Tongue Mucoceles: a retrospective clinic-pathological evaluation of 240 cases.

BACKGROUND: Minor salivary glands can be found in the ventral and anterior part of the tongue; these glands can rarely develop mucoceles that, due to their rarity and their unusual clinical appearance, may present an interesting differential diagnosis. Mucoceles appear as an exophytic, sometimes pedunculated, lesion, which is a feature that is due to the absence of a capsule; thus, the glands are right beneath the mucosa and over the muscle tissue. The aim of this article is to retrospectively present and discuss the anatomy, pathology, clinical features and therapy of several cases of Blandin-Nunh mucoceles collected from two different institutions. METHODS: A retrospective case review was carried out in two university institutions, retrieving all cases of tongue mucoceles from 1999 to today. Two oral pathologists reviewed all the slides, confirming the diagnosis. Demographic data of the patient, anatomic location and clinical appearance were retrieved from clinical charts, together with the type of surgical procedure and possible relapses. RESULTS: A total of 240 cases of tongue mucoceles were gathered from the archives: the mean age was 22 years (DS = 14,7; Range 2-83), 126 were females (52,5%, mean age 22,7 years, DS = 16,5; Range 2-83), and 114 were males (47,5%, mean age 20,9 years, DS = 12,4; Range 3-73); in all cases, a history of trauma was reported. The ventral surface was the most frequent location (224 cases - 93,3%), and in the great majority (235 cases - 97,9%), pathology revealed mucous spillage with a wall formed by fibrous connective and granulation tissue with no epithelium lining the cavity. Superficial mucocele and sclerosing sialoadenitis were the more frequent pathological variants (21 cases - 8,8%). All lesions were treated with excision and enucleation of the servicing gland. The healing was uneventful in all cases, but there were four recurrences and two cases of sensory paraesthesia of the border of the tongue, all in males, except one case of paraesthesia in a female. CONCLUSIONS: Tongue mucoceles must be differentiated from many benign and malignant lesions. For this reason, surgical removal of the lesion and of the associated gland with a pathological exam is mandatory. In fact, the anatomical location of the glands and the possible pathological variants must be considered to reach a correct diagnosis and diminish possible relapses. TRIAL REGISTRATION: CE-Muc_Ton_3/2023.

Attitudes and practices of dentists treating HIV+ patients in the era of new antiretroviral therapy: A 12-year update.

During the first years of the HIV pandemic, the virus diffusion was responsible for discriminatory behavior from medical and dental care workers towards HIV-infected patients, as described by our research group in 2009. The aim of the current study was to provide an update on the previous data, investigating the presence of discriminatory behaviors, evaluating the level of dentists' knowledge about the virus and proposing strategies to be implemented to avoid professional exposure and cross-infections. This study was a cross-sectional, online, national survey on dentists, members of the main national dental associations (ANDI and AIO). The questionnaire was divided into four major sections, with the same structure as the questionnaire administered in 2009. The differences between groups were analyzed using the software program IBM SPSS Statistic, version 21.0. A total of 1054 dentists filled out the questionnaire completely. Among them 0.04% revealed a discriminatory attitude towards HIV-infected patients. The univariate analysis showed that discrimination towards HIV + patients was statistically associated with personal experiences and the level of fear associated with treating them (p = 0.001) and with the type of dental treatments performed (p = 0.01). This cross-sectional study revealed the persistence of dentists who still discriminate against HIV + patients, and the percentage of these dentists was only slightly lower than that in the previous survey (4.3% in the present survey vs. 4.5%). The survey also depicted other information worthy of consideration, such as a perceived ability to detect HIV + patients based on their appearance, complaints about not having received adequate training for treating HIV + individuals, and a lack of scientific knowledge about the virus. From the evidence reported by the present survey, it can be argued that universities, professional boards, and training institutions must increase their efforts in spreading correct knowledge about HIV among all dental care workers.

Anxiety and depression in keratotic oral lichen planus: a multicentric study from the SIPMO.

