Oral health in two heterozygote female twins with congenital lactic acidosis

Introduction: Congenital lactic acidosis (CLA) is a rare disease caused by mutations in Mithocondrial DNA (mtDNA), which affects the ability of cells to use energy that causes accumulation of lactic acid in the body. No oral manifestations have been documented in these patients. Methods: We report the oral health status of two young adolescent heterozygote female twins, one of them being diagnosed at 8 weeks of life by muscle biopsy with a severe neonatal form of CLA. In order to avoid biopsy-related complications, the second twin did not undergo a diagnostic procedure and both girls were treated for CLA. They underwent clinical oral health examination at the age of 12, for caries evaluation (diagnostic threshold D1 - early enamel demineralization) by ICDAS II clinical assessment, photographic documentation and fluorescence intra-oral camera. Results: Among the two twins, the CLA-diagnosed one presented with severe enamel carious hypomineralizations on upper and lower vestibular smooth surfaces. Moreover, deep occlusal enamel carious lesions were detected by intra-oral fluorescence camera. The second twin had no obvious decay lesions, neither on pit and fissures nor on vestibular smooth surfaces. Conclusions: Congenital lactic acidosis might be associated with hypomineralized defects and caries susceptibility in young adolescents. Preventive measures and personalized caries risk assessment should be encouraged and implemented in these patients following current caries management systems protocols, as ICCMS (International Caries Classification and Management System)

Evaluation of the esthetic properties of developmental defects of enamel: a spectrophotometric clinical study

Objectives. Detailed clinical quantification of optical properties of developmental defect of enamel is possible with spectropho- tometric evaluation. Developmental defects of enamel (DDE) are daily encountered in clinical practice. DDE are an alteration in quality and quantity of the enamel, caused by disruption and/or damage to the enamel organ during amelogenesis. Methods. Several clinical indices have been developed to categorize enamel defects based on their nature, appearance, microscopic features, or cause. A sample of 39 permanent teeth presenting DDE on labial surface was examined using the DDE Modified Index and SpectroShade evaluation. The spectrophotometric approach quantifies L∗ (luminosity), a∗ (quantity of green-red), and b∗ (quantity of blue- yellow) of different DDE. Conclusions. SpectroShade evaluation of the optical properties of the enamel defect enhances clinical understanding of severity and extent of the defect and characterizes the enamel alteration in terms of color discrepancy and surface characterization

Evaluation of aesthetic integration between composite restorations and natural tooth in NCCL: a case report

NCCL (non carious cervical lesion) is defined as irreversible loss of dental hard tissue that does not involve bacteria. It consists of erosion, attrition, abrasion and abfraction that rarely occur alone. Dentinal hypersensitivity is an early symptom of NCCL. Preventive measures and restorative treatment can avoid the progress of NCCL. This paper reports a case of NCCL treatment with aesthetic purpose. The aesthetic evaluation was made by means of spectrophotometry as a standardized method. Spectrophotometric measurements such as International Commission on Illumination (CIE-Commission Internationale de l’Eclaraige) CIE L* a* b* and ΔE between the sound enamel and resin restoration, provide all the information about the outcome of the aesthetic restorative treatment

Effect of biofilm removal from the occlusal tooth surfaces on fluorescence measurements. A clinical study

Aim: Early diagnosis and monitoring of caries lesions are the most important issues of primary and secondary prevention policies.The intraoral VistaCamiX(DurrDental, Bietigheim‐Bissingen,Germany) uses the fluorescence phenomenon for a non‐invasive, quantitative caries diagnosis. In order to make a precise evaluation the tooth surface must be completely cleaned and without biofilm. The current study aimed to evaluate the effects of biofilm removal, using air‐polishing device (Combi,MectronSpA) with glycine, on fluorescence VistaCam iX camera quantitative measurements of caries. Methods: Patients with complete permanent dentition without any kind of restorative treatments in the lateral and posterior section of upper and lower dental arches were enrolled. The occlusal surfaces of molars and premolars were photographed using the fluorescence terminal Proof of the intraoral camera VistaCam iX before and after air polishing glycine procedures, registering the highest value gained for each occlusal surface. Results:133cuspidate permanent teeth of patients aged between 13 and 25 were analyzed. Descriptive analysis showed an average of 0.82 (SD=0.65; Min=0.00; Max=1.80; Median=1.20) and of 0.93 (SD=0.60; Min=0.00; Max=1.70; Median=1.20) for values before and after treatment, respectively.The scores assigned by VistaCam iX Proof fluorescence based camera to the occlusal surfaces, after the air‐polishing treatment, are averagely higher than those before treatment, especially in the diagnosis of initial tooth decay. Conclusion: Biofilm removal with glycine air‐polishing improves the VistaCam camera accuracy in recognizing healthy tissue from the decayed one, due to the fact that air-polishing treatment increases the decayed tissue reaction to the fluorescence

Dental hypomineralized enamel resin infiltration. Clinical indications and limits

Enamel hypomineralized lesions are often encountered in clinical practice. Among non-operative treatment options with topical fluoride or casein-phosphopeptide amorphous calcium phosphate) resin infiltrative procedure shows predictable results with minimum patient’s compliance. Enamel resin infiltration clinical procedure and inclusion criteria for enamel resin infiltration treatment have been reported

