Buccal Fat Pad: "Glandula" of Heister or "Boule Graisseuse" of Bichat?

Two prominent personalities in Medicine, Lorenz Heister (1683-1758) and Xavier Bichat (1771-1802), compete for the attribution of the discovery of the buccal fat pad (BFP). A careful reading of the original texts reported here, seems to identify Bichat as the first to describe the BFP. However, Heister most probably was the first to describe an accessory parotid gland.

Emil Zuckerkandl and his Dental Tubercle (Historical Note).

One of the eponyms most frequently cited in dental morphology texts, together with the Carabelli tubercle of the first permanent maxillary molars, is the Zuckerkandl tubercle of deciduous molars. However, references about Emil Zuckerkandl in the field of dental history and this particular entity are scarce. The reason this dental eponym was pushed "into the shadows" probably lies in the many other anatomical parts (including another tubercle, the pyramidal one of the thyroids), which took their names from this great anatomist.

Quality of life in patients affected by medication-related osteonecrosis of the jaws: A systematic review.

OBJECTIVE: The aim of this systematic review was to describe the quality of life and oral health-related quality of life of patients affected by medication-related osteonecrosis of the jaw. STUDY DESIGN: The review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A combination of keywords and MeSH terms was used in PubMed, Scopus, Cochrane Library, Web of Science, and EBSCO up to December 13, 2020. RESULTS: A total of 1066 results were obtained after duplicate exclusion and 11 articles were included in the final qualitative analysis. Most of the articles described the quality of life in patients with osteonecrosis of the jaw secondary to cancer treatment. The main drugs associated with the disease were bisphosphonates. Surgical treatment of the osteonecrosis improves the quality of life of these patients. CONCLUSIONS: The present systematic review suggested the negative influence of osteonecrosis of the jaw on the quality of life and oral health-related quality of life among oncologic and osteoporotic patients. The use of quality of life questionnaires in daily practice could be an important tool to better diagnose and manage patients affected by osteonecrosis of the jaws who have received or are receiving drugs associated with this complication.

Effectiveness of Calcium Phosphate Desensitising Agents in Dental Hypersensitivity Over 24 Weeks of Clinical Evaluation.

BACKGROUND: Calcium phosphate-based compounds are used to treat dental hypersensitivity (DH). Their long-term clinical behaviour needs further research. This study compared the 24-week effectiveness of Teethmate Desensitizer (TD), a pure tetracalcium phosphate (TTCP) and dicalcium phosphate dihydrate (DCPD) powder/water, to that of Dentin Desensitizer (DD), and Bite & White ExSense (BWE), both of calcium phosphate crystallites. METHODS: A total of 105 subjects were selected. A random table was utilised to form three groups of 35 subjects. DH was evaluated using the evaporative sensitivity, tactile sensitivity tests, and the visual analogue scale (VAS) of pain. Response was recorded before the application of the materials (Pre-1), immediately after (Post-0), at 1 week (Post-1), 4 weeks (Post-2), 12 weeks (Post-3) and 24 weeks (Post-4). The non-parametric distribution was assessed with the Shapiro-Wilk statistical test. Intra-group differences for the six time points were evaluated with the Friedman statistical test and the Kruskal-Wallis test. RESULTS: All the materials decreased DH after 24 weeks in comparison to Pre-1. However, the TTCP/DCPD cement showed the greatest statistical efficiency. CONCLUSIONS: The significant decrease of VAS scores produced by TD in the long term suggest the material as the most reliable in the clinical relief of DH.

A "Sacra Rappresentazione" of Saint Apollonia's Martyrdom.

The literary sources of Saint Apollonia's martyrdom and the evolution of Medieval and Renaissance religious drama are presented along with the compendium of a "Sacra Rappresentazione" from Italian Renaissance regarding Saint Apollonia's Martyrdom.

[Very late but too early... prof. Angelo Chiavaro and the Italian degree in dentistry] / Molto tardi ma troppo presto... il prof. Angelo Chiavaro e la laurea in odontoiatria italiana

The birth of the Degree in Dentistry in Italy has been very troubled, and only in 1980 saw its effective implementation. Very "instructive" in this regard is the history on the establishment in 1924 (the period of the seizure of power by Fascism) of a "National School of Dentistry" at the University of Rome, which was withdrawn after only ten months. The biggest supporter and proponent of the School, Prof. Angelo Chiavaro, after a few years, was "punished" with the transfer from the University of Rome to that of Genoa. We present some brief notes on the biography of this courageous pioneer and the matter of which he was the protagonist.

Nanomaterials for Tissue Engineering In Dentistry.

