Prevalence of myopia in a population with malocclusions.

AIM: The purpose of this study was to investigate the prevalence of myopia among a paediatric population with malocclusions. MATERIALS AND METHODS: A total of 322 consecutive patients of the department of Orthodontics and Gnathology, Dental Clinic, University of L'Aquila, were enlisted for the study and 292 were selected according to the exclusion criteria. Pretreatment diagnostic data, which included radiographic cephalometric and dental cast evaluation, were recorded and presence of myopia was assessed through an ophthalmological examination. Differences in the prevalence of myopia by sex and malocclusion were analysed by using Pearson's chi-square and Fisher's exact tests. RESULTS: According to the sagittal malocclusion, patients were classified as Class I (N=162), Class II division 1 (N=75), Class II division 2 (N=38), or Class III (N=12). No gender influence was found for myopia or malocclusion. No differences were recorded when analysing the influence of sex on the prevalence of myopia in classes of malocclusion. A statistical significant higher prevalence was found for subjects showing myopia in Class II division 1 malocclusion, while no other significant differences were found for prevalence in the other classes of malocclusions. DISCUSSION: Few studies investigated a possible relationship between the ocular and stomatognathic system, and no data are available in the scientific literature. A higher prevalence of myopia was found in patients with Class II division 1: as expected no other significant association was found. CONCLUSION: The findings of the present study suggest a possible association between myopia and Class II, but further studies are needed to confirm and explain this observation.

Neuromuscular diagnosis in orthodontics: effects of TENS on maxillo-mandibular relationship.

AIM: This study was conducted in order to assess the changes in the occlusal position of the mandible after Ultra Low Frequency (ULF)-TENS relaxing procedure in children with diagnosed functional mandibular lateral deviation. METHODS: This study was performed on 20 children, aged between 8 and 12 years, with a mean age of 10 years (SD 0.79) with functional mandibular lateral deviation, diagnosed by clinical and cephalometric evaluation, referred to the Dental Clinic for paediatric dental care. Diagnostic neuromuscular registrations were made for all children, and their casts mounted on articulator Galetti at the myocentric position and compared to casts provided of a wax bite registration in intercuspal position. RESULTS: The alignment of the midline after TENS was not punctual (p >0.05). Compared with the existing intercuspal position, neuromuscular registration showed improvement in 10 (50%) patients, 6 patients (30%) showed no changes, while worsening of the tooth-midline discrepancy was assessed in the remaining 4 (20%). The molar relationship did not follow the same trend of the midline because of the three-dimensional changes in the maxillo-mandibular relationship induced by TENS. After TENS there was a significant correlation between midline and right side deviation (r >0.65), there was no correlation between midline and the left side (r <0.65). Furthermore, right molar movement showed no correlation with the contralateral molar (r <0.65). The posterior areas of the arch were moving in a very unpredictable way, resulting in the diagnosis and prognosis of mandibular lateral deviation as absolutely individual and unpredictable. Conclusion This study suggests that TENS recorded occlusion is an interesting diagnostic approach in orthodontics since it allows visualising the trends of the neuromuscular system.

Dental caries and bone mineral density: a cross sectional study.

AIM: The relationship between bone mineral density (BMD), age and dental caries has been studied. Quantitative ultrasonography (QUS) is an economic, non invasive, and reproducible method for measuring both bone mineral density and bone elasticity in growing subjects in large populations. METHODS: This study evaluated the relationship between BMD and prevalence of dental caries (Decayed Missing Filled Tooth - DMFT) in 540 healthy adolescent with mean age 12.3 years, age range 10 to 15 years, resident in two provinces in south Italy. BMD was measured using QUS by calculating the speed of sound (m/s) on the last four fingers of the non dominant hand, with the estimate thus obtained being defined as the AD-SoS (Amplitude-Dependent Speed of Sound and categorised as AD-SoS < or = 1900 m/s and AD-SoS > 1900 m/s). Occurrence of dental caries was defined using the DMFT index (DMFT=0 and DMFT > 0). RESULTS: The results of the multifactorial analysis, carried out with logistic model, confirms the expected statistically significant association between response (DMFT) and explicative variables -- AD-SoS (P < 0.006) and Age (P < 0.004). CONCLUSION: Greater bone mineralisation (AD-SoS1900 m/s) and younger age (Age < or =12 years) are dental caries prevention factors: the probability to have caries for the subjects in such conditions is 0.34, about the half of that recorded in the subjects with lower bone mineralisation and older age (0.62).