OBJECTIVES: Oral lichen planus with exclusive keratotic reticular, papular, and/or plaque-like lesions (K-OLP) is a clinical pattern of OLP that may be associated with a complex symptomatology and psychological alteration. The aim of the study was to evaluate the prevalence of anxiety (A) and depression (D) in patients with K-OLP, analyzing the potential predictors which can affect mental health status. METHODS: Three hundred K-OLP patients versus 300 healthy controls (HC) were recruited in 15 Italian universities. The Numeric Rating Scale (NRS), Total Pain Rating Index (T-PRI), and Hamilton Rating Scales for Depression and for Anxiety (HAM-D and HAM-A) were administered. RESULTS: The K-OLP patients showed statistically higher scores in the NRS, T-PRI, HAM-D, and HAM-A compared with the HC (p-value < 0.001**). A and D were found in 158 (52.7%) and 148 (49.3%) K-OLP patients. Strong linear correlations were identified between HAM-A, HAM-D, NRS, T-PRI, and employment status and between HAM-D, HAM-A, NRS, T-PRI, employment status, and female gender. Multivariate logistic regression revealed that HAM-D and HAM-A showed the greatest increase in the R2 value for A and D in the K-OLP patients, respectively (DR2 = 55.5% p-value < 0.001**; DR2 = 56.5% p-value < 0.001**). CONCLUSIONS: The prevalence of A and D is higher in the K-OLP patients compared with the HC, also found in K-OLP subjects without pain, suggesting that the processing of pain may be in a certain way independent of the processing of mood. CLINICAL RELEVANCE: Mood disorders and pain assessment should be carefully performed in relation to K-OLP to obtain a complete analysis of the patients.

Oral Candida and psoriasis: Is there association? A systematic review and trial sequential analysis.

To assess (i) the prevalence of oral colonization by Candida spp. in patients with psoriasis and (ii) the prevalence of oral lesions associated with Candida spp. in patients with psoriasis and identify the risk factors for oral lesions. A systematic review was conducted in accordance with PRISMA criteria. The PROSPERO registration code is CRD42019127178. PubMed, Scopus and Web of Science were used as search engines. Meta-analyses and trial sequential analyses were performed. Among the 5805 retrieved records, nine articles were included. Among 530 psoriatic patients, 255 patients had an oral Candida spp. colonisation with an odds ratio (OR) = 3.44 (95% CI:2.38-5.00). Among 490 psoriatic patients, 43 patients developed oral Candida spp. lesions with an OR = 5.31 (95% CI:1.04-27.23). Among the patients without the main predisposing factors for infections, psoriatic patients had a higher OR (3.48, 95% CI: 2.0-6.0) for Candida spp. colonization, but not for Candida spp. infection, when compared with healthy controls (p-value > 0.05). Meta-analysis showed a higher risk of Candida spp. colonisation in patients with psoriasis. Patients who received immunosuppressive therapies were also at higher risk of developing oral lesions. Further studies are needed to understand these associations.

Microbiota and Oral Cancer as A Complex and Dynamic Microenvironment: A Narrative Review from Etiology to Prognosis.

A complex balanced equilibrium of the bacterial ecosystems exists in the oral cavity that can be altered by tobacco smoking, psychological stressors, bad dietary habit, and chronic periodontitis. Oral dysbiosis can promote the onset and progression of oral squamous cell carcinoma (OSCC) through the release of toxins and bacterial metabolites, stimulating local and systemic inflammation, and altering the host immune response. During the process of carcinogenesis, the composition of the bacterial community changes qualitatively and quantitatively. Bacterial profiles are characterized by targeted sequencing of the 16S rRNA gene in tissue and saliva samples in patients with OSCC. Capnocytophaga gingivalis, Prevotella melaninogenica, Streptococcus mitis, Fusobacterium periodonticum, Prevotella tannerae, and Prevotella intermedia are the significantly increased bacteria in salivary samples. These have a potential diagnostic application to predict oral cancer through noninvasive salivary screenings. Oral lactic acid bacteria, which are commonly used as probiotic therapy against various disorders, are valuable adjuvants to improve the response to OSCC therapy.

Where do you live? North versus Central-South differences in relation to Italian patients with oral lichen planus: a cross-sectional study from the SIPMO (Italian Society of Oral Pathology and Medicine).

