Salivary biomarkers for early detection of oral squamous cell carcinoma (OSCC) and head/neck squamous cell carcinoma (HNSCC): A systematic review and network meta-analysis

Oral cancer became a very common condition. WHO estimates that there are 4 cases of lip and oral cavity cancer for every 100,000 people worldwide. The early diagnosis of cancers is currently a top focus in the health sector. Recent systematic reviews and meta-analyses have identified promising biomarkers for early detection in several original research investigations. However, it is still unclear the quality of these evidence and which biomarker performs the best in terms of early detection. Therefore, the objective was, to map the methodological and reporting quality of available oral squamous cell carcinoma (OSCC) or head/neck squamous cell carcinoma (HNSCC) systematic reviews and meta-analysis. Secondly, to evaluate diagnostic accuracy of salivary biomarkers for common craniofacial cancers and to compare the diagnostic value of different salivary biomarkers. PubMed, Scopus, Web of Science, Embase and Cochrane Library electronic databases were used to map the methodological and reporting quality of the systematic reviews and meta-analysis conducted on the HNSCC, OSCC using the AMSTAR-2 checklist. The inclusion criteria were systematic reviews and meta-analysis published in the topic of HNSCC and OSCC biomarkers. Exclusion criteria were no animal studies; original primary studies, due to limitation of competency in other languages articles with language other than English were excluded. The sensitivity and specificity were calculated for salivary biomarkers and ranked according to network meta-analysis principles. A total of N = 5893 patients were included from four meta-analysis studies. All together, these included n = 37 primary studies. n = 94 biomarkers were pooled from these four meta-analyses and categorised into the stages at which they were detected (I-IV). In OSCC, Chemerin and MMP-9 displayed the highest sensitivity, registering 0.94 (95% CI 0.78, 1.00) and a balanced accuracy of 0.93. Phytosphingosine closely followed, with a sensitivity of 0.91 (95% CI 0.68, 0.99) and a balanced accuracy of 0.87. For HNSCC, the top three biomarkers are Actin, IL-1β Singleplex, and IL-8 ELISA. Actin leads with a sensitivity of 0.91 (95% CI 0.68-0.99), a specificity of 0.67, and an overall accuracy of 0.79. Subsequently, IL-1β Singleplex exhibits a sensitivity of 0.62 (95% CI 0.30-0.88), a specificity of 0.89, and an accuracy of 0.75, followed by IL-8 ELISA with a sensitivity of 0.81 (95% CI 0.54-0.97), a specificity of 0.59, and an accuracy of 0.70. In conclusion, there was highest sensitivity for MMP-9 and chemerin salivary biomarkers. There is need of further more studies to identify biomarkers for HNSCC and OSCC.

The experience of the rigid lockdown in the dental emergency room and urgency care during COVID-19 pandemic: a transnational multicenter observational study

OBJECTIVE

The COVID-19 pandemic had a major impact on our lives all over the world. Changes have occurred in daily life as well as in all medical services. The aim of the present study was to evaluate the emergency accesses in four universities' emergency services during the lockdown period from March to June 2020 during the COVID-19 pandemic.

SUBJECTS AND METHODS

A cross-sectional study was carried out on 44,787 patients to evaluate the emergency services of university centers. The medical data of Medical Emergency Service Data (MESD) were assessed by five independent operators considering the epidemiological findings for statistics methods.

RESULTS

A lower level of emergency access was reported in March-July compared to the pre-COVID period. The epidemiological data confirmed that female pathologies were more frequent compared to male patients. A fluctuation for almost all urgent healthcare centers was detected, showing one/two peaks per year during the years 2017-2019. The COVID-19 pandemic period did not influence the variety of pathology detected.

CONCLUSIONS

After the lockdown period, the emergency services slowly increased in cases. The pre-COVID period showed an overlapping of the most frequent pathologies compared to the post-COVID period: periodontitis (Bari and Tirana), dental fractures (Bari and Bucharest), odontogenic abscess (Bari, Cluj and Tirana).

Ceramic biomaterials in dentistry: chemical structure and biosafety - a review and a bibliometric visual mapping on Scopus database

OBJECTIVE

A biomaterial is any non-pharmaceutical substance or a mixture of synthetic or natural substances used independently or as part of a system for any amount of time with the aim of mending, supporting the growth, or replacing tissues, organs, or functions of the body. It is a non-renewable material that interacts with biological systems. The purpose of this study was to assess the advances in ceramic biomaterials and perform a bibliometric mapping of the literature on the subject.

MATERIALS AND METHODS

The Scopus database was used for manuscript screening (Elsevier, Amsterdam, The Netherlands). The effect of the scientific production has been assessed using scientometric citational metrics.

RESULTS

A total of 2,554 pieces of literature, including 2,234 papers, 170 conference proceedings, 109 reviews, 35 book chapters, 3 editorial letters, and 3 short surveys, were retrieved. Based on the research conducted, it is noted that ceramic materials are high-performing by being porous or glassy and can, therefore, serve as fillers, covering materials, and scaffolds in medicine and biotechnology. They are frequently employed not only in orthopedic and maxillofacial surgery but also in dentistry for dental prostheses.

CONCLUSIONS

Materials monitoring methods enable us to track the three-dimensional evolution of ceramics' volume, as well as flaws or micro-cracks.

Correlation between use of different type protective facemasks and the oral ecosystem

BACKGROUND

Spread worldwide through droplets, the Virus Sars-Cov-19 has caused a global health emergency alarm. In order to limit its spread, the use of masks has become part of the daily life of the entire population, however, little is known about its constant use and the changes generated in the oral cavity. This work aims to investigate correlations between the continuous use of masks covering the nose and mouth for 3 h and changes in the ecological factors of the oral cavity.

METHODS

34 volunteers were divided into 2 groups: wear only the filtering facepiece code 2 (FFP2) mask (Group A) and wear the FFP2 mask covered by a surgical mask (Group B). Measurement of Volatile Organic Compounds (VOCs), saliva rehydration and consistency test, collection of basal saliva and saliva stimulated with paraffin gum and mucosal swab were collected and analyzed at two times: before using the mask(s) (T0) and 3 h after continuous use of the mask(s) (T1).

RESULTS

The results indicated a significant difference between the groups, in which the basal saliva volume and pH and the peaks of VOCs increased for group B between T0 and T1. The rehydration time decreased and the volume and pH of the stimulated saliva increased, but with no significant difference between the groups. Furthermore, group B showed a significant decrease in Candida albicans Colony Forming Units (CFUs) and Total Bacterial Count (TBC) between T0 and T1.

CONCLUSION

It is concluded that the prolonged use of the FFP2 mask covered by a surgical mask can generate oral alterations in the user.

Application of Graphene Oxide in Oral Surgery: A Systematic Review

The current review aims to provide an overview of the most recent research in the last 10 years on the potentials of graphene in the dental surgery field, focusing on the potential of graphene oxide (GO) applied to implant surfaces and prosthetic abutment surfaces, as well as to the membranes and scaffolds used in Guided Bone Regeneration (GBR) procedures. "Graphene oxide" and "dental surgery" and "dentistry" were the search terms utilized on the databases Scopus, Web of Science, and Pubmed, with the Boolean operator "AND" and "OR". Reviewers worked in pairs to select studies based on specific inclusion and exclusion criteria. They included animal studies, clinical studies, or case reports, and in vitro and in vivo studies. However, they excluded systematic reviews, narrative reviews, and meta-analyses. Results: Of these 293 studies, 19 publications were included in this review. The field of graphene-based engineered nanomaterials in dentistry is expanding. Aside from its superior mechanical properties, electrical conductivity, and thermal stability, graphene and its derivatives may be functionalized with a variety of bioactive compounds, allowing them to be introduced into and improved upon various scaffolds used in regenerative dentistry. This review presents state-of-the-art graphene-based dental surgery applications. Even if further studies and investigations are still needed, the GO coating could improve clinical results in the examined dental surgery fields. Better osseointegration, as well as increased antibacterial and cytocompatible qualities, can benefit GO-coated implant surgery. On bacterially contaminated implant abutment surfaces, the CO coating may provide the optimum prospects for soft tissue sealing to occur. GBR proves to be a safe and stable material, improving both bone regeneration when using GO-enhanced graft materials as well as biocompatibility and mechanical properties of GO-incorporated membranes.

