A critical evaluation of the use of ozone and its derivatives in dentistry.

OBJECTIVE: The therapeutic application of ozone and its derivatives in the dental field has been used for many purposes. However, there has yet to be a consistent evaluation of the outcomes, due to the lack of standardization of the treatment operating procedures. MATERIALS AND METHODS: The keywords "ozone", "ozonated", "ozonation" "ozonized", "ozonization", "dentistry", "periodontology", "oral surgery", "oxygen-ozone therapy" were used to perform a literature review using PubMed, Cochrane, Google Scholar, Zotero databases with the temporal restriction for manuscripts published between 2010 and 2020. Clinical trials and case reports of good, neutral, as well as negative results related to ozone treatment specifications were evaluated. DISCUSSION: A better understanding of the mechanisms of action of this bio-oxidative therapy could open new horizons related to the personalization of treatments and the quality of dental care. The critical condition to achieve these goals is an improved knowledge of the qualitative/quantitative characteristics of ozone and its derivatives.

Laser surgical approach to impacted maxillary incisors: case series and brief review.

OBJECTIVE: Report Authors' clinical case series on impacted maxillary incisors treatment with laser technology. PATIENTS AND METHODS: Studied population was composed by 6 male and 12 female undergoing orthodontic treatments for lack of eruption of 28 upper incisors; eight impacted teeth (4 patients) spontaneously erupted after orthodontic creation of the correct eruptive space. Twenty maxillary incisors were surgically exposed; in 5 patients seven un-erupted incisors were exposed through an apically positioned flap technique; in two patients a guided closed eruption technique was performed on a central and two lateral maxillary incisors; in seven patients laser exposure technique was applied on ten incisors. All impacted teeth resulted correctly aligned at the end of therapy. RESULTS: Impaction of incisors is not a frequent event in dental practice. The positioning of the incisors was obtained by creating the eruptive space and aligning the un-erupted teeth with orthodontic treatment or after removing any obstacle or after their exposure with different surgical methods. In all patients the treatment allowed the restoration of both the aesthetic and function aspect of the stomatognathic apparatus. CONCLUSIONS: In this case load, patients undergoing exposure of the dental crown using diode laser showed the best postoperative course.

Salivary pH and flow rate in menopausal women.

OBJECTIVE: This study aims at determining pH and Flow Rate (FR) of Unstimulated Whole Saliva (UWS) in a sample of 120 ♀ (60 menopausal women and 60 healthy fertile women with similar mean age); detecting the DMFT index (Decayed, Missing, Filled Teeth index) and evaluating any correlations between pH, FR, age and DMFT. PATIENTS AND METHODS: Concerning the day before sample collection, patients were advised to keep a relaxed attitude and not to practice sports. They were also told to not eat or drink during the hour preceding sampling procedures. Saliva was collected via "spitting" method. Each sampling session started at 11:00 a.m., lasted for 5 minutes and used a pre-weighed, dry, deionized and sterile test tube. The procedure took place under controlled environmental temperature and humidity conditions (means 23.27°C; 60.08%). FR was evaluated via weighing technique and pH was measured with a portable pH-meter. RESULTS: There was a minimal but significant pH difference (0.11; p<0.05) between menopausal women (6.75 ± 0.34) and fertile women (6.86 ± 0.24); and a FR difference (0.19; p<0.0001) between menopausal women (0.29 ± 0.17 mL/min) and fertile women (0.48 ± 0.19 mL/min). Correlation (R2) between pH and age was 0.0135 for fertile women and 0.0055 for menopausal women; while the correlation between FR and age was 0.0673 for fertile women and 0.139 for menopausal women. Mean DMFT was 11.93 ± 7.14 in menopausal women and 12.23 ± 6.37 in fertile women. CONCLUSIONS: We observed a minimal decrease in pH and a decrease in FR in menopausal women. Further studies will be needed to investigate the possible role of other environmental and individual variables in the determination of such values.

Charged molecular silica trigger in vitro NETosis in human granulocytes via both oxidative and autophagic pathways.

