Comparative ergonomic evaluation of the hand-pieces of three instrument series for root planning

Introduction: Musculoskeletal disorders (MSD) are the most frequent cause of disability in the working population, exceeding accidental trauma in frequency. The risk of developing work-related upper limb disorders (WURLDs) is high among dental hygienists and the most frequently affected are elderly subjects and women. Since such disorders can have a negative effect on the working life and on the quality of life, it is of vital importance to put in place preventive measures. Aim: To make a comparative analysis of the hand-pieces of three different manual instruments used for root planning. Materials and Methods: To evaluate the physical characteristics (section, diameter, external surface, weight) of the hand-pieces of three series of instruments for root planning, twentynine dental hygienists students were videoed while working clinically. They were also interviewed using a specific questionnaire to determine subjective preferences in terms of perceived efficacy, safety, comfort and general acceptability of the hand-piece used. Results: Lightness, full-cylindrical section with larger- diameter ends, and coating with anti-slip silicone are the most appreciated characteristics of a handpiece. Conclusions: Ergonomic analyses of manual instruments are not frequent in the dental field, and the literature reports no guidelines to guide selection of the type of hand-piece of manual instruments. The data gathered may help manufacturers in designing new manual instruments, and guiding professionals in their selection

A report on the clinical-pathological correlations of 788 gingival lesion

The diagnosis and treatment of a variety of non-plaque related gingival diseases have become an integrated aspect of everyday dentistry. The aim of this study was to analyse the relationship between clinical appearance and histopathological features of gingival lesions in a large Northern Italian population. A retrospective study of 788 cases of gingival and alveolar mucosal biopsies was set up. Statistical analysis was performed by calculating the odds ratio and 95% confidence interval (C.I.), in order to assess the degree of association between the clinical parameters considered (primary lesions) and the single pathologies, statistically evaluated by Mantel-Haenszel tests. The correlation between clinical and histological diagnosis was classified as follow: 1) expected data (ED): provisional clinical diagnosis; 2) real data (RD): final histopathology diagnosis; 3) concordant data (CD): correspondence between the expected data and real data. The correlation was calculated as follow: CC (complete concordance) = CD x 100 / ED, this expressing the percentage in which the clinical and the histological diagnosis overlapped. The most frequently observed and biopsied primary lesions resulted to be exophytic, followed by mucosal colour changes and finally by losses of substance. The statistically significant association between primary lesion and their manifestation in gingival pathologies was reported. Volume increases, for instance, were positively correlated to plasma cell epulis, pyogenic granuloma, fibrous reactive hyperplasia and hemangioma. Verrucous-papillary lesions were most often seen in verrucous carcinoma, verrucous leukoplakia and mild dysplasia. White lesion resulted to be related to leukoplakia or oral lichen planus. Red lesions resulted to be related only oral lichen planus. Erosive vesicle-bullous lesions were linked to disimmune pathologies. Ulcerative lesions were positively associated to oral squamous cell cancer. Finally, potentially malignant disorders have the most percentage high concordance. Among the malignant lesions, the correlation increased up to the squamous cell carcinoma and leukaemia. This article presented the frequency and the clinico-pathological concordance of all primary lesions and the histopathological diagnosis of gingival lesions. For every primary lesion, it is possible to correlate a specific histopathological diagnosis in a statistical manner. This can be a valuable aid for not specialist clinicians who daily observe mucosae and have the opportunity to intercept major diseases

Desquamative Gingivitis: Protocols, Procedures and Critical Issues

Desquamative gingivitis (DG) isn’t a specific disorder; it simply represents the gingival manifestation associated with some heterogeneous mucocutaneous disorders, such as oral lichen planus (OLP), mucous membrane pemphigoid (MMP), pemphigus vulgaris (PV), plasma cell gingivitis (PCG) and few others. [...

Comparative ergonomic evaluation of the hand-pieces of three instrument series for root planning

Introduction: Musculoskeletal disorders (MSD) are the most frequent cause of disability in the working population, exceeding accidental trauma in frequency. The risk of developing work-related upper limb disorders (WURLDs) is high among dental hygienists and the most frequently affected are elderly subjects and women. Since such disorders can have a negative effect on the working life and on the quality of life, it is of vital importance to put in place preventive measures. Aim: To make a comparative analysis of the hand-pieces of three different manual instruments used for root planning. Materials and Methods: To evaluate the physical characteristics (section, diameter, external surface, weight) of the hand-pieces of three series of instruments for root planning, twentynine dental hygienists students were videoed while working clinically. They were also interviewed using a specific questionnaire to determine subjective preferences in terms of perceived efficacy, safety, comfort and general acceptability of the hand-piece used. Results: Lightness, full-cylindrical section with larger- diameter ends, and coating with anti-slip silicone are the most appreciated characteristics of a handpiece. Conclusions: Ergonomic analyses of manual instruments are not frequent in the dental field, and the literature reports no guidelines to guide selection of the type of hand-piece of manual instruments. The data gathered may help manufacturers in designing new manual instruments, and guiding professionals in their selection

