Multicenter randomized, double-blind controlled trial to evaluate the efficacy of laser therapy for the treatment of severe oral mucositis induced by chemotherapy in children: laMPO RCT

Objectives: To demonstrate the efficacy of laser photobiomodulation (PBM) compared to that of placebo on severe oral mucositis (OM) in pediatric oncology patients. The primary objective was the reduction of OM grade (World Health Organization [WHO] scale) 7 days after starting PBM. Secondary objectives were reduction of pain, analgesic consumption, and incidence of side effects. Methods: One hundred and one children with WHO grade\ua0>\ua02 chemotherapy-induced OM were enrolled in eight Italian hospitals. Patients were randomized to either PBM or sham treatment for four consecutive days (days +1 to +4). On days +4, +7, and +11, OM grade, pain (following a 0\u201310 numeric pain rating scale, NRS) and need for analgesics were evaluated by an operator blinded to treatment. Results: Fifty-one patients were allocated to the PBM group, and 50 were allocated to the sham group. In total, 93.7% of PBM patients and 72% of sham patients had OM grade\ua0<\ua03 WHO on day +7 (P\ua0=\ua00.01). A significant reduction of pain was registered on day +7 in the PBM versus sham group (NRS 1 [0\u20133] vs. 2.5 [1\u20135], P\ua0<\ua00.006). Reduced use of analgesics was reported in the PBM group, although it was not statistically significant. No significant adverse events attributable to treatment were recorded. Conclusions: PBM is a safe, feasible, and effective treatment for children affected by chemotherapy-induced OM, as it accelerates mucosal recovery and reduces pain

Self-etch adhesives: A review of the literature

Objectives. This literature review summarizes the main aspects involved in the process of adhesion to enamel and dentin and focuses the reader's attention on the evolution of self-etch systems, highlighting their chemical and bond properties and applications in the clinical practice. Materials and methods. An online search of keywords on the PubMed database was performed to search for scientific articles (reviews, original articles) published in recent years regarding self-etch adhesives. Results. Multiple laboratory and clinical studies described adhesion mechanisms of self-etch adhesives. The majority of these publications found a higher bond quality of self-etch adhesive to dentin, while the bond to enamel remained questionable, especially for single step adhesives. Conclusions. The self-etch technique is considered a valid dental adhesion approach from a restorative standpoint. \ua9 2014 EDRA LSWR SpA

Regional odontodysplasia: case report and literature review|Odontodisplasia regionale: case report e revisione della letteratura

OBIETTIVI: Questo articolo descrive un caso clinico di un bambino di 4 anni affetto da odontodisplasia regionale. La revisione della letteratura fornisce un inquadramento epidemiologico, descrive le caratteristiche cliniche e i piani di trattamento proposti per questa rara anomalia. MATERIALI E METODI: E.B., un bambino di anni 4, si presenta nel gennaio 2021 per una prima visita odontoiatrica per sospetta mancata eruzione di alcuni molari decidui. L’anamnesi medica e odontoiatrica è negativa. L’esame obiettivo extra- orale non evidenzia anomalie. L’esame obiettivo intra-orale evidenzia: dentizione decidua, igiene orale domiciliare migliorabile, diastemi tipici, cross bite a livello del canino deciduo 53, linee mediane centrate. I denti sono sani a eccezione di primo e secondo molare deciduo superiore destro, parzialmente erotti, con corone malformate, marcatamente ipoplasiche e di colore marrone, con gengiva iperemica; gli elementi antagonisti, in particolare l’85, sono estrusi. La radiografia endorale di 54 e 55 evidenzia corone ipoplasiche in assenza di contrasto tra smalto e dentina, di minore radiopacità rispetto ai denti adiacenti; l’anatomia endodontica appare marcatamente atipica con radici solo abbozzate. Queste caratteristiche radiografiche conferiscono al dente l’aspetto tipico di “dente fantasma”. La mamma riferisce assenza di sintomatologia. L’OPT mostra un ritardo di sviluppo del 14, del 16, che presenta una corona malformata, e del 17; non è visibile il germe del 15. In base alle caratteristiche cliniche e radiografiche viene fatta diagnosi di odontodisplasia regionale. A scopo preventivo, viene posizionato un sigillante vetroionomerico. La revisione della letteratura è stata condotta su PubMed, Scopus e Google Scholar con parole chiave “odontodysplasia”, “regional odontodysplasia”, “ghost teeth”. Sono stati inclusi case report e case serie. RISULTATI: Dopo 6 mesi l’elemento 54 appare decoronato e la corona dell’elemento 55 marcatamente compromessa. Il nuovo piano di trattamento proposto prevede l’estrazione di 54 e 55 e il posizionamento di un dispositivo ortodontico a contrastare la progressiva estrusione dei denti antagonisti. La revisione della letteratura include 132 articoli per un totale di 168 casi. CONCLUSIONI: L’odontodisplasia regionale è un’anomalia dello sviluppo dei tessuti di origine dentale che derivano dalle componenti ectodermiche e mesenchimali del germe dentale. È un’anomalia localizzata, non ereditaria, relativamente rara con specifiche caratteristiche istologiche, cliniche e radiografiche. SIGNIFICATO CLINICO: Il trattamento dell’odontodisplasia regionale richiede un approccio multi e interdisciplinare nel lungo termine. Fondamentale il ruolo dell’odontoiatra infantile nel diagnosticare precocemente questa patologia e nel monitorarla con controlli periodici frequenti nel corso dei quali attuare interventi preventivi

