52 research outputs found
Infection Control in Dental Practice during the COVID-19 Pandemic: What Is Changed?
No full textThe COVID-19 pandemic has profoundly changed our lives. Since the SARS-CoV-2 was discovered, many studies have been done on the transmission mode, its replication within humans, and its survival even in the outside environment and on inanimate surfaces. Undoubtedly, health care workers have faced the greatest risks because of their close contact with potentially infected patients. Of these, dental health care professionals are certainly among the most vulnerable categories, precisely because infection occurs with the airborne virus. The treatment of patients within the dental office has changed profoundly, respecting all preventive measures towards the patient and the practitioners themselves. The aim of this paper is to understand whether the protocols changed for the prevention of SARS-CoV-2 infection among dentists remained even after the most acute phase of the pandemic. In particular, this study analyzed habits, protocols, preventive measures, and any costs incurred in the COVID-19 era for the prevention of SARS-CoV-2 infection among dental workers and patients
Lower Incisor—Pg: A New Cephalometric Parameter to Evaluate the Anterior Limit of Dentition
No full textBackground: This present retrospective study aimed to introduce Lower Incisor—Pg and to assess how this new parameter varies with the skeletal sagittal and vertical relationships. Methods: A total of 1256 cephalometric analyses were performed using lateral cephalometric radiographs of a sample of subjects divided according to SN^Go-Gn, ANPg^, and IMPA measurements. The differences in Lower Incisor—Pg between the groups were assessed through ANOVA tests and posthoc analyses, while Pearson’s correlation analysis was used to assess the correlations between the measurements. Results: The mesofacial growth pattern (61.0%) was more common than dolichofacial (30.0%) and brachyfacial (8.6%) ones in the sampled population. Regarding skeletal sagittal relationships, Class I was more frequent (70.9%) than Class II (19.3%) and Class III (9.8%). The mean value of the Lower Incisor—Pg was 3.2 ± 4.0 mm. Linear regression showed that the β coefficient was 0.45 and 0.36 for ANPg^ and SnGoGn^, respectively. Conclusions: Lower Incisor—Pg is a linear cephalometric measurement to evaluate the lower incisor sagittal position. For each degree of increase in ANPg^ and SNGoGn^, the Lower Incisor—Pg increased 0.45 mm and 0.36 mm, respectively
Reliability and Educational Suitability of TikTok Videos as a Source of Information on Sleep and Awake Bruxism: A Cross‐Sectional Analysis
No full textBackground: TikTok contains many videos about bruxism that may help raise the level of awareness on the topic. However, the quality of these videos' information represents the greatest concern. Objective: The present cross-sectional analysis aimed to systematically assess the reliability and educational suitability of TikTok videos as a source of information on bruxism. Methods: TikTok was searched for relevant videos uploaded until 6 March 2024, using the hashtags #bruxism, #grindingteeth and #jawclenching. Independent pre-calibrated operators conducted video inclusion and data collection, noting videos' characteristics, source, popularity, content, reliability (assessed through the DISCERN scoring system) and educational value (assessed through the Global Quality Score [GQS]). The Kruskal-Wallis test was adopted to compare videos from different sources. Videos with low and high educational value were compared using the Mann-Whitney U-test. Tests were considered significant when the p-value was < 0.05. Results: A total of 105 bruxism videos were analysed. Most videos covered bruxism management and clinical features, and more than 60% were uploaded by healthcare professionals. According to the DISCERN and GQS scoring, the videos' reliability and educational value were judged to be very poor and low, respectively, but on average they were higher for videos uploaded by healthcare professionals compared to those uploaded by laypeople. When comparing videos with high educational value to those with low educational value, differences were found in popularity, content and reliability. Conclusion: The present results suggest the need for greater control of information disseminated on social media to fulfil its potential role in educating laypeople about bruxism
PointIpg: an AI Model for Assessing Lower Incisor-Pg as a Cephalometric Parameter for the Anterior Limit of Dentition
No full textPeri-Implant Bone Loss in Fixed Full-Arch Implant-Supported Mandibular Rehabilitation: A Retrospective Radiographic Analysis
No full textBackground: the aim of the study was to assess, through orthopantomograms (OPGs), the existence of peri-implant bone loss of distal implants in implant-supported full-arch mandibular restorations. A comparison between full-arch implant-supported rehabilitations performed in the inter-foraminal region and full-arch rehabilitations that include implant insertion distal to the mental foramen was conducted. Methods: a retrospective observational analysis of 17,950 OPGs from 2010 to 2020 was conducted. The presence of fixed implant-supported prostheses in a fully edentulous mandible was the inclusion criteria of the study. OPGs were divided according to the number of implants (four, six, and eight), position of the implants (mesial or distal to the mental foramen), and positioning patterns (models 1, 2, 3, 4, and 5). Results: a total of 51 OPGs were included in the study, 19 of which showed peri-implant bone loss. In particular, 16 belonged to the six-implant rehabilitation group and 3 to the eight-implant rehabilitation group; none of the four-implant-supported rehabilitations were affected by peri-implant bone loss. In all rehabilitations affected by peri-implant bone loss, the distal implant was the most involved, in particular the implant in positions 36 and 46. Conclusions: implants distal to the mental foramina are more susceptible than mesial implants to bone resorption in full-arch fixed implant-supported prostheses. This significant difference should be investigated further for the presence and synergy of biomechanical factors that could act predominantly in this area, such as mandibular flexure and occlusal loading
Impact of maxillary expansion on the sagittal skeletal and dental parameters of growing Class II patients: A systematic review with meta‐analysis