BACKGROUND: Oral lichen planus (OLP) is an immune-mediated inflammatory chronic disease of the oral mucosa, with different patterns of clinical manifestations which range from keratotic manifestations (K-OLP) to predominantly non-keratotic lesions (nK-OLP). The aim of the study was to analyze the differences in the clinical, psychological profile and symptoms between Italian patients of the North and Central-South with K-OLP and nK-OLP. METHODS: 270 K-OLP and 270 nK-OLP patients were recruited in 15 Italian universities. The Numeric Rating Scale (NRS), Total Pain Rating Index (T-PRI), Hamilton Rating Scales for Depression and for Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) were administered. RESULTS: The Central-South K-OLP (CS-K-OLP) patients reported a higher frequency of pain/burning compared with the K-OLP patients of the North (N-K-OLP) with higher scores in the NRS and T-PRI (p value < 0.001**). The CS-K-OLP and the CS-nK-OLP patients showed higher scores in the HAM-D, HAM-A, PSQI and ESS compared with the Northern patients (p value < 0.001**). Multivariate logistic regression revealed that the NRS and T-PRI showed the greatest increase in the R2 value for the CS-K-OLP (DR2 = 9.6%; p value < 0.001**; DR2 = 9.7% p value < 0.001**; respectively) and that the oral symptoms (globus, itching and intraoral foreign body sensation) and PSQI showed the greatest increase in the R2 value for the CS-nK-OLP (DR2 = 5.6%; p value < 0.001**; DR2 = 4.5% p value < 0.001** respectively). CONCLUSIONS: Pain and mood disorders are predominant in patients with OLP in the Central-South of Italy. Clinicians should consider that the geographical living area may explain the differences in oral symptoms and psychological profile in OLP.

Assessment of sleep disturbance in oral lichen planus and validation of PSQI: A case-control multicenter study from the SIPMO (Italian Society of Oral Pathology and Medicine).

BACKGROUND: The wellbeing of oral lichen planus patients (OLPs) may be strongly influenced by a poor quality of sleep (QoS) and psychological impairment. The aims were to analyze the prevalence of sleep disturbance, anxiety, and depression in OLPs and to validate the Pittsburgh Sleep Quality Index (PSQI) in OLPs. METHODS: Three hundred keratotic OLPs (K-OLPs), 300 with predominant non-keratotic OLP (nK-OLPs), and 300 controls were recruited in 15 Italian universities. The PSQI, Epworth Sleepiness Scale (ESS), Hamilton Rating Scales for Depression and Anxiety (HAM-D and HAM-A), Numeric Rating Scale (NRS), and Total Pain Rating Index (T-PRI) were administered. RESULTS: Oral lichen planus patients had statistically higher scores than the controls in the majority of the PSQI sub-items (p-values < 0.001**). Moreover, OLPs had higher scores in the HAM-D, HAM-A, NRS, and T-PRI (p-values < 0.001**). No differences in the PSQI sub-items' scores were found between the K-OLPs and nK-OLPs, although nK-OLPs suffered from higher levels of anxiety, depression, and pain (p-values: HAM-A, 0.007**, HAM-D, 0.009**, NRS, <0.001**, T-PRI, <0.001**). The female gender, anxiety, depression (p-value: 0.007**, 0.001**, 0.020*) and the intensity of pain, anxiety, and depression (p-value: 0.006**, <0.001**, 0.014*) were independent predictors of poor sleep (PSQI > 5) in K-OLPs and nK-OLPs, respectively. The PSQI's validation demonstrated good internal consistency and reliability of both the total and subscale of the PSQI. CONCLUSIONS: The OLPs reported an overall impaired QoS, which seemed to be an independent parameter according to the regression analysis. Hence, clinicians should assess QoS in OLPs and treat sleep disturbances in order to improve OLPs management.

Osteoradionecrosis of the Jaws Due to Teeth Extractions during and after Radiotherapy: A Systematic Review.

