The prevalence of malocclusal traits and their correlations in mixed dentition children: results from the Italian OHSAR Survey.

PURPOSE: To know the prevalence of malocclusal traits and their correlation in Italian mixed dentition children. MATERIALS AND METHODS: A sample of 1,198 children 7 to 11 years old, who had never undergone orthodontic treatment, were included in the Italian Oral Health of Schoolchildren of the Abruzzo Region (OHSAR) Survey. Canine and molar classes, overbite, overjet, dental crowding, maxillary midline diastema, crossbite and scissorbite were recorded. The canine and molar classes were considered as dependent variables, and their separate correlations with all of the other occlusal traits were analysed by multivariate methods. RESULTS: Over 90% of the children showed at least one malocclusal trait; the mean +/- SD of malocclusal traits was 3.5 +/- 1.8. Gender did not affect the prevalence of any malocclusal traits. Dental class II was correlated with increased overbite and overjet, and negatively correlated with the maxillary midline diastema; dental class III was correlated with decreased overbite and overjet, and crossbite. Asymmetrical dental class was correlated with increased overjet and crossbite. Dental crowding showed very little correlation. CONCLUSIONS: The prevalence of malocclusal traits in Italian children is very high, and more effort is needed to implement early interventions, including close monitoring and modifications of lifestyle.

Prevalence of dental caries in schoolchildren living in rural and urban areas: results from the first region-wide Italian survey.

PURPOSE: The collection of comprehensive epidemiological data for dental caries of Italian schoolchildren in both rural and urban areas. MATERIALS AND METHODS: The dft and DMFT indices were recorded from 27163 6-to-9-year-old children attending the primary schools of Abruzzo, a region of Central Italy, according to the World Health Organization recommendations. RESULTS: The number of surveyed children were 5413, 8359, 8362 and 5026 in the 6-, 7-, 8- and 9-year-old groups respectively; the percentages of children positive for caries were 39.5, 48.3, 54.4 and 60.8 respectively. The mean dft (SD) values of the age groups were 1.57 (2.67), 1.79 (2.59), 1.88 (2.47) and 2.02 (2.45) respectively, with mean DMFT (SD) values of 0.07 (0.37), 0.18 (0.62), 0.37 (0.90) and 0.55 (1.09) respectively. All outcomes were significantly greater in schoolchildren living in rural areas compared with those living in urban areas, and these differences were more pronounced in the permanent dentition of the older groups. Of particular note, there was a SiC Index (DMFT) of 2.22 for the 9-year-old children living in rural areas. CONCLUSION: This survey initially reports the dental caries prevalence in a very large sample of Italian schoolchildren and shows that the WHO global goal for 2000 has been largely achieved in 6-year-old children, although more efforts are needed to reach the new global goal for 2015. The large differences in caries prevalence between different areas (rural and urban) and their behaviour related to the age group of the samples constitute useful findings if prevention programs are to be established in Italy.

Aspartate aminotransferase activity in pulp of orthodontically treated teeth.

This study examines the aspartate aminotransferase activity in the pulp of orthodontically treated teeth. Seventeen healthy male and female subjects (ages: 14.5-19.6; mean 16.8 +/- 1.6 years) who needed extraction of the maxillary first premolars for orthodontic reasons were enrolled in the study. One randomly chosen maxillary first premolar, included in a straight-wire fixed orthodontic appliance and supporting orthodontic force, was considered as the test tooth. The contralateral first premolar, included in the orthodontic appliance but not subjected to mechanical stress, was used as the control tooth. After a week of treatment, the dental pulp tissues were extracted from both experimental teeth. Aspartate aminotransferase activity was significantly elevated in the test teeth as compared with the control teeth. These results demonstrate that in the early phases of treatment, orthodontic force application to the teeth can lead to significant metabolic changes in the pulp of these teeth.

Ability of healthy and inflamed human dental pulp to reduce hydrogen peroxide.