Conservative approach in patients with pemphigus gingival vulgaris: A pilot study of five cases

Objectives. The aim of this pilot study was to describe the clinical efficacy of a conservative oral hygiene protocol in patients affected by gingival pemphigus vulgaris (PV) applied in a case series. Methods. Subjects suffering from PV with gingival localisation and slightly responsive to conventional treatment with systemic corticosteroids and immunosuppressive drugs were selected among individuals treated in the Unit of Oral Medicine Section of the University of Turin. Five subjects received nonsurgical periodontal therapy, over a 7-day period, including oral hygiene instructions; patients were instructed about domiciliary oral hygiene maintenance and instructions were reinforced at each visit and personalised if necessary. Clinical outcome variables were recorded at baseline (before starting) and 16 weeks after intervention, including full mouth plaque score (FMPS), bleeding scores (FMBS), probing pocket depth (PPD), oral pemphigus clinical score (OPCS), and patient related outcomes (visual analogue score of pain). Results. Five patients were treated and, after finishing the proposed therapy protocol, a statistical significant reduction was observed for FMBS (P=0.043) and OPCS (P=0.038). Conclusions. Professional oral hygiene procedures with nonsurgical therapy are related to an improvement of gingival status and a decrease of gingival bleeding in patients affected by PV with specific gingival localization

<i>ONJ (MRONJ) Update 2021</i>—Osteonecrosis of Jaw Related to Bisphosphonates and Other Drugs—Prevention, Diagnosis, Pharmacovigilance, Treatment: A 2021 Web Event

On the 8th and 9th of May 2021, an online conference was organized to connect Italian physicians, dentists and oral care specialists, students, nurses, psychologists, dental hygiene experts, and other professionals to discuss controversial issues about Medication-Related Osteonecrosis of Jaw (MRONJ). The first section evaluated differences between Italian recommendations, released on 2020 by Italian Societies of Oral Pathology and Medicine (SIPMO) and Maxillofacial Surgery (SICMF), and other international practice guidelines or documents. A first round table gathered expert opinions about MRONJ definitions and staging systems. Another round table was dedicated to opinion of drug prescribers (oncologists, hematologists, rheumatologists, and other physicians treating osteoporosis). Educational sessions illustrated the main differences between previous (2013) and more recent (2020) Italian recommendations. A large space was dedicated to the presentation of scientific contributions from centers in Italy, divided in specific sessions (epidemiology; case series; special case reports; prevention experiences; MRONJ treatment). Conclusions: in an innovative web conference, talks and scientific reports underlined importance of adequate imaging study of bone in definition and staging of MRONJ cases, the role of surgery in treatment of the disease, and the value of oral hygiene in the prevention

The preventive care of medication-related osteonecrosis of the jaw (MRONJ): a position paper by Italian experts for dental hygienists

Purpose The prevention and early diagnosis of medication-related osteonecrosis of the jaw (MRONJ) is fundamental to reducing the incidence and progression of MRONJ. Many in the field believe that dental hygienists should play an integral role in primary and secondary MRONJ prevention. However, to date, very few publications in the literature have proposed standardised MRONJ protocols, which are dedicated to dental hygienists. The aim of this study was to provide guidance to the health care providers managing MRONJ.Methods The expert opinion in this study was developed by dental hygienists from the main Italian technical-scientific associations (Italian Dental Hygienists Association, AIDI and National Union of Dental Hygienists, UNID) and authors of the latest Italian recommendations regarding MRONJ from the field of dentistry and maxillofacial surgery.Results The oral care protocol outlined in this position paper is focused on the role of dental hygienist in patients at risk or affected by MRONJ, and it regards 3 main issues: primary prevention, secondary prevention and supporting the treatment of MRONJ. Each issue contains easy-to-apply indications and procedures, as described by the authors, regarding the role of the dental hygienist.Conclusion Referring to the main issues under consideration (primary prevention, secondary prevention and the treatment of MRONJ), a clinical examination of periodontal tissue is critical in preventing MRONJ. It is the opinion of the authors of this study that the application of a periodontal screening score is fundamental in defining personalised strategies for patients at risk of MRONJ. By means of these basic procedures, a protocol for assisting the health care provider and the presentation of a practical approach for patients at risk or affected by MRONJ are described in this study