatments, the elongated care process and the establishment of a trustworthy relationship and familiarity with the patient represent important aspects in the configuration of the dentistpatient relationship and in the process of acquiring informed consent. The dentist must offer correct information on diagnosis, prognosis, the therapeutic perspective and the likely consequences of therapy, alternative therapy and refusal of therapy, as well as eventual commitments for the period after treatment. Particular consideration must be given to minors and patients of unsound mind: the dentist's approach to these patients needs to be clear and appropriate to the person's age and understanding ability, even if the decisional power for sanitary treatment may be in the hands of a third person

Espansione palatale in pazienti con labiopalatoschisi in dentizione mista: confronto tra quad-helix ed espansore rapido del palatoDoctor Os. 2004 Vol. 15(1): 76-78

I pazienti con Labio-palato schisi mostrano un mascellare superiore collassato dovuto alla riparazione chirurgica della schisi (1). La maggior preoccupazione che sorge da un mascellare collassato è lo sviluppo di crossbite.Il crossbite può essere risolto ortodonticamente in dentatura mista utilizzando un quad-helix (2) o un espansore rapido del palato (3). In questo studio retrospettivo sono stati considerati 27 pazienti Labio- palato schisi di età compresa tra 5 e 13 anni. Il trattamento ortodontico effettuato ha comportato per sei pazienti l’applicazione di un espansore rapido del palato (ERP) e per i rimanenti ventuno di un quad – helix (QDH). Il diametro intercanino (DMA) e intermolare (DMP) sono stati misurati prima e dopo la fase di espansione e confrontati a quelli presenti in pazienti sani secondo dati tratti dalla letteratura al fine di determinare quale dei due è l’apparecchio più idoneo. I modelli di gesso sono stati riprodotti usando una macchina fotocopiatrice in modo da considerare solo due delle tre dimensioni e di conseguenza facilitare le misurazioni. Prima della fase di espansione il diametro mascellare intercanino e intermolare dei pazienti affetti da schisi si è dimostrato deficitario rispetto a quello dei bambini sani di pari età, ricavato da tabelle antropometriche. Dopo la fase di espansione nel gruppo QDH il DMA ha sostanzialmente eguagliato quello della popolazione sana mentre il DMP è leggermente maggiore di quello riscontrato nella popolazione sana. Nel gruppo ERP permane una lieve deficienza dei diametri traversi anteriore e posteriore rispetto alla popolazione sana. Nonostante entrambi gli apparecchi abbiano portato alla risoluzione del crossbite posteriore, il quad-helix risulta più efficace, provoca meno dolore e non richiede collaborazione da parte dei parenti

Dentistry and eating disorders: a comprehensive concept of health care

Dental care professionals have a key role in identifying anorexia nervosa and bulimia nervosa, through an early identification of smooth erosion of the lingual surfaces of the upper teeth or perimylolysis as common effect of self – induced vomiting. Opening an effective dialogue from the beginning with the purpose of building a therapeutic alliance with patients suspected of having an eating disorder can be difficult – in particular when the patient is an adolescent and then dental professional must involve his/ her parents – but it is the first step in order to make an appropriate management and successive oral state monitoring, and to refer the patient to other healthcare professionals (psychiatrists, psychologists, nutritionists) for a definitive diagnosis and appropriate medical care with empowerment of the patients

Evaluation of a Digital Protocol for Pre-Surgical Orthopedic Treatment of Cleft Lip and Palate in Newborn Patients: A Pilot Study

The aim of this study was to evaluate the accuracy, invasiveness and impact on clinical results of a digital oral impression protocol in the pre-surgical orthopedic treatment (PSOT) of newborn cleft lip and palate (CLP) patients undergoing primary alveolar surgical repair. Six patients were divided, according to impression technique used, into a digital (intraoral scanner (IOS)) and a non-digital (tray and putty (T&P)) group. Parents considered IOS impressions to be less invasive, compared to T&P impressions. The clinician that took all the impressions considered the IOS to be less stressful compared to the T&P method. In two T&P patients, the impression was repeated because some important anatomical details were missing, in one case due to patient regurgitation during the first attempt. No impression was repeated, and any adverse event was reported in the IOS group. There were no significant differences between these two protocols in pre-surgical alveolar gap reduction and surgical challenge. The study results indicate that this digital protocol can accelerate the production process of the passive molding plate with an instantaneous transmission of the digital impression to the dental lab, maintaining the same accuracy level and clinical outcomes of classical techniques and reducing the invasiveness of impression taking, avoiding any risk of impression material ingestion or inhalation