No full textA "spontaneous" correction of the Class II malocclusion has been described after maxillary expansion (ME) treatment. The aim of the present review was to systematically summarize changes in the sagittal dentoskeletal parameters of growing Class II patients after ME. The study protocol was developed according to the PRISMA statement and registered in PROSPERO before literature search, data extraction and analysis. The PICO model was followed in the definition of the research question, search strategies and study selection criteria. Randomized and non-randomized studies on the sagittal effects of ME published in English language without date restrictions were electronically searched across the Cochrane Library, Scopus and MEDLINE/PubMed databases. Changes in sagittal dentoskeletal cephalometric parameters were analysed. The risk of bias in randomized and nonrandomized studies was assessed using the Rob2 and ROBINS-I tools, respectively. A narrative synthesis was performed, focusing on the investigated population, intervention, comparison, and main outcomes. Pairwise meta-analyses were used to compare the outcomes assessed in subjects who underwent ME versus untreated subjects. Ten studies met the inclusion criteria, four were included in the pairwise meta-analyses due to the presence of a control group. Slight but significant improvements in OVJ (MD: -0.36; 95%; CI [-0.69 to -0.01]; p = .04) and 6/6 molar relation (MD: 1.5; 95%; CI [0.69 to 1.61]; p < .0001) were found in patients who underwent ME compared with untreated subjects, whereas no improvement in skeletal parameters was observed. However, the limitations of a small body of moderate-quality evidence and possible confounding factors should be considered. Evidence on the sagittal skeletal and dental effects of ME in Class II patients is still ambiguous, suggesting the need for more clinical trials, including appropriate control subjects, randomization and blinding during outcome assessment
Multiple-Drugs-Related Osteonecrosis of the Jaw in a Patient Affected by Multiple Myeloma: A Case Report
No full textA 60-year-old woman suffering from multiple myeloma (MM) was treated with zoledronic acid (bisphosphonate), dexamethasone (corticosteroid), bortezomib (a chemotherapeutic agent), and lenalidomide (thalidomide analog) for about a year and with lenalidomide alone as maintenance therapy for almost two years and developed stage three medication-related osteonecrosis of the jaws (MRONJ) in the upper left dental arch approximately two weeks after tooth extraction, which was treated with a medical nonoperative conservative approach until reversion to stage one. The present case report describing the development of multi-drug-related osteonecrosis of the jaws during the pharmacologic MM maintenance phase draws attention to the complex multidisciplinary and multistage management of MM subjects and also that during disease remission, crucially involving oral healthcare providers for MRONJ prevention and pharmacovigilance. To prevent similar cases, cancer patient management should ensure proper dental care not only before starting but also throughout therapy duration and ensure continuous interdisciplinary consensus between oncologists and dentists. Moreover, also considering the independent negative and potentially synergistic effect on bone metabolism and mucosal healing processes of employed medicaments, additionally combined with the cumulative one of previous intravenous bisphosphonates, further studies should highlight the polypharmacy effect and hopefully aid in patient-specific MRONJ risk assessment in cancer patients
Attitude of Italian dental practitioners toward bruxism assessment and management: A survey-based study
No full textIntroduction: Bruxism is a spectrum of masticatory muscles activities. According to the recent evidence and international consensus, there is no indication to treat bruxism unless clinical consequences are present. The aim of the present study was to investigate the approach of Italian dentists to bruxism in their clinical practice. Methods: An anonymous online survey was developed, composed by 26 items grouped into five sections: (1) Characteristics of the respondent (Q1–Q6); (2) Bruxism frequencies (Q7–Q11); (3) Bruxism assessment (Q12–Q15); (4) Bruxism management (Q16–Q20); (5) Occlusal splints therapy (Q21–Q26). Results: A total of 384 practitioners, including specialists and non-specialists, participated in this survey. The majority of the respondents reported that 1–3 out of ten patients presented with bruxism. The diagnosis is mainly performed with non-instrumental methods, and facial pain and dental wear are the major clinical consequence associated with bruxism. Almost the entire sample of respondents report to offer occlusal splints to bruxism patients, and 41% refer to perform occlusal adjustments. Almost half of the respondents have never proposed any form of cognitive-behavioural therapy. Conclusion: The results of the current survey highlighted several inconsistencies in Italian dentists' approaches to bruxism, suggesting the need for better education of practitioners and for the development of a standardized protocol to assess and manage bruxism in dental practices
Oral and Extra-Oral Manifestations of Hypersensitivity Reactions in Orthodontics: A Comprehensive Review
No full text: Although rare, oral manifestations of hypersensitivity reactions in orthodontic patients pose a significant clinical challenge due to their heterogeneous presentations, and can cause discomfort and pain, possibly impacting patients' quality of life and orthodontic treatment duration and outcomes. This comprehensive review aimed to elucidate the oral, perioral, and systemic manifestations of hypersensitivity reactions in orthodontic subjects, focusing on patients with fixed appliances, removable appliances, and clear aligners, and detailing their epidemiology, macroscopic and microscopic features, allergy testing, clinical implications, and specific management strategies. Oral and extra-oral manifestations of (immediate and delayed) hypersensitivity reactions occur rarely and are due to the release of metal and non-metal ions from orthodontic appliances. They typically present as erythema, erosive-ulcerative lesions, and gingival hyperplasia, with histopathological findings showing inflammatory infiltrates. Nickel is a significant allergen, and diagnostic tests like patch tests are essential for managing these reactions. Likely due to prolonged contact with oral tissues, fixed orthodontic appliances pose a higher risk compared to removable appliances and clear aligners. Early identification and removal of allergenic materials, combined with effective treatments, can resolve symptoms and prevent recurrence. Keeping dental and medical records updated and knowing family and personal medical histories helps clinicians choose appropriate materials and counsel patients about potential risks. Proper patient education, regular monitoring, and using hypoallergenic materials are key strategies for managing these reactions
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