OBJECTIVE: Neutrophils play a key role in immunity and are known to respond to exogenous threats by releasing neutrophil extracellular traps (NETs) through NETosis, a process involving the release of neutrophils nuclear DNA decorated with proteins into the extracellular space. In this study, attention has been focused on the ability of differently charged molecular systems polyhedral oligomeric silsesquioxanes (POSS) to induce NETosis. MATERIALS AND METHODS: NETs formation was induced by phorbol myristate acetate (PMA) (positive control) and POSS treatment and visualized by confocal microscopy. Moreover, NETs production was quantified by Sytox green staining. Oxidative stress, autophagy as well as endocytosis involvement in the observed phenomena was evaluated by a specific inhibitory approach. RESULTS: Results obtained in this study demonstrate a POSS time and dose-dependent ability in inducing NETs release irrespectively to their charge. POSS induced NETosis is a consequence of their internalization, as demonstrated by the strong reduction in NETs formation after endocytosis inhibition. Moreover, POSS induced NETosis involves both an increase in superoxide anion generation and autophagy pathway activation as demonstrated by the protective effect displayed by sodium azide and wortmannin. CONCLUSIONS: Data presented in this study indicate that nanomaterials and molecular systems could have a role in the onset of inflammatory phenomena.

Relationship between oral microbiota and periodontal disease: a systematic review.

OBJECTIVE: In recent years metagenomic analysis has become more accessible for the characterization of biological specimens. There has been an important increase of studies using this technique for subgingival human samples. To date, there are no updated systematic reviews on the relationship between oral microbiota and periodontal disease. The aim of the present systematic review was to update data about studies concerning the influences of changes in oral microbiota composition on the periodontal status in human subjects. MATERIALS AND METHODS: An electronic search was conducted in four databases (MEDLINE, Scopus, CENTRAL and Web of Science) for articles published in English from January 2014 to April 2018. In vitro or animal studies, case reports, case series, retrospective studies, review articles, abstracts and discussions were excluded. Also, studies that evaluated less than 5 microbial species, only viruses or already known periodontal pathogens were excluded. Two independent researches selected the studies and extracted the data. The quality of evidence was assessed as high, moderate or low for each microorganism. RESULTS: Eight studies and three additional publications recovered from the bibliography search of the selected articles were included in the review. The Bacteria domain was the main detected among the others and it included 53 species. The review confirmed the presence of recognized periodontal pathogens such as the members of the red complex but also identified, with high weight of evidence, the presence of new pathogens. CONCLUSIONS: The results of this systematic review support high evidence for the association of 3 new species/genera with the etiology of periodontitis. Future investigations on the actual role of these new pathogens in the onset and progression of the disease are needed.

Molecular basis of trigeminal nerve disorders and healing.

OBJECTIVE: This review aims to describe trigeminal neuralgia and the molecular basis contributing to the pathophysiology of this condition by focusing on the state of the art. PATIENTS AND METHODS: An electronic search of PubMed was performed using the following keywords: "trigeminal neuralgia" AND "classification", "pathophysiology," "molecular basis" and "mitochondrial role." RESULTS: Mitochondrial abnormality, whether functional or morphological, can contribute to neurological disorders. Additionally, one recent finding showed that gain-of-function mutation in the voltage-gated sodium channel NaV1.6 contributes to the pathophysiology of trigeminal neuralgia by increasing the excitability of trigeminal nerve ganglion neurons. It also exacerbates the pathophysiology of vascular compression. Healing of the trigeminal nerve is controlled by many molecular signaling pathways, including extracellular-signal-regulated kinase, c-Jun, p38, Notch, and mitogen-activated protein kinases. CONCLUSIONS: More investigations regarding the gain-of-function mutation of NaV1.6 sodium channels are essential for the diagnosis and treatment of trigeminal nerve disorders, regardless of whether these are associated with vascular compression or not.

Epiregulin-loaded PLGA nanoparticles increase human keratinocytes proliferation: preliminary data.

OBJECTIVE: Epiregulin is a member of the epidermal growth factor (EGF) family produced by keratinocytes: the aim of this study was to investigate the ability of biocompatible nanoparticles loaded with such growth factor to increase human keratinocytes proliferation. MATERIALS AND METHODS: Different PLGA (Poly-d,l-lactide-co-glycolide)-nanoparticles (NPs) formulations have been characterized in size and zeta potential by dynamic light scattering (DLS) analysis. The ability of the different PLGA-NPs formulations to adhere onto dental surfaces has been tested, and epiregulin-enriched PLGA-NPs has been produced. Epiregulin release from NPs has been tested by enzyme-linked immunosorbent (ELISA) assay and the proliferative effects of epiregulin-NPs on human keratinocytes have been evaluated. RESULTS: DLS analysis revealed a different size distribution depending on the PLA/PGA (poly lactic acid/poly glycolic acid) ratio used. 50:50 PLGA-NPs exhibited the smaller size and the best dental adhesive ability. Moreover, such epiregulin-loaded NPs was able to increase cell proliferation. CONCLUSIONS: Direct dental pocket drug delivery implies the NPs solution loading onto the dental surface at the cement-enamel junction level: 50:50 PLGA-NPs, with their small size and excellent adhesive ability, represent an interesting tool to deliver epiregulin directly where there is the need for epithelial proliferation. These results describe a possible strategy for periodontal pocket delivery of Epiregulin-loaded PLGA-NPs and might provide a new approach for the treatment of gingival recession, where gingival epithelium proliferation is needed.

