Clinical Indications to Germectomy in Pediatric Dentistry: A Systematic Review.

Germectomy is a procedure often required in patients at developmental age. It is defined as the surgical removal of the third molar at a very specific stage of development. The aim of this study was to systematically analyze the literature in terms of clinical indications for germectomy in patients at developmental age. Literature searches were performed using PubMed, Google Scholar, Cochrane Library and Scopus from 1952 to 30 June 2021. The study protocol was registered after the screening stage (PROSPERO CRD42021262949). The search strategy identified 3829 articles: 167 from PubMed, 2860 from Google Scholar, 799 from Cochrane Library and 3 from Scopus. Finally, eight full-text papers were included into the qualitative analysis. Based on the included studies, clinical indications for germectomy were mainly related to orthodontic causes, infectious and cariogenic causes and prophylaxis. Based on these results, it is not possible to present evidence-based clinical indications for germectomy in patients at developmental age. Clinical trials on this subject focused specifically on patients at developmental age are awaited.

Dilated Odontoma Arising in the Mandibular Third Molar Germ: Report of a Case of an Unusual Lesion in an Uncommon Site.

Dilated odontoma is the most severe variant of dens invaginatus. It is extremely uncommon in the posterior mandible. It is thought to originate during the morpho-differentiation stage of dental development. However, its etiology and pathogenesis remain obscure. We report here the clinical and pathologic findings of an incidentally discovered dilated odontoma arising in the left third mandibular molar germ of an 11-year-old male and a review of the pertinent literature. As dilated odontoma is not established as an independent entity in the current WHO classification of odontogenic tumors and is the result of a well-established developmental anomaly of the tooth (that is, the invagination of the enamel organ into the dental papilla), it should be better identified as dilated dens invaginatus.

The Role of the Pediatric Dentist in the Multidisciplinary Management of the Cleft Lip Palate Patient.

The focus of this paper is the pediatric dental care of Cleft Lip and Palate (CLP) children and the role of the pediatric dentist in the CLP team. The management of children with cleft lip and palate presents many challenges and a multidisciplinary and prepared team is always required. Affected individuals present a multiplicity of problems: effective management involves a wide range of specialities. The value of a multidisciplinary team is widely known and mentioned in the literature, but very few papers focus on the role and the importance of the pediatric dentist. Therefore, the purpose of this article is to underline the role of the pediatric dentist as a member of the cleft lip and palate team which ranges from prenatal counseling, presurgical prevention and orthopedics, to post-treatment rehabilitation and restoration.

External Root Resorption Management of an Avulsed and Reimplanted Central Incisor: A Case Report.

Background: Avulsion and reimplantation of permanent teeth represent a major challenge in terms of treatment and long-term prognosis. The present study reported clinical management of external root resorption of an avulsed and reimplanted maxillary central incisor. Case report: A 9-year-old boy reported an uncomplicated crown fracture and avulsion of tooth 11 and complicated crown fracture of tooth 21 due to trauma. Reimplantation of element 11 was obtained within 30 min post-trauma and 3 days after both elements were diagnosed with necrotic pulp. In addition, tooth 11 showed early external root resorption. Both elements underwent endodontic treatment and root closure with apical plug using calcium-silicate-based cement. At 6-month follow-up root resorption appeared to be arrested. Twenty-four months after trauma the clinical results were stable, although signs and symptoms of ankylosis were observed. Conclusions: An immediate endodontic approach and use of calcium-silicate-based cement seemed to contrast the progression of root resorption of an avulsed and reimplanted central incisor after 24 months of follow-up.

The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study.

This randomized, double-blind and controlled clinical trial investigates how a diode laser lingual frenectomy can improve obstructive sleep apnea syndrome (OSAS) in pediatric patients. BACKGROUND: Several authors have shown that a short lingual frenulum causes a reduction in incoming air flow and the relationship between OSAS and a short lingual frenulum. METHODS: Thirty-two pediatric patients were equally randomly divided into a Study Group (SG) and a Control Group (CG). On each SG patient a polysomnography 1 (PSG1) and a lingual frenectomy were performed using a diode laser via Doctor Smile Wiser technology, power 7 W. After three months, a new polysomnography (PSG2) was performed to evaluate the lingual frenectomy efficacy in pediatric patients. The pain was assessed by a numerical rating scale (NRS) before and after surgery. The CG followed the same protocol without a lingual frenectomy but myofunctional and speech therapy were conducted to qualitatively and quantitatively improve the lingual functionality. In the SG, eight subjects (50%) had severe OSAS and eight had moderate (50%) while in the CG, three subjects had severe OSAS (18.8%) and thirteen had moderate (81.2%). RESULTS: In the SG, 93.8% were classified as mild OSAS and 6.2% as moderate. In contrast, in the CG, 18.75% were classified as mild OSAS, 62.5% as moderate and 18.75% as severe. CONCLUSION: The study demonstrates how a lingual laser frenectomy can improve OSAS in pediatric patients.