Relationship between mandibular deviation and ocular convergence.

Recent studies have confirmed the relationship between head posture, mandibular position and visual focusing. A case-controlled study was conducted to assess the occurrence of ocular convergence defects between subjects with functional mandibular latero-deviation and healthy subjects in pediatric age. Sixty subjects (the study group) presented mandibular latero-deviation classified as functional according to the use of a clinical examination and frontal and basal tele-radiography. Sixty subjects without functional mandibular laterodeviation (control group) were selected randomly from all subjects seeking pediatric dental care and matched by gender and age to study group. All one hundred and twenty subjects were submitted to orthoptic tests performed by the same operator. These results seemed to confirm that in mandibular latero-deviation subjects ocular convergence defects occurred in greater frequency than in controls underlining the importance of role of pediatric dentistry among interdisciplinary cooperation.

[Histopathological and therapeutical aspects of cervical lesions]. / Aspetti istopatologici e terapeutici delle lesioni cervicali.

The term "cervical lesions" definies all the alterations consisting in a loss of hard dental tissues located along the cement-enamel junction, and may be more specifically defined as carious lesions (LCC) and non-carious lesions (NCCL). The non-carious cervical lesions are characterized by the loss of mineralised dental tissue in the absence of a carious process. This definition includes three different lesion categories: abrasion, erosion and the cervical lesions caused by stress (abfractions). In this paper the authors explain the histological, clinical, preventive findings of NCCL and try to give some guidelines to choose the appropriate material to restore different types of non carious cervical lesions.

The anxiety in bruxer child. A case-control study.

BACKGROUND: The etiopathogenesis of bruxism in children is not clear although different authors would associate it with several factors, changes in dentition, malocclusions, certain parasomnias and most notably emotional stress. This study was performed to test the hypothesis that anxiety states measured by "Anxiety Scale for evolutive age" may affect the development of bruxism. METHODS: A total of eighty-six children, aged between 7 and 1, were evaluated. In the study-group were enlisted forty-three children with bruxism selected among patients afferent to the paediatric dentistry clinic. The forty-three non bruxer children, the control group, were chosen through the Pair Matching procedures, so that each bruxer child had a matching age case control. The gravity of bruxism was scored by means of 0 to 3 graduated scale of dental wear. The psychological aspects were estimated by means of an Anxiety Scale for evolutive age. Statistical analysis was undertaken using the "Odds Ratio" on statistically significant values. The most significant level was evaluated by the Mc Nemar test. RESULTS: Remarkable differences in anxiety levels were found among the children of the two groups; 72% of bruxers showed significant anxiety scores versus 12% of non bruxers. The results of Odds Ratio reveal that a bruxer child has a 16 times greater probability to be anxious than an non bruxer one. CONCLUSIONS: The data provide support for the concept that anxiety state is a prominent factor in the development of bruxing behaviour in children.

[Temporomandibular disorders in pediatric age]. / Disordini temporo-mandibolari in età pediatrica.

In this work the authors consider TMJ disorders in children, evaluating the epidemiological, etiopathogenetic and diagnostic aspects compared to the TMJ pathology in adults and with reference to recent literature. In order to achieve a better understanding of TMJ disorders in children and to promote an appropriate prevention and therapeutic approach, four questions are raised: 1) What are the signs and the symptoms of TMJ disorders during the growth? 2) What factors are associated with TMJ disorders? 3) What is the prognostic meaning of the signs and the symptoms? 4) What is the importance of TMJ disorders in a protocol which considers treatment needs and priority?

[Oral premedication with clonidine as an alternative in dental practice. The effects on the pain threshold, blood pressure and salivary flow]. / La premedicazione orale con clonidina come alternativa nella pratica odontoiatrica. Effetti sulla soglia del dolore, pressione sanguigna e flusso salivare.