Orofacial-Myofunctional therapy after lingual frenectomy in patient with tongue-tie: a systemic postural approach with mezieres method and postural bench

AIM

In this study we present the new postoperative oro-myofunctional protocol following frenectomy by atmospheric plasma associated with a systemic postural approach, which determines functional recovery through body symmetry restoration based on the concepts of the French "Mezieres Method" and postural bench.

METHODS

A total of 130 patients (76 female, 54 male) affected by ankyloglossia of class III/IV, according to Kotlow's Tongue Tie Classification have been treated with atmospheric plasma followed by oro-myofunctional therapy associated with a systemic postural approach. The overall change, improved/worsened speech, feeding, or sleep has been evaluated through the 10 points Parents Speech Satisfaction (PSS) Score after one week and two months.

CONCLUSION

Based on the findings of the current investigation, myofunctional therapy in tongue-tie results in a consistent significant functional ameliorating of feeding capability, speech and sleeping of subject treated as reported with traditional oro-myofunctional therapy.

Cannabidiol for Oral Health: A New Promising Therapeutical Tool in Dentistry

The medical use of cannabis has a very long history. Although many substances called cannabinoids are present in cannabis, Δ9tetrahydrocannabinol (Δ9-THC), cannabidiol (CBD) and cannabinol (CBN) are the three main cannabinoids that are most present and described. CBD itself is not responsible for the psychotropic effects of cannabis, since it does not produce the typical behavioral effects associated with the consumption of this drug. CBD has recently gained growing attention in modern society and seems to be increasingly explored in dentistry. Several subjective findings suggest some therapeutic effects of CBD that are strongly supported by research evidence. However, there is a plethora of data regarding CBD's mechanism of action and therapeutic potential, which are in many cases contradictory. We will first provide an overview of the scientific evidence on the molecular mechanism of CBD's action. Furthermore, we will map the recent developments regarding the possible oral benefits of CBD. In summary, we will highlight CBD's promising biological features for its application in dentistry, despite exiting patents that suggest the current compositions for oral care as the main interest of the industry.

Current Status of Peri-Implant Diseases: A Clinical Review for Evidence-Based Decision Making

BACKGROUND

the prevalence of peri-implant diseases is constantly growing, particularly with the increasing use of dental implants. As such, achieving healthy peri-implant tissues has become a key challenge in implant dentistry since it considers the optimal success paradigm. This narrative review aims to highlight the current concepts regarding the disease and summarize the available evidence on treatment approaches clarifying their indications for usage following the World Workshop on the Classification of Periodontal and Peri-implant Diseases (2017).

METHODS

we reviewed the recent literature and conducted a narrative synthesis of the available evidence on peri-implant diseases.

RESULTS

scientific evidence on case definitions, epidemiology, risk factors, microbiological profile, prevention, and treatment approaches for peri-implant diseases were summarized and reported.

CONCLUSIONS

although there are numerous protocols for managing peri-implant diseases, they are diverse and nonstandardized, with no consensus on the most effective, leading to treatment confusion.

Wettability of mg-ha/Chitosan-based membrane surfaces: blood vs. autologous platelet liquid (APL)

OBJECTIVE

The physical and physical chemistry is able to influence the interaction of the scaffolds and bone substitutes with the body fluid and blood. The aim of the present investigation was to evaluate the wettability properties of an Mg-HA Chitosan-based Gel with blood vs. autologous platelet gel.

MATERIALS AND METHODS

A total of 6 study groups were evaluated according to the Mg-HA Chitosan-based Gel thickness (1, 2 and 3 mm) and the fluids (blood vs. autologous platelet gel). The biomaterial wettability was conducted through the sessile drop technique.

RESULTS

The study findings showed a significant difference in contact angle between the APL and blood groups (p<0.05). The MG-Ha Chitosan-based membrane thicknesses seem to produce no significant effects on contact angles measurement for all groups (p>0.05).

CONCLUSIONS

In the present investigation, a similar MG/Ha gel membranes wettability was reported between APL and blood groups. In addition, a high hydrophilicity of MG/Ha gel membranes was reported with a potential advantage in terms of a more effective osteogenic capability in the clinical practice.

Topical hemostatic agents in oral surgery: a narrative review

Sufficient hemostasis during oral surgical procedures is crucial for successful outcomes and to reduce healthcare resource utilization. The purpose of this narrative review is to give a rational insight into the management of bleeding in oral and dental practice through modern drugs. A narrative literature review has been performed on the present topic identifying all articles on Pubmed/Medline and Google Scholars. Acceptable hemostasis during oral surgery is also required to improve visibility and provide a dry operational area. Many oral surgeons, in their daily practice, encounter problems in controlling postoperative bleeding and use a topical hemostatic agent to promote platelet activation or aggregation to form a stable clot.

Volumetric evaluations of the maxillary sinus before and post regenerative surgery

OBJECTIVE

The purpose of this study was to investigate possible differences in the filling of the various recesses of the maxillary sinus after the procedure of sinus floor elevation in relation with the initial volume of the same and if the sinus volume can influence long-term graft dimensions, by using cone beam computed tomography (CBCT) as diagnostic analysis device.

PATIENTS AND METHODS

This study included 32 sinuses corresponding to 16 patients referred for bilateral maxillary sinus augmentation procedures needing to increase the volume of the surgical site with the porcine cortical bone for dental implant placement in the posterior maxilla. The sinuses were analyzed by preoperative and postoperative (15 days and 6 months after sinus surgery) cone beam computed tomography.

RESULTS

No statistically significant relations were observed between initial sinus dimensions and the entity of the contraction of the graft between T1 (15 days after surgery) and T2 (180 days after surgery). The behavior was the same either for the large sinus (> 15.65 cm3) and for the small one (< 15.65 cm3). Instead, about the filling of the various sinus recesses, a linear regression model was used to explain the difference between the mean preoperative and postoperative surgical spaces; in most of the samples, the filling of the anterior recess was ~15% of the total volume of the graft, i.e., the minor one among the main recesses.

CONCLUSIONS

Our findings suggest that: (1) in the procedure of sinus floor augmentation by a lateral approach with deproteinized porcine bone there are no relations between the initial dimensions of the sinus and the long-term dimensional changes of the graft, and (2) that, among the main recesses of the sinus, the anterior one is generally the less filled.

Microleakage and mechanical behavior of conical vs. internal hexagon implant-abutment connection under a cyclic load fatigue test

OBJECTIVE

The aim of the present investigation was to evaluate, by an in vitro simulation, the mechanical behavior of the conical vs. internal hexagon under cyclic load and the microleakage of the prosthetic connection of the fixture.

MATERIALS AND METHODS

A standardized cyclic loading was performed considering the implant with conical connection (diameter 4 mm - length 10 mm) (CS) and internal hexagon connection (diameter 4 mm - length 10 mm) (IH). The toluidine blue infiltration has been evaluated with the paper cone test.

RESULTS

After a total of 5x104 loads, the screw has been removed and the abutment appears solid and stable to the implant fixture for CS, while the IH was unstable. There was no infiltration of the toluidine marker in the connection interfaces of CS implants, while the IH was positive to the paper cone test.

CONCLUSIONS

The study data showed that the conical connection showed higher stability compared to the internal hexagon connection under the loading and it is able to prevent bacterial microleakage. This effectiveness should be considered for the long-term maintenance of the peri-implant soft and hard tissues around the fixture.

Rehabilitation of patients with thin ridges by conical expanders and immediate cone morse dental implant: a case report

BACKGROUND

Horizontal atrophic ridges need a regenerative procedure for implant positioning and fixed rehabilitation. Cone Morse taper implants are characterized by the intimate fitting of the prosthetic interface with the absence of microgaps and micromovements of the interfaces. The aim of this case report was to evaluate the clinical outcome of Cone Morse implant design in split crest augmentation treatment.

CASE REPORT

A female patient with partial edentulism of atrophic posterior maxilla was treated for split crest procedure and implant-supported rehabilitation. A full-thickness flap was elevated, and horizontal and vertical osteotomic lines were produced with piezoelectric device. A total of 4 Cone Morse Taper implants (Universal III, Implacil de Bortoli, Brasil) were positioned and the site was grafted with bone substitute and covered by a heterologous membrane.

