Childhood overweight-obesity and periodontal diseases: is there a real correlation?

OBJECTIVE: The association between obesity and periodontitis has been extensively investigated in adults but not in young people. The aim of this study was to examine the association between overweight-obesity and periodontal disease in pediatric subjects. METHODS: Controlled cross-sectional study involving 100 school children of both gender (50 M and 50 F) between 7 and 12 years of age (mean age 9,19±1,57). Two groups were formed based on Body Mass Index value: test group with BMI ≥ 25 Kg/m2 and control group with BMI ≤ 24 Kg/m2. Diet intake and oral hygiene habits were recorded by a specific questionnaire and the periodontal clinical parameters were evaluated. RESULTS: The periodontal examination in the control group revealed a full-mouth plaque score (FMPS) value equal to 21.86% against 50.08% in the group of patients overweight/obese; the full-mouth bleeding score (FMBS) in the control group amounted to 12.7% against 26.24% of test group. No patient in either group included in the study presented a probing pocket depth (PPD) ≥3, so a significant difference regarding this value was not found. Regarding the frequency and quantity of food consumption, the number of obese patients who did not follow a balanced diet largely exceeded the number of normal-weight patients (70 versus 20%). CONCLUSIONS: These results focus the attention on the negative impact of obesity on gingival health in young subjects, probably due to a combination of metabolic and inflammatory profiles and the result of a careless attitude towards prevention diseases of the oral cavity.

Surgical Management of Compound Odontoma Associated with Unerupted Tooth.

Odontomas represent the most common type of odontogenic benign jaws tumors among patients younger than 20 years of age. These tumors are composed of enamel, dentine, cementum, and pulp tissue. According to the World Health Organization classification, two distinct types of odontomas are acknowledged: complex and compound odontoma. In complex odontomas, all dental tissues are formed, but appeared without an organized structure. In compound odontomas, all dental tissues are arranged in numerous tooth-like structures known as denticles. Compound odontomas are often associated with impacted adjacent permanent teeth and their surgical removal represents the best therapeutic option. A case of a 20-year-old male patient with a compound odontoma-associated of impacted maxillary canine is presented. A minimally invasive surgical technique is adopted to remove the least amount of bone tissue as far as possible.

Immediate loading of post-extractive single-tooth implants: a 1-year prospective study.

PURPOSE: The aim of this prospective clinical trial was to assess clinical, radiological, and esthetic outcomes of immediate-loaded post-extractive implants after 1 year of follow-up. MATERIALS AND METHODS: Twenty-four consecutive patients (15 females and nine males) with a mean age of 47.27 years (range 35-65) requiring single-tooth extraction in the maxillary or mandibular anterior or premolar areas were enrolled. Twenty-five NobelActive implants (Nobel Biocare, Göteborg, Sweden) were placed and loaded immediately after tooth extraction. The definitive prosthetic restoration was delivered 6 months later. Clinical parameters, marginal bone loss, as well as, pink and white esthetic scores (PES and WES) were evaluated at 3, 6, and 12 months after implant placement. RESULTS: After 12-month follow-up period, a success rate of 91.67% was reported: Two of the 25 initially placed implants were lost after 4 weeks due to lack of osseointegration. The mean marginal bone loss after 1-year follow-up was 0.383 (SD ± 0.749) at mesial site and 0.278 (SD ± 0.595) at distal site. No statistically significant changes in the full-mouth plaque score (FMPS) and in the full-mouth bleeding score (FMBS) were observed from baseline to 12 months. The mean total PES/WES was 17.13 ± 1.91 (range: 13-20). None of 23 implants had an overall score <12 (threshold of clinical acceptability). CONCLUSION: Within the limitations of the present study, when careful patient selection and strict clinical protocol are observed, the immediate placement and loading of a single NobelActive(™) implant in a fresh extraction socket may be considered a valuable and predictable option in terms of implant success as well as hard and soft tissues stability.

Graftless sinus augmentation technique with contextual placement of implants: a case report.

