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)

Impact of Green Tea (Camellia Sinensis) on periodontitis and caries. Systematic review and meta-analysis

Background: The oral health-promoting effects of green tea are attributed to its polyphenol components. Aim of this work was to systematically review the literature in search for clinical trials assessing green tea for managing periodontitis and caries. Methods: Randomized clinical trials comparing the efficacy of green tea versus control groups in oral hygiene and gingival health; periodontitis; caries; periodontal pathogens number; Streptococcus mutans, Lactobacillus spp. Meta-analysis and meta-regression analysis were performed. Literature searches were carried out using MedLine (PubMed), Scopus, and the Cochrane Library. Eighteen studies (870 subjects) were included. Results: Green tea treatment had medium positive effect size in reducing GI (SMD: 0.50; 95%CI: −0.02/1.01); PI (SMD: 0.54; 95%CI: 0.14/0.95); GBI (SMD: 0.58; 95%CI: −0.41/1.56) and BOP (SMD: 0.52; 95%CI: −0.57/1.60) in respect to the control group. Splitting to subgroups, green tea showed a small neg- ative effect in the chlorhexidine control groups. Green tea treatment had medium positive effect size in reducing CAL (SMD 0.58; 95%CI: −0.49/1.65) and large positive effect size in reducing PPD (SMD:1.02; 95%CI: 0.45/1.59). Conclusion: Even if the results are encouraging, there is insufficient evidence to recommend the use of green tea formulation as first choice treatment for gingivitis, periodontitis and caries

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

Diagnostic drama. Use of ICDAS II and fluorescence-based intraoral camera in early occlusal caries detection: A clinical study

Background: Early diagnosis of occlusal caries is of paramount importance for a minimally invasive approach in dentistry. The aim of the present in vivo clinical prospective study was to compare the diagnostic outcomes of visual subjective evaluation between the International Caries Detection and Assessment System (ICDAS-II) and an intraoral fluorescence-based camera (VistaCam iX Proof, Dürr Dental, Bietigheim-Bissingen, Germany) for the detection of pits and fissures in early caries lesions of posterior teeth. Methods: The study included 1011 posterior teeth in 255 patients aged 13–20 years (mean age 16 ± 2.2 years). Two blinded operators evaluated all the occlusal surfaces and the first assigned an ICDAS-II code, while the second assessed the VistaCam score: sound enamel (score 0–1.2); initial enamel decay (score 1.2–1.5); dentine caries (score 1.5–3). Results: Some 283 (28%) of the assessed teeth were ICDAS-II code 0; 334 (33%) code 1; 189 (18.7%) code 2; 176 (17.4%) code 3; and 29 (2.9%) code 4. The level of agreement between the two procedures was expressed by using Cohen’s and Fleiss’ kappa statistics and performing McNemar’s test. VistaCam assessed in 513 (50.7%) sound enamel; in 292 (28.9%) initial enamel decay; and in 206 (20.4%) dentine caries. Conclusions: This comparative study showed a poor agreement between the two diagnostic methods, especially between ICDAS-II 0, 1 and 2 codes and fluorescence assessments.publishedVersio

Treatment of developmental defects of enamel

Developmental defects of enamel are encountered daily in our dental practice. The management of enamel hypomineralized lesions may be challenging, especially as esthetic concern around the young population is increasing. Resin infiltration, a new technique firstly proposed to halt caries progression in the posterior segment, showed a strong positive esthetic effect in the treatment of developmental defects with different etiologies. Future in-vivo studies are needed to evaluate the longterm color stability, in order to provide a strong clinical recommendation

How dentistry is impacting the environment

In march 2019, the European Parliament has voted for a ban of single-use plastics to come into force by 2021 in all EU member states. Europe is setting new and ambitious standards, paving the way for the rest of the world. Dentistry aims to diminish its environmental footprint by adopting the 4R’s concept (reduce, reuse, recycle, rethink) and through the switch to eco-friendly home oral hygiene products

Long-term effectiveness of treating dentin hypersensitivity with bifluorid 10 and futurabond U: a split-mouth randomized double-blind clinical trial

