101,930 research outputs found
Complete pre-eruptive idiopathic crown resorption
No full textThe purpose of this paper was to present the unique case of complete pre-eruptive idiopathic crown resorption, few of which have ever been reported, because most have concerned partial idiopathic crowns. Crown resorption affects only a part of the crown and begins when crown mineralization is complete, leading to hypomineralization of the teeth. Treatment usually consists of restorative/endodontic care or extraction. A 12-year-old-boy presented with complete idiopathic resorption of the permanent mandibular left third molar and secondary failure of eruption of the permanent mandibular left first molar. The finding was incidental during routine radiographs for orthodontic treatment and was documented using cone beam computed tomography and computed tomography (one-mm slices). Follow-up, using a panoramic radiograph, occurred after one year, confirming the absence of the third molar. No preventive or therapeutic regimen is known
VALUTAZIONE DELLA COMPRESENZA DEL PAPILLOMAVIRUS (HPV) IN SEDE ORALE E GENITALE IN DONNE CON CITOLOGIA CERVICALE POSITIVA E NEI RISPETTIVI PARTNER
No full textIntroduction/Objective
The human papilloma viruses (HPVs) are DNA viruses associated with benign and malignant
lesions.
For gynaecologists, the carcinogenic potential and the necessity of HPV presence for the
development of cancer has been understood for decades in relation to the cervix uteri, and for a
large portion of other anogenital tumours.
The HPVs have been studied in last decades also by many other different specialist due to its role
in association with numerous different cancers in several tissues including Head and neck squamous
cell cancer (HNSCC) and Oral Squamous Cell Carcinoma (OSCC).
HNSCC accounts for more than 7 % of all human cancer types. Despite the development of new
surgical techniques and the introduction of multidisciplinary treatments still almost half of the
patients decease. For a long time period smoking and alcohol were the main risk factors
contributing to HNSCC. Even if a decline in smoking has been registered from '70s till now, the
incidence of OSCC is still rising. This might be explained by an increasing of HPV positive tumors.
For this reason the women’s HPV-positive cervix is discussed to act as a virus reservoir. However,
until today it remains unclear if the women’s HPV-positive cervix uteri really serves as a virus
reservoir and if certain sexual practices are the cause for HPV transmission to the oropharynx.
Data on genotype-specific concordance of oral-oral and genital-oral HPV infections among
heterosexual couples are key to understand HPV transmission between partners.
This study aimed at assessing the concurrence of oropharyngeal HPV infection, with relative
genotyping, in women with cervical lesions and in their current stable sexual partners in an Italian
population.
Material and methods
105 female subjects with a positive PAP test were enrolled in this study.
Complete datas, cervical brush, oral swab, oral rinse and urine (only male) samples were collected
from 44 women and 28 men. Demographic and behavior data were obtained through a structured
questionnaire.
HPV-DNA amplification was performed by polymerase chain reaction assay (PCR) using both
primers MY09/MY11 and FAP59/64. HPV genotyping has been performed with Sanger technique
and each sequence compared with the Finch software and "The PapillomaVirus Episteme" (PaVE)
database.
Positive samples have been analyzed also with the Inno-Lipa Genotyping Extra kit in order to have
an higher accuracy in case of multiple genotype infections.
Different variables were considered for the statistical analyses: gender, age, number of partners, oral
sex, alcohol consumption per week, lesions etc. The effect of the variables on the HPV infection
status was assessed, by fitting a generalized model, using the GLM (General Linear Model)
function in R software. The family “binomial” was used for the description of the error distribution
and link function. The function fisher test was used to perform Fisher’s exact test as a verification
test. The model was tested using the maximum likelihood to evaluate the effect of the inclusion of
each parameter to the model. As a supplementary analysis, the correlations were calculated between
all parameters.
Results
86% of cervical samples were HPV-positive. Different genotypes have been isolated (i.g. 6, 66, 39,
16, 31, 56, 42, 58, 114, 59, 61, 68, 45, 35, 33 e 53, 89, 114).
20% of the oral samples were positive in the female group and 25% in the male one.
Only one sample of urine was positive and the same HPV genotype has been found in the cervical
brush of his female partner.