CONCLUSIONS

A complete healing of the surgical site was evident at the follow-up with no evidence of bone resorption. No radiolucency or inflammatory aspects of the treated site were evident in the radiographic control. Simultaneous Cone Morse implants positioning with split crest technique seems to be a promising treatment for posterior maxillary rehabilitation of atrophic edentulous ridges.

Histological aspects of cellulite: shedding light on 100 years of uncertainties

Cellulite is a common topographic condition of the skin manifested as lumpy, dimpled flesh resembling an orange peel on some zones such as the thighs, hips, buttocks and abdomen. The aetiology of this cosmetic issue is multifactorial, with hormonal, anatomical, environmental and genetic factors influencing its origin, although the exact mechanisms which cause this condition are still unknown. In the present work, a bibliographic analysis of the cellulite etiology has been updated and exposed, as well as the multiple classification grade scales established over the decades. In addition, a new method to classify cellulite severity, in which the clinical manifestations are correlated to the histological aspects more frequently found in the patients, has been presented. Several theories regarding its appearance, structure and clinical aspects have arisen with the aim of developing and establishing a valuable therapeutic approach. However, the lack of a consensus regarding the classification of cellulite severity has complicated the developments within this field.

Perioperative Management of Antithrombotic Therapy in Patients Who Undergo Dental Procedures: A Systematic Review of the Literature and Network Meta-Analysis

BACKGROUND

The surgical dental treatment of subjects admitted for anticoagulants therapy represents a consistent risk for peri-operative bleeding. The aim of the present study was to investigate the clinical findings of dental surgery operative management of the patients under anticoagulants drugs protocol.

METHODS

The literature screening was performed using Pubmed/Medline, EMBASE and Cochrane library, considering only randomized clinical trials (RCTs) papers. No limitations about the publication's period, follow-up time or clinical parameters were considered.

RESULTS

A total of eight RCTs were included for the qualitative synthesis. No thromboembolic complications were reported in any studies. Several bleeding episodes associated with anticoagulant drugs in dental surgery were mild and generally happened on the first day after the treatment.

CONCLUSIONS

The use of local haemostatic measures is generally effective for bleeding control with no further pharmacological drug management or suspension.

Effectiveness of Apigenin, Resveratrol, and Curcumin as Adjuvant Nutraceuticals for Calvarial Bone Defect Healing: An In Vitro and Histological Study on Rats

Bone healing is a major clinical issue, especially in bone defects of critical dimensions. Some studies have reported in vivo positive effects on bone healing by some bioactive compounds, such as the phenolic derivatives found in vegetables and plants, such as resveratrol, curcumin, and apigenin. The aim of this work was (1) to analyze in vitro in human dental pulp stem cells the effects of these three natural compounds on the gene expression of related genes downstream to RUNX2 and SMAD5, key factor transcriptions associated with osteoblast differentiation, in order to better understand the positive effects that can occur in vivo in bone healing, and (2) to evaluate in vivo the effects on bone healing of critical-size defects in the calvaria in rats of these three nutraceuticals tested in parallel and for the first time administered by the gastric route. Upregulation of the RUNX2, SMAD5, COLL1, COLL4, and COLL5 genes in the presence of apigenin, curcumin, and resveratrol was detected. In vivo, apigenin induced more consistent significant bone healing in critical-size defects in rat calvaria compared to the other study groups. The study findings encourage a possible therapeutic supplementation with nutraceuticals during the bone regeneration process.

Autologous Tooth Graft: Innovative Biomaterial for Bone Regeneration. Tooth Transformer® and the Role of Microbiota in Regenerative Dentistry. A Systematic Review

Different biomaterials, from synthetic products to autologous or heterologous grafts, have been suggested for the preservation and regeneration of bone. The aim of this study is to evaluate the effectiveness of autologous tooth as a grafting material and examine the properties of this material and its interactions with bone metabolism. PubMed, Scopus, Cochrane Library, and Web of Science were searched to find articles addressing our topic published from 1 January 2012 up to 22 November 2022, and a total of 1516 studies were identified. Eighteen papers in all were considered in this review for qualitative analysis. Demineralized dentin can be used as a graft material, since it shows high cell compatibility and promotes rapid bone regeneration by striking an ideal balance between bone resorption and production; it also has several benefits, such as quick recovery times, high-quality newly formed bone, low costs, no risk of disease transmission, the ability to be performed as an outpatient procedure, and no donor-related postoperative complications. Demineralization is a crucial step in the tooth treatment process, which includes cleaning, grinding, and demineralization. Since the presence of hydroxyapatite crystals prevents the release of growth factors, demineralization is essential for effective regenerative surgery. Even though the relationship between the bone system and dysbiosis has not yet been fully explored, this study highlights an association between bone and gut microbes. The creation of additional scientific studies to build upon and enhance the findings of this study should be a future objective of scientific research.

Clinical and Radiological Evaluation of a Self-Condensing Bone Implant in One-Stage Sinus Augmentation: A 3-Year Follow-Up Retrospective Study

Stabilization of dental implants in the sinus region with a bone height below 4 mm gen-erally requires a two-stage sinus floor elevation surgery. To improve this aspect, the aim of this retrospective study was to demonstrate the feasibility of performing a one-stage maxillary sinus augmentation using an innovative self-condensing implant design, even in case of a bone height close to 2 mm. Clinical and radiological outcomes from 54 patients (26 females; 28 males; 69 total implants positioned) were analyzed 3 years post-surgery. The three-dimensional grafts change was evaluated by Cone-Beam Computed Tomography (CBCT) before surgery (T0), immediately after surgery (T1), and 1-year post-surgery (T2). The sinus floor levels measured at the medial (M-W), middle (MD-W), and lateral (L-W) walls reported: M-W of 1.9 ± 2.4 mm (T1) and 1.7 ± 2.6 mm (T2); MD-W of -0.1 ± 2.7 mm (T1) and 0.7 ± 2.4 mm (T2); L-W of 3.1 ± 3.0 mm (T1) and 3.1 ± 3.0 mm (T2); besides a bone crest height (C-F) of 4.6 ± 2.0 mm (T1) and 12.1 ± 1.4 mm (T2). Moreover, after 3 years only 1 implant was lost, and so an implant survival rate of 98.55% was recorded. In conclusion, these results suggest the efficacy of using this implant design for a one-stage sinus lift approach, not only in terms of increased implant survival rate and decreased marginal bone loss, but also for its potential applicability in case of reduced bone height.

Implant Survival in Patients with Chronic Kidney Disease: A Case Report and Systematic Review of the Literature

BACKGROUND

The aim of this systematic review and case reports was to evaluate osseointegration and implant survival rate in patients with chronic kidney disease.

METHODS

The paper screening process was conducted on electronic databases in order to identify clinical studies concerning the study topic. The literature data were evaluated for eligibility and studies were included for the qualitative synthesis. The case report concerned a male subject affected by renal disorders, a candidate for full arch immediate loading procedure.

RESULTS

The article screening process reported a total of 54 manuscripts and one paper identified through the manual search. At the end of the review process, a total of 45 articles were excluded while nine manuscripts were included for the descriptive synthesis. No significant complications or events were present during the intraoperative/post-operative phases. The clinical course reported no significant inflammation or symptoms. At follow-up, the rehabilitation was found to be functionally and aesthetically integrated with no complications, probing, or bone resorption.

CONCLUSIONS

The available evidence supports the clinical efficacy of the early implant placement protocol. Present findings indicate that the early implant placement protocol results in implant outcomes similar to immediate and delayed placement protocols and a superior stability of peri-implant hard tissue compared with immediate implant placement.

Tooth Complications after Orthodontic Miniscrews Insertion

Orthodontic miniscrews (OM) are widely used in modern orthodontic clinical practice to improve skeletal anchorage and have a high safety profile. A complication at the time of OM insertion is tooth root perforation or periodontal ligament trauma. Rarely, OM injury can cause permanent damage, such as ankylosis, osteosclerosis, and loss of tooth vitality. The aim of this work was to analyze potential risks and dental complications associated with the use of OMs. A search of the PubMed, Cochrane, Web of Science, and Scopus databases was conducted without a time limit using the keywords "orthodontic mini-screw" and "dental damage", resulting in 99 studies. After screening and eligibility, including articles obtained through a citation search, 13 articles were selected. Four studies revealed accidental injuries caused by OM. Most of the damage was localized at the root level and resolved spontaneously with restorative cement formation after prompt removal of the OM, while the pain disappeared. In some cases, irreversible nerve damage, extensive lesions to the dentin-pulp complex, and refractory periapical periodontitis occurred, requiring endodontic and/or surgical treatment. The choice of insertion site was the most important element to be evaluated during the application of OMs.

