Oral health in two heterozygote female twins with congenital lactic acidosis

Introduction: Congenital lactic acidosis (CLA) is a rare disease caused by mutations in Mithocondrial DNA (mtDNA), which affects the ability of cells to use energy that causes accumulation of lactic acid in the body. No oral manifestations have been documented in these patients. Methods: We report the oral health status of two young adolescent heterozygote female twins, one of them being diagnosed at 8 weeks of life by muscle biopsy with a severe neonatal form of CLA. In order to avoid biopsy-related complications, the second twin did not undergo a diagnostic procedure and both girls were treated for CLA. They underwent clinical oral health examination at the age of 12, for caries evaluation (diagnostic threshold D1 - early enamel demineralization) by ICDAS II clinical assessment, photographic documentation and fluorescence intra-oral camera. Results: Among the two twins, the CLA-diagnosed one presented with severe enamel carious hypomineralizations on upper and lower vestibular smooth surfaces. Moreover, deep occlusal enamel carious lesions were detected by intra-oral fluorescence camera. The second twin had no obvious decay lesions, neither on pit and fissures nor on vestibular smooth surfaces. Conclusions: Congenital lactic acidosis might be associated with hypomineralized defects and caries susceptibility in young adolescents. Preventive measures and personalized caries risk assessment should be encouraged and implemented in these patients following current caries management systems protocols, as ICCMS (International Caries Classification and Management System)

Tailored Brushing Method (TBM): an innovative simple protocol to improve the oral care

Background. The objective of this study is to describe and assess the effectiveness and acceptability of a modern tailored protocol of oral hygiene, based on the concordance between professionals and patients, and based on the proper choice of best tools for oral hygiene regardless of the technique used. This new method has been called Tailored Brushing Method (TBM). Material and methods. Two groups of adult patients (n=200) were involved in this research, according to specific inclusion criteria. Test group followed the indications of the new Tailored Brushing Method, while control group was involved in a standard protocol of oral hygiene with the suggestions of a brushing technique and the typical approach based on the compliance. Plaque Index, bleeding on Probing index and patients' acceptability of the methods (Visual Analog Scale) were assessed at different time points. Descriptive and statistical analyses were performed. Results and conclusions. Test group had statistically lower Plaque Index and Bleeding on Probing after 30 days, in comparison with control group. Test group expressed a better acceptance of the new tailored method. This research suggests to use a tailored approach to oral hygiene, overcoming the need of patient's compliance, often affected by bias such as alteration of the protocols and wrong brushing maneuvers

Oral health literacy: how much Italian people know about the dental hygienist

People with poor OHL have the highest level of oral diseases and the worst oral treatment results. The main aim of the present study was to investigate the degree of knowledge of the role of the dental hygienist in patients who go to a public dental facility for the first time. A semi-structured questionnaire was administered to the patients with the “face-to-face” mode during a 12-month period. The principal component analysis, the general linear model and the chi-square test were used for the statistical analysis. A total number of 900 questionnaires were completed. Sixty-seven per cent of patients know that a specific degree is needed to practice dentistry and 93.1% of them know that a specific educational qualification is required to practice the dental hygienist profession. Sixty-three per cent of the subjects were aware of dental hygienist’s activities. There is no patient preference of gender as far as both dentist (84.11%) and dental hygienist (85.11%) are concerned. Seventy-five per cent of patients claimed to know what “dental hygiene” means and 65% of them believed that a good level of oral hygiene was important for oral disease prevention. Both qualification and marital status of patients are significantly associated with the patient’s level of knowledge of the dental hygienist profession. Patients with “High” scholastic qualifications showed significantly higher scores than those with “Low” qualifications. Married patients have less knowledge than widows/widowers, while divorced patients have greater knowledge than widows/widowers. Patients’ educational qualification itself only partially justifies the apparent high level of knowledge of patients about the dental hygienist’s role

Changes in microflora in dental plaque from cancer patients undergoing chemotherapy and the relationship of these changes with mucositis: a pilot study

