La patologia cariosa e metodiche di prevenzione

Questa guida nasce da un'equilibrata e consolidata collaborazione, che vede Pediatri di Famiglia (PdF) e Odontoiatri alleati nella campagna di prevenzione delle patologie odontoiatriche in età pediatrica, mettendo cosi in atto un progetto inter-societario. Nasce, certamente, con lo scopo specifico di affrontare la prevenzione delle patologie orali ma anche con quello di promuovere un rapido riconoscimento di queste patologie al fine di indirizzare i bambini e gli adolescenti alla consulenza odontoiatrica nei tempi e nei modi corretti e condivisi. L'impostazione schematica e pragmatica con cui e stata costruita fa di questa guida un valido strumento al quale il pediatra può facilmente attingere quando, soprattutto in termini di prevenzione, si trova di fronte ad un piccolo paziente che ha (o potrebbe avere) patologie di pertinenza di quest'ambito specialistico. La Guida, inoltre, fornisce cenni completi per l'inquadramento di molte patologie con le quali ci si confronta durante l'attività quotidiana

Management of traumatic dental injuries in paediatric age: the importance of adhesion to national guidelines

The objective of this study is to evaluate the application of National guidelines for prevention and clinical management of traumatic dental injuries in developmental age published in November 2012 in Italy by the Ministry of Health and updated in February 2018. Materials and Methods: Italian National Guidelines for Prevention and Clinical Management of Traumatic Dental Injuries in developmental age indicate the strategies for prevention of traumatic dental injuries and health education, the first aid protocol, the certification of traumatic dental injuries and the identification of child abuse. In the present retrospective and multicenter study, 83 patients (54 M, 29 F) who underwent dental injury were selected to assess the management of the traumatic event complied with the protocol provided by the Nationals Guidelines for Prevention and Clinical Management of Traumatic Dental Injuries in developmental age. The study is aimed at first aid doctors, family and hospital pediatricians, private dentists, University and hospitals.Every each health worker involved in the study was sent an evaluation form to be completed, related to dental injury, to standardize the collected data. The reference center has been identified for data collection: University of Rome “Sapienza”. All the evaluation forms, completed correctly, were sent to the various reference center, which after collecting them sent the material to the coordinating center (University of Rome “Sapienza”) for data processing. Results: Evaluating the distribution by age we had: that 27.24% (8 F, 10 M) of the enrolled patients were aged 1-5 years, 51.63% 6-10 years (15 F, 33 M), 19,92% 11-17 years (6 F, 11 M). The dental injury occurred in 10.16% at home, 50.81% at school, 28.86% for play, and 9.35% at the gym. The deciduous dentition is involved in 34.96% of the traumas while the permanent dentition is involved in 69.51%. Conclusions: From the present study it emerged that the National guidelines for prevention and clinical management of traumatic dental injuries in developmental age are not uniformly applied

Evalutation of an imaging software for 3D rendering of deciduous teeth

Aim: To evaluate the performance of a three-dimensions (3D) imaging software (3D Slicer) developed for medical surgeons, in the 3D rendering of images of deciduous teeth made by CBCT. 3D Slicer is an open source platform for segmentation, registration and 3D visualization of medical imaging data. Slicer started as a research project between the Surgical Planning Lab (Harvard) and the CSAIL - Computer Science and Artificial Intelligence Laboratory (MIT). So far this software has never been used for evaluating root canal anatomy in dentistry and more specifically in paediatric dentistry. Therefore we wanted to explore its possibilities to clearly visualize the external root surface of deciduous teeth and the relative canal configuration in three-dimensions. Methods: Clinical CBCT images were used for the study, selecting scans previously taken for other purpose (e.g. impacted canines, odontoma) in which deciduous teeth were present. The CBCT scan had been obtained with the consent of the parents for the specific therapies. The age of young patients ranged from 6 to 14 years old . To use 3D slicer, some changes in the use and in the procedures had to be made. First import the DICOM file into software. Then crop volume for single tooth visualization, so do the segmentation selecting a satisfying threshold. Eventually edit the segment created for remove the aberration. Results: Results are shown by pictures, illustrating the possible achievement: root anatomy including resorption, root canal anatomy, intracanal navigation, measurements. In addition is possible export created surface in .stl file (stereo litography). With .stl file, for example students can navigate with a stl viewer application, even on their smartphone. Furthermore is possible with 3D printer make model that show root resorption and difference between anatomic apex and apical foramen. Conclusion: 3D rendering of deciduous teeth is an interesting diagnostic and teaching tools in pediatric dentistry. The available software, even though is not specifically developed for tooth rendering, it can be used for do this and excellent results can be achieved. However it must be underlined the fact that the suggested modifications are custom made and require computer skills and knowledge to be applied. Moreover they are time consuming. Therefore the hope is that in future new specific software for dentistry could be developed, to make 3d rendering more easy and rapid to perform

Prevention campaign: "A Smile School": prevalence of dental caries in the pediatric population of central Rome

Aim: Tooth decay is a disease closely related to eating habits and lifestyles, easily correctable in the child and adolescent population. Indeed, it is remarkably widespread among the Italian population. Hence the need for a monitoring to define the trend of the disease and to provide educational programs that promote good eating habits and oral hygiene. Method: In this view The U.O.C. of Pediatric Dentistry, Policlinico Umberto I in Rome (Dir. Prof. Antonella Polimeni) sponsored by the second municipality of Rome, have promoted, for the current school year, dental examinations to pupils in nursery classes, primary and secondary, between the ages of 3 and 13 years old, carried out at school, trained by dentists, with the use of sterile disposable material (dental probe and mirror) and clinical detection folders that include: questionnaire addressed to parents about hygiene and eating habits of their children and personal data; a detection folder for caries and periodontal disease with plaque index for home oral hygiene assessment. Parents were issued a letter of accompany with the medical observations. For each child was asked consent to the visit and processing of data. Result: The examined sample of 372 children, 202 males and 170 females. Of these, 74.19% did not carry out any kind of additional fluoride further home care by toothbrushing. By clinical observation on sample, 40.05% had absence of plaque, plaque detectable to the probe in 27.69%, the 18.1% seen with the naked eye plaque and 10.48% abundant accumulations of plaque. Bleeding on probing was present only in 9.41%. The DMF is 0.7 and def 0.6. Compared with the data relating to the parents education, 69.62 of mothers graduated and 62.91 of the fathers, the remainder is split between middle and high schools, no one do not appear any kind of education. Conclusion: Sample thus far examined has a satisfactory level of oral health with a DMF of 0.7 and a def of 0.6 or less than 1. However, the WHO goals for 2020, we recall, promote between 5 and 6 years old subjects free from tooth decay, so prevention and oral health promotion campaigns in these age groups are necessary to achieve that goal not yet reached