166 research outputs found
COVID-19: dalle indicazioni ministeriali per la fase 2 alla nuova visione di odontoiatria sicura, sostenibile e centrata sul paziente
No full textLa pandemia COVID-19, originaria di Wuhan in Cina, è diventata una grande sfida per la salute pubblica globale, modificando radicalmente la vita di tutti i giorni e le attività lavorative, specialmente quelle di ambito sanitario tra cui l’attività odontoiatrica.
È stato necessario attuare delle misure di controllo delle infezioni per prevenire ulteriori diffusioni del virus. L’alto livello di attenzione che si è riusciti a raggiungere nella fase acuta della pandemia stessa ha determinato un efficiente bio-contenimento.
Si impone, sin dalla fase 2, un ragionato e idoneo adeguamento di protocolli operativi di prevenzione e protezione. Prudenza, perizia e diligenza devono essere i punti cardine per l’odontoiatra (e tutto il team), atti a garantire sicurezza durante l’attività lavorativa per sé stessi e per i pazienti.
Questi ultimi, in particolare, necessitano di rassicurazioni esteriori (e.g. un ambiente sicuro e attento al bio-contenimento) e sub-liminali (e.g. workflow standardizzati da parte degli operatori), soprattutto dopo questo periodo buio per la salute mondiale che può aver amplificato la diffidenza verso tutte quelle prestazioni che trasmettono loro paura per il contagio. Un paziente spaventato evita le cure, mettendo a rischio la sua salute orale: l’odontoiatra deve essere capace di instaurare un rapporto empatico con tutti i suoi pazienti, soprattutto con quelli di difficile gestione, informandoli e rassicurandoli.
Questo articolo, basato sull’esperienza degli autori, sulle linee guida ministeriali e sulla letteratura pertinente, introduce elementi di novità sulla gestione odontoiatrica nel post COVID-19 e fornisce utili suggerimenti nella gestione odontoiatrica sia tecnica sia comportamentale
COVID-19 and periodontitis: reflecting on a possible association
No full textRecent studies have demonstrated a relationship between the severe clinical course of COVID-19 and other chronic diseases such as: cardiovascular disease, hypertension, diabetes mellitus, obesity and chronic renal disease. It may be possible to extend this association to a common and chronic oral disease in adults: periodontitis. Alternatively, the latter could be simply related to the systemic chronic diseases cited above, as already observed in the non-COVID-19 literature. In order to provide an overview and their opinion, the authors in this perspective article will report and discuss the most recent references of interest relating to COVID-19 and periodontitis pathophysiology. Within such a narrative review, the authors will hypothesize that the association between chronic periodontitis and COVID-19 could exist via two pathways: a direct link, through the ACEII and CD147 receptors used by the virus to infect the cells, which would occur in greater numbers in cases of periodontitis (thereby favoring a SARS-CoV-2 infection); and/or an indirect pathway involving the overexpression of inflammatory molecules, especially IL-6 and IL-17. An expression of the latter has been found to play a role in periodontitis, in addition to severe cases of COVID-19, although it is still unclear if it plays a direct role in the worsening of the clinical course
Oral Squamous Cell Carcinoma on Gingiva, Edentulous Ridge, and Retromolar Pad: A Case Series
No full text(1) Background: Gingival cancer has a significant incidence and is often diagnosed at advanced stages. The aim of this paper is to highlight its clinical aspects on the basis of a case series analysis in order to promote awareness and improve the diagnosis process. (2) Methods: Oral cancers diagnosed and treated at three Italian University Hospitals over ten years were retrospectively investigated. Cancer location on the gingiva, edentulous ridge, and retromolar pad was addressed. Data regarding clinical features, stage at the diagnosis, and time from presenting symptoms to first medical consultation were retrieved. (3) Results: Thirty-three cancers located on the gingiva, edentulous ridge, and retromolar pad were retrieved from 276 total oral cancer cases (11.9%). A median of 50 days (range 2–300) passed for the patient to seek for a medical evaluation. At the time of diagnosis, 63.3% were advanced stage cancers, mainly located at the mandible (91%), especially in the retromolar pad (48.5%) and the edentulous alveolar ridge (24.2%). Lesions were red (45.5%), red and white (45.4%), or white (9.1%), appearing as an ulcer (69.7%), exophytic mass (12.1%) or flat lesion (12.1%). Sixty-six percent of cancers were completely asymptomatic, regardless their clinical appearance. A statistically significant association between the time from the presentation of symptoms to the first medical consultation and the cancers stage was found. (4) Conclusions: The clinical appearance of gingival cancer is very polymorphous; its understanding may be significant to improve patient education and early medical consultation
Esthetic smile rehabilitation with direct composite veneers: a narrative review with a practical explanation of the technique