Laser Surgical Approach of Upper Labial Frenulum: A Systematic Review

An abnormal and hypertrophied upper labial frenulum (ULF) can cause diastemas, gingival recession, eruption abnormalities, and the onset of carious and periodontal problems in the upper central incisors, as well as aesthetic and functional disorders of the upper lip. The goal of this investigation is to review the evidence on the surgical techniques that are currently available for treating ULF in order to identify the best approach. PubMed, Scopus, Cochrane Library, and Embase were searched for papers that matched our topic from 13 November 2012 up to 22 November 2022 using the following Boolean keywords: "frenulum" and "surgery*". A total of eight articles were selected for the purpose of the review. ULF can be surgically treated using either traditional scalpel surgery or laser surgery. The latter is the better option due to its intra- and post-operative benefits for both the patients and the clinicians, in terms of faster healing, fewer side effects and discomfort, and greater patient compliance. However, a higher learning curve is required for this technique, especially to calibrate the appropriate power of the laser. To date, it is not possible to identify which type of laser achieves the best clinical results for the treatment of ULF.

Atmospheric Plasma Lingual Frenectomy Followed by Post Operative Tongue Exercises: A Case Series

The lingual frenulum is a submucosal component significantly involved in the mobility of the tongue. In the case of short lingual frenulum, different surgical approaches have been proposed. Atmospheric plasma is a thermal technique of vaporization or sublimation of the superficial tissues, without going deep, and the resulting fine carbonized layer avoids bleeding. The aim of the present investigation was to evaluate the effectiveness of atmospheric plasma (voltaic arc dermabrasion) for the frenectomy of a short lingual frenulum. A total of 30 patients with an age range between 6−11 years old and a class III/IV Kotlow’s ankyloglossia classification were included in the study. The Kotlow’s free-tongue, maximal interincisal mouth opening (MIO, mm) and interincisal mouth opening with tongue tip to maxillary incisive papillae at roof of mouth (MOTTIP, mm) were calculated at the baseline, immediately postoperatively (T0), at one week (T1), one month (T2) and two months (T3). A significant increase of Kotlow’s measurements, MOTTIP and MIO were detected when comparing the baseline and the T0 (p < 0.05). No significant difference was detected between the T0, T1 and T2 (p > 0.05). The atmospheric plasma demonstrated a very minimal invasive approach for frenectomy, without important or fibrotic complications and with very low recurrence rates.

Diagnosis of SARS-CoV-2 during the Pandemic by Multiplex RT-rPCR hCoV Test: Future Perspectives

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly become a significant threat to public health. However, among the Coronaviridae family members, there are other viruses that can also cause infections in humans. Among these, severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS-CoV) have posed significant threats to human health in the past. Other human pathogenic coronaviruses have been identified, and they are known to cause respiratory diseases with manifestations ranging from mild to severe. In this study, we evaluated the performance of a multiplex RT-rPCR specific to seven human pathogenic coronaviruses in mainly detecting SARS-CoV-2 directly from nasopharyngeal swabs obtained from suspected COVID-19 infected patients, while simultaneously detecting different human pathogenic coronaviruses in case these were also present. We tested 1195 clinical samples suspected of COVID-19 infection. The assay identified that 69% of the samples tested positive for SARS-CoV-2 (1195), which was confirmed using another SARS-CoV-2 RT-PCR kit available in our laboratory. None of these clinical samples were positive for SARS-CoV, MERS-CoV or HCoV. This means that during the endemic phase of COVID-19, infection with other human pathogenic coronaviruses, even the common cold coronavirus (HCoV), is very uncommon. Our study also confirmed that the multiplex RT-rPCR is a sensitive assay for detecting SARS-CoV-2 regardless of differences among the variants. This multiplex RT-rPCR is also time- and cost-saving and very easy to apply in the diagnostic laboratory due to its simple procedure and its stability in storage after preparation. These features make the assay a valuable approach in screening procedures for the rapid detection of SARS-CoV-2 and other human pathogenic coronaviruses that could affect public health.

Peri-Implant Mucositis Treatment with a Chlorexidine Gel with A.D.S. 0.5%, PVP-VA and Sodium DNA vs a Placebo Gel: A Randomized Controlled Pilot Clinical Trial

BACKGROUND

Peri-implant mucositis is a bacterial and inflammatory disease of implant surrounding soft tissues. Chlorhexidine (CHX) associated with PVP-VA (Polyvinylpyrrolidone/vinyl acetate) has an adjuvant function in the antibacterial activity: it protects the film-forming layer, due to polymer, from microbial contamination or over-infection, and prolongs its permanence, without a direct action on the tissues and wounds. Sodium DNA is able to improve gingival trophism. The aim of the study was to compare a gel with CHX and antidiscoloration system (A.D.S.) 0.5% with the addition of PVP-VA and sodium DNA with a placebo gel without chlorexidine in peri-implant mucositis treatment.

METHODS

Trial design: A single center randomized controlled pilot clinical trial was conducted on a total of 24 patients with mucositis, randomly allocated into two groups. In the group (A) (n = 12) patients were treated with a gel with CHX + A.D.S. 0.5% while a placebo gel was used in the group (B) (n = 12).

OUTCOME

Plaque Index (PI) (primary outcome), Bleeding on probing (BOP) and Gingival Index (GI) (secondary outcomes) were assessed at baseline and at 2 weeks after treatment period.

RESULTS

Mean PI score recorded at baseline was 2.4 ± 0.4 [95% CI: -2.682/7.482] in the group (A) and 2.2 ± 0.5 [95% CI: -4.153/8.553] in the group (B) (p > 0.05) while mean PI score at 2 weeks was 0.5 ± 0.4 [95% CI: -4.582/5.582] and 1.7 ± 1.9 [95% CI: -9.736/13.14] in the group and in the group respectively (p < 0.05). Mean BOP value at baseline was 57.1 ± 15.2% [95% CI: -136.0/250.2] in the group (A) and 55.3% ± 11.7% [95% CI: -93.36/204.0] (p > 0.05) while mean BOP value at 2 weeks follow-up was 14.3% ± 6.6% [95% CI: -69.56/98.16] (A) and 45.4% ± 9.8% [95% CI: -79.12/169.9] (B) respectively (p < 0.05).

CONCLUSIONS

A significant reduction in gingival inflammation indexes was found at 2 weeks in patients with peri-implant mucositis treated with a gel with CHX + A.D.S. 0.5% with the addition of PVP-VA and sodium DNA compared to those treated with a placebo gel.

CLINICAL TRIAL REGISTRATION

2019-004976-20.

Antispike Immunoglobulin-G (IgG) Titer Response of SARS-CoV-2 mRNA-Vaccine (BNT162b2): A Monitoring Study on Healthcare Workers

The secretion of IgG SARS-CoV-2 antispike antibodies after vaccination with BNT162b2 and the protection represent the response of the human organism to the viral vector symptomatic infections. The aim of the present investigation was to evaluate the immune reaction in health workers of the Polyclinic of Bari to identify the relationship of antispike titers with blood type, sex, age, and comorbidities. This prospective observational study (RENAISSANCE) had as its primary endpoint the assessment of serologic response to BNT162b2 at three blood titers: the first at 60 days after the second dose (3 February 2021); the second titer at 75 days after the first titer; and the third titer at 130 days after the second titer. Out of 230 enrolled staff members, all responded excellently to the mRna Pfizer (BNT162b) vaccine. Only one patient, 40 days after the second dose (3 February 2021), was positive on the swab control performed on 15 March 2021, although completely asymptomatic, and was negative on the subsequent molecular swab performed on 30 March 2021. All the patients responded to the mRNA Pfizer (BNT162b) vaccine with an antispike IgG level above 500 BAU/mL at the first antispike protein essay (60 days after the second dose on 3 April 2021); at the second titer (75 days after the first titer on 20 June 2021), 4 (1.7% of 230 enrolled) patients showed an antispike IgG level under 500 BAU/mL; at the third titer (130 days after the second titer on 30 June 2021, which means 9 months after the second dose), 37 (16.1% of 230 enrolled) patients showed an antispike IgG level under 500 BAU/mL. The data analysis demonstrated that patients belonging to blood group 0, regardless of their rhesus factor, showed the strongest level of antibodies compared to the other groups. No dependency was found between low antibodies level and sex or age. Molecular swab controls were performed every 15th of the month continuously. However, the enrolled patients' activity was at high risk because they carried out medical activities such as dental and surgical as well with droplets of water vaporized by the effect of turbines, piezosurgery. The vaccination campaign among health workers of the Policlinico of the University of Bari "Aldo Moro" led to an excellent serological response and the complete absence of COVID-19 incident cases, so the antibody response was excellent. The COVID-19 vaccine booster shot should be administered after 9 months and not without prompt antispike titer detection to assess if any sign of waning immunity is present in that specific patient.

