Paediatric Orthodontics Part 3: Masticatory function during development.

The importance of masticatory function during development, the aim of early therapies. Hypoplasia of the upper maxilla is a widespread condition which orthodontists often need to face during early treatment. Mechanical maxillary expansion (both rapid and slow) produce undiagnosed effects on the palatal suture and unwanted side- effects on the periodontium and alveolar process, as well as anchorage-teeth displacement, root resorption, bone fenestration. It is clear that early therapies need a non-mechanical and non-traumatic approach in the respect of the physiology and biology of one of the most important systems for the future health of the developing patient.

Clinical evaluation of the oral health status in vascular-type dementia patients. A case-control study.

AIM: The aim of this study was to evaluate the oral health status in patients with vascular dementia (VaD). Moreover, the association of the disease severity and the patients' cognitive and functional impairment with the oral findings have been recorded. METHODS: The study was directed on the study group (86 VaD patients) and the control group (82 healthy volunteers of the same age) from the IRCSS Neurolesi Bonino-Pulejo in Messina, Italy. Cognitive status was evaluated with the MMSE scoring system. Oral parameters, such as decaying, missing, filled teeth (DMFT) index, plaque index (PI), periodontal probing depth (PPD) and bleeding on probing (BOP) were evaluated in all patients. Denture condition and denture-induced stomatitis were also analysed. The frequency of untreated caries, periodontal diseases and missing teeth of the Study Group was significantly higher than in Control Group. RESULTS: Particularly, VaD patients presented higher number of decayed teeth and deeper periodontal pockets. Decreased cognitive functions in VaD patients have been demonstrated to result in a decline of denture care and increased denture-related mucosal lesions. CONCLUSION: These results underlined that clinicians should direct high attention to oral hygiene of patients with VaD in order to prevent the evolution of those pathologic dental and periodontal conditions, especially in patients with decreased cognitive functions.

Oral health-related quality of life in partially edentulous patients before and after implant therapy: a 2-year longitudinal study.

OBJECTIVES: The aim of this study was to measure the Oral Health-Related Quality of Life (OHRQoL) before and after a prosthodontic implant therapy so to determine the physical and psychological impact of implant-supported fixed partial dentures (IFPD) rehabilitation among edentulous patients. METHODS: 50 partially edentulous patients aged 40-70 years, treated with IFPD, completed the OHRQoL questionnaire before the implant surgery (Time 0) and 2 years after their whole implant-prosthetic rehabilitation (Time 1). The questionnaire was proposed in a short version of Oral Health Impact Profile (OHIP-14, range 0-56) and analyzed through the 'additive method'. We evaluated statistical mean, standard deviation, median, variance and mode of all OHIP-14 domains and the statistical significance about oral changes at Time 0 and Time 1 using the Chi-square test (p-values < 0.05). RESULTS: Patients reported significant changes in mean OHIP scores (Time 0: 2.15; Time 1: 0.65; p < 0.01). The most prevalently affected domain was "functional limitation", followed by "psychological discomfort" and "physical pain". There were no significant differences dependent on age, gender and antagonistic teeth (p > 0.05). Patients with I and IV Kennedy's class edentulism showed better improvement (p < 0.05). CONCLUSIONS: Preoperative and post-treatment assessments of OHRQoL exhibited significant differences. The IFPD treatment had a positive effect on the OHRQoL, which improved better in patients with I and IV Kennedy's edentulous class.

[Computerized tomography in the diagnosis of Crohn disease]. / Contributo della tomografia computerizzata alla diagnosi del morbo di Crohn.

Fifty patients affected with Crohn's disease were examined with CT in a 12-month period; 39 of them underwent an intestinal enema and 24 a colon enema. Our goal was to assess the comparative contribution of CT and conventional radiology to the diagnosis of this disease. CT proved to be the method of choice to diagnose wall diseases with colon or small bowel wall thickening, which is usually homogeneous as demonstrated in 94% of the patients, intraabdominal abscesses in 3 patients (6%), perianal (4%), enterocutaneous (2%) and enteromuscle (2%) fistulas. CT was comparable to barium studies for rectovaginal (2%) and enterocolic (4%) fistulas. Conventional radiology was better than CT to assess mucosal diseases and ileum-ileal fistulas which were demonstrated with small bowel enema in 4 patients and in one patient only with CT. Therefore, we believe CT to be a complementary method to barium studies and a necessary tool for the correct staging of this disease, especially relative to the diagnosis of extramural lesions.

Embolization of glomus tumors of the carotid: temporary or definitive?

The authors describe the use of preoperative embolization of glomus tumors in 7 patients. In two cases a nonresorbable substance (IBCA) was used for the embolization, and no subsequent operation was needed. They therefore suggest that embolization could be a definitive treatment and an alternative to surgery.

[Angioplasty of renal arteries in the treatment of renovascular hypertension. Our experience in 63 cases]. / L'angioplastica delle arterie renali nel trattamento della ipertensione nefrovascolare. La nostra esperienza in 63 casi.

Percutaneous transluminal angioplasty for treatment of renovascular hypertension was performed on 63 patients during a 5 years period. No compliance related to this procedure set in. At follow-up, the clinical results were shown to be positive in 85.7% of the cases.

[Clinico-radiologic evaluation of glomus tumors for permanent embolization]. / Valutazioni clinico-radiologiche per l'embolizzazione permanente dei tumori glomici.

The utility of the preoperative embolization of glomus tumors observed in 7 cases is reported. Two patient have been embolized with non reabsorbable materials and haven't been operated. The possibility of a definitive embolizing therapy as alternative to a surgical treatment is therefore supposed.

[Use of a new type of endoprosthesis in internal biliary drainage]. / Sull'applicazione di un nuovo tipo di endoprotesi, nel drenaggio biliare interno.

The authors, reporting the present value and importance of the interventional biliary radiology in the therapy of the obstructive inoperable jaundice, describe the features of a "long" endoprosthesis and its advantages in comparison with the common endoprosthesis.