This study examined the defensive ability of human dental pulp against H2O2 in healthy and reversible and irreversible pulpitis tissues through determination of catalase activity by spectrophotometric methods. Thirty-five systemically healthy patients were donors of the pulp tissue, and pulp conditions were assessed using clinical and X-ray evaluations. Catalase activity was 1.61 +/- 0.23 U mg(-1) protein in the healthy tissues, 2.99 +/- 0.45 U mg(-1) protein in the reversible pulpitis tissues, and 2.44 +/- 467 mU mg(-1) protein in the irreversible pulpitis tissues. All differences between the groups were statistically significant. These results point to a role for catalase during dental pulp inflammation in humans, and therefore demonstrate an inherent biological defense system against reactive oxidants in human dental pulp.

A positioning device for computed tomography: a clinical report.

This clinical report describes a device (Centrascan) used to assist in the correct alignment of the patient's head during computed tomography (CT) assessment of a proposed implant site. To obtain the desired anatomic detail, CT requires precise alignment of the axial images at right angles to the long axis of the proposed implant. This clinical report compared the anatomic morphology of a projected implant site derived from axial images provided by DentaScan software analysis of the CT scan acquisition. Images from a conventional scan, with the patient's head aligned along the frontal plane (perpendicular to the Frankfort plane) and along the sagittal plane (coinciding with either the cortical bone of the hard palate or the inferior border of the mandible), were compared with images acquired by use of the Centrascan device. The two scans differed substantially. In particular, the cross-sectional images obtained by the conventional procedure showed a distorted anatomy; conversely, the images obtained by the Centrascan procedure showed a better reproduction of the examined area. The Centrascan device seemed to help the radiologist achieve a more correct alignment of the patient's head during CT scan acquisition. Further studies are necessary to fully explore the relative technical merits of the Centrascan device.

Subpedicle acellular dermal matrix graft and autogenous connective tissue graft in the treatment of gingival recessions: a comparative 1-year clinical study.

BACKGROUND: Many surgical techniques have been proposed for the correction of dental root exposition. Among these, bilaminar techniques (BTs) have been reported as offering the best results in terms of root coverage (RC). However, BTs require a second surgical site to harvest the graft, with discomfort for the patient. The use of an acellular dermal matrix (ADM) avoids the need for a donor site. The aim of this study was to compare the clinical results of 2 BTs by autogenous connective tissue (CT) or ADM. METHODS: In 30 systemically healthy, non-smoking patients aged 34.5 +/- 5.2 years, who showed no periodontal pockets >4 mm after a hygienic phase, a Miller's class I or II gingival recession was treated for root coverage. All patients underwent a BT: in 15 patients, an autogenous connective tissue graft was employed (CT group); in the other 15 subjects, ADM was used as a subepithelial graft (ADM group). Prior to and 1 year after surgical treatment, the following clinical parameters were recorded: gingival recession (GR), probing depth (PD), clinical attachment level (CAL), width of keratinized tissue (KT), and gingival thickness (GT); the percentage of RC (%RC) was also calculated, and the data were statistically analyzed. The number of weeks needed to obtain complete healing with mature tissue appearance was also recorded. RESULTS: Both groups yielded significant improvements in terms of GR decrease, CAL and KT gain, and GT increase as compared to baseline values. The mean %RCs were 88.80 +/- 11.65% and 83.33 +/- 11.40% in the CT and ADM groups, respectively. Complete RC was observed in 46.6% of patients from the CT group, and 26.6% of the ADM group patients. No significant differences were observed between the two techniques for GR, CAL, and GT improvements; however, the CT group produced a significantly (P <0.01) greater increase in KT as compared to the ADM group. Complete healing of the surgical procedure was observed 6.20 +/- 1.01 and 8.93 +/- 1.33 weeks after suture removal in the CT and ADM groups, respectively (P <0.001). CONCLUSIONS: The CT and ADM subepithelial grafts were similarly able to successfully treat gingival recession defects; however, the CT group obtained a significantly greater increase in KT, and showed a quicker complete healing.

Immunosuppressive treatment in dialysis patients.