Effectiveness of SARS-CoV-2 Vaccines for Short- and Long-Term Immunity: A General Overview for the Pandemic Contrast

Background: The recent COVID-19 pandemic produced a significant increase in cases and an emergency state was induced worldwide. The current knowledge about the COVID-19 disease concerning diagnoses, patient tracking, the treatment protocol, and vaccines provides a consistent contribution for the primary prevention of the viral infection and decreasing the severity of the SARS-CoV-2 disease. The aim of the present investigation was to produce a general overview about the current findings for the COVID-19 disease, SARS-CoV-2 interaction mechanisms with the host, therapies and vaccines’ immunization findings. Methods: A literature overview was produced in order to evaluate the state-of-art in SARS-CoV-2 diagnoses, prognoses, therapies, and prevention. Results: Concerning to the interaction mechanisms with the host, the virus binds to target with its Spike proteins on its surface and uses it as an anchor. The Spike protein targets the ACE2 cell receptor and enters into the cells by using a special enzyme (TMPRSS2). Once the virion is quietly accommodated, it releases its RNA. Proteins and RNA are used in the Golgi apparatus to produce more viruses that are released. Concerning the therapies, different protocols have been developed in observance of the disease severity and comorbidity with a consistent reduction in the mortality rate. Currently, different vaccines are currently in phase IV but a remarkable difference in efficiency has been detected concerning the more recent SARS-CoV-2 variants. Conclusions: Among the many questions in this pandemic state, the one that recurs most is knowing why some people become more seriously ill than others who instead contract the infection as if it was a trivial flu. More studies are necessary to investigate the efficiency of the treatment protocols and vaccines for the more recent detected SARS-CoV-2 variant.

Rapid Maxillary Expansion on the Adolescent Patient: Systematic Review and Case Report

Aim: In the literature, many studies and articles are investigating new devices and approaches to achieve rapid palate expansion through the opening of the palatal suture, and evaluating the skeletal, dental, and soft tissue effects. The purpose of this review was to assess how palatal expansion is performed in adolescent patients with permanent dentition. Furthermore, it was reported as an example of successful orthodontic treatment of an 11-year-old female patient affected by maxillary skeletal transverse deficiency, in permanent dentition. Methods: A search of the literature was conducted on PubMed, Cochrane, Scopus, Embase, and Web of Science databases. Inclusion criteria were the year of publication between 2017 and 2022, patients aged 10 to 16 years in permanent dentition, with transversal discrepancy, treated with tooth-borne, bone-borne, hybrid palatal expanders. Results: A total of 619 articles were identified by the electronic search, and finally, a total of 16 papers were included in the qualitative analysis. Conclusions: From this study, it was assessed that MARPE is more predictable, and it determines a more significant expansion of the suture than the Hyrax expander, with fewer side effects.

Innovative Application of Diathermy in Orthodontics: A Case Report

Introduction: Several strategies have been proposed in the literature to accelerate tooth movement, many of which are invasive and have numerous side effects, such as surgical techniques (corticotomy and piezocision technique). This research investigates to what extent diathermy can accelerate the orthodontic alignment phase. Materials and Methods: A patient with lower teeth crowding index of the same magnitude was selected. The orthodontic treatment with Nickel–Titanium (NiTi) thermal arc 0.015 in the lower arch was performed, associated with a weekly application of diathermy using the intraoral handpiece. The total duration of treatment was three weeks. During each session, an intraoral transducer was employed to stimulate the hard and soft tissues of the left dental hemiarch, which was also orthodontically aligned like the right one. Results: Comparing the tooth movements of four elements of the two hemiarchies, it was found that, overall, the two teeth examined on the treated side underwent a more significant number of changes than on the untreated side, although not by a significant amount. Conclusions: The use of diathermy, according to the authors, is a non-invasive approach that may speed up the orthodontic alignment phase and reduce treatment duration, resulting in a lower risk of caries, gingival recessions, root resorptions, and patient compliance improvement, without side effects. Further studies and an adequate sample size will be needed to confirm the findings.

Early Response and Clinical Efficacy of a Mouthwash Containing Chlorhexidine, Anti Discoloration System, Polyvinylpyrrolidone/Vinyl Acetate and Sodium DNA in Periodontitis Model: A Triple-Blind Randomized Controlled Clinical Trial

Polyvinylpyrrolidone/vinyl acetate (PVP/VA) is a molecule with increased adhesion capacity, and can be associated in the bacterial plaque control with sodium DNA, a natural anti-aging molecule able to improve gingival trophism. The aim of the study is to test at two weeks the antimicrobial and antiplaque properties, subjects affected by chronic periodontitis, showed by a mouthwash containing Chlorhexidine (CHX) 0.2% with Anti Discoloration System (ADS), PVP-VA, and Sodium DNA in comparison with a placebo mouthwash. A single center randomized controlled trial was conducted on a total of fifty-four (54) subjects. In the test Group (n = 27) patients were treated by a 0.2% Chlorhexidine (CHX) mouthwash with ADS, PVP-VA, and Sodium DNA, while a placebo mouthwash was used in the control Group (B). The full mouth plaque score (FMPS), full mouth bleeding score (FMBS), and gingival index (GI) were assessed at baseline, and at 1 and 2 weeks after treatment. FMPS score recorded at baseline (V2) was 52.7 ± 9.2 in the Group Test and 58.2 ± 6.1 in the Group Control (p > 0.05). After 1 week (V3), FMPS was 13.3 ± 5.6 in the Group Test and 18.7 ± 4.3 in the Group Control (p < 0.05), while at V4 (2 weeks), FMPS was 14.2 ± 4.1 in the Group Test and 20.3 ± 5.2 in the Group Control (p < 0.05). FMBS score recorded at baseline (V2) was 46.7 ± 8.7 in the Group Test and 49.2 ± 6.2 in the Group Control (p > 0.05). After 1 week (V3), FMBS was 12.7 ± 4.2 in the test Group Test and 18.5 ± 5.9 in the control Group Control (p < 0.05), while after 2 weeks (V4), it was 13.1 ± 3.2 in the Group Test and 19.8 ± 4.9 Group Control (p < 0.05). This trial has clinically showed the efficacy of a new formulation of chlorhexidine mouthwash in reducing bacterial plaque and gingival inflammation. A significant reduction of inflammation and bleeding scores was found in periodontal patients treated by a mouthwash containing CHX 0.2% with ADS, PVP-VA, and Sodium DNA compared to those treated with a placebo mouthwash.