The tissue engineering (TE) of dental oral tissue is facing significant changes in clinical treatments in dentistry. TE is based on a stem cell, signaling molecule, and scaffold triad that must be known and calibrated with attention to specific sectors in dentistry. This review article shows a summary of micro- and nanomorphological characteristics of dental tissues, of stem cells available in the oral region, of signaling molecules usable in TE, and of scaffolds available to guide partial or total reconstruction of hard, soft, periodontal, and bone tissues. Some scaffoldless techniques used in TE are also presented. Then actual and future roles of nanotechnologies about TE in dentistry are presented.

Scanning Electron Microscopy Evaluation of Dental Root Resorption Associated With Granuloma.

The inflammatory resorption of dental root apex (i.e., the process of removal of cementum and/or dentine through the activity of resorbing cells) may show different configurations and damage the apical root structure. As knowing the morphology of resorption areas of human teeth is essential for the success of endodontic treatments, we investigated the apical resorption by scanning electron microscopy, focusing on roots with granulomas. A total of 30 teeth (with penetrating carious lesions and chronic periapical lesions) were examined, the apical third of the roots were removed and analyzed to estimate periforaminal and foraminal resorption, shape and morphology of foramen resorption, centering of the periforaminal resorption area, and diameters of each apical foramen. Periforaminal resorption was present in all samples, whereas foraminal resorption was present in 92% of cases (mainly funnel shaped). Lacunae were observed in the foraminal resorption area with an average diameter of 35±14 µm. The major and minor diameters of the foramina in teeth with resorption were 443 and 313 µm, respectively (higher than in healthy teeth). This result indicates an expansion of the apical diameters caused by the pathology, which could encourage a different clinical instrumentation for these teeth.

Methamphetamine abuse and "meth mouth" in Europe

With easy chemical synthesis from its precursor, methamphetamine (MA) is now widespread in many countries. The abuse of methamphetamine is associated with several negative effects on health, because MA is a neurotoxin and a dangerous central nervous system stimulant. It changes levels of neurotransmitters in the brain, releasing dopamine and inhibiting nor epinephrine uptake which increases sympathetic nervous system activity and can lead to cardiac arrhythmia, hypertension and tachypnea. The consequences of MA abuse are clearly manifested in oral diseases (like “meth mouth”) which is characterised by extensive caries, teeth grinding with ensuing dental wear and trismus. The present review was designed to fill the gap in knowledge about methamphetamine abuse in the European Union (EU) and to illustrate the main clinical effects of prolonged use. After describing the pharmacology and systemic effects of methamphetamine and concentrating on its effects on the mouth, the present review compares the epidemiology and incidence of abuse in the world, particularly the USA and the EU

Methamphetamine abuse and "meth mouth" in Europe.

With easy chemical synthesis from its precursor, methamphetamine (MA) is now widespread in many countries. The abuse of methamphetamine is associated with several negative effects on health, because MA is a neurotoxin and a dangerous central nervous system stimulant. It changes levels of neurotransmitters in the brain, releasing dopamine and inhibiting nor epinephrine uptake which increases sympathetic nervous system activity and can lead to cardiac arrhythmia, hypertension and tachypnea. The consequences of MA abuse are clearly manifested in oral diseases (like "meth mouth") which is characterised by extensive caries, teeth grinding with ensuing dental wear and trismus. The present review was designed to fill the gap in knowledge about methamphetamine abuse in the European Union (EU) and to illustrate the main clinical effects of prolonged use. After describing the pharmacology and systemic effects of methamphetamine and concentrating on its effects on the mouth, the present review compares the epidemiology and incidence of abuse in the world, particularly the USA and the EU.

Root canal obturation: experimental study on the thermafil system related to different irrigation protocols.

AIM: The aim of this study was to stress the ability of a specific obturation technique (thermafil technique) to seal root canal system in presence or absence of smear layer. METHODOLOGY: Sixteen monoradicular teeth, extracted for periodontal reasons, were collected for this study. All specimens were prepared with nickel-titanium rotary files, and then divided into two groups: for each group was applied a different kind of irrigation method, verifying the effectiveness in removing the smear layer, thus rendering the dentinal tubules more permeable for penetration of softened gutta-percha. Thermafil system was used to fill the root canals, and then all the specimens were observed under scanning electron microscope (SEM). RESULTS: The results showed that the Group which followed irrigation only with sodium hypochlorite exhibited significantly less gutta-percha tags when compared to the second Group, which was irrigated with sodium hypochlorite and EDTA. CONCLUSION: The thermafil systems have a very good quality of compression and fluency that permit to gain a good seal of endodontic space; furthermore it allows the penetration of gutta-percha with the formation of numerous of gutta-percha tags inside the dentinal tubules above all when smear layer is reduced or eliminated.