Background: The definition of dental hypersensitivity is “pain derived from exposed dentin in response to chemical, thermal tactile or osmotic stimuli which cannot be explained as arising from any other dental defect or disease”. One of the treatments proposed is tubular occlusion. The aim of this in vivo split-mouth randomized clinical trial was to evaluate the clinical efficacy of a in-office application of a fluoride varnish (Bifluorid 10) and a bonding resin (Futurabond U) in adults with dentin hypersensitivity. Material and methods: A total of 180 teeth were treated with Bifluorid 10 and 160 with Futurabond U. Outcome measurements were taken one or two weeks before treatment, at baseline at the application days, at 1 week and at 1–6 months after first treatment. Results: Both treatments reduced pain intensity. Bifluorid 10 and Futurabond U have similar efficacy in reducing SCHIFF-measured pain reduction, while Bifluorid 10 is significantly more efficient for VAS-measured pain reduction, mainly due to long-term pain reduction. Patient age has a significant negative influence on pain reduction, while the influence of patient gender and BEWE of the tooth is insignificant. Conclusions: Bifluorid 10 and Futurabond U are effective in the treatment of dental hypersensitivity. The RCT was registered at the US National Institutes of Health (ClinicalTrials.gov) #NCT04813848

Treatment of severe fluorosis by a combined use of: at-home bleaching and at-office resin infiltration. A case report

Introduction: Severe Enamel Fluorosis is frequently found in young adolescents with aesthetic concerns. Colourimetric alterations could vary from diffuse opacities to demarcated brown and white areas. Material and methods: One young patient with a severe fluorosis was treated by a combined use of at-home bleaching and at-office resin infiltration. Results: In all the affected teeth, existing aesthetic enamel alterations, were successfully treated by the combined use of bleaching and Icon® resin application. Given the minimal substance loss due to the erosion infiltration procedure, the patient was extremely satisfied with the results. Conclusions: Our case report show the capability of treating severe fluorosis with bleaching and subsequent Icon® resin infiltration. Longer observation periods in studies with larger patients population are needed to validate the clinical significance found in this case report

Phototherapy and tailored brushing method. Personalized oral care in patients with facial and dental trauma. A report of a case

Abstract: (1) Background: Traumatic dental injuries are frequent in children and young adults. The facial structures involved in dental trauma may include soft tissues of the face and mouth, bone and dental structures. Dental trauma often results in augmented dental anxiety. Phototherapy can improve stress and pain control thereby improving compliance in young patients with the necessary dental treatments, after dental trauma has occurred. (2) Methods: Phototherapy was performed to enable soft tissue healing. The Tailored Brushing Method (TBM), a personalized approach for at-home oral hygiene procedures, was also utilized, with the aim of improving biofilm control in traumatized patients. (3) Results: The approach hereafter presented made it possible to obtain subjective control of anxiety and pain documented on a visual analog scale (VAS) due to the innovative use of photobiomodulation. In addition, for the first time, the TBM was adapted to the needs of a patient with facial trauma and illustrated. (4) Conclusions: Phototherapy and TBM were found to be effective in the combined treatment of soft tissue wounds and in the oral care of the traumatized patien

Facial and oral manifestations following COVID-19 vaccination: a survey-based study and a first perspective

(1) Background: Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) emerged in Wuhan, China, in late 2019. The development of effective and safe vaccines against SARS-CoV-2 has been extremely fast. The list of orofacial adverse effects of BNT162b2 and mRNA-1273 vaccines based on the clinical trials are reported to be rare. The aim of this study was to investigate the facial and oral manifestations of COVID-19 vaccination using a survey-based study. (2) Methods: The questionnaire was developed using Google Forms and sent anonymously to a total of 700 subjects (medical personnel) in Poland, Italy, and other EU countries. (3) Results: 223 people answered the questionnaire, mainly vaccinated with BNT162b2. Only 3.1% and 5.4% experienced oral and facial symptoms, respectively. General diseases presence and age have significant influence on the probabil- ity of oral symptoms occurrence after the second dose. Facial symptoms are correlated with general disease; autoimmune pathologies and age, at first and second dose, respectively. Gender, smoking and regular medication intake have significant influence on the probability of taking an absence day. Gender, age, and smoking have a significant influence on the duration of symptoms after second dose. (4) Conclusions: Based on the results of this preliminary survey, there is no observed significant correlation between vaccine administration for COVID-19 and facial and oral manifestations