Pre-odontoblast proliferation induced by near-infrared laser stimulation.

OBJECTIVE: Laser therapy is known to stimulate cell proliferation and differentiation, an effect called "biostimulation". Although many clinical applications of laser therapy take advantage from such positive effect, the underlying molecular mechanisms are not fully understood. The aim of this work was to investigate the effect of near-infrared laser stimulation on rat pre-odontoblast cells (MDPC-23 cells) and the molecular mechanism/s involved. MATERIALS AND METHODS: MDPC-23 cells were stimulated with a near-infrared (980 nm) laser source with different energy settings (1-50 J, corresponding to 0.65-32.47 J/cm2) and cell proliferation was evaluated by manual count. ERK 1/2 pathway activation was evaluated by Western blot analysis. RESULTS: 1-10 J stimulation (corresponding to 0.65-6.5 J/cm2) significantly increase MDPC-23 cell proliferation and such effect seems to be mediated by ERK 1/2 signalling pathway activation, showing a key role of ERK 1/2 pathway in mediating the proliferative response induced by laser stimulation. CONCLUSIONS: Near infrared laser stimulation with low energies (1-10 J) is able to increase cell proliferation through ERK 1/2 signalling pathway activation. At the same time, higher energy stimulation (25-50 J) induces an initial toxic effect, probably activating pro-apoptotic signalling molecules, downstream ERK 1/2 kinase. Such results foster the application of this therapeutic approach in different clinical settings in which a regenerative tissue response is needed.

Family practitioners screening for HIV infection.

BACKGROUND: We assessed how family physicians screened for HIV infection in Paris, in 2013 and whether their practice had changed after publication of the HAS (French National Authority for Health) recommendation for systematic screening. METHOD: Family practitioners (FPs) in Paris answered a questionnaire by e-mail or regular mail from January to April 2013. The statistical analysis was performed with the Chi(2) test. RESULTS: Four hundred and seven FPs answered (77.8% response rate). FPs did not always identify risk cases: 78% in case of sexually transmitted infection, but 32% for partner change, 39% for patients from a highly HIV endemic country, and 21% for sexually active teenagers or adults. Practices differed according to districts. FPs in the 1st and in the Northeastern Paris districts detected risk cases for HIV more often than their colleagues, and they used screening more often, with, consequently, more frequently positive results. The screening strategies also differed according to the FPs' demographic characteristics and their type of practice: young (P = 0.0002) female (P = 0.02) FPs working in "sector 1 (patients fully reimbursed)" (P = 8.10(-5)) prescribed more HIV blood tests. Surprisingly, only 45% of FPs was aware of the recent recommendation for systematic screening of HIV. CONCLUSION: The Paris FP screening practices differ according to demographic characteristics, place, and type of practice. Screening practices have not changed since the publication of the new screening strategy.

Daily and annually variation of unstimulated whole saliva flow rate and pH and their relation with body profile in healthy young adults.

AIM: To analyse pH and flow rate (FR) of unstimulated whole saliva (UWS), detecting their possible correlations both among themselves and with body profile; in addition to identify daily, annually and gender differences. MATERIALS AND METHODS: Eighty-one (47 ♀; 34 ♂) healthy young adults (mean age 22.7±4.09 years old) were enrolled. Saliva was sampled using spitting method. The data were statistically analysed using Pearson's coefficient, ANOVA or Kruskal-Wallis test, Student's t test or the Wilcoxon-Mann-Whitney test. RESULTS: The mean UWS/FR was 0.643 ml/min (range 0.164-1.656 ml/min; percentile 25 = 0.400 ml/min; percentile 50 = 0.643 ml/min, percentile 75 = 0.832 ml/min; median = 0.590 ml/min) and no significant differences were found in gender. The mean UWS/pH was 6.95 (range 6.06-7.91, S.D. 0.28, RSD % 4.08): pH was higher in males (7.02) than females (6.92; p = 0.009). The UWS/FR increased almost steadily during the day: from 0.593 ml/min at 9:00 to 0.669 ml/min at 17:00 (p = 0.04), the greatest increase was found between 9:00 and 11:00. Through the seasons the UWS/FR decreased from summer to spring with a difference of 0.048 ml/min (p < 0.05). The UWS/pH showed a slight increase between 9:00 and 17:00 (p < 0.05). There were little differences in UWS/pH among the seasons (max. 0.09; p < 0.05). Only a significant correlation between UWS/FR and pH was found (R = 0.20; p = 0.008). CONCLUSIONS: We did not find correlations between body profile vs UWS/FR or pH. UWS/FR varies more widely than UWS/pH: maintaining a proper acid/base balance is an essential factor for the homeostasis of the oral cavity and probably this would explain the reason for the lack of the variables evaluated influencing UWS/pH.