Transinusal Pathway Removal of an Impacted Third Molar with an Unusual Approach: A Case Report and a Systematic Review of the Literature

Background: The purpose of the present case report was to investigate a very rare ectopic third molar removal by a trans-sinusal approach and report the study findings through a systematic review of the literature on this topic. Case presentation: A 38-year-old female patient was visited for pain at the level of the right maxillary region. No relevant medical history was reported. The CBCT tomography assessment revealed an impacted third tooth at the level of the postero-lateral maxilla. Review Methods: An electronic search was performed through Boolean indicators query on Pubmed/Medline, EMBASE, Cochrane Library databases. The clinical reports were identified and selected in order to perform a descriptive analysis. The surgical approach concerned a trans-sinusal access to the site for the ectopic tooth removal with a lateral antrostomy. No evident inflammatory alteration was associated to the ectopic tooth and a non-relevant post-operative sequelae was reported at the follow up. Results: A total of 34 scientific papers were retrieved from the database search. Only two cases reported a wait-and-see radiographical follow-up approach, while the most common treatment was surgical removal, also for asymptomatic cases. Conclusion: The third-molar ectopic tooth into the maxillary sinus is an uncommon occurrence that is beast treated by an in-chair intraoral tran-sinusal approach, with a consistent reduction of the invasivity, a mild morbidity and a successful functional outcome.

Treatment of Class III Malocclusion and Anterior Crossbite with Aligners: A Case Report

The article describes the orthodontically treated case of a 25-year-old patient with skeletal and dental class III malocclusion, anterior crossbite, which caused functional and aesthetic problems, occlusal trauma, and incisor wear. Treatment with transparent aligners was proposed to meet the patient's needs, using the sequential distalization protocol. While sequential distalization is well documented for class II malocclusion treatment in maxillary arch teeth, further investigations are necessary for class III malocclusions. In fact, lower teeth movements are more complex due to mandibular bone density and the presence of the third molars, which are often extracted to perform distalization. In addition, the use of intermaxillary elastics helps control the proclination of the anterior teeth as a reaction to distalizing forces. At the end of the treatment, the patient reached molar and canine class I and positive overjet and overbite. The inclination of lower incisors and the interincisal angle have improved, resulting in aesthetic and functional enhancement.

Mixed-dust pneumoconiosis in a dental technician: a multidisciplinary diagnosis case report

Background

In dental laboratories, exposure to crystalline silica can occur during procedures that generate suspended mineral dusts, e.g. dispersion of mixing powders, removal of castings from molds grinding, polishing of castings and porcelain, and use of silica sand for blasting. There is also a large list of toxic agents (acrylic resins, polymeric materials, etc.) used to produce removable and fixed prostheses, but also impression materials and more. Using personal protective equipment and other aids reduces the exposure to these potentially harmful agents.

Case presentation

We report the case of a 42-year-old male dental technician who began to suffer from a dry cough and exertional dyspnea after approximately 15 years of work. The operations he conducted for his job resulted in the generation of crystalline silica, aluminum, chromium and titanium dust. The worker did not regularly wear personal protective equipment and some of the above operations were not carried out in closed circuit systems. The Chest X-ray showed diffused micronodules in the pulmonary interstitium of the upper-middle lobes, bilaterally, and a modest left basal pleural effusion. Simple spirometry showed small airway obstruction in its initial stage. High Resolution Computerized Tomography of the chest showed bilateral micronodulation of a miliariform type, with greater profusion to the upper lobes, also present in the visceral pleura, bilaterally. Histological examination showed aggregates of pigment-laden macrophages forming perivascular macules or arranged in a radial pattern around a core of sclerohyalinosis. Scanning Electron Microscopy and Energy Dispersive Spectrometry revealed several mineral particles, typically characterized by the presence of crystalline silica and metal aggregates. The environmental concentrations of total dust and its respirable fraction were all lower than the relative TLV-TWA—ACGIH, yet not negligible.

Conclusions

The above findings and a multidisciplinary assessment led to the diagnosis of mixed dust pneumoconiosis s/q with 2/2 profusion of occupational origin. This diagnosis in a dental technician was supported for the first time in literature by environmental exposure analysis.

COVID-19 Infection in Children and Infants: Current Status on Therapies and Vaccines

Since the beginning in December 2019, the SARS-CoV-2 outbreak appeared to affect mostly the adult population, sparing the vast majority of children who only showed mild symptoms. The purpose of this investigation is to assess the status on the mechanisms that give children and infants this variation in epidemiology compared to the adult population and its impact on therapies and vaccines that are aimed towards them. A literature review, including in vitro studies, reviews, published guidelines and clinical trials was performed. Clinical trials concerned topics that allowed a descriptive synthesis to be produced. Four underlying mechanisms were found that may play a key role in providing COVID-19 protection in babies. No guidelines are available yet for therapy due to insufficient data; support therapy remains the most used. Only two vaccines are approved by the World Health Organization to be used in children from 12 years of age, and there are currently no efficacy or safety data for children below the age of 12 years. The COVID-19 clinical frame infection is milder in children and adolescents. This section of the population can act as vectors and reservoirs and play a key role in the transmission of the infection; therefore, vaccines are paramount. More evidence is required to guide safely the vaccination campaign.

Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure

Background

The eyebrow area is a clinically critical district due to the anatomical complexity and the propensity to aging-related atrophy. Hyaluronic acid fillers have been proposed to recover the dermal volume of the facial and lips regions.

Aim

The aim of the present investigation was to evaluate hyaluronic acid fillers enriched with glycine and proline for the treatment of eyebrow augmentation.

Methods

A total of 15 healthy patients were treated with eyebrow augmentation procedure. The distance between mid-bipupil to lateral eyebrow and mid-eyebrow to the medial eyebrow was measured before, immediately after treatment and at follow-up of 6 months.

Results

The healing period was uneventful, and no evidence of inflammation or swelling associated with the treatment was reported. No macroscopical alteration was reported in the surrounding tissues with no evidences of visible wheals or lumps in the treated sites at the follow-up. Before treatment, the angle was equal to 9.32 ± 0.2°, while after treatment it was 11.21 ± 0.4° (p < 0.01); after three and 6 weeks, it was, respectively, 10.66 ± 0.2° (p<0.05) and 10.02 ± 0.3°(p > 0.05).

Conclusions

The study results suggest that the hyaluronic acid fillers enriched with glycine and proline treatment resulted as being a useful procedure for augmentation, contour and volume definition and elevation of the eyebrow region with a high-level aesthetic result.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Innovative Concepts and Recent Breakthrough for Engineered Graft and Constructs for Bone Regeneration: A Literature Systematic Review

Background: For decades, regenerative medicine and dentistry have been improved with new therapies and innovative clinical protocols. The aim of the present investigation was to evaluate through a critical review the recent innovations in the field of bone regeneration with a focus on the healing potentials and clinical protocols of bone substitutes combined with engineered constructs, growth factors and photobiomodulation applications. Methods: A Boolean systematic search was conducted by PubMed/Medline, PubMed/Central, Web of Science and Google scholar databases according to the PRISMA guidelines. Results: After the initial screening, a total of 304 papers were considered eligible for the qualitative synthesis. The articles included were categorized according to the main topics: alloplastic bone substitutes, autologous teeth derived substitutes, xenografts, platelet-derived concentrates, laser therapy, microbiota and bone metabolism and mesenchymal cells construct. Conclusions: The effectiveness of the present investigation showed that the use of biocompatible and bio-resorbable bone substitutes are related to the high-predictability of the bone regeneration protocols, while the oral microbiota and systemic health of the patient produce a clinical advantage for the long-term success of the regeneration procedures and implant-supported restorations. The use of growth factors is able to reduce the co-morbidity of the regenerative procedure ameliorating the post-operative healing phase. The LLLT is an adjuvant protocol to improve the soft and hard tissues response for bone regeneration treatment protocols.

The Efficacy of a New AMCOP® Elastodontic Protocol for Orthodontic Interceptive Treatment: A Case Series and Literature Overview

BACKGROUND

Elastodontics is a specific interceptive orthodontic treatment that uses removable elastomeric appliances. They are functional appliances that produce neuromuscular, orthopedic and dental effects. Thus, these devices are useful in the developmental age, when skeletal structures are characterized by important plasticity and adaptation capacity, allowing to remove factors responsible for malocclusions. Elastomeric devices are generally well tolerated by patients requiring simple collaboration and management. This work can be useful to update all orthodontists already adopting these appliances or for those who want to approach them for the first time. This study aimed to describe four cases treated with new elastomeric devices called AMCOP Bio-Activators and to provide an overview of elastodontics, its evolution, indications and limits.

METHODS

A total of four clinical cases were presented after a treatment period of 16-20 months to evaluate the clinical and radiological effects of the elastodontic therapy.