BACKGROUND: Clonidine, an alpha 2-adrenoceptor agonist, has been recently shown to be effective in conscious sedation because of its analgesic and sedative properties, having also proven to be active in reducing neuroendocrine responses to stressful stimuli perioperatively. The current study was designed to investigate the efficacy of 150 micrograms oral clonidine as a premedicant in dentistry. METHODS: In a prospective, randomized, double-blind controlled clinical trial, 40 patients, aged 16-64 yr, undergoing conservative, or prosthetic, or dental surgery procedures, received placebo (n = 20) or 150 micrograms of oral clonidine (n = 20) 90 min before the estimated time of induction of local anesthesia. A blinded observer recorded: salivary flow, systolic and diastolic blood pressure each 30 min lasting 2-3 hours, as well as the degree of pain and sedation intra and postoperatively. RESULTS: Clonidine produced significant salivary flow reduction (p < 0.001) and sedation (p < 0.001) as well as significant difference in postoperative pain scores (p < 0.05) compared to placebo. Xerostomia persisted postoperatively in clonidine premedicated patients as compared to those given the placebo (p < 0.01). Systolic blood pressure decreased significantly only after 120 (p < 0.01) and 150 min (p < 0.001) following clonidine pretreatment, but none of the patients were treated for hypotension. 55% of the clonidine treated patients positively evaluated the experience. CONCLUSIONS: These results suggest that a dose of 150 micrograms of clonidine, given orally 90 min preoperatively, is an effective premedication in dentistry, without causing excessive haemodynamic depression and sedation, and moreover confirm that the oral route of administration is very well accepted.

[Indices of treatment needs in orthodontics: the applicability of the DAI (Dental Aesthetic Index)]. / Indici di necessità di trattamento in ortodonzia: l'applicabilità del DAI (Dental Aesthetic Index).

The objective assessment of esthetic impairment and relative psychosocial handicap for unacceptable dental aspect (useful for characterizing the need of treatment), could be satisfied by an index that measures each individual's occlusal trait and the psychological impact of the same. An index with these characteristics was suggested by Cons and Jenny, already since 1985. This is an index (DAI: Dental Aesthetic Index) designed specifically to measure dental esthetics, based on esthetic standards socially defined and focused through an extensive and finalized search. Therefore this index assesses the social acceptability of the dental appearance based on the public perception of dental esthetics. The authors, in this work, indicate as measuring the objective traits of occlusion and arriving to final score trough simple calculation. This score provides severity levels of esthetic, psychologic and functional impairment relative to dental aspect in examination.

[Scanning electron microscopic study of the surface finish of the round sections of preformed arches of NiTi (orthodontic wires made of nickel/titanium]. / Studio al SEM della finitura superficiale di archi preformati NiTi a sezione tonda.

The authors indicate the advantageous characteristics of NiTi wire, focusing the attention on finishing surface accuracy. Every surface damage can become the start of a fracture.

[Papilloma of the palate. Clinical and histopathology]. / Papilloma del palato. Clinica ed istopatologia.

An asymptomatic, exophytic and unusually large mass of hard and soft palate is presented. Its papillary surface architecture is characteristic of an oral squamous papilloma. The cause is unknown. Recurrent or malignant change, or both, are possible.

[Diazepam versus midazolam for "wakeful sedation" in oral surgery]. / Diazepam versus midazolam nella "sedazione vigile" in chirurgia orale.

I.v. midazolam was compared with diazepam in 112 dental outpatients in order to obtain a control of sedation. Midazolam has shown better results in all the parameters evaluated (memory scale, pharmacokinetics and pharmacodynamics values) and in controlling sedation. The Authors consider midazolam as a preferred drug in dental outpatients and hope to get it available also in Italy.

[Severe tooth agenesis. Presentation of a case]. / Agenesia dentaria grave. Presentazione di un caso.

In the present work the Authors describe a case of a patient affected by Duchenne disease as well as by dental multiple agenesis. It is a particular case of such rare syndromes in the same subject.

[Subcutaneous emphysema during intraligamental anesthesia]. / Enfisema sottocutaneo durante anestesia intralegamentosa.

Periodontal ligament anaesthesia (PDLA) is a good choice to most common local anaesthesia methods. In the present work the Authors report a case of subcutaneous emphysema as adverse effect of this injection technique.

[Epidemiological and clinical study of dental agenesis]. / Contributo allo studio epidemiologico e clinico delle agenesie dentarie.

This work realized thanks to exchange by IFMSA happened at Medical School Praga's invitation, describes two researchs. The first presents the casuistry of scholastic czechoslovak population; the second 87 cases with multiple teeth agenesis observed at Pedodontic's Clinical of Praga's Hospital Motol. The Authors, after describing the review of literature about epidemiology, etiopathogenetic, symptomatology and diagnosis aspects, present a personal contribution in accordance with existing literature.