Immunosuppressive treatment is a critical procedure in dialysis patients, in whom an increased risk of infection is already present. Haemodialytic treatment increases the patient's susceptibility to bacterial infection, mainly by impairing polymorphonuclear leukocyte phagocytosis, but it can also restore the patient's immunological defences by improving the T-cell function, which is reduced by pre-dialysis uraemia. Patients on dialysis usually continue the immunosuppressive treatment that had been established for the illness that caused their renal failure [e.g. systemic lupus erythematosus (SLE) or renal vasculitis]. Less frequently, patients on dialysis need immunosuppression for immunological or inflammatory diseases that appear 'de novo' after initiation of dialysis. SLE and antineutrophil cytoplasmic antibody (ANCA)-related vasculitides are immunological illnesses that frequently cause end-stage renal failure (ESRF). A reduction in serological and/or clinical activity is usually observed in SLE patients after they reach ESRF, but a similar or increased frequency of extrarenal relapse episodes in lupus patients after the beginning of the dialysis, compared with the pre-dialysis period, has also been described. Frequency of relapse episodes in patients on dialysis treatment for ANCA-related vasculitides varies from 10 to 30% per patient/year in different reports, and it is higher than the frequency of relapses after renal transplantation; anti-rejection therapy seems to be the most likely protective factor in these conditions. The treatment of relapse episodes in SLE or ANCA vasculitis in dialysis-dependent patients is usually not different from treatment of relapses in patients with dialysis-independent renal function. However, the risk of severe infection caused by immunosuppressive treatment is relevantly higher in dialysis patients. Furthermore, there is a lack of prospective controlled studies indicating the optimal management of immunosuppressive protocols in dialysis patients. A particularly careful assessment of the patient's risks and benefits is necessary in deciding how long immunosuppressive treatment should last after acute or rapidly progressive renal damage, that should require dialysis treatment, in patients with SLE or ANCA vasculitis. In the above conditions, the risks of prolonging immunosuppressive treatment must be balanced against the relatively good prognosis offered to these patients by dialysis and renal transplantation. In a retrospective review of 24 patients receiving long-term steroid therapy (>3 months) in our dialysis unit in the past 5 years, we found relevant clinical differences in the patients receiving steroid treatment compared with 24 controls. Steroid-treated patients showed less favourable nutritional conditions, with lower serum albumin and body mass index vs non-steroid-treated patients; moreover, C-reactive protein values were persistently higher in the steroid-treated group. Steroid treatment in these patients was usually performed at the beginning of regular dialysis, as a continuation of the treatment that started before the initiation of dialysis. Only two patients, who needed a prolonged low-dose steroidal treatment to control a malnutrition-inflammation-atherosclerosis (MIA) syndrome, started steroids many years after beginning dialysis. Steroid treatment was effective in improving the nutritional condition and inflammatory symptoms in these two patients after all conventional measures had failed.

Early involvement of the temporal area in attentional selection of grating orientation: an ERP study.

The aim of the present study was to investigate the neural mechanisms of stimulus orientation selection in humans by recording event-related potentials (ERPs) of the brain with a 32-channel montage. Stimuli were isoluminant black-and-white gratings (3 cpd) having an orientation of 50, 70, 90, 110 and 130, randomly presented in the foveal portion (2 of visual angle) of the central visual field. The task consisted in selectively attending and responding to one of the five grating orientations, while ignoring the others. ERP results showed that orientation selection affected neural processing starting already at an early post-stimulus latency. The P1 component (80-140 ms) measured at temporal area, which might well be reflecting the activity of the ventral stream (i.e. 'WHAT' system) of the visual pathways, showed an enhanced amplitude for target orientations. These effects increased with progressive neural processing over time as reflected by selection negativity (SN) and P300 components. In addition, both reaction times (RTs) and ERPs showed a strong 'oblique' effect, very probably reflecting the perceptual predominance of orthogonal versus oblique stimulus orientation in the human visual system: RTs were much faster, and SN and P300 components much larger, to gratings presented vertically than in other orientations.