No full text: Social relationships, self-esteem, and one's own view are all greatly impacted by smile aesthetics. Smile harmony can be upset by abnormalities like peg-shaped lateral incisors, which leads patients to look for the least invasive yet effective cosmetic procedures. Direct composite veneers are a conservative way to improve your appearance without requiring a lot of dental preparation. This research investigates clinical application, material improvements, and overall patient satisfaction of direct composite veneers in the context of esthetic smile rehabilitation. The outcomes of recent research on direct composite veneers, with an emphasis on minimally invasive cosmetic rehabilitation methods, are summarized in this narrative overview of the literature. Through extensive searches in PubMed, Scopus, and ScienceDirect, studies were chosen using keywords like "direct composite veneers," "esthetic restoration," and "minimally invasive dentistry." The inclusion of articles was determined by their applicability to patient satisfaction, clinical results, and composite material improvements. According to the review, direct composite veneers are a practical, affordable, and reversible substitute for porcelain veneers. Benefits include instant results, little tooth preparation, and the use of multilayer composite procedures to provide natural-looking results. Nevertheless, drawbacks like staining vulnerability, decreased durability, and upkeep needs highlight the necessity of cautious patient selection. Direct composite veneers are becoming more and more feasible for long-term aesthetic solutions because to recent developments in composite resins, such as nanohybrid and nanofilled technologies, which have improved their polishability, durability, and color stability. Direct composite veneers are a good choice for those looking for a customizable, minimally intrusive method of improving the appearance of their smiles. Composite veneers are a useful and versatile option for improving appearance, even though they could need upkeep over time. To increase their lifetime and expand their use in cosmetic dentistry, more study on material advancements is necessary
May VelScope Be Deemed an Opportunistic Oral Cancer Screening by General Dentists? A Pilot Study
No full textEarly diagnosis of oral cancer through visual inspection followed by histopathological confirmation is a pivotal step for reducing rates of morbidity and mortality. There are several auxiliary devices used to improve oral examination. The purpose of this cross-sectional pilot study is to evaluate the sensitivity and specificity of the Visually Enhance Lesion Scope (VelScope) system when it is used by the general dentist after a yearly oral medicine training. Thirty-five patients with oral lesions were evaluated with clinical and VelScope examination by two general dentists, one of which trained with a specific course. A comparison of the histopathological results, clinical examination, and VelScope made by both dentists was performed through statistical analysis. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detecting oral potentially malignant disorders (OPMDs) are 53.3%, 65%, 53.3%, 76.5% for unskilled dentist, 73.3%, 65%, 61.1%, 76.5% for skilled clinician. When both examiners use VelScope the values are 53.3%, 70%, 57.1%, 66.7% for unskilled general dentist (u-GD), 86.7%, 90%, 86.7%, 90% for skilled general dentist (s-GD). Improvement of a skilled general dentist for detecting malignancies is higher than inexperienced examiner when using VelScope. VelScope alone is unable to improve the general dentist’s ability to detect malignancies, but it could be a useful adjunctive device for clinicians when a focused training program is performed
Calcium Silicate Cements vs. Epoxy Resin Based Cements: Narrative Review
No full textIn recent years, calcium silicate cements have been introduced. The purpose of this study is to analyze the main differences between calcium silicate-based cements and epoxy resin-based cements, analyzing the scientific literature of the last year to highlight the main advantages for predictable clinical use. Data collected from the included studies were used in order to analyze different features: chemical-physical properties, cytotoxicity and cell migration, inflammatory response, mineralizing and osteogenic activity, ion release and the filling efficiency of root canals. The calcium silicate cements analyzed in these studies showed good biological and mechanical properties compared to conventional resin-based cements, resulting in better biocompatibility and less cytotoxicity; long-term studies are needed, but these cements have ideal characteristics to allow efficient filling of root canals
Natural compounds may contribute in preventing SARS-CoV-2 infection: a narrative review