Teeth extractions before or after radiotherapy (RT) could be procedures at high risk for osteoradionecrosis (ORN) onset. This systematic review was performed to investigate the ORN incidence following teeth extractions during and after RT for head and neck (H&N) cancer and to evaluate any other possible risk factor. METHODS: This systematic review was conducted according to PRISMA protocol, and the PROSPERO registration number was CRD42018079986. An electronic search was performed on the following search engines: PubMed, Scopus, and Web of Science. A cumulative meta-analysis was performed. RESULTS: Two thousand two hundred and eighty-one records were screened, and nine were finally included. This systematic review revealed an ORN incidence of 5.8% (41 patients out of 462, 95% CI = 2.3-9.4); 3 ORN developed in the maxilla. No other clinical risk factors were detected. CONCLUSION: Post-RT teeth extractions represent a major risk factor for ORN development, especially in the mandible, with a diminishing trend in the last years. Further research on other possible risk factors might improve this evidence.

Psychological profile and unexpected pain in oral lichen planus: A case-control multicenter SIPMO studya.

OBJECTIVES: To analyze psychological profiles, pain, and oral symptoms in patients with oral lichen planus (OLP). MATERIALS AND METHODS: 300 patients with keratotic OLP (K-OLP; reticular, papular, plaque-like subtypes), 300 patients with predominant non-keratotic OLP (nK-OLP; erythematosus atrophic, erosive, ulcerative, bullous subtypes), and 300 controls were recruited in 15 universities. The number of oral sites involved and oral symptoms were recorded. The Numeric Rating Scale (NRS), Total Pain Rating Index (T-PRI), Hamilton Rating Scales for Depression and for Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) were administered. RESULTS: The OLP patients, especially the nK-OLP, showed higher scores in the NRS, T-PRI, HAM-D, HAM-A and PSQI compared with the controls (p-value < .001** ). A positive correlation between the NRS, T-PRI, HAM-A, HAM-D, and PSQI was found with the number of oral symptoms and number of oral sites involved. Pain was reported in 67.3% of nK-OLP and 49.7% of K-OLP cases with poor correspondence between the site of lesions and the site of the symptoms. CONCLUSIONS: Mood disorders are frequently associated with OLP with an unexpected symptomatology correlated with the number of oral symptoms and with the extension of disease suggesting a peripheral neuropathy.

Tooth extraction before radiotherapy is a risk factor for developing osteoradionecrosis of the jaws: A systematic review.

OBJECTIVES: The aim of this systematic review was to estimate the osteoradionecrosis rate in patients with head and neck cancer due to teeth extraction performed before radiotherapy and to identify possible risk factors. MATERIAL AND METHODS: PRISMA protocol was used to evaluate and present the results. PubMed, Scopus and Web of Science were used as search engines: English full-length papers of clinical studies, in peer-reviewed journals, were investigated. Cumulative meta-analysis was performed with a random effects model (PROSPERO registration code: CRD42018079986). RESULTS: Among 2,020 records screened, 8 were included in this review. Sixteen of 494 patients who underwent tooth extraction before radiotherapy developed osteoradionecrosis, with an osteoradionecrosis incidence of 2.2% (95% Confidence of Interval = 0.6-3.9, p < .185, I2  = 3,044%). All cases were reported in the mandible. No other clinical risk factor for osteoradionecrosis was detected. CONCLUSIONS: Even if it is generally recommended to remove oral foci before radiotherapy, this systematic review confirmed that teeth extractions before radiotherapy represent a risk factor for osteoradionecrosis; the considerable amount of missing data prevented us from identifying other possible risk factors for osteoradionecrosis onset. Major efforts should be done to perform sounder methodological clinical investigations.

Child healthcare services offered by the Vatican City State in its national territory and in extra-territorial neighboring Italian areas.

Pediatric healthcare activity related to the Vatican City State is carried out at secondary and tertiary levels in the two main pediatric territorial and extra-territorial medical centers, which are administered by the Vatican: the Bambino Gesù Pediatric Hospital and the Mother and Child pediatric Department of the Casa Sollievo della Sofferenza Medical Center. Both centers are recognized by the Italian State and internationally with the formal legal status of Scientific Institutes for Clinical Research. The relations established between the Holy See, in the person of the Secretary of State, the Board of Directors, the President of the Board, and the Board of Auditors regulate the management of the two medical centers. The child healthcare and research activity of the two Vatican State administered medical centers is described in this article.