RESULTS

The effectiveness of Bio-Activators on clinical cases was evidenced with a significant improvement in skeletal and dentoalveolar relationship, and malocclusion correction in a limited treatment period (16-20 months).

CONCLUSIONS

The Bio-Activators showed clinical effectiveness to achieve therapeutic targets according to a low impact on the patient's compliance.

Evaluation of a new antibacterial coating of the internal chamber of an implant via real time measurement of Volatile Organic Compounds (VOCs)

The aim of the present investigation was to evaluate the efficacy of an antibacterial coating of implant-abutment prosthetic junctions by real time measurement of Volatile Organic Compounds (VOCs). A total of 20 patients and 40 internal prosthetic junction implants were evaluated in the present investigation: 20 fixtures with antibacterial internal coating (Test) and 20 without treatment (Control). The VOCs measurements were evaluated at the baseline (T₀) after the cover unit unscrewing, after 7 days (T₁) and at 14 days (T₂). No significant difference were detected at T0 (baseline), as Test and Control groups showed a VOCs max peak mean respectively of 2.15 ± 0.71 and 2.21 ± 0.69 (p > 0.05). At T₁ and T₂ as significant difference between the Test and Control Groups was detected (p < 0.01). At T2 the Test max peak was 2.29 ± 0.73 and the Control was 3.65 ± 0.91 (p < 0.01). The antibacterial internal coating demonstrated the capacity to prevent microbial VOCS activity at the level of the implant internal chamber and could be useful for long-term peri-implant tissue health.

Genetic Pattern, Orthodontic and Surgical Management of Multiple Supplementary Impacted Teeth in a Rare, Cleidocranial Dysplasia Patient: A Case Report

Background: Cleidocranial dysplasia (CCD) is a rare, autosomal dominant skeletal dysplasia with a prevalence of one per million births. The main causes of CCD are mutations in the core-binding factor alpha-1 (CBFA1) or runt-related transcription factor-2 (RUNX2), located at the 6p21 chromosomal region. RUNX2 plays important roles in osteoblast differentiation, chondrocyte proliferation and differentiation, and tooth formation. The disease is characterized by clavicular aplasia or hypoplasia, Wormian bones, delayed closure of cranial suture, brachycephalic head, maxillary deficiency, retention of primary teeth, inclusion of permanent teeth, and multiple supernumerary teeth. Materials and Methods: A 22-year-old girl suffering from cleidocranial dysplasia with short stature, narrow shoulders, craniofacial manifestations (short face, broad forehead, etc.) and dental anomalies (different lower dental elements under eruption, supernumerary and impacted multiple teeth, etc.) was examined at our service (Complex Operative Unit of Odontostomatology of Policlinico of Bari). RX Orthopantomography (OPG) and cone beam computed tomography (CBCT) were requested to better assess the position of the supernumerary teeth and their relationships with others and to evaluate the bone tissue. Results: Under eruption was probably caused by dental interferences with supernumerary teeth; hence, extractions of supernumerary upper canines and lower premolars were performed under general anaesthesia. Surgery outcome was excellent with good tissue healing and improvements in the therapeutic possibilities with future orthodontics. Conclusions: The objective of this article is to give an update about radiological, clinical, and molecular features of CCD and to alert the health team about the importance of establishing an early diagnosis and an appropriate treatment in these patients to prevent impacted teeth complications and to offer them a better quality of life.

A New Treatment for Stretch Marks and Skin Ptosis with Electromagnetic Fields and Negative Pressure: A Clinical and Histological Study

Background:

Stretch marks (SM) are nowadays the most common aesthetic pathology of the body; in the XX century, it mainly affected pregnant women, while today it also affects teenagers during puberty, boys and girls without distinction. The aim of this study was to evaluate possible variations in the histological structure of the skin—in terms of quality/quantity of the extracellular matrix and of the collagen and elastic fibers—following the electromagnetic fields and negative pressure (V-EMF) treatment as regards hypotonia and SMs.

Materials and Methods:

For the current study, 60 women, aged between 25 and 45, were examined. All of them presented deep, white or pearly white colored SMs having had them for between 12 and 25 years. These were documented, asking patients their level of satisfaction, through pictures and biopsies. All patients underwent a cycle of 6 or 8 weekly sessions; everyone was highly satisfied with the results obtained.

Results:

Biopsies proved that the tissue was reorganized and restored to the original volume, characterized by the production of new, high-quality collagen and elastin molecules, by the reorganization of the basement membrane and by the correct positioning of the melanocytes. No side effects were observed during the treatments. This synergy stands as the most suitable treatment of striae rubra and alba.

Conclusion:

V-EMF enhances the keratinocyte migration base, melanocytes, and promotes neoangiogenesis with the result of improvement in the SM.

Immunity Profiling of COVID-19 Infection, Dynamic Variations of Lymphocyte Subsets, a Comparative Analysis on Four Different Groups

Background: A novel coronavirus (SARS-CoV-2)-induced pneumonia (COVID-19) emerged in December 2019 in China, spreading worldwide. The aim of the present investigation was to evaluate the immunological response and the clinical subset of peripheral lymphocyte subset alteration in COVID-19 infection. Methods: the study was conducted on four different clinical groups (n = 4; total n = 138). Each individual was assigned to different groups based on specific criteria evaluated at the admission such as fever, dyspnea, arterial blood gas analysis (ABG), oral-nasopharyngeal swab/RT-PCR, and thoracic CT-scan. Treatment was performed only after blood samples were collected from each patient (PP and PP) at day 1. The blood samples were analyzed and tested the same day (CBC and Flowcytometry). The positive–positive group (PP n = 45; F = 18/ M = 27; median age = 62.33), comprised individuals affected by COVID-19 who showed fever, dyspnea (ABG = pO2 < 60), confirmed positive by oral-nasopharyngeal swab/RT-PCR and with CT-scan showing ground-glass opacities. The negative–positive (NP; n = 37; F = 11/M = 26; median age = 75.94) or “COVID-like” group comprised individuals with fever and dyspnea (ABG = pO2 < 60), who tested negative to nasopharyngeal swab/RT-PCR, with CT-scans showing ground-glass opacities in the lungs. The negative–affected group (NA; n = 40; F = 14/M = 26; median age = 58.5) included individuals negative to COVID-19 (RT-PCR) but affected by different chronic respiratory diseases (the CT-scans didn’t show ground-glass opacities). Finally, the negative–negative group (NN; n = 16; F = 14/M = 2) included healthy patients (NN; n = 16; median age = 42.62). Data and findings were collected and compared. Results: Lymphocytes (%) cells showed a decline in COVID-19 patients. The subsets showed a significant association with the inflammatory status in COVID-19, especially with regard to increased neutrophils, T-killer, T-active, T-suppressor, and T-CD8+CD38+ in individuals belong to the either COVID-19 and Covid-like NP group. Conclusions: Peripheral lymphocyte subset alteration was associated with the clinical characteristics and progression of COVID-19. The level of sub-set cells T-lymphocytes (either high or low) and B-lymphocytes could be used as an independent predictor for COVID-19 severity and treatment efficacy.

COVID-19 Infection in Children, Infants and Pregnant Subjects: An Overview of Recent Insights and Therapies

BACKGROUND

The SARS-CoV-2 pandemic has involved a severe increase of cases worldwide in a wide range of populations. The aim of the present investigation was to evaluate recent insights about COVID-19 infection in children, infants and pregnant subjects.

METHODS

a literature overview was performed including clinical trials, in vitro studies, reviews and published guidelines regarding the present paper topic. A descriptive synthesis was performed to evaluate recent insights and the effectiveness of therapies for SARS-CoV-2 infection in children, infants and pregnant subjects.

RESULTS

Insufficient data are available regarding the relationship between COVID-19 and the clinical risk of spontaneous abortion and premature foetus death. A decrease in the incidence of COVID-19 could be correlated to a minor expression of ACE2 in childrens' lungs. At present, a modulation of the dose-effect posology for children and infants is necessary.

CONCLUSIONS

Pregnant vertical transmission has been hypothesised for SARS-CoV-2 infection. Vaccines are necessary to achieve mass immunity for children and also pregnant subjects.