The Evaluation of Further Complications after the Extraction of the Third Molar Germ: A Pilot Study in Paediatric Dentistry.

Some authors suggest germectomy to prevent the impaction of mandibular third molars, which can cause anterior crowding. The aim of the study, conducted with 2 years of follow-up, was to clarify when the extraction of the germ of the third molar is optimal, together with possible post-operative complications. A new surgical approach was performed through the application of a combined suture, which can provide better wound healing. The study was performed on 25 patients with a mean age of 15.44 ± 2.06. Based on orthodontic and surgical indications, 46 germectomies were performed. Follow-ups were conducted after 1 week, 2 weeks, 4 weeks, 1 year and 2 years. All procedures were carried out by the same operator and were standardized. Data analysis was conducted using R-Software. Statistical evaluation used the chi-squared test and the Monte Carlo test. The level of significance was set as 0.05. Results showed that out of 46 germectomies, the prevalence of complications was 4.2% for two patients (8%). Both complications were observed in male patients. In the first case, the patient (at Nolla stage 7) showed delayed onset infections after four weeks; in the second case, the patient (at Nolla stage 6) showed bleeding immediately after surgery and suture. With reference to delayed onset infections, no statistically significant association was found among gender (χ2 = 0.719; p = 0.396), germ development stage (χ2 = 2.595; p = 0.658) or Winter's classifications (χ2 = 0.046; p = 0.829); similarly, no significant associations were found among bleeding, gender (χ2 = 0.719; p = 0.396), germ development stage (χ2 = 2.595; p = 0.658) or Winter's classification (χ2 = 0.046; p = 0.829). From our results, it is also possible to state that post-operative complications following germectomy of the mandibular third molar germ in adolescence occur in a significantly reduced percentage of patients, so this oral surgery treatment becomes a reliable surgical technique in adolescence.

The Characteristics of Adjacent Anatomy of Mandibular Third Molar Germs: A CBCT Pilot Study in Patients with Osteogenesis Imperfecta.

(1) Objectives: The aim of our study was to investigate the anatomical features of lower third molar and its adjacent anatomical connections in type I Osteogenesis Imperfecta (OI) patients through cone beam computed tomography (cbct). (2) Methods: The study was conducted among 25 patients, 13 patients with type I OI and 12 control patients (individuals with no disorders and no treatment); average age was 15.44 ± 2.06, 23 third molar germs for each group. The germs have been compared to the parameters using the Mann-Whitney test. A chi-square test was also used to investigate the correlation between the status case/control and tooth development stage. (3) Results: Mann-Whitney test showed significant differences between cases and controls: diameter of the tooth germ in toto (U = 93.5; p < 0.001), tooth development stage, (U = 145; p < 0.01), roots length (U = 44.5; p < 0.01), cementoenamel junction diameter (U = 157.5; p < 0.05), size of the pulp chamber (U = 95.5; p < 0.05). Type I OI is not associated with the relationship between the germ of mandibular third molar and alveolar canal on axial plane (χ2 = 4.095; p = 0.129), and parasagittal (χ2 = 4.800; p = 0.091). The association between type I OI and relationship with the germ of mandibular third molar and alveolar canal on the coronal plane has been significant (χ2 = 9.778; p < 0.05) as the perforation of the lingual cortical bone in the region of mandibular third molar tooth germ (χ2 = 11.189; p < 0.01). (4) Conclusions: The results confirm the cbct accuracy in the evaluation of bone density in type I OI patients giving also the opportunity to study the tridimensional anatomy of germs and the adjacent anatomical structures in order to avoid any perioperative complications.

Diode versus CO2 Laser Therapy in the Treatment of High Labial Frenulum Attachment: A Pilot Randomized, Double-Blinded Clinical Trial.