Brown tumors of the oral cavity: presentation of 4 new cases and a systematic literature review.

OBJECTIVE: The aim of this study was to obtain data from a review of cases of brown tumors (BT), which are benign lesions of bone characterized by giant cells that arise during hyperparathyroidism (HPTH). BTs may affect the maxillofacial area and manifest as a brownish, slow-growing swelling causing difficulty in the differential diagnosis. STUDY DESIGN: We present data from 4 new cases of oral BTs based on a systematic literature review conducted by searching EMBASE, Medline, and CENTRAL databases, according to the PRISMA guidelines. Only articles in English were considered. Individual patient data were analyzed to identify risk factors for multiple or extraoral maxillofacial BTs. RESULTS: In total, 167 cases (163 from 136 articles and 4 new cases; mean age 36.6 years; male-to-female ratio 1:2) were retrieved. The onset of extraoral maxillofacial BTs (odds ratio [OR] 176.3; 95% confidence interval [CI] 18.7-1657.8; P < .05) and maxillary BTs (OR 17.5; 95% CI 6.0-50.8; P < .05) were the risk factors for multiple oral BTs, whereas the presence of a BT in the mandible (OR 0.01; 95% CI 0.001-0.1; P < .05) was a negative predictor for the presence of other extraoral maxillofacial BTs. CONCLUSIONS: The results of this systematic review suggested that the mandible is the most frequent oral location of BTs. Whenever a BT is detected in the maxilla or when multiple oral BTs are diagnosed, more BTs in the maxillofacial area should be suspected.

Overexpression of nicotinamide N-methyltransferase in HSC-2 OSCC cell line: effect on apoptosis and cell proliferation.

OBJECTIVES: Oral squamous cell carcinoma (OSCC) is the most common malignancy of oral cavity. Despite advances in therapeutic approaches, the 5-year survival rate for oral cancer has not improved in the last three decades. Therefore, new molecular targets for early diagnosis and treatment of OSCC are needed. In the present study, we focused on the enzyme nicotinamide N-methyltransferase (NNMT). We have previously shown that enzyme expression is upregulated in OSCC and NNMT knockdown in PE/CA PJ-15 cells significantly decreased cell growth in vitro and tumorigenicity in vivo. MATERIAL AND METHODS: To further explore the role of the enzyme in oral cancer cell metabolism, HSC-2 cells were transfected with the NNMT expression vector (pcDNA3-NNMT) and the effect of enzyme upregulation on cell proliferation was evaluated by MTT assay. Subsequently, we investigated at molecular level the role of NNMT on apoptosis and cell proliferation, by exploring the expression of ß-catenin, survivin, and Ki-67 by real-time PCR. Moreover, we performed immunohistochemistry on 20 OSCC tissue samples to explore the expression level of NNMT and survivin ΔEx3 isoform. RESULTS: Enzyme upregulation significantly increased cell growth in vitro. Moreover, a positive correlation between NNMT and survivin ΔEx3 isoform expression levels was found both in HSC-2 cells and in OSCC tissue samples. CONCLUSION: Taken together, our results indicate a possible involvement of NNMT in the proliferation and tumorigenic capacity of OSCC cells and seem to suggest that the enzyme could represent a potential target for the treatment of oral cancer. CLINICAL RELEVANCE: The involvement of NNMT in cell growth and anti-apoptotic mechanisms seems to suggest that this enzyme could be a new therapeutic target to improve the survival of OSCC patients.

Rate of malignant transformation of oral lichen planus: A systematic review.

