Mezzi di prevenzione della carie in ortodonzia

Poiché in campo odontoiatrico sono in atto diverse metodiche di prevenzione, basate principalmente sulla remineralizzazione della superficie dentale offesa dopo il trattamento, in questo lavoro abbiamo voluto revisionare la letteratura disponibile per conoscere la loro reale efficacia durante il trattamento ortodontico. Com’è noto l’utilizzo di apparecchi comporta spesso difficoltà nel mantenimento di un’adeguata igiene orale. Per questo motivo nei pazienti ortodontici si rileva frequentemente un aumento di accumulo di placca e, di conseguenza, dell’incidenza di demineralizzazione dello smalto dovuta agli acidi organici derivati dai batteri contenuti nella placca stessa

Modifications of oral hygiene and dietary habits in the patients in treatment with invisalign system

AIM: to evaluate the habits of hygiene of the mouth and appliance, and the changes in the diet in patients treated with INVISALIGN System, to optimize and personalize the indications during treatment. MATERIALS AND METHODS: a 22 question informative questionnarie has been elaborated. 25 patients between 15 and 62 years of age anonymously completed the questionnaires. The data have been entered in an Excel database file and graphically showed through histograms and pies. RESULTS: all the patients who have answered the questions carry out the daily oral hygiene by toothbrushing (¾ manual, ¼ electric toothbrush) and they replace it, not with a regular timing, but when “it’s consumed”. More than a half of the patients are prompt to the dental hygienist visits.The appliance is generally cleaned 2 times a day. The diet changes are very intersting: a tendency to reduction of the potential coloring (tea, coffee, colored drinks) or decayed (sweet, candies, sugar drinks) food and the number of snacks has been observed.The patients concentrate the food assumption during the principal meals. CONCLUSIONS: the INVISALIGN patients pay more attention at the health of the mouth and the hygiene of the appliance, with a highrespect of the visits with the dental hygienist and in attempting to optimize the relations between oral hygiene and food assumption

Modifications of oral hygiene and dietary habits in the patients in treatment with invisalign system

AIM: to evaluate the habits of hygiene of the mouth and appliance, and the changes in the diet in patients treated with INVISALIGN System, to optimize and personalize the indications during treatment. MATERIALS AND METHODS: a 22 question informative questionnarie has been elaborated. 25 patients between 15 and 62 years of age anonymously completed the questionnaires. The data have been entered in an Excel database file and graphically showed through histograms and pies. RESULTS: all the patients who have answered the questions carry out the daily oral hygiene by toothbrushing (¾ manual, ¼ electric toothbrush) and they replace it, not with a regular timing, but when “it’s consumed”. More than a half of the patients are prompt to the dental hygienist visits.The appliance is generally cleaned 2 times a day. The diet changes are very intersting: a tendency to reduction of the potential coloring (tea, coffee, colored drinks) or decayed (sweet, candies, sugar drinks) food and the number of snacks has been observed.The patients concentrate the food assumption during the principal meals. CONCLUSIONS: the INVISALIGN patients pay more attention at the health of the mouth and the hygiene of the appliance, with a highrespect of the visits with the dental hygienist and in attempting to optimize the relations between oral hygiene and food assumption

Mezzi di prevenzione della carie in ortodonzia.

Poiché in campo odontoiatrico sono in atto diverse metodiche di prevenzione, basate principalmente sulla remineralizzazione della superficie dentale offesa dopo il trattamento, in questo lavoro abbiamo voluto revisionare la letteratura disponibile per conoscere la loro reale efficacia durante il trattamento ortodontico. Com’è noto l’utilizzo di apparecchi comporta spesso difficoltà nel mantenimento di un’adeguata igiene orale. Per questo motivo nei pazienti ortodontici si rileva frequentemente un aumento di accumulo di placca e, di conseguenza, dell’incidenza di demineralizzazione dello smalto dovuta agli acidi organici derivati dai batteri contenuti nella placca stessa

Caseina fosfopeptide: una moderna visione della gestione della carie nel xxi secolo

