Prevention of neurological injuries during mandibular third molar surgery: technical notes

Surgery to the mandibular third molar is common, and injuries to the inferior alveolar nerve and the lingual nerve are well-recognized complications of this procedure. The aim of these technical notes is to describe operative measures for reducing neurological complications during mandibular third molar surgery. The following procedure should be used to prevent damage to the inferior alveolar nerve: a well-designed mucoperiosteal flap, to obtain appropriate access to the surgical area; a conservative ostectomy on the distal and distal-lingual side; tooth sectioning, to facilitate its removal by decreasing the retention zones; tooth dislocation in the path of withdrawal imposed by the curvature of the root apex; and careful socket debridement, when the roots of the extracted tooth are in intimate contact with the mandibular canal. To prevent injury to the lingual nerve, it is important (I) to assess the integrity of the mandibular inner cortex and exclude the presence of fenestration, which could cause the dislocation of the tooth or its fragment into the sublingual or submandibular space; (II) to avoid inappropriate or excessive dislocation proceedings, in order to prevent lingual cortex fracture; (III) to perform horizontal mesial-distal crown sectioning of the lingually inclined tooth; (IV) to protect the lingual flap with a retractor showing the cortical ridge; and (V) to pass the suture not too apically and from the inner side in a buccal-lingual direction in the retromolar are

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

Factors influencing consideration of dental specialisation: a survey of current dental students at the University of Western Australia

Aim. At present, little research exists regarding factors that influence dental students and recent graduates to pursue specialist training. Through the provision of a questionnaire, the study investigated student's perceptions of dental specialities and factors impacting specialisation.Methods. Questionnaires (n=65) were undertaken by Doctor of Dental Medicine students in year three (n=34) and four (n=31) through paper means. An analysis was undertaken of the knowledge of speciality courses, speciality preferences and the main motivating and deterring factors influencing specialisation.Results. A response rate of 70% was observed, revealing that 13% of all participants correctly identified the speciality courses available in Western Australia, with 6% of students wanting to specialise in the long term. Altruistic factors were most motivating and financial most deterring when considering specialisation. Speciality preferences also varied between cohorts.Conclusions. Findings highlight that a small proportion of students want to pursue specialisation and the majority of students are unaware of the speciality courses available in Western Australia. This emphasises the need for greater exposure and education in dental specialties. Further research is advised in this field to better understand factors involved in the pathway to dental specialisation and how to encourage specialisation

Randomised study for the 1-year crestal bone maintenance around modified diameter implants with different loading protocols: a radiographic evaluation.

This study evaluated by standardised digitised periapical radiography the crestal bone maintenance around modified diameter internal hex implants with variable thread design and narrow neck loaded with different procedures. Forty implants were placed in 25 patients. Twenty implants were conventionally loaded, 20 ones immediately loaded. Radiographs were taken with a customised bite record and processed with software. Measurements of bone from the fixture–abutment junction to mesial and distal marginal bone levels were made. Student’s t test statistical analysis was adopted. Baseline data were variable; at 1-year follow-up, there were no significant differences for marginal bone loss between immediately and conventionally loaded maxillary implants (p=0.1031), whilst there were slight significant differences between immediately and conventionally loaded implants in the mandible (p=0.0141). Crestal bone maintenance around conventionally and immediately loaded modified diameter implants was similar, with slight significant differences in mandible where a lower marginal bone loss was observed

Knowledge of emergency management of avulsed teeth among Italian dentists-questionnaire study and next future perspectives

(1) Background: In Italy, about one fourth of all schoolchildren experience a trauma to the permanent dentition. Management of avulsion trauma is challenging and requires adherence to clinical protocols. The aim of this study was to investigate the management knowledge of avulsed teeth among Italian dentists and to promote the guidelines’ dissemination through the use of new social media. (2) Methods: The survey was carried out during the COVID-19 lockdown in Italy (March–May 2020). The questionnaire was sent anonymously to a total of 600 dentists. The questionnaire consisted of two parts. Part A—demographic and professional data and Part B—management of traumatic avulsion. (3) Results: The response rate was 50.6% and the mean fraction of correct responses was 0.524. Issues related to the therapeutic management of avulsed teeth were shown to be not well understood by the respondents. Professionals with qualifications in dentistry and those who declared to know the guidelines responded better, while other demographic and professional factors were insignificant. (4) Conclusions: Italian dentists’ knowledge of the management of avulsion trauma should be improved. Educational programs and campaigns must be undertaken to improve their awareness and adherence to the Italian and international guidelines

Prevalence of molar incisor hypomineralization among school children in Rome, Italy

