Variation of Efficacy of Filtering Face Pieces Respirators over Time in a Dental Setting: A Pilot Study

Since aerosol continuously persists in dental settings, where different procedures and patients come in succession, the use of oronasal masks is highly recommended. Among them, respirators known as Filtering Face Pieces (FFP) show a protective superiority compared to surgical masks. Even concerning respirators classified as non-reusable, it is not known how many hours of use are necessary to compromise their filtering capacity. The aim of this study is to investigate the variations of filtering capacity of an FFP2 respirator over time, in order to safely optimize the timing of its use. Five respirators were worn by the same operator during clinical activity for different usage times (8, 16, 24, 32, 40 h), and one respirator was kept unused. All respirators underwent a bacterial filtration efficacy (BFE) test. T-test for paired data with Bootstrap technique and Wilcoxon test for paired data compared BFE values of the five tested FFP2s respectively at each time, and the areas with the corresponding values of the control respirator (FFp2-F). A generalized linear mixed effect model (GLM) was applied considering type of respirator and time as fixed effects and intercept as random effect. No significant statistical differences were present in the BFE of each time. Data obtained by the present study highlight the important ability of FFP2s to maintain their BFE over time, suggesting a long lasting protective function

Investigation on periodontal disease in subjects with Down Syndrome. Clinical, genetic and microbiological analysis.

La sindrome di Down (DS) è una malattia genetica associata ad un cromosoma 21 extra. La condizione è associata a tipici aspetti dismorfici, ritardo mentale ed altre alterazioni sistemiche. La malattia parodontale è una condizione orale frequente e particolarmente grave tra le persone con DS. Numerosi fattori possono essere coinvolti nell'aumentata suscettibilità alla parodontite. La presente ricerca è focalizzata su due aspetti: la composizione microbiologica ed il polimorfismo dell’Interleuchina 1 (IL-1). L'esame microbiologico è stato eseguito su due gruppi distinti: 30 bambini DS (età media 5,5±1,2) e 46 bambini sani (età media 4,5±1,2), ogni soggetto con dentizione decidua ed assenza di perdita d’attaccamento clinico. Con il test PCR sono stati studiati 5 agenti patogeni parodontali: Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia (Tf) e Aggregatibacter actinomycetemcomitans (Aa). Non sono state evidenziate differenze significative tra i due gruppi ad eccezione di Tf e Aa (p = 0,001). I soggetti del gruppo di studio hanno presentato una probabilità di circa 8 volte superiore per positività Aa e 9 volte superiore per Tf rispetto al gruppo di controllo (p = 0,001). Il polimorfismo IL-1 è stato studiato su 19 soggetti DS adulti (età media 46±7) e parodontite. Una quantità corrispondente a 40ng di DNA è stata utilizzata per l'analisi dei seguenti polimorfismi genetici IL-1A-889, IL-1B + 3954 e IL-1RN + 2018 mediante real-time PCR. Il polimorfismo raro per l’ IL-1A è stato rilevato in 12 soggetti (63%), quello per l’IL-1B in 10 soggetti (53%), quello per l’IL-1RN in 7 soggetti (37%). La condizione composita dell'allele raro per IL-1 A/B è stata rilevata in 9 soggetti (47%). È stata evidenziata un'associazione significativa con i parametri parodontali indagati e le varianti rare dei polimorfismi IL-1, questo in particolare per il genotipo composito risultante correlato a ciascuna variabile oggetto di studio.Down Syndrome (DS) is a genetic disease associated with an extra chromosome #21 and It is the most common chromosomal disorder. The condition is associated with characteristic dysmorphic features, mental retardation and other systemic alterations. Periodontal disease is a serious and morbid oral condition among individuals with DS. A multitude of factors may be involved in the increased susceptibility to periodontitis. The present research focuses on two aspects: the microbiological composition and the Interleukin 1 (IL-1) polymorphism. The microbiological examination has been performed on two distinct groups: 30 DS children (mean age 5.5±1,2) and 46 healthy children (mean age 4.5±1,2), each subject with deciduous dentition and absence of clinical attachment loss. By PCR assay 5 periodontal pathogens were investigated: Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia (Tf) e Aggregatibacter actinomycetemcomitans (Aa). Statistical evaluation showed no significant differences between the two groups except for Tf and Aa (p = 0.001). The study group subjects presented a probability of about 8 times higher for Aa positivity and 9 times higher for Tf than the control group (p = 0.001). The IL-1 polymorphism was investigated on 19 DS adult (mean age 46±7) caucasian subjects with periodontitis. An amount corresponding to 40ng of DNA was used for the analysis of the following genetic polymorphisms IL-1A-889, IL-1B + 3954 and IL-1RN + 2018 by Real-Time PCR assay. Rare polymorphism for IL-1A was detected in 12 subjects (63%), that for IL-1B in 10 subjects (53%), that for IL-1RN in 7 subjects (37%). The composite condition of the rare allele for IL-1 A/B was detected in 9 subjects (47%). A significant association with the clinical parameters of periodontal disease and number of tooth loss was detected with the rare variants of IL-1 polymorphisms, in particular for the composite genotype that resulted correlated to each variables investigated