No other specific genotype concordance has been found between female and male couples.
The regression of the variables against the total infection status highlighted three significant factors:
gender, oral sex and alcohol (p value: 0,000224, 0.0119 and 0.0362 respectively). This finding
shows that males and females are different in what concerns the HPV infection; the oral sex is
associated with HPV infection and third that alcohol consumption seems to have a negative effect
on HPV infection status. Other variables such as the number of partners, number of sexual rapports,
age or use of bird controls pills do not seems to be significant. The regression of the variables
against the oral infection status shows that gender is a significant factor (p value 0.04517) but not
oral sex and alcohol. Age and smoking although not significant show a trend close to significance
(p value 0.0885 and 0.0901 respectively). Moreover, the analyses highlighted that oral sex and
alcohol are significant factors for the cervical infections (p value 0.0492 and 0.0229 respectively).
The number of partners, the use of bird control pills, smoking and age seem do not to have an effect
on cervical infections.
As a second step, we divided the data into males samples and females samples. Subsequently, we
did two regressions using the two datasets subsets. We found that oral sex is highly significant in
women but only suggestively significant in men for HPV infection. In our study oral sex was about
three times more common in men than in women. Moreover, in men the number of the partners and
the number of sexual rapport seem to have an effect on oral HPV infection (p value 0,0514 and 0,08
with a trend close to significance respectively). As the sample size is relatively low we checked and
confirmed the significance of the oral sex and alcohol association using the Fisher exact test. We
calculated also the correlations between all the parameters which gives some important biological
considerations. Correlation between oral sex and cervical infection was significant (p value
0.04001).
Conclusions
The limited data suggest that among sexual partners in Italy, HPV transmission to the oropharynx
by oral–genital sex or by autoinoculation is a rare event with low HPV concordance.
An interesting result is that an asymptomatic HPV infection was common in both spouses while
genotype-specific concordance was low.
The presence of the virus in both male and female oral mucosa was detected in over 20% of the
subjects suggesting an important presence of the virus even if the direct correlation with the cervical
infection is still not clear.
The presence of the virus in the urine of the male partners was detected only in one case suggesting
a low transmission of the virus from the cervical site to the male genital mucosa.
Alcohol consumption, oral sex practice and higher number of sexual partners seems to be associated
with the presence of the virus
Relationship between mandibular second molar calcification stages and cervical vertebrae maturity in Italian children and young adults
No full textAIM: The aim of this study was to investigate the relationship between the stages of calcification of the mandibular second molar and the stages of skeletal maturity among Italian children and young adults.
MATERIALS AND METHODS: Cross-sectional descriptive study. The samples were derived from panoramic radiographs and lateral cephalograms of 500 Italian subjects aged from 10 to 20 years. Dental maturity index (DM) was assessed by calcification stages of the mandibular second molars according to the Demirjian method; skeletal maturity was evaluated with cervical vertebrae maturation index (CVM) according to Hassel and Farman. The Pearson r coefficient and Spearman rank correlation coefficient were estimated to determine the relationship between DM and CVM.
RESULTS: Skeletal maturation stages occurred earlier in females (about 6 months). A highly significant correlation between CVM and DM (0.78-0.86 cor according to Pearson test and 0.81-0.85 rho according to Spearman test) was found. DM stage E corresponds to phase CVM 1 and 2 (the phase prior to the growth spurt), DM stage F corresponds to the phase of pubertal growth spurt, stages CVM 2 and CVM 3; DM stage G is indicator of the growth spurt underway (CVM 3-4), but it can still be found during CVM 5 in females.