Serum anti-p53 antibodies as a diagnostic tumor marker: observations in patients with malignant and premalignant oral cavity lesions.

AIM: To determine whether serum anti-p53 antibody (p53-Abs) positivity in patients with oral carcinoma corresponds with tumor localization, histological grade, stage, and recurrence. METHODS: The study population was divided into three groups: controls; patients with a premalignant lesion; and patients with oral squamous cell carcinoma (SCC). The third group was composed of patients attending outpatient services for pathological diagnosis or for follow-up monitoring only. The cancer patients had undergone resective surgery in local anesthesia. Serum p53-Abs levels were measured using a commercial enzyme-linked immunosorbent assay (ELISA) and monitored over a 3-year follow-up period. RESULTS: Controls and patients with premalignant lesions did not test positive for p53-Abs at ELISA testing. Patients with a malignant lesion tested positive at initial diagnosis when a high histopathological grade lesion was present or localized to the posterior region of the oral cavity. Postoperative serum p53-Abs levels gradually declined until complete seronegativity. Patients with a recurrent tumor tested positive for p53-Abs. CONCLUSION: Seropositivity for p53-Abs may be associated with histopathological tumor grade, localization, and recurrence. The findings suggest that serum p53-Abs analysis is a useful diagnostic marker for oral SCC.

La halitosis: revisión de la literatura. Segunda parte / Halitosis: literature review. Second part

La halitosis es un trastorno capaz de condicionar la calidad de vida, particularmente en lo que atañe a las relaciones sociales. Mediante una atenta revisión de la literatura se han puesto de relieve las hipótesis etiológicas, tanto orales como extraorales, de la halitosis y el correspondiente enfoque diagnóstico-terapéutico por parte del odontólogo y del higienista dental (AU)

Halitosis is a problem that may affect the quality of life, social relations in particular. Through a careful literature review, aetiological hypotheses, both oral and extraoral, on halitosis are highlighted as well as the dianostic and therapeutic approach that should be adopted by the dentist and the dental hygienist (AU)

La halitosis: revisión de la literatura. Primera parte / Halitosis: literature review. First part

La halitosis es un trastorno capaz de condicionar la calidad de vida, particularmente en lo que atañe a las relaciones sociales. Mediante una atenta revisión de la literatura se han puesto de relieve las hipótesis etiológicas,tanto orales como extraorales, de la halitosis y el correspondiente enfoque diagnóstico-terapéutico por parte del odontólogo y del higienista dental (AU)

Halitosis is a problem that may affect the quality of life, social relations in particular. Through a careful literature review, aetiological hypotheses, both oral and extraoral, on halitosis are highlighted as well as the dianostic and therapeutic approach that should be adopted by the dentist and the dental hygienist (AU)

Incisor and mandibular movement during retrusion.

Human mastication, respiration, speech, swallowing and suckling are directed by the jaw muscle activites, the temporo-mandibular joints, the ligaments and by the occlusal dental contacts. Mastication is usually assessed by border movements of the mandibular incisors. While the border movements of opening, protrusion and lateratrusion are often used to determine the mandibular functions, the movement of retrusion is rarely considered in the study of the human oro-facial functions. Our purpose was to evaluate the mandibular movement of retrusion in a population that did not present any symptoms nor clinical signs of temporo-mandibular disorders. The study was performed on 117 males and 121 females (age range: 17.7-65.2 years; mean age: 31.1 years) using electrognathographic registrations (Sirognatograph(*), Siemens, Benshein, Germany). Every patient was instructed and trained before recording. The measurements were calculated on the sagittal plane registrations. The results showed that the mandibular movement of retrusion was present in 233 out of the 238 studied subjects (97.9%) whatever was the dental class, the age or the sex. The width range was between 0.3 and 5.4 mm and the mean value was 1.75+/-0.91 mm. The inferential analysis performed by a 3-way ANOVA model demonstrated no significant difference in retrusion value by dental class, gender or age. The most frequent numerical value was 1.5 mm, observed in 16 subjects (6.7% of the studied population). These results suggest that, in order to respect the physiological characteristics, more attention is needed in performing dental treatments.