L’impiego di terapie mediche nella gestione della carie sta rapidamente diventando un aspetto essenziale nella moderna odontoiatria. I tre principi fondamentali del moderno approccio curativo alla gestione della carie si possono cosi riassumere: ■ identificare e valutare qualunque potenziale fattore di rischio della carie preventivamente; ■ prevenire l’insorgenza della carie eliminando o minimizzando questi fattori di rischio; ■ restaurare il dente in modo conservativo anche quando è necessario l’approccio chirurgico, utilizzando materiali bioattivi che facilitano la riparazione dello smalto demineralizzato e forniscono protezione contro ulteriori danni. Per attuare in modo efficace l’approccio mini-invasivo è necessario integrare completamente tutti e tre i principi mini-invasivi nei piani di trattamento dei pazienti. Accanto ai tradizionali sistemi preventivi, in continua fase di ottimizzazione e diffusione, la ricerca scientifica si sta orientando verso strategie innovative in grado di superare i limiti culturali ed economici delle metodiche attualmente disponibili. GC Tooth Mousse è il primo prodotto professionale, sul mercato dalla fine del 2002, che contiene la tecnologia Recaldent, sviluppata presso la School of Dental Science dell’Università di Melbourne, Victoria, Australia. Recaldent ™ è un derivato della proteina del latte, la caseina. Da anni ormai si sa che il latte e i suoi derivati hanno un effetto protettivo per i denti. Attorno alla fine degli anni ‘90 la ricerca ha dimostrato che questa attività è dovuta a una parte della proteina della caseina chiamata caseina fosfopeptide (o CPP), alla quale sono “legati” ioni di calcio e fosfato nella forma di calcio fosfato amorfo (o ACP). Il calcio fosfato normalmente è insolubile, ovvero forma una struttura cristallina con pH neutro. Tuttavia, la CPP mantiene il calcio e il fosfato in uno stato amorfo, non cristallino. Questo complesso di CPPACP (Recaldent™) è pertanto un sistema ideale per l’erogazione di ioni di calcio e fosfato liberamente disponibili. Quando viene applicata GC Tooth Mousse nella cavità orale, la parte “adesiva” CPP del complesso CPP-ACP si lega subito allo smalto, alla pellicola, alla placca e al tessuto molle, erogando il calcio e il fosfato esattamente dove servono. La sua incorporazione nella pellicola salivare sembra ridurre notevolmente l’adesione di determinati batteri della placca. Gli ioni liberi di calcio e fosfato si liberano poi dalla CPP, entrano nello smalto e si riformano come cristalli di apatite. Pertanto GC Tooth Mousse è come uno “smalto liquido” che protegge i denti e contribuisce in modo unico a mantenere l’equilibrio naturale degli acidi nel cavo orale. Le indicazioni di Tooth Mousse in campo odontoiatrico sono molteplici e si stanno scoprendo grazie ai numerosi studi che possiamo trovare pubblicati negli ultimi 5 anni

Peanut allergy in Italy: A unique Italian perspective

Background Peanut allergy has not been well characterized in Italy. Objective Our aim was to better define the clinical features of peanut allergy in Italy and to detect the peanut proteins involved in allergic reactions. Methods A total of 22 centers participated in a prospective survey of peanut allergy over a 6-month period. Clinical histories were confirmed by in vivo and/or in vitro diagnostic means in all cases. Potential risk factors for peanut allergy occurrence were considered. Levels of IgE to Arachis hypogea (Ara h) 1, 2, 3, 6, 8, and 9 and profilin were measured. Results A total of 395 patients (aged 2-80 years) were enrolled. Of the participants, 35% reported local reactions, 38.2% reported systemic reactions, and 26.6% experienced anaphylaxis. The sensitization profile was dominated by Ara h 9 (77% of patients were sensitized to it), whereas 35% were sensitized to pathogenesis-related protein 10 (PR-10) and 26% were sensitized to seed storage proteins (SSPs). Sensitization to 2S albumins (Ara h 2 and Ara h 6) or lipid transfer protein (LTP) was associated with the occurrence of more severe symptoms, whereas profilin and PR-10 sensitization were associated with milder symptoms. Cosensitization to profilin reduced the risk of severe reactions in both Ara h 2– and LTP-sensitized patients. SSP sensitization prevailed in younger patients whereas LTP prevailed in older patients (P < .01). SSP sensitization occurred mainly in northern Italy, whereas LTP sensitization prevailed in Italy's center and south. Atopic dermatitis, frequency of peanut ingestion, peanut consumption by other family members, or use of peanut butter did not seem to be risk factors for peanut allergy onset. Conclusions In Italy, peanut allergy is rare and dominated by LTP in the country's center and south and by SSP in the north. These 2 sensitizations seem mutually exclusive. The picture differs from that in Anglo-Saxon countries

Use of narrative medicine to identify key factors for effective doctor-patient relationships in severe asthma

Background In this project the authors use a narrative medicine (NM) approach to assess the promotion of trust in the relationship between physicians and their asthma patients. Methods Following a NM educational course for physicians, a research was carried out in which at least 5 written narratives (parallel charts) for each participating physician were collected and qualitatively analysed according to Bury's classification and the Grounded Theory. Results The results of this study were of speculative and clinical interest. In particular, 66 participants wrote 314 narratives (246 on adult and 68 on paediatric patients). As a result of applying the NM approach, when the relationships remained problematic, many physicians wrote with a moral style about their adult (67%), and paediatric patients (33%) - especially in cases of asthmatic children's or adolescents' overprotective or absent families (40%) -. On the contrary, physicians who were able to listen to their patients with empathy (35%) made more shared decisions with patients, even with those they initially had a bad relationship. The used words of welcome, interest and acceptance were promoting patients' trust that lead to restoring their activities in 45% of cases, according to physicians self-reporting. Conclusions These approaches of NM are useful in daily clinical practice, with the goal of improving the quality of life (QOL) of patients with severe asthma, even in cases in which the doctor-patient relationship isn't initially good