Molar incisor hypomineralization (MIH) is a highly prevalent condition associated with increased caries experience, dental pain and treatment need. Aim of this study was to determine the prevalence and severity of MIH in a group of 7–8 years old primary school children living in Rome, Italy; and to assess the association with caries experience and possible perinatal risk factors. A survey has been conducted in the city of Rome, between April 2019 and March 2020 with a total of 49 primary schools and 176 2nd grade primary school classes and a total of 3611 children being involved. Of these, a subset of 346 children of 21 primary schools was selected for the epidemiological investigation. The prevalence of MIH was of 18.2%, with girls showing twice the probability of being subject to a mild-severe condition. Molar location was present in 71.4%, while location on both molar plus incisor was present in 28.6% of cases. The mean DMFT was 0.44 ± 0.78, “D” was 0.17 ± 0.58; the mean dmft was 1.7 ± 2.56, “d” was 1.32 ± 2.21. Female gender, caries experience, insufficient oral hygiene were risk factors. The incidence of MIH is increasing in the pediatric population. Knowledge about diagnosis and treatment options should be disseminated among dental professionals.publishedVersio

KRAS-regulated glutamine metabolism requires UCP2-mediated aspartate transport to support pancreatic cancer growth

The oncogenic KRAS mutation has a critical role in the initiation of human pancreatic ductal adenocarcinoma (PDAC) since it rewires glutamine metabolism to increase reduced nicotinamide adenine dinucleotide phosphate (NADPH) production, balancing cellular redox homeostasis with macromolecular synthesis1,2. Mitochondrial glutamine-derived aspartate must be transported into the cytosol to generate metabolic precursors for NADPH production2. The mitochondrial transporter responsible for this aspartate efflux has remained elusive. Here, we show that mitochondrial uncoupling protein 2 (UCP2) catalyses this transport and promotes tumour growth. UCP2-silenced KRASmut cell lines display decreased glutaminolysis, lower NADPH/NADP+ and glutathione/glutathione disulfide ratios and higher reactive oxygen species levels compared to wild-type counterparts. UCP2 silencing reduces glutaminolysis also in KRASWT PDAC cells but does not affect their redox homeostasis or proliferation rates. In vitro and in vivo, UCP2 silencing strongly suppresses KRASmut PDAC cell growth. Collectively, these results demonstrate that UCP2 plays a vital role in PDAC, since its aspartate transport activity connects the mitochondrial and cytosolic reactions necessary for KRASmut rewired glutamine metabolism2, and thus it should be considered a key metabolic target for the treatment of this refractory tumour

Epigenetics of human cutaneous melanoma: setting the stage for new therapeutic strategies

Cutaneous melanoma is a very aggressive neoplasia of melanocytic origin with constantly growing incidence and mortality rates world-wide. Epigenetic modifications (i.e., alterations of genomic DNA methylation patterns, of post-translational modifications of histones, and of microRNA profiles) have been recently identified as playing an important role in melanoma development and progression by affecting key cellular pathways such as cell cycle regulation, cell signalling, differentiation, DNA repair, apoptosis, invasion and immune recognition. In this scenario, pharmacologic inhibition of DNA methyltransferases and/or of histone deacetylases were demonstrated to efficiently restore the expression of aberrantly-silenced genes, thus re-establishing pathway functions. In light of the pleiotropic activities of epigenetic drugs, their use alone or in combination therapies is being strongly suggested, and a particular clinical benefit might be expected from their synergistic activities with chemo-, radio-, and immuno-therapeutic approaches in melanoma patients. On this path, an important improvement would possibly derive from the development of new generation epigenetic drugs characterized by much reduced systemic toxicities, higher bioavailability, and more specific epigenetic effects

Prevalence of oral disease and treatment types proposed to children affected by autistic spectrum disorder in pediatric dentistry: a systematic review

PURPOSE: To investigate the prevalence of dental caries and periodontal disease in children with ASD, and to analyse the necessity of treatment and the prevalence of using general anaesthesia in order to perform it. MATERIALS AND METHODS: A search was performed covering the last 10 years utilising the following databases: Pubmed, Scopus, Medline, BASE, Science Citation Index, Science Direct, Web of Science. Four reviewers evaluated each study. Review findings were summarised using the PRISMA Statement for reporting. Thirteen articles were included in this systematic review. RESULTS: When analysing the articles selected, the evidence turned out did not show a common DFMT and dmft for the groups of children affected by Autism Spectrum Disorder considered. When compared to group of unaffected children, groups of ASD children not always showed a higher prevalence of caries but always higher Periodontal Indexes (PI and GI), resulting in higher prevalence of periodontal disease. Where the treatment was performed and taken into consideration, there was a high incidence of necessity of General Anaesthesia due to the lack of collaboration of the children. CONCLUSION: The high prevalence of treatment under general anaesthesia and the often-reported negative behaviour evidence how there is a lack of protocols specifically designed for these patients, in order to better improve their collaboration and subsequently their oral health and so additional strategies for a preventive care should be applied for these patients