Background: The labial frenula are triangular plicas departing from the alveolar mucosa and attaching themselves at different heights of the gingiva. Sometimes a high attachment can determine a gingival recession. The most suitable surgical resolution is the use of laser devices. The aim of this study was to compare the labial frenulectomy through the use of Diode and CO2 laser techniques in pediatric patients with a high labial frenulum attachment, clarifying at the same time the preventive role of the surgical treatment to avoid further recession. Methods: A pilot randomized, double-blinded clinical trial was conducted to compare both the surgical advantages and the preventive treatment of laser technology using two different wavelengths within a population of pediatric patients with a high labial frenulum attachment. Different parameters intra and post-surgery were taken into account (Bleeding, Wound Healing, Gingival Recession, Periodontal pocket and Numerical Scale Value for pain) to compare Diode versus CO2 laser therapy. Results: Although both the laser devices provide a good performance in the post-operative period, the Diode laser shows better results (p < 0.001) in three of the five parameters evaluated. Conclusions: From the results it was found that the Diode Laser device is more suitable compared to the CO2 device.

Primary Oro-Facial Manifestations of Langerhans Cell Histiocytosis in Pediatric Age: A Bi-Institutional Retrospective Study on 45 Cases.

AIMS: Langerhans Cell Histiocytosis is a rare hematologic disorder usually affecting children and most commonly involving the head and neck region. Primary oro-facial manifestations are rare, and their diagnosis is often challenging as they are numerous and often resemble common pathologies, refractory to conventional medical and/or instrumental treatments. For such reasons, the diagnosis is frequently delayed, as is the following staging and therapy onset. We retrospectively studied 45 pediatric patients affected by Langerhans Cell Histiocytosis with onset in the head and neck, to examine their clinical and radiological features at the early stage. MATERIALS AND METHODS: The study was a retrospective bi-institutional analysis (Department of Pediatric Dentistry and Pediatric Oncology of "Sapienza" University of Rome, Department of Interdisciplinary Medicine of the University of Bari "Aldo Moro"), which enrolled 45 patients (age range 0-18 year-old) affected by Langerhans Cell Histiocytosis with oro-facial onset. Data regarding clinical appearance, number, site, synchronous or metachronous occurrence, involved tissues/organs, radiographic features and clinical outcomes were collected, listed and overall differentiated by two age ranges (0-10-year-olds and 10-18-year-olds). RESULTS: Patients were 26 males and 19 females, with an average age at the time of diagnosis of 4.8 ± 3.8 years (median = 3.9 years). The most common findings were inflamed, hyperplastic, painful and often ulcerated gingival lesions (22 cases), associated with deciduous tooth mobility and/or dislocation with bone loss in 18 cases, followed by nine single eosinophilic granulomas of the mandible and two of the maxilla. Lesions of the palatal mucosa were observed in six patients; nine patients showed on radiograms the characteristic "floating teeth" appearance in the mandible with synchronous lesions of the maxilla in six. Paresthesia was relatively un-frequent (three cases) and the pathological fracture of the mandible occurred in six. Head/neck lymph nodes involvement was associated with oral lesions in 12 cases and skull lesions in 14. Otitis (media or externa) was detected in four instances, exophthalmia in two, cutaneous rush in nine, contextual presence or subsequent onset of insipidus diabetes in eight. As for therapy, single or multiple small jaw lesions were all surgically removed; chemotherapy with vinblastine alone or associated with corticosteroids was the principal treatment in almost the 80% of cases; more than 50% of patients received corticosteroids, while only three patients received adjunctive radiotherapy. The overall mortality account for less than 9% (four of 45 cases) and recurrence observed in eight patients after therapy. CONCLUSIONS: Langerhans Cell Histiocytosis may mimic several oro-facial inflammatory and neoplastic diseases. Considering the potential disabling sequela following head and neck localization of Langerhans Cell Histiocytosis in children, especially at the periodontal tissues with teeth and alveolar bone loss, lesion recognition along with the histological examination of suspicious tissues is mandatory to achieve an early diagnosis and to prevent further organ involvement.

An Unusual Intraoral Lipoma: A Case Report and Literature Review.

BACKGROUND Lipoma is a painless tumor derived from mesenchymal connective tissue. It manifests itself on soft tissue and is characterized by a slow and circumscribed growth. Its incidence in the oral cavity is relatively low (1-4%). Despite the fact that it poses very little threat, as it is a benign form, as opposed to liposarcomas, its position in the oral cavity can create the prerequisite conditions for the buccal mucosa to be continuously traumatised by chewing and thus be altered. Given the fact that it is a painless lesion, patients can undergo years with an intraoral lipoma without ever recognizing it. There, we report a case of an unusual, large, intraoral lipoma that caused speech problems. CASE REPORT A 46-year-old man presented a large, soft mass in the buccal mucosa. No pain was described by the patient, but there was a slight impediment in chewing and talking. The patient underwent surgical excision of the lesion, which was then sent for histological examination. Results confirmed the initial hypothesis that the lesion was a lipoma. CONCLUSIONS Lipomas can be subtle lesions that may go unnoticed for several years until their size causes difficulties with normal masticatory movement and aesthetic problems. However, given the benignity of the mass, it rarely poses a serious threat to health. They are relatively sporadic lesions and, after being removed, relapse is rare.