CONCLUSION: The second mandibular molars can be considered reliable indicators for the evaluation of the growth phases. In case of females the end of the growth spurt it is not clearly associated with a dental maturity stage and needs to be stated with further parameters such as CVM
Space-maintaining management in maxillary sinus lifting: a novel technique using a resorbable polymeric thermo-reversible gel
No full textSeveral techniques have been proposed to achieve sinus floor elevation and the formation of new bone through the grafting of autologous, heterologous, or alloplastic materials. The grafted materials act as a scaffold for bone formation inside the maxillary sinus. This study investigated a non-graft sinus lifting procedure using a resorbable polymeric thermo-reversible gel. A space-maintaining approach to sinus lifting, using a resorbable polymeric thermo-reversible gel, was applied in 11 patients undergoing implant treatment in the atrophic posterior maxilla. After a healing period of 6 months, a total of 14 implants were placed; biopsies were taken and evaluated histologically and histomorphometrically. The parameters evaluated included the percentages of new bone formation, residual gel, and fibrous tissue. Histological examination showed the formation of new bone with no fibrous tissue or severe inflammatory cellular infiltration. The percentage of newly formed bone was in the range of 54–60%; this consisted of both lamellar and woven bone. No foreign-body reaction was observed. The mean quantities of both residual gel and connective tissue were small. This non-graft sinus lifting procedure using a space-maintaining gel appears to stimulate predictable bone formation; it is thus a useful technique for promoting bone formation in the sinus
Orthodontic treatment of binder syndrome: a case report with 5 years of follow-up
No full textWe report here the case of orthodontic nonsurgical treatment in a patient with Binder syndrome. This rare syndrome (<1/10,000) is a deforming alteration of the middle third of the face, also known as maxillonasal dysplasia/dysostosis. The therapeutic approach often undertaken is an orthodontic-surgical protocol, which includes several invasive interventions such as LeFort I or II. In this patient and early diagnosis made it possible to intervene on an orthodontic level only, thus avoiding highly invasive surgical procedures (as of a 5-year follow-up)
Accidental aspiration of foreign bodies in dental practice: clinical management and prevention
No full textObjectiveForeign body aspiration is a possible complication of dental treatment that may result in a life-threatening situation. The foreign body is often spontaneously ejected from the airway, but in other cases, surgical intervention is needed. Prevention, diagnostic procedures, treatment and complications are discussed.
Materials and methodsThree cases of aspiration of dental instruments are described: the piece was localised in the right main bronchus in two cases and in the left main bronchus in one case.
ResultsAll three cases underwent surgery (resection and bronchoscopy); in one case, the surgical attempt failed, and the foreign body was not located by radiography; it was assumed to have been expelled spontaneously.
ConclusionThe management of dental materials and instruments requires particular care, especially if the patient is supine or semi-recumbent. The dentist must be able to manage emergency situations in which patients accidentally inspire or swallow dental instruments or materials during treatment. Preventive techniques must be put in place because these incidents are preventable if the correct precautions are taken
Three-dimensional evaluation of upper airway in patients with obstructive sleep apnea syndrome during oral appliance therapy
No full textObstructive sleep apnea syndrome (OSAS) represents a frequent and common respiratory disease characterized by repeated episodes of complete and/or partial obstruction of upper airways during sleep, normally associated with reduction of oxygen saturation in blood. The oral appliances (OAs) are considered to be an effective treatment modality thanks to the upper airway enlargement. Lateral cephalometry has been used for the 2-dimensional evaluation of upper airway form with several limits. We obtained an accurate 3-dimensional (3D) volume analyses with cone beam computed tomography (CBCT) scans to confirm the effects of OA on the upper airway in patients with OSAS.
Ten Italian patients with moderate or severe OSA (3 males and 7 females, 53.4 ± 11.3 years of age, and BMI 24.5 ± 2.7), who cannot tolerate continuous positive air pressure therapy and rejected a surgical approach, were treated with non-adjustable customized OAs and evaluated with CBCT and polysomnography. Upper airway form was examined in the presence and absence of OA and the volume was measured and compared in 2 different areas. Specific planes have been considered to match the data and calculate the benefit obtained with therapy.
Nine out of ten patients showed an improvement of total upper airway volume and an improvement in apnea-hypopnea index. Volume increased both in the posterior soft palate region and in the posterior tongue region. In the inferior area, we observed greater differences.