OBJECTIVE: The aim of this study was to systematically review the literature to determine: (a) the malignant transformation rate (TR) of oral lichen planus (OLP) and its risk factors; (b) whether or not oral lichenoid lesions (OLL) have a different malignant TR. MATERIALS AND METHODS: PubMed, Scopus, and Web of Science were used as search engines: only observational, full-length, English language studies were investigated. PRISMA protocol was used to evaluate and present results. PROSPERO registration code is CRD42016048529. RESULTS: Among 7,429 records screened, only 21 were included in this review. Ninety-two of 6,559 patients developed oral squamous cell carcinoma, with an overall TR of 1.40% (1.37% for OLP and 2.43% for OLL), an annual TR of 0.20%. Female gender, red clinical forms, and tongue site seem to slightly increase the transformation risk. CONCLUSIONS: This systematic review confirms that both OLP and OLL, the latter with a slightly higher TR, may be considered potentially malignant disorders and suggest that erosive type, female gender and tongue site should be considered as risk factors for OLP transformation. Major efforts should be done to establish strict clinical and histological criteria to diagnose OLP and to perform sounder methodological observational studies.

The crucial role of protein phosphorylation in cell signaling and its use as targeted therapy (Review).

Protein phosphorylation is an impo-rtant cellular regulatory mechanism as many enzymes and receptors are activated/deactivated by phosphorylation and dephosphorylation events, by means of kinases and phosph-atases. In particular, the protein kinases are responsible for cellular transduction signaling and their hyperactivity, malfunction or overexpression can be found in several diseases, mostly tumors. Therefore, it is evident that the use of kinase inhibitors can be valuable for the treatment of cancer. In this review, we discuss the mechanism of action of phosphorylation, with particular attention to the importance of phosphorylation under physiological and pathological conditions. We also discuss the possibility of using kinase inhibitors in the treatment of tumors.

Can Inspection of the Mouth Help Clinicians Diagnose Crohn's Disease? A Review.

PURPOSE: Crohn's disease (CD) is a chronic inflammatory bowel disease characterised by localised areas of nonspecific, noncaseating granulomas. Approximately 1/3 of CD patients develop extraintestinal manifestations in the course of their disease. This review focuses on oral manifestations of CD to understand if oral lesions could help clinicians in the diagnosis of systemic CD. MATERIALS AND METHODS: Literature for the review was retrieved using PubMed Medline, Ebsco Library and Web of Science. RESULTS: After a careful preliminary evaluation, only 43 articles were eligible for inclusion in the qualitative evaluation, whereas only 7 mentioned oral CD as the first sign of a systemic disease and were included in the quantitative evaluation. CONCLUSIONS: Oral manifestations of CD can be classified as specific and non-specific. The aetiology of oral CD seems to be linked to particular bacterial infections. Although the evidence from the literature is weak, it seems that in some cases the inspection of the mouth could assist in the diagnosis of a systemic Crohn's disease.

Relationship Between Biotype and Bone Morphology in the Lower Anterior Mandible: An Observational Study.

BACKGROUND: Different clinical parameters have been advocated as potential predictors of alveolar and basal jawbone morphology. The aim of this study is to describe, by tomographic means, alveolar and basal osseous dimensions of the anterior mandible in healthy individuals and evaluate potential correlations with biotype, along with other clinical parameters. METHODS: One hundred consecutive healthy patients needing surgery in the posterior mandible were enrolled in this observational study (group 1 = 50 patients with thin biotype; group 2 = 50 patients with thick biotype). Data were collected for: 1) Little irregularity index for anterior crowding; 2) molar and canine class relationship; 3) previous orthodontic treatment; 4) gingival recession; and 5) band of keratinized gingiva for each of the six anterior mandibular teeth (#22 through #27). At the most mid-buccal computerized tomography slice of each tooth, other parameters were measured, including: 1) distance from the cemento-enamel junction to the bone crest; 2) tooth torque (TT); 3) labial cortical bone thickness (BT) for alveolar and basal bone; and 4) BT 5 and 10 mm apical to the tooth apex. Data were statistically analyzed, and significance was set at P ≤0.05. RESULTS: Mean thickness of alveolar bone ranged from 6.66 to 4.51 mm (standard deviation [SD] = 1.46 for tooth #27; SD = 1.01 for tooth #25) whereas mean thickness of basal bone ranged from 8.9 to 8.2 mm (SD = 2.06 for tooth #22; SD = 2.06 for tooth #26). Mean thickness of bone at 5 mm from apex ranged from 11.94 to 10.47 mm (SD = 2.96 for tooth #25; SD = 2.22 for tooth #22), whereas mean thickness of bone at 10 mm from apex ranged from 13.75 to 11.08 mm (SD = 2.79 for tooth #25; SD = 2.53 for tooth #27). No statistically significant differences were detected among biotypes, whereas: 1) TT, 2) age, and 3) smoking habit were often predictors of reduction in BT in a multiple linear regression model. Male sex was often a predictor of positive changes in BT, and previous orthodontic therapy was a protective factor against developing bone loss >5 mm. CONCLUSIONS: Although some differences were detected among biotypes, data indicate that biotype does not play a fundamental role in influencing alveolar BT, whereas other variables (i.e., TT, sex, age, and smoking habit) do influence alveolar BT. Further studies are needed to better understand the extent of influence of each clinical variable.