Variables Affecting the Gingival Embrasure Space in Aesthetically Important Regions: Differences between Central and Lateral Papillae

This study evaluated different variables to determine their role in the appearance of the central and lateral upper jaw papillae. 292 interdental embrasures were examined. Personal variables were: age, smoke, and use of interproximal hygiene devices. The clinical characteristics were: tooth shape, periodontal biotype and papilla appearance. Radiographic measurements were: root to root distance at the cemento-enamel junction (horizontal distance), and bone crest to interdental contact point distance (vertical distance). The papilla recession increased with patient age. The horizontal distance of the central papilla was always greater (up to 1 mm) than that of the other papillae. The vertical distance of the central papilla was greater (up to 2 mm) than that of the other papillae for each class except for the normal one (Nordland & Tarnow classification). For vertical distances ≤5 mm, papillae were almost always present; for distances up to 6 mm, the lateral papillae belonging to the normal class disappeared, while the central papilla remained in 11% of cases; central papillae of class 1 were present in larger proportions until a vertical distance of 8 mm. The present observational study shows that differences on clinical and radiographic determinants do exist between central and lateral papillae. This variance should be strictly taken in account for a harmonious and stable treatment outcome on this highly aesthetic area

A Proposed New Index for Clinical Evaluation of Interproximal Soft Tissues: The Interdental Pressure Index

The interdental pressure index (IPI) is introduced to specifically evaluate clinical interproximal-tissue conditions and assess the effect of interproximal hygiene stimulation. This index scores clinical responses of periodontal tissues to the apical pressure of a horizontally placed periodontal probe. It is negative when gingival tissues are firm, bleeding-free, and slightly ischemic by the stimulation; otherwise it is positive. The clinical validation showed high intraoperator agreement (0.92; 95% CI: 0.82\u20130.96; ) and excellent interoperator agreement (0.76; 95% CI: 0.14\u20131.38; ). High internal consistency with bleeding on probing () and gingival index (Cronbach\u2019s ) was obtained. Histological validation obtained high sensitivity (100%) and specificity (80%) for IPI+ toward inflammatory active form. The same results were recorded for IPI 12 toward chronic inactive form. IPI results as a simple and noninvasive method with low error probability and good reflection of histological condition that can be applied for oral hygiene motivation. Patient compliance to oral hygiene instructions is essential in periodontal therapy and IPI index can be a practical and intuitive tool to check and reinforce this important aspect

Recognition and treatment of peri-implant mucositis: Do we have the right perception? A structured review

Peri-implant mucositis is a common inflammatory lesion of the soft tissues surrounding endosseous implants, with no loss of the supporting bone. Its prevention or early diagnosis are vital for dental implant success.The aim of this review was to investigate knowledge strengths and gaps in clinicians'perceptions of periimplant mucositis prevalence and evidence for successful treatment.A literature search for articles published until 2020, reporting on the prevalence of peri-implant mucositis and its treatment was performed in standard online databases. The inclusion criteria were as follows: studies in English; studies with an available abstract; studies on humans with at least 1 dental implant; and studies reporting on the prevalence and/or treatment of peri-implant mucositis. Sixty-five studies fulfilled the inclusion criteria. The included papers were analyzed to identify data on the prevalence and treatment of peri-implant mucositis. The prevalence statistics for peri-implant mucositis had wide ranges in both the patient-based (PB) analysis and the implant-based (IB) analysis; the possible reasons for these wide ranges are discussed. Treatment methods for peri-implant mucositis were analyzed individually and compared to the management of gingivitis.It was determined that the currently available information on the prevalence rates and the standardized therapeutic protocols for peri-implant mucositis are insufficient. Since the mean gingivitis and peri-implant mucositis prevalence rates in the PB analysis were similar, it is possible that peri-implant mucositis is under estimated due to variables related to implant rehabilitation itself

Role of dental training and distance of the observer on the perception of apically shifted gingival margin with increased vertical tooth size in the esthetic zone