Self-induced soft-tissue injuries following dental anesthesia in children with and without intellectual disability. A prospective study

Purpose: Self-induced soft-tissue injuries (SSI) are reported as local anesthesia complications, particularly in children. The purpose of the study was to evaluate the frequency of SSI following dental anesthesia in children with and without intellectual disability. Methods: 241 children receiving dental treatments with local anesthesia were divided into 2 groups: A, children without intellectual disability (159 individuals, 299 injections); B, children with intellectual disability (82 individuals, 165 injections). Each group was divided into subgroups according to age, injection technique and dental treatment. Two days after the dental procedure, a phone survey was conducted to determine the presence of SSI. Results: The frequency of SSI in group B was 19%, with no differences in relation to gender and age. In group A the frequency of SSI was significantly lower (9%; p = 0.002; Chi-square test); the children in the ≤ 6&nbsp;years-old subgroup experienced a higher frequency of SSI (p = 0.002). The lower arch was at major risk of SSI in both groups (p = 0.002). According to a multilevel approach group (p = 0.001) and injection technique (p = 0.0001) significantly influenced SSI; no influence of dental treatment is evidenced. Conclusions: SSI are common complications of local anesthesia in young children and individuals with intellectual disability

Applicability of Demirjian's method for age estimation in a sample of Italian children with Down syndrome: A case-control retrospective study

Age estimation is widely applied in several clinical and forensic fields. The radiographic evaluation of dental development is one of the most accepted tools for this purpose. Among the different methods proposed, Demirjian's method was the most extensively used and tested in the medical literature revealing that the original standards for the French\u2013Canadian population tends to over-estimate the age of different population groups. The aims of this study were to evaluate the applicability of the Demirjian method in a sample of Italian children with Down syndrome (DS) and to compare the data with age and gender matched healthy subjects (non-DS). A retrospective study was performed on 146 orthopantomograms of DS individuals aged 6.3\u201316 years. The mean chronological age (CA) and the mean dental age (DA) were calculated. Using Cohen's kappa statistics, the inter- and intra-examiner agreement was reported as good (k = 0.75) and very good (k = 0.86). The differences between CAs and DAs were statistically significant for males and females (Wilcoxon Signed Rank test; p &lt; 0.05). The median overestimation was 0.6 years in males and 0.9 years in females. Demirjian's method is unsuitable for dental age estimation in DS individuals. The same trend in overestimation was found in the control group. Comparing DS and non-DS subjects, the differences between DAs were not statistically significant for both males and females revealing that the dental development process is similar

Periodontology Part 2: Localised Juvenile Spongiotic Gingival Hyperplasia: histopathological and clinical features

Localised juvenile spongiotic gingival hyperplasia (LJSGH) is a poorly understood but distinctive inflammatory hyperplasia. It is an exophytic lesion lined with non keratinised hyperplastic stratified squamous epithelium characterised by acanthosis, papillomatosis and spongiosis. Despite the name, it is not limited to juveniles but it can affect also adults. Its aetiology is unknown and the pathogenesis is controversial. Histological and immunophenotypic similarities suggest that LJSGH may result from a less keratinised junctional or sulcular epithelium. The excisional biopsy was considered the treatment of choice for a very long time. However, new evidence has suggested the efficacy of a conservative approach as it was seen that spontaneous remission of the lesion was possible. Even if LJSGH is not a plaque-induced lesion, the wait-and-see approach involves recall visits to evaluate the periodontal health and to reinforce oral hygiene instructions

Craniofacial and occlusal features of individuals with Turner Syndrome: A cephalometric study

: Craniofacial features of 18 individuals with Turner Syndrome (TS) were compared with age and gender matched healthy individuals. Dental history, panoramic radiograph, dental casts and cephalometric measurements were assessed. The dental casts analysis showed a significantly higher PH/PW ratio in individuals with TS under GH therapy compared to healthy individuals (p=0.004; paired t-test). This data objectively supported the definition of a high-narrow palate. The ANB angle and the Wits index were similar in the two group, showing a skeletal class I malocclusion. The vertical characteristics did not differ between the two groups, showing a mesofacial growth pattern. Our results showed similar cephalometric characteristics in individuals with TS treated with GH and healthy controls

Oral health status of Italian children with Autism Spectrum Disorder

Aim Autism Spectrum Disorder (ASD) is characterised by communication deficits and repetitive unusual behaviours. The behaviour guidance of these children represents a challenge for the dental team. The aim of the study was to evaluate the oral health status in a group of Italian children with ASD. Materials and methods Study Design: Sixty-four Italian children with ASD and 64 controls were included. Data were collected by means of questionnaires and clinical examinations. Results Dental trauma (p=0.007), bruxism (p=0.001) and biting objects habit (p=0.021) were more frequent in the study group; fluoride exposure was lower (p=0.001) (chi-square test). The mean plaque index was 1.48 ±0.75 in the study group and 0.81±0.56 in the control group (p=0.001; Mann-Whitney U test); the mean dmft/DMFT was 3.00 ±1.2 and 2.3 ±1.8 in the study group and 1.8 ±1.1 and 1.0 ±1.1 in the control group (p&lt;0.001; Mann-Whitney U test). Anterior open bite was more frequent in the study group (p=0.013; Chi-square test). No significant differences were found for enamel defects, molar relationship, posterior crossbite and deep bite. Significantly more children with ASD showed a negative behaviour (80% vs 35%: p =0.001; Chi-square test). Conclusion Children with ASD have a poorer oral health status than healthy children. The early establishment of a home dental hygiene should be encouraged