The dentist's role in recognizing childhood abuses: study on the dental health of children victims of abuse and witnesses to violence.

AIM: Up to today, little attention and training has been paid, in the Italian dental field, to a dramatically widespread problem, childhood abuse and neglect (CAN). Our research fits into a current of thought on alerting physicians, not only paediatricians, to the problem of abused children. Violence is often part of neglect and carelessness toward children, and it often also concerns their personal hygiene and health care. Aim of our study was to verify the hypothesis that dental neglect, intended as a specific form of neglect, is often associated to other types of neglect, and therefore it could represent an important sign in identifying childhood abuse and neglect situations. These were investigated through the comparison between a group of children with psychological disorder and a control group, as far as their dental health is concerned. Our results indicate that the abused children show: a significantly higher dental plaque index (p=.02); a higher gingival inflammation (p =.2); a higher number of untreated decays (p=.004); more evidences of neglect (p = .0002). Additionally, the abused subjects were less cooperative during dental visits (p=.0005). Our data support the hypothesis that the abused children in our group are, both under the hygiene point of view and access to treatment, more neglected by their caregivers.

Clinical guidelines for prevention of osteonecrosis of the jaws in patients in treatment with bisphosphonates: literature review and report of three cases.

Lately clinical evidence has suggested that the development of osteonecrosis of the jaws (ONJ) might be associated to assumption of high doses of nitrogen-bisphosphonate (N-BPs), quite common in the treatment of multiple myeloma and skeletal metastasis due to breast and prostate cancer. Bisphosphonates are used for the treatment of several pathologies such as osteoporosis, Paget's disease, multiple myeloma, malignant hypercalcemia, breast and prostate tumours, and other tumours associated with bone metastasis. Their use might improve patient's life standard, reducing pain and complications of the skeletal structure. In this report three clinical cases of ONJ of patients in treatment with BPs are presented, and the possible pathogenesis is analysed. Further-more, treatment guidelines for the management of patients in treatment with BPs who need restorative dental care and oral surgery are proposed.