Autism spectrum disorder and paediatric dentistry: A narrative overview of intervention strategy and introduction of an innovative technological intervention method.

AIM: When treating patients with Autism Spectrum Disorder (ASD) the doctor-patient relationship can be very challenging. The dentist is often forced to work under general anaesthesia or conscious sedation. Children with ASD are patients with an increased risk of caries due to poor oral hygiene, a cariogenic diet and the use of xerostomal drugs. In this work therapeutic strategies used to treat this kind of patients are evaluated and a new method to treat children with ASD is presented in order to increase awareness about this condition in the dental field. METHODS: The Atlas Center (a non-profit organisation in Peurgia, Italy) has developed a software, called paINTeraction, that allows these special children to immerse themselves in a virtual reality with the help of an operator. Through this system the child can explore the dental office (and all its sounds and noises) before the real dental visit, thus connecting to the dental professional, achieving greater compliance and reducing anxiety. CONCLUSION: paINTeraction, with the use of digital technology tools, may be particularly well suited to introduce patients to the therapeutic environment, particularly in the dental setting.

Index of Orthodontic Treatment Need (IOTN) and distribution of malocclusion traits in a population of growing patients attending a public orthodontic service in Perugia (Italy).

AIM: Malocclusions are widespread all over the world with high prevalence values and represent a social vulnerability and health problem because of the important burden of orthodontic treatment for both families and the public health service. The Italian Ministry of Health identified the principles for priority setting in dental care, i.e. patients with IOTN (Index of Orthodontic Treatment Need) 4-5 and those in particular conditions of health or social vulnerability. METHODS: A retrospective study was carried out to assess the IOTN and malocclusion in a population attending the public Orthodontic Health Service of Perugia (Italy) from September 2018 to February 2020. Medical charts, social income information, study models, photos and lateral cephalograms were examined to assess the orthodontic treatment need. CONCLUSION: Orthodontic health service in Italy tends to have many patients on the waiting list, while the 72% of subject under orthodontic treatment are not part of the orthodontic priority (IOTN grade 4-5). This study suggests the heath system to guarantee a priority of need for orthodontic treatment for patients with health vulnerabilities.

Postoperative bleeding risk of direct oral anticoagulants after oral surgery procedures: a systematic review and meta-analysis.

Direct oral anticoagulants (dabigatran, rivaroxaban, apixaban and edoxaban; DOACs) have been introduced to improve safety and superior therapeutic value compared to their predecessors such as warfarin or enoxaparin. The aim of this systematic review and meta-analysis was to assess the postoperative bleeding risk of DOACs during oral surgery procedures. Systematic searches were performed in electronic databases including PubMed, Scopus, Web of Science and Cochrane Library. Thirteen studies were included in the qualitative synthesis: two retrospective case-control studies, five prospective case-control studies, three cross-sectional studies, two case series and a case report; while only six studies were statistically analysed. The risk ratio of postoperative bleeding in DOACs patients was significantly greater than in healthy patients (3.04; 95% confidence interval (CI)=1.31-7.04). This is especially true for rivaroxaban (4.13; 95% CI=1.25-13.69), and less so for dabigatran which presented a risk ratio similar to that of healthy patients (1.00; 95% CI=0.21-4.82). However, further research is required to support these results. Both apixaban and edoxaban were excluded from statistical analysis due to the lack of clinical studies.

Fine-tuning of Th17 Cytokines in Periodontal Disease by IL-10.

Periodontitis (PD) is a chronic disease caused by the host inflammatory response to bacteria colonizing the oral cavity. In addition to tolerance to oral microbiome, a fine-tuned balance of IL-10 levels is critical to efficiently mount antimicrobial resistance without causing immunopathology. Clinical and animal studies support that adaptive T-helper (Th) cytokines are involved in the pathogenesis of alveolar bone destruction in PD. However, it remains unclear what type of Th response is related to human PD progression and what role IL-10 has on this process. We addressed the contribution of IL-10 in limiting Th1 and Th17 inflammatory response in murine and human PD. Through a combination of basic and translational approaches involving selected cytokine-deficient mice as well as human genetic epidemiology, our results demonstrate the requirement for IL-10 in fine-tuning the levels of Th17 (IL-17A and IL-17F) cytokines in experimental and human PD. Of novelty, we found that IL-17F correlated with protection in murine and human PD and was positively regulated by IL-10. To our knowledge, this is the first demonstration of the protective role for IL-17F in PD, its positive regulation by IL-10, and the potential differential role for IL-17A and IL-17F in periodontal disease.

N-acetyl-beta-D-glucosaminidase activity in urine of dental personnel.

BACKGROUND: Dental personnel is exposed to several potential nephrotoxic agents. Urinary N-acetyl-beta-d-glucosaminidase (U-NAG) activity has emerged as a sensitive marker of early nephrotoxicity. METHODS: U-NAG was evaluated, by fluorimetric assay, in urine from 30 healthy subjects and 30 dental personnels. RESULTS: The median value of U-NAG activity (133.5 U/mmol urinary creatinine (U-Cr) in urines of dental personnel was not statistically different (P>0.05) from activity (100.7 U/mmol U-Cr) of control urines. CONCLUSIONS: The results suggest that, for dental personnel, exposure to potential nephrotoxic agents is not usually high enough to increase U-NAG activity.

[A rare odontogenic calcifying epithelial tumor, or Pindborg tumor. Report of a clinical case nd review of the literature]. / Raro tumore odontogeno epiteliale calcificante o tumore di Pindborg. Presentazione di un caso clinico e revisione della letteratura.

Clinical, histological and embryogenetic features of calcifying epithelial odontogenic tumor or Pindborg's tumor are described. A case of Pindborg's tumor in the molar region of the right mandible in a 66 year old male patient is presented. Standard X-ray examinations and CT scan were performed in order to obtain information about tumor's size. The histologic features revealed the presence of a homogeneous substance resembling amyloid and many cells filled by calcified material in the form of concentric Liesegang's rings. Treatment methods are also discussed.

[Tests on ionic release from glass-ionomer cements]. / Prove sperimentali sul rilascio ionico da parte di sistemi ionomerovetrosi.

BACKGROUND: Dissolution process in oral liquids by the presence of glass-ionomer systems (due to surface corrosion, to diffusion through solutions and through mass) make an ionic release (particularly F, Al, Pb, As) which is a non secondary problem, due to the usual utilization of these materials in pedodontic and restorative dentistry. METHODS: In this work, considering the high toxicity of low quantity of Arsenic ion, a comparative research has been made in order to determine, by using high level liquid Cromatography (HPCL), the quantity in ppm of As hydro- and acid soluble given by five ionomeric products, in water and in nitric acid concentrated solution. RESULTS AND CONCLUSIONS: The results show that in some products arsenical concentrations are higher then the quantity accepted by ISO-FDI; therefore, a better control in the production of these products is needed as well as a limited use in dentistry. It is suggested to use glass-ionomer systems in patients with dental dike and varnish on the surfaces that are in contact with oral liquids action.