Background: To assess changes in oral microflora in dental plaque from cancer patients within 7 days of the first course of chemotherapy, and the relationship of the changes with mucositis. Material and Methods: Thirty cancer patients, divided into a test group undergoing chemotherapy and a control group no undergoing chemotherapy, were enrolled in this pilot study. Oral microflora were cultured from three samples of dental plaque at t0 (before chemotherapy), t1 (1 day after chemotherapy) and t2 (7 days after chemotherapy). Single and crossed descriptive analyses were used to establish prevalence, and the χ 2 test was used to establish the statistical significance of the differences observed in distributions (significance level: P <0.05). Results: In most patients (57%), oral microflora consisted mainly of Gram-positive cocci, while the remaining 43% of the bacterial flora also had periodontal-pathogenic species. No Porphyromonas gingivalis appeared in the test group. Actinobacillus was the least frequently found bacterium among periodontal pathogens in the test group, while Fusobacterium nucleatum was the most frequently found. No significant differences were found in quantitative bacterial changes between t0, t1 and t2 in either the test or control groups, or between the two groups. According to World Health Organization scores, oral mucositis developed in 10 patients (66.6%) in the test group. Conclusions: The results of this pilot study indicate that there were no changes in microflora in dental plaque in cancer patients within 7 days of the first course of chemotherapy. No correlations between oral mucositis and specific microorganisms were assessed

Monitoring pit and fissures using transparent sealant and fluorescence intraoral camera, 12 months follow up

The aim of this in vivo study is to report on the combined use of a fluorescence intraoral camera and transparent sealant for the clinical monitoring of pits and fissures. 96 permanent molars with a ICDAS II code 0, 1, or 2, (in 48 patients aged 12–14) were registered at the First Observation Unit (Oral and Maxillofacial Sciences Department), Sapienza University, Rome. Clinically selected teeth were double-checked using a VistaCam iX Proof (Durr Dental AG) and sealed with a transparent sealant (ControlSeal, VOCO GmbH), following the established indications for use if a pit and fissure condition was confirmed within the camera’s internal cutoff point of 1.5 (“early enamel demineralization”). Clinical followup was performed using VistaCam at 6 and 12 months to assess sealant retention and any demineralization trend. At baseline, 57.4% of the registered teeth were sound, both visually and when using the fluorescence camera, 42.6% presented an early demineralization (&lt;1.5 with VistaCam and ICDAS II 1- 2). Subsequent VistaCam assessment of surfaces underlying the transparent sealant totally confirmed initial evaluations. Complete sealant retention rated 95% at 6 months, and 91% at 12 months. No case of complete detachment was observed. At the 12-month follow-up, VistaCam measurements resulted stable in the whole sample, except for one permanent molar, which presented a demineralization increment and partial sealant retention. Visual and fluorescence assessments were consistent and feasible. Incomplete sealant retention occurred in 5% of cases at 6 months and 9% of cases at 12 months and was probably due to procedure imperfections. The combined use of transparent sealant and a fluorescence camera shows clinical effectiveness and diagnostic efficacy for occlusal surface monitoring

Evaluation of the esthetic properties of developmental defects of enamel: a spectrophotometric clinical study

Objectives. Detailed clinical quantification of optical properties of developmental defect of enamel is possible with spectropho- tometric evaluation. Developmental defects of enamel (DDE) are daily encountered in clinical practice. DDE are an alteration in quality and quantity of the enamel, caused by disruption and/or damage to the enamel organ during amelogenesis. Methods. Several clinical indices have been developed to categorize enamel defects based on their nature, appearance, microscopic features, or cause. A sample of 39 permanent teeth presenting DDE on labial surface was examined using the DDE Modified Index and SpectroShade evaluation. The spectrophotometric approach quantifies L∗ (luminosity), a∗ (quantity of green-red), and b∗ (quantity of blue- yellow) of different DDE. Conclusions. SpectroShade evaluation of the optical properties of the enamel defect enhances clinical understanding of severity and extent of the defect and characterizes the enamel alteration in terms of color discrepancy and surface characterization

