240 research outputs found
The Odyssey of Dental Anxiety: From Prehistory to the Present. A Narrative Review
Dental anxiety (DA) can be considered as a universal phenomenon with a high prevalence worldwide; DA and pain are also the main causes for medical emergencies in the dental office, so their prevention is an essential part of patient safety and overall quality of care. Being DA and its consequences closely related to the fight-or-flight reaction, it seems reasonable to argue that the odyssey of DA began way back in the distant past, and has since probably evolved in parallel with the development of fight-or-flight reactions, implicit memory and knowledge, and ultimately consciousness. Basic emotions are related to survival functions in an inseparable psychosomatic unity that enable an immediate response to critical situations rather than generating knowledge, which is why many anxious patients are unaware of the cause of their anxiety. Archeological findings suggest that humans have been surprisingly skillful and knowledgeable since prehistory. Neanderthals used medicinal plants; and relics of dental tools bear witness to a kind of Neolithic proto-dentistry. In the two millennia BC, Egyptian and Greek physicians used both plants (such as papaver somniferum) and incubation (a forerunner of modern hypnosis, e.g., in the sleep temples dedicated to Asclepius) in the attempt to provide some form of therapy and painless surgery, whereas modern scientific medicine strongly understated the role of subjectivity and mind-body approaches until recently. DA has a wide range of causes and its management is far from being a matter of identifying the ideal sedative drug. A patient's proper management must include assessing his/her dental anxiety, ensuring good communications, and providing information (iatrosedation), effective local anesthesia, hypnosis, and/or a wise use of sedative drugs where necessary. Any weak link in this chain can cause avoidable suffering, mistrust, and emergencies, as well as having lifelong psychological consequences. Iatrosedation and hypnosis are no less relevant than drugs and should be considered as primary tools for the management of DA. Unlike pharmacological sedation, they allow to help patients cope with the dental procedure and also overcome their anxiety: achieving the latter may enable them to face future dental care autonomously, whereas pharmacological sedation can only afford a transient respite
Porcine bone scaffolds adsorb growth factors secreted by MSCs and improve bone tissue repair
An ideal tissue-engineered bone graft should have both excellent pro-osteogenesis and
pro-angiogenesis properties to rapidly realize the bone regeneration
in vivo
. To meet this goal, in
this work a porcine bone scaffold was successfully used as a Trojan horse to store growth factors
produced by mesenchymal stem cells (MSCs). This new scaffold showed a time-dependent release
of bioactive growth factors, such as vascular endothelial growth factor (VEGF) and basic fibroblast
growth factor (bFGF),
in vitro
. The biological effect of the growth factors-adsorbed scaffold on the
in vitro
commitment of MSCs into osteogenic and endothelial cell phenotypes has been evaluated.
In addition, we have investigated the activity of growth factor-impregnated granules in the repair of
critical-size defects in rat calvaria by means of histological, immunohistochemical, and molecular
biology analyses. Based on the results of our work bone tissue formation and markers for bone
and vascularization were significantly increased by the growth factor-enriched bone granules after
implantation. This suggests that the controlled release of active growth factors from porcine bone
granules can enhance and promote bone regeneratio
Oral malodor in Special Care Patients: current knowledge
Epidemiological studies report that about 50% of the population may have oral malodor
with a strong social and psychological impact in their daily life. When intra-oral causes are
excluded, referral to an appropriate medical specialist is paramount for management and
treatment of extra-oral causes. The intra-oral causes of halitosis are highly common, and the
dentist is the central clinician to diagnose and treat them. Pseudohalitosis or halitophobia
may occur and an early identification of these conditions by the dentist is important in order
to avoid unnecessary dental treatments for patients who need psychological or psychiatric
therapy. The organoleptic technique is still considered the most reliable examination method
to diagnose genuine halitosis. Special needs patients are more prone than others to have
oral malodor because of concurrent systemic or metabolic diseases, and medications.
The present report reviews halitosis, its implications, and the management in special care
dentistry
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