No full textCoronavirus pandemic infection is the most important health issue worldwide. Coronavirus disease 2019 is a contagious disease characterized by severe acute respiratory syndrome coronavirus 2. To date, excluding the possibility of vaccination, against SARS-CoV-2 infection it is possible to act only with supportive care and non-virus-specific treatments in order to improve the patient's symptoms. Pharmaceutical industry is investigating effects of medicinal plants, phytochemical extracts and aromatic herbs to find out natural substances which may act as antiviral drugs. Several studies have revealed how these substances may interfere with the viral life cycle, viral entry, replication, assembly or discharge, as well as virus-specific host targets or stimulating the host immune system, reducing oxidative stress and inflammatory response. A natural compound can be used as a prophylaxis by people professionally exposed to the risk of contagion and/or positive patients not in intensive care. The aim of this paper is to perform a narrative review of current literature in order to summarize the most studied natural compounds and their modes of action
Impact of cerebrovascular stroke on inflammatory periodontal indices: a systematic review with meta-analysis and trial sequential analysis of case-control studies
No full textIntroductionCerebrovascular stroke, a leading cause of global morbidity and mortality, is influenced by several modifiable risk factors such as hypertension, diabetes, and smoking. Emerging evidence highlights the significant role of inflammation in stroke pathogenesis, with conditions like periodontitis potentially exacerbating this risk. The aim of this systematic review was to identify and quantify the real impact of periodontal disease in individuals with cerebral stroke through the analysis of inflammatory periodontal indicesMethodsFollowing PRISMA guidelines, we conducted a systematic review and meta-analysis of case-control studies assessing periodontal indices in stroke patients. Data sources included PubMed, Scopus, and Cochrane Library, with searches extended to grey literature. The review protocol was registered on PROSPERO (CRD42024529767). Studies were evaluated using the Newcastle-Ottawa Scale to assess risk of bias, and meta-analyses were conducted using Review Manager 5.4 and TSA software.ResultsThe review included seven case-control studies, comprising 723 stroke patients and 787 controls. Meta-analyses revealed significant differences between stroke and control groups in clinical attachment loss [MD 1.04 mm, 95% CI (0.54, 1.54)], probing pocket depth [MD 0.68 mm, 95% CI (0.31, 10.6)], and radiological bone loss (MD 2.15 mm, 95% CI [−1.58, 5.89]. These findings indicate that stroke patients exhibit worse periodontal health compared to controls, supporting a potential link between periodontal inflammation and stroke.ConclusionThis study confirms the significant impact of periodontal disease on stroke patients and highlights the importance of oral health in preventing adverse cerebrovascular events.Systematic Review RegistrationPROSPERO, identifier (CRD42024529767)
Clinico-Pathological Profile and Outcomes of 45 Cases of Plasma Cell Gingivitis
No full textPlasma cell gingivitis (PCG) is an infrequent inflammatory disease of the gingiva of unknown etiology, characterized by a dense polyclonal proliferation of plasma cells in the connective tissue. The aim of this study was to present a case series of patients affected by PCG, analyzing demographic, clinical, histopathological, and therapeutic data. A group of 36 females and 9 males with a mean age of 60.3 years was evaluated. Clinically, 25 cases were bullous, a clinical phenotype never reported to date, 4 erythematous, 4 keratotic, 4 verruciform, and 3 ulcerative. On histological examination, pure polyclonal plasma cell infiltrate was detected in 20 specimens, while in 25 specimens it was associated with a mixed infiltrate. The first-line therapy consisted of oral hygiene and topical corticosteroids in all patients. In 25 patients, doxycycline and sulfasalazine were added; in 10 of these patients, the disease persisted, and it was necessary to resort to systemic steroids. This study presented the clinico-pathological profile and outcomes of a case series of PCG. This could be an aid for clinicians to be aware of the heterogeneous clinical phenotype and of the possible pure bullous phenotype of PCG. Further studies are needed to improve the knowledge about this disorder
Teatranti di razza. Intervista a Pamela Villoresi
No full textUna delle più importanti attrici del teatro italiano,
Pamela Villoresi, racconta il suo rapporto con Eleonora Duse, dialogando con Maria Letizia Compatangelo, autrice del monologo La musica dell’anima. Ritratto di Eleonora Duse, che da alcuni anni interpreta con successo in teatro. Dalla giovanile attrazione istintiva verso il “personaggio Duse” alla comprensione matura del valore delle sue innovazioni
nel campo della recitazione. Confronti, eredità, insegnamenti: due epoche diverse, ma lo stesso impegno
totalizzante verso il teatro.One of the most important actresses of the Italian
theatre, Pamela Villoresi, talks about her relationship with Eleonora Duse. She is in conversation with
Maria Letizia Compatangelo, author of the monologue La musica dell’anima. Ritratto di Eleonora
Duse, successfully interpreted for some years. Villoresi’s talk is from her youthful instinctive attraction to the “Duse character”, to her mature understanding of the value of her innovations in the field
of acting. Comparisons, legacies, teachings: two different periods, but the same all-encompassing commitment to the theatre
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