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)

Tailored Brushing Method (TBM): an innovative simple protocol to improve the oral care

Background. The objective of this study is to describe and assess the effectiveness and acceptability of a modern tailored protocol of oral hygiene, based on the concordance between professionals and patients, and based on the proper choice of best tools for oral hygiene regardless of the technique used. This new method has been called Tailored Brushing Method (TBM). Material and methods. Two groups of adult patients (n=200) were involved in this research, according to specific inclusion criteria. Test group followed the indications of the new Tailored Brushing Method, while control group was involved in a standard protocol of oral hygiene with the suggestions of a brushing technique and the typical approach based on the compliance. Plaque Index, bleeding on Probing index and patients' acceptability of the methods (Visual Analog Scale) were assessed at different time points. Descriptive and statistical analyses were performed. Results and conclusions. Test group had statistically lower Plaque Index and Bleeding on Probing after 30 days, in comparison with control group. Test group expressed a better acceptance of the new tailored method. This research suggests to use a tailored approach to oral hygiene, overcoming the need of patient's compliance, often affected by bias such as alteration of the protocols and wrong brushing maneuvers

Public Target Selection and Family Firms

We examine the relation between ownership structure and M&A target selection when family firms pursue public firm acquisitions. We find that family firm acquirers select targets that have lower Tobin’s Q relative to non-family acquirers. Our results suggest that family firms choose to acquire less glamorous targets against which they can better negotiate. The market reacts more positively to these family firm acquisitions at announcement and out to one year. It is family firm target selection skill along with negotiation skill that leads to the favorable market reception

Monitoring pit and fissures using transparent sealant and fluorescence intraoral camera, 12 months 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 registered at the First Observation Unit (Oral and Maxillofacial Sciences Department), Sapienza University, Rome. Clinically selected teeth were double-checked using a VistaCam iX Proof (Durr Dental 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 cutoff point of 1.5 (“early enamel demineralization”). Clinical followup 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 demineralization (<1.5 with VistaCam and ICDAS II 1- 2). Subsequent VistaCam assessment of surfaces underlying the transparent sealant totally confirmed initial evaluations. Complete sealant retention 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, except for one permanent molar, which presented a demineralization increment and partial sealant retention. Visual and fluorescence 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

Oral health knowledge in pre-school children: a survey among parents in central Italy

Background: The aim of this survey was to evaluate the knowledge and awareness of parents about potential oral health risk factors and correct management of oral hygiene of their preschool children. Material and Methods: The participation to the survey was proposed to all parents of 3-5 year aged children attending a kindergarten in Campobasso. A self-administered questionnaire was completed to obtain information regarding demographic and education variables, knowledge about caries and its transmission, infant feeding practice, maternal oral health during pregnancy, parents and children’s oral hygiene habits and risk behaviors (e.g., sharing cutlery, tasting of baby food, nightly using of baby bottles or pacifier), oral health prevention and role of school. Results: Overall, the parents of 101 children consented to fill the questionnaire. Data analysis showed that only 24% of respondents was aware of the potential vertical transmissibility of cariogenic bacteria through contaminated saliva. It is still a common trend from61% of parents tasting food of their child. On 101 children, 30% used pacifier and 17% used baby bottle with milk during night and among these children 41% for more than 2 years. Parents reported no toothbrushing for 57% of the children in their first 3 years of life. Conclusions: From this survey, independently on parents education, it emerges as still nowadays parents are not fully trained and informed about the management of their child’s oral hygiene and as it’s necessary a parental oral health promoting program to control children oral health risk status, starting from school

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