[The 1562 De dentibus by Girolamo Cardano]. / IL "De Dentibus" (1562) Di Girolamo Cardano.

"In the year 1562, having noticed that none of the ancient or modern physicians had treated the subject of dental care, I wrote this first book on the teeth". So begins the preface to the five books of the Opuscula medica senilia by Girolamo Cardano, the first organic text on dentistry in history. It competed with the famous Libellus de dentibus by Bartolomeo Eustachio that appeared in 1563 (but was written in 1562). However, our intention is not to establish precedence but bring to reader's attention Cardano's work that complemented Eustachio's anatomy and physiology of the teeth with their pathology and therapy. This article summarises Cardano's biography and gives a brief review of literature on the De dentibus and of his first complete translation from Latin into Italian. De dentibus is the first of the five books of the Opuscula and is divided into three chapters, as described below. Chapter one, De dentibus, recalls briefly the anatomy and embryology of human teeth as bones and compares them with the teeth of some animals. Follows a description of systemic and local procedures, to preserve, protect, and cure the teeth. Preservation and protection are related to diet, sleep, physical activity, systemic and local medicaments, and amulets., whereas therapy involves remedies taken over from the Ancient Greek and Roman medicine (Hippocrates, Archigenes, Galen, Scribonius, Pliny the Younger, Ezio, Marcellus Empiricus ) and Arabic medicine (Avicenna in particular). The chapter continues with guidelines and procedures for shedding teeth that are damaged beyond repair using a special saltpetre and alum distillate of Cardano's own invention, which he finds very effective. The chapter concludes with tooth extraction tools and methods, especially the one by Scribonius Largo with red-hot iron. Chapter two, -De morbis dentium in specie, describes diseases that affect the teeth and that can cause ache, mobility, weakness, numbness, or deformity (dolor, commotio, imbecillitas, stupor, deformitas). All these conditions may interact, creating a wide range of situations. Ache has seven possible causes that include altered humour, a cavity, a nerve injury, an abscess, breath (flatus), worms, and cold, and Cardano describes the remedies at physician's disposal that even include spells. The causes of mobility are the same as for the ache plus periodontal problems such as dry root or alveolar laxity, and the author discusses local and systemic treatment options. Weakness is considered the worst of the dental pathologies, as it can easily require extraction. Stupor is caused by the corruption of the tooth or a nerve injury, and Cardano refers to it as a life-threatening condition (quoad vitam) in older people if untreated, but also easy to remedy if detected early. Cardano then identifies a whole series of deformities: tooth colour, roughness, fracture, position, number, absence, length, calculus, bad smell, and porosity, and for each of them he offers a wide variety of remedies, in part original and in part borrowed from the ancients. In the last part, Cardano stresses the need to extract as few teeth as possible: "I've never seen anyone die from the diseases of the teeth, except for a tooth extracted inappropriately" To emphasize the dichotomy between medicine and surgery, he explains that tooth care is medical, but extraction requires an experienced surgeon. Chapter three, De fluxione, frequentissima causa morborum dentium, identifies gumboil as a frequent cause of dental disease, and describes the pathogenesis and therapy of gumboil-related diseases, gout in particular.

The morphological effect of the acquired pellicle on acid-etched enamel: a scanning electron microscopy analysis.

PURPOSE: The aim of this study was to determine the effect of the acquired pellicle on enamel etching. MATERIALS AND METHODS: One-hundred teeth were sectioned in the buccal-lingual direction at the half crown. One-hundred half-crowns were polished with pumice powder and rotating brushes (group B) and one-hundred half-crowns were not polished on the buccal surface (group A). The samples were etched by 37% orthophosphoric acid gel for 30 seconds in a 2 mm diameter circular area at the middle upper section of the crown, rinsed with distilled water for 20 s, air dried for 20 s and observed by Scanning Electron Microscopy. Three independent operators determined the quality of enamel etching on a four-point scale using 200 images, which were computed by digital Image Analysis software. It analyses the grey values and converts them to three-dimensional graphics to value the surface extension. Analysis Of Variance test was used for comparisons between and within groups. RESULTS: The mean of the operator values for the A samples is 2 ("Poorly defined etch") and for the B samples is 3 ("Defined etch"). The Image Analysis showed a significant difference (Analysis of Variance test) in the extension of the etched areas between groups A and B. The samples from group B had 11.7% more effectively etched enamel surfaces than the samples from group A. CONCLUSION: Acquired pellicle removal by dental prophylaxis is necessary before enamel etching because it improves the effectiveness of the etching procedure.

Mechanical effect of static loading on endodontically treated teeth restored with fiber-reinforced posts.