3D image reconstruction accurately confirmed morphological changes in the upper airway during OA therapy. The use of this 3D evaluation is expected to improve the results of OA therapy in the future
The efficacy of orthodontic treatments for anterior crowding with Invisalign compared with fixed appliances using the Peer Assessment Rating Index
No full textObjective: The purpose of this retrospective study was to determine the efficacy of Invisalign in a large sample of patients compared to fixed appliances. Method and Materials: The test group consisted of 100 patients treated with Invisalign compared with a control group treated with conventional fixed appliances matched for sex, age, and initial severity of malocclusion based on the amount of anterior dental crowding (Little Index) and the Peer Assessment Rating (PAR Index) scores. The retainer used was a 0.0175-inch multistranded stainless-steel wire bonded from canine-to-canine in the mandibular arch and from lateral inisor-to-lateral incisor in the maxillary arch. A paired t test was used to compare both initial and final PAR scores. Results: There was an overall 80.9% improvement, and 63 subjects did not need any refinement. The mean number of aligners used was 14 (+ 15 for the refinements) in the maxillary arch and 29 (+ 14 for the refinements) in the mandibular arch. The mean duration of treatment was 14 months (+ 7 months for the refinements). Significant statistical differences were found in the posttreatment scores, within both the Invisalign group and the control group. No differences were found in the follow-up scores. Additionally, the duration of treatment was 4 months longer in the control group. Conclusion: More than 90% of the subjects treated with Invisalign achieved a significant improvement, as shown by the PAR scores. A need for additional aligners was reported for 37% of the patients. Fixed bonded retainers seem to be a good option in preventing tooth relapse after Invisalign and fixed conventional treatments
Effects of six different preventive treatments on the shear bond strength of orthodontic brackets : in vitro study
No full textObjective: The aim of this study is to evaluate the effect of six different prophylactic agents on shear bond strength (SBS) of orthodontic brackets. Materials and methods: One hundred twenty-six freshly extracted mandibular bovine incisors were used. Teeth were randomly divided into 7 equal groups (18 per group) as follows: group-1 served as control with no pre-treatment; group-2 enamel treated with fluoride varnish (Fluor Protector, Ivoclar Vivadent); group-3 containing casein-phosphopeptide-amorphous calcium-phosphate (CPP-ACP) paste (GC Tooth Mousse, RECALDENTTM); group-4 with ozone (HealOzone, Kavo); group-5 with glycine powder (Perio Flow, EMS); group-6 with hydroxyapatite powder 99.5% (Coswell S.p.A.); group-7 with a toothpaste made of hydroxyapatite nanocrystals (BioRepair® Plus, Coswell S.p.A). Brackets were all bonded using the same technique with transbond XT (3 M Unitek, Monrovia, CA). All the bonded specimens were stored for 24 h in deionized water (37 °C) and subjected to thermal cycling for 1000 cycles. The SBS was measured with an Instron Universal Testing machine and the adhesive remnant was assessed with the adhesive remnant index (ARI) using a stereomicroscope at 10× magnification. Results: Statistical differences (ANOVA) were found among the seven investigated groups (F = 12.226, p < 0.001). SBS of groups 2, 5 and 6 were significantly lower than the control group (p < 0.05). ARI scores (chi-square test) were correlated with the differences of SBS values. Conclusion: CPP-ACP paste, ozone or BioRepair® did not compromise on bracket bond strength. Fluoride, glycine or hydroxyapatite significantly decreased the SBS; only the fluoride group showed significant clinically low (<6 MPa) SBS values
Idiopathic hypoplasia of the masseter muscle: a case report
No full textObjective and importance: Hypoplasia of the masseter muscle is a rare condition, described as partial or total, associated with congenital malformations or pathologies. Rare cases are those with no genetic alterations in their familiar picture. The authors present a case of an idiopathic masseter muscle hypoplasia in the absence of other pathologies.
Clinical presentation: The case report involved a patient who presented to the consultant clinic complaining of facial asymmetry. The patient underwent several exams to confirm the diagnosis of masseter muscle hypoplasia, which included an X-ray, magnetic resonance of the temporomandibular articulation, and electromyography. Intervention: The patient was treated with a customized functional appliance and fixed orthodontic treatment with satisfactory functional and esthetic results.
Conclusion: The case presented highlights the possibility of finding a hypoplasia of the masseter muscle even in the absence of other pathologies and without specific clinical symptoms, and how to plan an appropriate treatment with functional appliance and fixed orthodontic therapy
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