Prevalence of maxillary canine impaction in skeletal Class III malocclusions compared to Class I malocclusions.

BACKGROUND: The aim of the present investigation was to evaluate if an orthodontic population of Class III malocclusion patients shows a different prevalence of maxillary canine impaction than Class I subjects. MATERIAL AND METHODS: Fifty-eight subjects were retrospectively selected and assigned to the Class I group (n= 32) or the Class III group (n= 26), depending on the ANB and WITS values. Lateral cephalograms were used to collect angular and linear measurements that described the skeletal and dental maxillary features of the subjects, while orthopantomography was used to assess the impaction or the correct eruption of the maxillary canines. An independent samples T-test or a Mann-Whitney U-test was used to compare the cephalometric values between the two groups, while a chi-squared test was used to evaluate the distribution of maxillary canine impaction between the two groups. RESULTS: No statistically significant difference was found for the cephalometric variables, and the frequency of canine impaction showed no difference between the Class III and Class I subjects. CONCLUSIONS: Patients with skeletal Class III malocclusions did not show a different prevalence of canine impaction; therefore, such skeletal features cannot be used as a diagnostic aid for assessment of the risk of maxillary canine impaction. Key words:Skeletal Class III, Angle Class III, maxillary canine impaction, tooth impaction.

Comparative Histological and Histomorphometric Results of Six Biomaterials Used in Two-Stage Maxillary Sinus Augmentation Model after 6-Month Healing.

OBJECTIVES: To evaluate the performances of six different bone substitute materials used as graft in maxillary sinus augmentation by means of histological and histomorphometric analysis of bone biopsies retrieved from human subjects after a 6-month healing period. MATERIALS AND METHODS: Six consecutive patients (3 males, 3 females, aged 50-72 years), healthy, nonsmokers, and with good oral hygiene, presenting edentulous posterior maxilla with a residual bone crest measuring ≤ 4 mm in vertical height and 3 to 5 mm in horizontal thickness at radiographic examination, were selected to receive sinus augmentation and delayed implant placement. Under randomized conditions, sinus augmentation procedures were carried out using mineralized solvent-dehydrated bone allograft (MCBA), freeze-dried mineralized bone allograft (FDBA), anorganic bovine bone (ABB), equine-derived bone (EB), synthetic micro-macroporous biphasic calcium-phosphate block consisting of 70% beta-tricalcium phosphate and 30% hydroxyapatite (HA-ß-TCP 30/70), or bioapatite-collagen (BC). After 6 months, bone core biopsies were retrieved and 13 implants were placed. Bone samples were processed for histological and histomorphometric analysis. CT scans were taken before and after surgery. After 4 months of healing, patients were restored with a provisional fixed acrylic resin prosthesis, as well as after further 2-4 months with a definitive cemented zirconia or porcelain-fused-to-metal crowns. RESULTS: There were no postoperative complications or implant failures. The histological examination showed that all biomaterials were in close contact with newly formed bone, surrounding the graft granules with a bridge-like network. No signs of acute inflammation were observed. The histomorphometry revealed 20.1% newly formed bone for MCBA, 32.1% for FDBA, 16.1% for ABB, 22.8% for EB, 20.3% for HA-ß-TCP 30/70, and 21.4% for BC. CONCLUSIONS: Within the limitations of the present investigation, all the six tested biomaterials showed good biocompatibility and osteoconductive properties when used in sinus augmentation procedures, although the FDBA seemed to have a better histomorphometric result in terms of newly formed bone and residual graft material. This trial is registered with ClinicalTrials.gov Identifier (Registration Number): NCT03496688.

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.

Pediatric patients tolerance: a comparative study about using of Er:YAG laser and self-adhesive flowable composite for treatment of primary decayed teeth.