Centering Ability of ProTaper Next and WaveOne Classic in J-Shape Simulated Root Canals.

Introduction. The aim of this study was to evaluate and compare the shaping and centering ability of ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland) and WaveOne Classic systems (Dentsply Maillefer) in simulated root canals. Methods. Forty J-shaped canals in resin blocks were assigned to two groups (n = 20 for each group). Photographic method was used to record pre- and postinstrumentation images. After superimposition, centering and shaping ability were recorded at 9 different levels from the apex using the software Autocad 2013 (Autodesk Inc., San Rafael, USA). Results. Shaping procedures with ProTaper Next resulted in a lower amount of resin removed at each reference point level. In addition, the pattern of centering ability improved after the use of ProTaper Next in 8 of 9 measurement points. Conclusions. Within the limitations of this study, shaping procedures with ProTaper Next instruments demonstrated a lower amount of resin removed and a better centering ability than WaveOne Classic system.

Surgical recommendations for the extraction of erupted maxillary third molars: landmarks emerging from a clinical study.

OBJECTIVE: This study evaluated the efficacy of an anatomicalradiologic- surgical protocol for the extraction of erupted maxillary third molars (EMTMs). METHODS AND MATERIALS: 166 EMTMs were extracted according to two different extraction techniques. Group 1 (G1, 97 teeth) was treated with the proposed protocol: multiple roots with forceps DG 117/DG 118; single roots with DG 250; tapered roots with DG 270; curved roots with Apexo 303 elevator. Group 2 (G2, 69 teeth) was treated with straight elevator and forceps DG 250 or DG 270. Extraction time and total number of complications (TNCs) were the main outcomes; TNCs were also divided in complications during the extraction (CDEs) and complications after the extraction (CAEs) as secondary outcomes. RESULTS: Differences between G1 and G2 were detected for extraction time (146.8 vs 225.6 seconds; P < .05) and for complications (G1, 13.4% vs G2, 47.8%; P < .001). Multivariate analysis showed that extraction time and smoking habit were independent risk factors for TNCs (P < .001); furthermore, "not applying the proposed extraction protocol" increases almost 7 times (6.86; 95% CI, 1.41-33.32; P < .02) the possible onset of CAEs. CONCLUSION: The proposed protocol can be helpful for the general dental practitioner in planning the extraction of EMTMs, shortening the extraction time, and diminishing the complications, especially those occurring after the extraction.

Cellular populations of periimplant tissues: cytological analysis with sulcular microbrushing.

PURPOSE: Cellular populations of gingival crevicular fluid cytological analysis of integrated implants sites have been investigated by using sulcular cytological brushing, as a means of providing an objective and reproducible technique for monitoring periimplant tissue health. MATERIALS AND METHODS: A total of 60 patients with osteointegrated implants bearing at least for 2 years were divided in 2 groups, A and B. Group A consisted of 30 subjects who presented scarce oral hygiene. In Group B, 30 subjects with a good oral hygiene were included. RESULTS: Comparative analysis of the data obtained by sulcular microbrushing of the 2 groups put into evidence significative differences in the expression of the microbiological and the cytological parameters. CONCLUSION: Clinical monitoring of parodontal and periimplant tissues makes use of several diagnostic tests ranging from clinical and radiological tests to biological assays. However, none of these techniques allows to evaluate periimplant tissue cytological status. This preliminary study suggested sulcular microbrushing might be a useful tool in the early diagnosis and in the micrological monitoring of peri-implantitis.