INTRODUCTION: The positioning of implants in the jaw bones with contextual graftless lateral approach sinus lifting is finding an increasingly broad consensus in the literature. Since the 1970s, various clinical research projects have been conducted on applications of biological and synthetic biomaterials in bone regenerative surgery, both in sinus lift procedures and in cystic cavity filling after cystectomy or in bone defects in regenerative periodontal surgery. Currently, we are finding that there is an increasing trend of clinicians aiming to adopt graftless techniques, with satisfactory results in terms of implant survival in the long term. In our study, through a case report, we describe a variant of graftless sinus augmentation technique with contextual implant placement, emphasizing the role of the blood clot, combined with collagen sponges, as a natural scaffold and the osteogenic potential of the subantral membrane in guided bone regeneration, with reduced morbidity of the patient. CASE PRESENTATION: To describe the surgical technique, the clinical case of a 38-year-old Caucasian woman with a lateral posterior edentulism was selected. The rehabilitation was solved by a graftless sinus augmentation technique with a contextual implant placement. For each implant, a resonance frequency analysis evaluation was reported as implant stability quotient values. The performance of the implant stability quotient values followed a gradual increase from time zero to the sixth month, as the clot was differentiated into osteoid tissue and then into bone tissue, due to the scaffold effect conferred by the equine collagen sponge. The stabilization phase took place between the fourth and the sixth month, according to the implant stability quotient values. CONCLUSIONS: Our graftless sinus augmentation technique seems to be very predictable thanks to the osteoconductive principles on which it is based, and in association with the proper management of peri-implant soft tissue, so as to increase the amount of keratinized tissue, which could represent the new gold standard for this type of rehabilitation in the future.

Unusual symptomatic inclusion cysts in a newborn: a case report.

INTRODUCTION: Dental lamina cysts are cysts that occur as white or pink small nodules, often multiple, approximately 1 to 3mm in diameter. They are typically located on the midpalatine raphe and less frequently on the maxillary and mandibular alveolar mucosa; in the latter case these can be appear to be neonatal teeth.On microscopic examination, these lesions show a stratified squamous epithelium (two to three cell layers); it is possible to find protein, keratin and/or exfoliated epithelial cells in the lumen of the lesions.Neonatal cysts usually show no particular symptoms. They are associated with an excellent prognosis because they regress spontaneously within a few weeks and are not associated to any complications. However, if pain, bleeding or other symptoms occur, a surgical excision is required. CASE PRESENTATION: In this paper, we present an anomalous case of symptomatic dental lamina cyst which affected a 60-day-old male Caucasian newborn. The surgical treatment was elective in this case and 6-month follow-ups were mandatory. CONCLUSIONS: We can underline the successful predictability of the surgical approach; however, we consider that the treatment choice should take place in the light of medical history and clinical considerations, and always be evaluated on a case-by-case basis. Further studies and reviews in this field should be performed in order to suggest guidelines for clinicians, although these cases are rare.

Fused upper central incisors: management of two clinical cases.

This paper reports the management of two clinical cases, in which the upper right central incisor was fused with a supernumerary tooth and the upper left central incisor was macrodontic. A radiographic examination revealed that the fused teeth had two separate roots. Hemisectioning of the fused teeth was performed, the supernumerary portion was extracted and the remaining part was reshaped to remove any sharp margins and to achieve a normal morphology. The macrodontic central incisors were not treated. At 12-months post-surgery there were no periodontal problems and no hypersensitivity. Orthodontic treatment was performed to appropriately align the maxillary teeth and to correct the malocclusion.

Leiomyoma of oral cavity: case report and literature review.

Leiomyoma is a benign smooth muscle tumour, that occurs most frequently in the uterine myometrium, gastrointestinal tract, skin and lower extremities of middle-aged women. Leiomyomas are uncommon in the oral cavity, but in this location are usually localized on the tongue, lips and palate. Most lesions are asymptomatic, although occasional tumours can be painful. The diagnosis is mainly determined by histological studies due to its unspecific clinical appearance.The purpose of this article is to present a case report of 49-year-old male patient with a lesion of the lower lip. After surgical resection hematoxylin-eosin staining confirmed the diagnosis of leiomyoma.