Wettability of implant surfaces: Blood vs autologous platelet liquid (APL)

Physicochemical properties of titanium surfaces, such as wettability, influence protein binding, cell adhesion and proliferation, therefore osseointegration. The objective of this study was to investigate the wetting behaviour of two titanium surfaces, sandblasted and double acid etched (group S/E) and sandblasted (group S), using blood and Autologous Platelet Liquid (APL). Surface morphology and roughness were investigated by scanning electron microscopy (SEM) and atomic force microscopy (AFM). The static contact angle (CA) was assessed with the sessile drop technique. The work also evaluates, with SEM observation, the fibrin clot structure that develops from blood and APL, knowing that a greater clot, firmly attached to an implant can facilitate cell migration to the implant interface. Both surfaces exhibited a hydrophobic behaviour, regardless of the wetting liquid used, but the S surface showed higher CA values for both the wetting fluids used. Lower CA values on the S/E surface are attributable to the different surface energy, which depends on different surface topography (the S surfaces were rougher) and on chemical composition. No statistically significant differences between the values of CA of blood and APL were found on the same surfaces. The clot obtained from whole blood differs from the APL clot due to a different cellular composition and fibrin density.

Cannabinoids Drugs and Oral Health-From Recreational Side-Effects to Medicinal Purposes: A Systematic Review

Background: marijuana, the common name for cannabis sativa preparations, is one of the most consumed drug all over the world, both at therapeutical and recreational levels. With the legalization of medical uses of cannabis in many countries, and even its recreational use in most of these, the prevalence of marijuana use has markedly risen over the last decade. At the same time, there is also a higher prevalence in the health concerns related to cannabis use and abuse. Thus, it is mandatory for oral healthcare operators to know and deal with the consequences and effects of cannabis use on oral cavity health. This review will briefly summarize the components of cannabis and the endocannabinoid system, as well as the cellular and molecular mechanisms of biological cannabis action in human cells and biologic activities on tissues. We will also look into oropharyngeal tissue expression of cannabinoid receptors, together with a putative association of cannabis to several oral diseases. Therefore, this review will elaborate the basic biology and physiology of cannabinoids in human oral tissues with the aim of providing a better comprehension of the effects of its use and abuse on oral health, in order to include cannabinoid usage into dental patient health records as well as good medicinal practice. Methods: the paper selection was performed by PubMed/Medline and EMBASE electronic databases, and reported according to the PRISMA guidelines. The scientific products were included for qualitative analysis. Results: the paper search screened a total of 276 papers. After the initial screening and the eligibility assessment, a total of 32 articles were considered for the qualitative analysis. Conclusions: today, cannabis consumption has been correlated to a higher risk of gingival and periodontal disease, oral infection and cancer of the oral cavity, while the physico-chemical activity has not been completely clarified. Further investigations are necessary to evaluate a therapeutic efficacy of this class of drugs for the promising treatment of several different diseases of the salivary glands and oral diseases.

Stabilized zirconia ceramics for dental applications

The research is aiming to obtain at room temperature a new ceramic material containing partially stabilized zirconia with different oxides after sintering used for dental and other technological purposes. Our research proposes a new method based on the use of stabilized zirconia with other oxides to obtain optimized dental material with a lower cost price and / or improved properties to allow wider use of these products to an increased number of patients in dental offices. X-ray diffraction, SEM analysis. FTIR spectroscopy, UVVis and density measurements were accomplished for the three ceramic systems. The correlation between the microstructure and the spectroscopic properties of zirconium stabilized by FTIR spectroscopy, UV-Vis helps understanding the mechanisms associated with the formation of high (tetragonal and / or cubic) temperature zirconia. Along with the simple, less costly preparation method and high purity of the ceramic products our study offers a highly desirable product for technological applications.

Management of anterior open-bite in the deciduous, mixed and permanent dentition stage: a descriptive review

Anterior open bite is one of the most complex malocclusions to manage. The interaction of skeletal, dental, and soft tissue effects can contribute to develop an anterior open bite. The skeletal open bite requires a more complex approach of treatment to reach function, aesthetics, and stability. The approaches vary depending on the causative factors and the age of patients. Treatment approaches for open bite patients differ when dealing with adults and growing patients. The aim of this descriptive review was to summarize the main existing treatment strategies for anterior open bite, from the noninvasive behavioural shaping to the orthodontic intrusion with skeletal anchorage.

Malar augmentation with Hyaluronic acid enriched with glycine and proline: a clinical evaluation

The aging process causes skin modification and wrinkle formation with an alteration of the face harmony and imperfections. The aim of the present investigation was to evaluate a cross-linked hyaluronic acid enriched with glycine and proline for zygomatic malar region infiltrations. A total of twenty healthy female patients were treated for zygomatic hypotonia. The level of patients and surgeon satisfaction was evaluated by global aesthetic improvement scale (GAIS) at baseline, immediately after the procedure and at 6 months from the treatment. The healing phase was uneventful, and no complications were reported in the perioperative and follow-up periods. No significant differences were reported between patients and surgeon GAIS score (p<0.05). A significant difference of GAIS score was reported immediately after the procedure and at 6 months if compared to the baseline (p<0.05). The cross-linked hyaluronic acid enriched with glycine and proline is a useful biomaterial for zygomatic- malar augmentation with no significant local complications and a high stability and satisfaction level of the procedure.

The bad relationship, osteo-decay and diabetes type 2 searching for a link: a literature review

The diabetes and osteoporotic metabolic diseases are characterized by a wide prevalence of the population worldwide and correlated to alteration of the bone tissues. Several cofactors could influence the clinical course and the biochemistry of the pathologies such as human microbiome, nutrition characteristics, gut microbiota activity and interactions with vitamin K and D across IGF/GH and TP53 signaling pathways and the glucose/energy as mechanism for bone tissue health. Moreover, also the calories and sugar consumption seem to be correlated to an increased inflammatory state with several consequences for hematopoiesis and host tissues response. The aim of the present literature review was to highlight the role of osteoporotic diseases and diabetes type 2 link for the bone metabolism. The literature cases showed that a correlation between bone-gut-kidney-heart-CNS-Immunity crosstalk seems to be linked with bone metabolism and health regulation. Moreover, also the aging process could represent a valuable co-factor for the sustaining of the metabolic disorders upon a multi-systemic level.

Correlation between occlusal trauma and oral microbiota: a microbiological investigation

The occlusal trauma has been defined as an injury to the periodontium resulting from occlusal forces that exceeds the reparative capacity of the attachment apparatus. Currently, the effects of occlusal trauma on tooth support tissues, the onset and the progression of periodontal disease are still debated. In fact, researchers started evaluating the possible effects of occlusal discrepancies on incidence, progression, and treatment outcomes of periodontitis, but all the results underlined the more significant role played by microbiological flora. The results of this study show that after 60 days of treating the occlusal trauma, a significant reduction was achieved in the periodontal bacterial flora.

The effectiveness of autologous demineralized tooth graft for the bone ridge preservation: a systematic review of the literature

Resorption of alveolar ridge after tooth extraction often compromises dental implant placement and esthetic. Alveolar ridge preservation is a common procedure performed in order to preserve the pontic site for a prosthetically ideal position. This procedure has already become an indisputable need. Tooth matrix as bone substituted material poses osteoconduction and osteoinduction properties and as autologous graft, this material is free of antigenic reaction. This biomaterial allows the threedimensional reconstruction of the bone, is easy to prepare and has a low cost. The aim of this review is to summarize and put in evidence the properties of tooth as bone substitute and its use in alveolar ridge preservation. Keyword: autologous tooth, autologous graft, bone regeneration, bone substitute, alveolar ridge preservation, alveolar ridge augmentation, socket preservation.

The integumentary system and its microbiota between health and disease

The aim of the present investigation was to evaluate the essential physiological functions of the skin microbiota in human health and diseases. The main characteristics of the normal microbiota in the different anatomical sites have been reported in relation to the main factors, such as the effect of age, on its composition and stability for the eubiosis condition. Moreover, the present overview analyzed the functions and composition and the correct functionality of the skin microbiota in the light of current knowledge. According to several evidence is important preserving the eubiosis of the commensal microbes of the microecosystem (symbiotic and pathogenic), and probiotics are able to counteract the conditions of dysbiosis. Also, it has been shown that there is a crosstalk between gut and skin microbiota that affects human health and is still being studied, and its relationship to the current pandemic SARS-CoV-2.