Challenges in dental statistics: survey methodology topics

This paper gathers some contributions concerning survey methodology in dental research, as discussed during the first Workshop of the SISMEC STATDENT working group on statistical methods and applications in dentistry, held in Ancona on the 28th September 2011. The first contribution deals with the European Global Oral Health Indicators Development (EGOHID) Project which proposed a comprehensive and standardized system of epidemiological tools (questionnaires and clinical forms) for national data collection on oral health in Europe. The second contribution regards the design and conduct of trials to evaluate the clinical efficacy and safety of toothbrushes and mouthrinses. Finally, a flexible and effective tool used to trace dental age reference charts tailored to Italian children is presented

Awareness of complications and maintenance mode of oral piercing in a group of adolescents and young Italian adults with intraoral piercing

Background: The aim of the study was to focus the awareness of complications of oral piercing among a group of adolescents and young Italian adults with intraoral piercings. Material and Methods: A total of 225 teenagers were asked to complete a questionnaire on the awareness of complications of oral piercing. An additional questionnaire was administered in case of oral piercing worn, based on site piercing, knowledge about piercer license, oral and systemic risks due to oral piercing, disinfection and sterilization of the material pierced, information by the piercer about piercing hygiene maintenance and post-piercing dentist check-up. After questionnaire all partecipants received a brochure with some information about risks and maintenance mode of piercing. Results: Data revealed that more than 50% of teens surveyed was found to wear a piercing. Only 25.3% was aware of the risk of HCV cross-infection and only 17.3% reported of knowledge about risk of endocarditis. Only 17% checked the piercer license and only 18% sterilization and disinfection of the materials used. 53.7% did not received explanations about the risks associated with piercing. With regard to the maintenance mode of the piercing, it has been suggested to brush the piercing bar in 17% of cases. The post piercing specialist visits have been suggested only in 7% of cases. Conclusions: The general lack of awareness of complications and maintenance mode related to oral piercing needs to be addressed by some education programs performed at school and by dentists

Evaluation of aesthetic integration between composite restorations and natural tooth in NCCL: a case report

NCCL (non carious cervical lesion) is defined as irreversible loss of dental hard tissue that does not involve bacteria. It consists of erosion, attrition, abrasion and abfraction that rarely occur alone. Dentinal hypersensitivity is an early symptom of NCCL. Preventive measures and restorative treatment can avoid the progress of NCCL. This paper reports a case of NCCL treatment with aesthetic purpose. The aesthetic evaluation was made by means of spectrophotometry as a standardized method. Spectrophotometric measurements such as International Commission on Illumination (CIE-Commission Internationale de l’Eclaraige) CIE L* a* b* and ΔE between the sound enamel and resin restoration, provide all the information about the outcome of the aesthetic restorative treatment

Oral hygiene management in patients with visual sensory disabilities

Aim: Oral hygiene maintenance is one of the most difficult tasks for visually impaired people. The aim of study was to investigate about knowledge on oral hygiene practices among patients with visual sensory disabilities by proposing an effective management in order to achieve and maintain oral health status of these patients. Methods:It was administered a questionnaire about oral health management to the patients with visual disabilities accessing to dental unit of “Mons. Di Liegro” Hospital of Gaeta. Results: The survey covered a sample of 49 patients, aged between 14 and 95 years. More than half (66%) was blind ( 65% of cases with primary blindness and the remain ing 35% with secondary blindness). Only 32.65% brushed their teeth 3 times a day; 68% of the surveyed patients limited home oral hygiene procedures to toothbrush and toothpaste; 79% used manual toothbrush; 49% of respondents report ed odontophobia (it was basically generated by pain) often due to bad experience during childhood. More than half declared a dental office attendance as needed. Conclusions: This study showed as, although starting from a compromised oral health and inadequate knowledge of oral hygiene practices, visual impaired/ blind patients were able to achieve and maintain a good level of oral hygiene, using the most appropriate techniques and instrument