Evaluation of salivary matrix metalloproteinase (MMP-8) in periodontal patients undergoing non-surgical periodontal therapy and mouthwash based on ozonated olive oil: a randomized clinical trial

Background: Extracellular matrix metalloproteinases (MMPs) play a pivotal role in the damage to the periodontal tissue in patients with periodontitis. Scaling and root planning (SRP) attempt to control the plaque amount and consequentially reduce the bacterial load. Non-surgical periodontal treatment could be integrated with drug therapy and physiotherapy procedures such as ozone therapy. The aim of this study was to evaluate in a cohort of patients with a diagnosis of periodontitis: (1) the efficacy of non-surgical periodontal therapy assisted by the use of ozonated olive oil-based mouthwash on salivary metalloproteinase (MMP-8) and (2) the reduction of periodontal indices. Methods: Ninety-six subjects with a diagnosis of periodontitis were enrolled in this study and randomly assigned to the study group (SRP + mouthwash) or control group (SRP). The study duration was 3 months. Data on MMP-8, plaque index (PI), bleeding on probing (BoP) and probing pocket depth (PPD) were recorded at T0, T1 (14 days), T2 (1 month) and T3 (6 months). Group differences were assessed using Student’s t-test for independent samples. Results: A significant improvement in PI, BoP, PPD and salivary MMP-8 levels was observed in both groups. An analysis of differences in relative changes of indices revealed the efficacy of ozonated olive oil in decreasing MMP-8 level. Simultaneously, it slowed the decrease of BoP index. Conclusions: Scaling and root plaining with the aid of ozonated olive oil mouthwash were found to be more effective on salivary MMP-8 reduction than scaling and root plaining alone

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin

Spectrophotometric analysis of Icon treatment outcome in two celiac siblings with developmental defects of enamel, a case report

Developmental defects of enamel (DDE) are common oral manifestation of celiac disease whose onset can overlap to teeth calcification in permanent dentition. The defects of the enamel symmetrically and chronologically occur in all the four quadrants, particularly in maxillary and mandibular incisors and molars. Icon® infiltration technique is a minimally invasive procedure for DDE treatment. This paper reports two cases of treatment of celiac siblings with aesthetic purpose. The aesthetic evaluation was made by means of spectrophotometry as a standardized method. International Commision on Illumination (CIE) L*a*b*, ΔE variations, contrast ratio (CR), and opalescence, measured against black and white backgrounds before and after the treatment, provide all the quantitative information about the outcome of the Icon® infiltration technique. Icon® infiltration technique has been showed to be an effective procedure for DDE treatment

Developmental Defects of Enamel : an increasing reality in the everyday practice

Developmental defects of enamel (DDE) are daily encountered in clinical practice. DDE are alteration in quality and quantity of the enamel, caused by disruption and/or damage to the enamel organ during the amelogenesis process. Several clinical indices have been developed to categorize enamel defects based on their nature, appearance, microscopic features or their cause. The aetiology of DDE is not completely clear. Enamel fluorosis is a hypo-mineralization of enamel characterised by subsurface porosity as a result of excess fluoride intake during the period of enamel formation. Several types of treatment have been r eported, related to the degree of enamel defect. Correct diagnosis according to lesion depth and prognosis of the technique are fundamental factors in the treatment decision making process

Monitoring pits and fissures using a transparent sealant and fluorescence intraoral camera, with a 12-month follow-up

The aim of this in vivo study is to report on the combined use of a fluorescence intraoral camera and transparent sealant for the clinical monitoring of pits and fissures. 96 permanent molars with a ICDAS II code 0, 1, or 2, (in 48 patients aged 12–14) were regis- tered at the First Observation Unit (Oral and Maxillofacial Sci- ences Department), Sapienza University, Rome. Clinically selected teeth were double-checked using a VistaCam iX Proof (Dürr Den- tal AG) and sealed with a transparent sealant (ControlSeal, VOCO GmbH), following the established indications for use if a pit and fissure condition was confirmed within the camera’s internal cut- off point of 1.5 (“early enamel demineralization”). Clinical follow- up was performed using VistaCam at 6 and 12 months to assess sealant retention and any demineralization trend. At baseline, 57.4% of the registered teeth were sound, both visually and when using the fluorescence camera, 42.6% presented an early deminer- alization (&lt;1.5 with VistaCam and ICDAS II 1- 2). Subsequent VistaCam assessment of surfaces underlying the transparent seal- ant totally confirmed initial evaluations. Complete sealant reten- tion rated 95% at 6 months, and 91% at 12 months. No case of complete detachment was observed. At the 12-month follow-up, VistaCam measurements resulted stable in the whole sample, ex- cept for one permanent molar, which presented a demineralization increment and partial sealant retention. Visual and fluores- cence assessments were consistent and feasible. Incomplete sealant retention occurred in 5% of cases at 6 months and 9% of cases at 12 months and was probably due to procedure imperfections. The combined use of transparent sealant and a fluorescence camera shows clinical effectiveness and diagnostic efficacy for occlusal surface monitoring. This project has been made possible in part by VOCO GmbH