AIM: To verify the tolerance of children aged between 3 and 8 years, having class I caries and treated with Er:YAG Laser in association with a new self-adhesive flowable resin in comparison with a high-speed diamond bur and a conventional flowable resin treatment. METHODS: A group of 80 healthy children (43 male and 37 female) ranging in age from 3 to 8 years, who had been diagnosed with at least one active occlusal non-cavitated superficial carious lesions in first or second deciduous molars, were selected for the present study. They were divided in 4 groups: group A: Class I occlusal cavities prepared using an Er:YAG laser and a self-adhesive flowable resin; Group B: Class I occlusal cavities prepared using an Er:YAG laser and a conventional flowable resin; Group C: Class I occlusal cavities prepared using a high-speed diamond bur and a self-adhesive flowable resin; Group D: Class I occlusal cavities prepared using a high-speed diamond bur and a conventional flowable resin. Before and after the treatments the patient tolerance was tested with the modified Wong-Baker pain level scale. RESULTS: In the first group, the tolerance rate was 95% with 0 score (no hurt) for 19 patients; in Group D, the tolerance rate was 75%. Just one child of group D experienced hurting worst because of non cooperative patient. CONCLUSION: From these results it emerged that, although the limits of the study, Er:Yag laser in association with self-adhering composite, is very effective in pediatric dentistry and is a good treatment option especially for non cooperative patients.

Histological and Histomorphometric Human Results of HA-Beta-TCP 30/70 Compared to Three Different Biomaterials in Maxillary Sinus Augmentation at 6 Months: A Preliminary Report.

OBJECTIVE: The aim of this investigation was to examine the bone regenerative potential of newly biphasic calcium phosphate ceramics (HA-ß-TCP 30/70), by assessing histological and histomorphometric results of human specimens retrieved from sinuses augmented with HA-ß-TCP 30/70, and comparing them to anorganic bovine bone (ABB), mineralized solvent-dehydrated bone allograft (MSDBA), and equine bone (EB), after a healing period of 6 months. MATERIALS AND METHODS: Four consecutive patients with edentulous atrophic posterior maxilla were included in this report. A two-stage procedure was carried out for sinus augmentation with HA-ß-TCP 30/70, ABB, MSDBA, and EB. After 6 months, specimens were retrieved at the time of implant placement and processed for histological and histomorphometric analyses. RESULTS: At histological examination, all biomaterials were in close contact with the newly formed bone and showed the same pattern of bone formation; the grafted granules were surrounded by a bridge-like network of newly formed bone. A limited number of ABB particles were partially covered by connective tissue. The histomorphometric analysis revealed 30.2% newly formed bone for Ha-ß-TCP 30/70, 20.1% for ABB, 16.4% for MSDBA, and 21.9% for EB. CONCLUSIONS: Within the limitations of the present investigation, these results support the successful use of HA-ß-TCP 30/70 for sinus augmentation.

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.

The arginine-deiminase enzymatic system on gingivitis: preliminary pediatric study.

AIM.: The lactic bacteria are Gram-positive microorganisms with coccus or stick shape, which share a number of physiological and biochemical properties. Several experimental evidences suggest the possibility of using lactic acid bacterial as a preventive or therapeutic potential approaches, alternative or complementary to prevention or treatment protocols currently followed in several pathological conditions. Lactobacillus brevis is able, through the arginine-deiminase activity, to subtract the substrate (arginine) to nitric oxide synthase, and to inhibit in vitro generation of nitric oxide from rat's peritoneal macrophages. These data led us to study the in vivo L. brevis anti-inflammatory effect choosing as experimental model the gingivitis. MATERIALS AND METHODS.: In our study were examined 21 subjects, 16 males and 5 females, aged between 5 and 12 years, with marginal gingivitis problems who have been given chewing gum containing the principle to test in measure of three per day. RESULTS.: At the time T1, after treatment, 18 patients no longer showed inflammation; 2 of them had a slight inflammation and only 1 patient still showed a moderate inflammation. CONCLUSIONS.: From our research, as confirmed by clinical and laboratory investigation, results an effective anti-inflammatory action of arginine-deiminase system that some bacteria possessing.

Estrogenicity of bisphenol A released from sealants and composites: a review of the literature.

This study aims to critically summarize the literature about bisphenol A (BPA), indicate whether and how those risks are real and emphasize how it is eventually possible to prevent them. With this in mind, we should consider nature, risks and control of BPA, as well as its presence and its role in sealants and composites. It is important to note that we will focus on literature exclusively written about the possible estrogenic activity (and not about the general toxicology profile) of BPA or its possible derivatives released from composites and sealants (without mentioning, or covering just briefly, similar activities performed by their components).