Objectives: To evaluate the influence of the gingival contour on the smile esthetics. The influence of size, symmetry, teeth involved in apically shifted gingival margins, and the distance and clinical training of the observer were investigated. Materials and Methods: Two groups were identified: 33 first‐year dental students (inexperienced) and 40 last‐year students (trained). Each observer expressed four evaluations on four different images assigning a score from 0 to 10. Using a picture of an “ideal” female smile, 10 variants were virtually created by shifting (2 and 4 mm) the gingival contour apically at different sites of the upper incisors and canines. A total of 292 evaluations were collected. Results: Considering a score >6 for a “pleasant smile,” only one 4mm single alteration at the canine gingival contour obtained an insufficient score. “Observa- tional distance” and “clinical training” did not influence the final score, while size and symmetry of alterations displayed a significant role. Conclusions: The dental training of the observer and a close interpersonal distance seemed to be irrelevant in the esthetic perception of gingival margin alterations

Bone Modeling after Orthodontic Extrusion: A Histomorphometric Pilot Study

During osteogenesis and bone modeling, high vascularity and osteoblastic/osteoclastic cell activity have been detected. A decrease in this activity is a sign of complete bone formation and maturation. Alveolar bone maturation seems to occur within weeks and months; however, the precise timing of the alveolar bone modeling is still unknown. The aim of this clinical pilot study was to investigate the bone modeling of neo-apposed tissue during orthodontic extrusive movements, through a histomorphometric analysis of human biopsies. This study was conducted on third mandibular molars sockets, and all teeth were extracted after orthodontic extrusion between 2010 and 2014. After different stabilization timings, extractions were performed, and a specimen of neo-deposed bone was harvested from each socket for the histomorphometric analysis. Histological parameters were evaluated to identify bone quantity and quality. This study included 12 teeth extracted from 9 patients. All specimens were composed of bone tissue. Bone samples taken after 1 and 1.5 months of stabilization presented remarkable percentages of woven bone, while after 2 months, a relevant decrease was observed. Histomorphometric analysis suggested that after orthodontic extrusion, a period of stabilization of 2 months allows the neo-deposed bone to mature

Minimally invasive non-surgical periodontal therapy of intrabony defects: A prospective multi-centre cohort study

Aim: To assess the potential benefits of minimally invasive non-surgical therapy (MINST) in teeth with intrabony defects and to explore factors associated with the outcomes. Materials and methods: A multi-centre trial was conducted in 100 intrabony defects in periodontitis patients in private practice. Steps 1 and 2 periodontal therapy including MINST were provided. Clinical and radiographic data were analysed at baseline and 12 months after treatment, with the primary aim being change in radiographic defect depth at 12 months. Results: Eighty-four patients completed the 12-month follow up. The mean total radiographic defect depth reduced by 1.42 mm and the defect angle increased by 3° (both p < .05). Statistically significant improvements in probing pocket depth (PPD) and clinical attachment level (CAL) were seen at 12 months compared to baseline (p < .001). Fifty-six defects (66.7%) achieved pocket closure (PPD ≤ 4 mm) and 49 defects (58.3%) achieved the composite outcome (PPD ≤ 4 mm and CAL gain ≥3 mm). Deeper and narrower angled defects were positively correlated with radiographic and clinical improvements, respectively. Conclusions: Improvements in clinical and radiographic outcomes were seen after MINST. This study highlights the generalizability and wide applicability of this approach, further supporting its effectiveness in the treatment of intrabony defects. Clinical trial registration: NCT03741374. https://clinicaltrials.gov/study/NCT03741374?cond=minimally invasive non surgical therapy&locStr=UK&country=United Kingdom&distance=50&rank=2

Laryngopharyngeal reflux diagnosis in obstructive sleep apnea patients using the pepsin salivary test

Background: To investigate the presence of laryngopharyngeal reflux in patients with obstructive sleep apnea (OSA) employing the salivary pepsin concentration method. To compare the results of pepsin concentration with the severity of the pathology. Methods: Seventy-five OSA patients (44 males, 31 females) were enrolled in the study. For each patient, the AHI (apnea–hypopnea index) and the BMI (body mass index) were initially evaluated. All the patients enrolled were assessed using the reflux symptom index (RSI) and the reflux finding score (RFS) in order to perform a clinical diagnosis of laryngopharyngeal reflux. In all patients a salivary sample was taken to estimate the presence of pepsin and its concentration. Results: The incidence of LPR (laryngopharyngeal reflux) in OSA patients, evaluated using the salivary pepsin concentration test (PEP-test), was found to be 32% of cases. Linear regression testing did not show any correlation between AHI and pepsin concentration in salivary samples (p = 0.1). Conclusion: A high number of patients with OSA seem to show positivity for salivary pepsin, correlated to an LPR. There does not appear to be a correlation between the severity of apnea and the grade of salivary pepsin reflux. On the other hand, direct correlation between BMI and the value of pepsin in salivary specimens was observed