The aim of this study was to investigate the mechanical behavior of a dental system built up with fiber-reinforced composite (FRC) endodontic posts with different types of fibers and two cements (the first one used with a primer, the second one without it). Six FRC posts were used. Each system was characterized in terms of structural efficiency under external applied loads similar to masticatory forces. An oblique force was applied and stiffness and maximum load data were obtained. The same test was used for the dentine. The systems were analyzed by scanning electron microscope (SEM) to investigate the surface of the post and inner surface of root canal after failure. The mechanical tests showed that load values in dental systems depend on the post material and used cement. The highest load (281 ± 59 N) was observed for the conical glass fiber posts in the cement without primer. There was a 50 and 85% increase in the maximum load for two of the conical posts with glass fibers and a 229% increase for the carbon fiber posts in the cement without primer as compared with the cement with primer. Moreover, almost all the studied systems showed fracture resistances higher than the typical masticatory loads. The microscopic analysis underlined the good adhesion of the second cement at the interfaces between dentine and post. The mechanical tests confirmed that the strength of the dental systems subjected to masticatory loads was strictly related to the bond at the interface post/cement and cement/dentine.

Johann Baptist Spix and the "lingula mandibularis".

Johann Baptist Ritter von Spix (1781-1826), a German zoologist, was famous in his time and highly honored after making one of the first exploration voyages in the wildest part of Brazil. He was almost forgotten in the annals of history for nearly two centuries after his birth, at which time some enlightened biographers brought him back into prominence in both the biological and zoological fields. On the contrary though, he had never been forgotten in the science of odontostomatology thanks to his discovery of the "Lingula Mandibularis" also known as "Spine of Spix". Johannes Baptist Spix was born in Hoechstadt, Germany in 1781. He was the Conservator of the Museum of Natural History in Munich and was a distinguished Comparative Anatomist. He died Munich inl 1826. The purposes of this work are to present some biographical notes on J.B. Ritter von Spix, to explain whythe "Lingula Mandibularis" has been called by the name of Spix and why this eponym has been used as such.

[Arturo Beretta and the "trophomicrobic theory of the caries"]. / Arturo Beretta e la "teoria trofomicrobica della carie".

The most original contribution made by the Italian School to the study of caries aetiology is undoubtedly the "trophomicrobic theory" proposed by Arturo Beretta, the first teacher of dentistry at the University of Bologna in 1918. This article brings biographical and bibliographical notes about Beretta (who was, among other things, Dean of the Faculty of Medicine of Bologna and Senator), and summarises the principles of his theory, which adds to Miller's "chemical-parasitic" theory of caries-predisposing properties of the enamel and host saliva. It also recalls the work of major Italian and non-Italian researchers who have used or modified Beretta's idea.

Classical music and the teeth.

Teeth and their pathologies are frequent themes in classical music. The teeth have inspired popular songwriters such as Thomas Crecquillon, Carl Loewe, Amilcare Ponchielli & Christian Sinding; as well as composers whose works are still played all over the world, such as Robert Schumann and Jacques Offenbach. This paper examines several selections in which the inspiring theme is the teeth and the pain they can cause, from the suffering of toothache, to the happier occasion of a baby's first tooth.

Mozart: the toothache of a genius.

The medical history of Wolfgang Amadeus Mozart (1756-1791) has been pieced together from his letters and from anecdotes, but his dental health is one aspect which has been somewhat overlooked. It is known that, from an early age, he suffered from toothache and tooth abscesses, problems that may even have had other medical repercussions. In this paper, the authors explore and consider whether these negative experiences might have influenced Mozart's work and his attitude to teeth and dental pathologies. Two pieces of evidence from the life and work of this great composer provide clues: the aria entitled "A tooth decayed and sensitive to cold" (KV 209 a) (1772), containing the lament of a "sick man" suffering from toothache; and the first of the "Zoroastrian Riddles," which Mozart proposed during a masked ball in 1786, and whose solution is "teeth." Close examination of these two creative feats demonstrate that Mozart's attitude toward dental pathologies was calm and rational, so much so that he even managed to use the topic as a source of inspiration for a small jewel of a composition.

Not just two million teeth: Giovanni Battista Orsenigo, monk dentist.

Brother Giovanni Battista Orsenigo, a monk of the "Ospitalieri di San Giovanni di Dio--Fatebenefratelli" holy order, was the most famous dental surgeon in Rome from 1870 to the start of the 20th century, but it was his nomination in 1972 by the Guinness Book of Records as the "most dedicated dentist", having kept more than 2 million extracted teeth, that brought him international reknown. Orsenigo was not merely a tooth-drawer, but a truly great dentist, and one who honored the code of his monastic order. It is important that this distinguished colleague, who is not mentioned in international dental literature, be restored to dental history and that his memory be preserved.

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).