Glycemic Control and Implant Stability in Patients with Type II Diabetes: Narrative Review

Advancements in implant design, surface characteristics, and surgical protocols have made implant restorations safe and highly predictable procedures. Bone metabolism plays a central role in the success of implant therapy. Diabetes mellitus is a significant disease impacting bone metabolism, particularly during the initial stages of osseointegration and in long-term survival. Moreover, aging is linked to various systemic conditions, such as diabetes, which increase the susceptibility of the periodontium and teeth to disease, often resulting in tooth loss. Studies on the impact of glycemic control on the success and longevity of implant-prosthetic rehabilitation in diabetic patients highlight a significant association between hyperglycemia and complications in implant therapy. This review identified 18 relevant publications through Medline, and studies were screened against the aim and objectives of the review. A total of five articles were excluded because of lack of focus on the effect of glycemic control on dental implants. Diabetic patients with poorly controlled blood glucose levels may face a heightened risk of developing implant complications. Effective glycemic control plays a critical role in the long-term success of dental implants in these individuals. Marginal bone loss (MBL) is a critical indicator of implant health and success. Clinical studies generally show greater MBL in diabetic patients compared to non-diabetic individuals. Furthermore, controlled type 2 diabetes mellitus (T2DM) has been associated with significantly better maintenance.

Periodontitis and Depressive Disorders: The Effects of Antidepressant Drugs on the Periodontium in Clinical and Preclinical Models: A Narrative Review

Background/Objectives: Several psychological conditions, including stress and depression, can adversely affect oral health; in fact, antidepressants, commonly used to treat depressive disorders, may have conflicting effects on the periodontal status of individuals. The aim of this review was to determine the effects of antidepressants on the periodontium. Methods: A literature search was conducted using electronic databases, Pubmed/MEDLINE, Cochrane Library, focusing on the use of antidepressants and their effects on periodontal health in animals or humans. Results: Seventeen articles have been included with the use of amitriptyline (two studies), desipramine (one study), imipramine (two studies), desvenlafaxine (one study), fluoxetine (six studies), venlafaxine (three studies) and tianeptine (two studies). One study evaluated several categories of antidepressants, such as selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), tricyclic, atypical and monoamine oxidase inhibitors (MAO). Most trials showed improvements in periodontal health, especially with fluoxetine, but also with imipramine, desipramine, desvenlafaxine and tianeptine; on the contrary, worsening of clinical periodontal indices and increased loss of alveolar bone were reported with venlafaxine. Conclusions: This review suggests that in the presence of comorbidity between periodontitis and depression, pharmacological treatment with SNRIs, SSRIs and mixed antidepressants is associated with improvement in periodontal parameters, except for venlafaxine. Healthcare professionals (especially oral and mental health professionals) should investigate proper adherence to medication therapy in patients with a history of periodontitis and depression. Further clinical trials are needed to confirm these results.

Microbiological and Clinical Assessments of Suture Materials and Cyanoacrylate Application in Impacted Third Molar Surgeries: A Scoping Review

The extraction of impacted third molars is a common but potentially complication-prone oral surgical procedure. Wound healing plays a vital role in preventing complications. This scoping review aimed to assess the clinical and microbiological aspects of various suture materials and cyanoacrylates. Unlike existing studies, we included more articles and comprehensively compared suture materials. Articles published in languages other than English; duplicate studies; studies deemed irrelevant for the specific research questions, including those analyzing different supplementary treatments or not corresponding to the abstract's content; ex vivo or experimental animal studies; studies lacking approval from an ethics committee; and narrative reviews, systematic reviews, or systematic and meta-analysis reviews were excluded. Thus, only 17 studies, published between 2000 and 2023, were included in the search. Suture techniques varied among surgeons, with debates on primary and secondary closure methods. A comparison of different suture materials and their effects on wound healing, infection rates, and other factors was described. Cyanoacrylate has also been used as an alternative to traditional sutures. Microbiological analysis showed varying bacterial adhesion based on the suture material, with silk sutures retaining more microbes than PTFE sutures. Clinical assessments have revealed differing inflammatory responses that affect wound healing and complications. Cyanoacrylate has emerged as a promising alternative to traditional sutures, owing to its rapid polymerization and early healing. However, the choice of suture material in impacted third molar surgery remains controversial, considering microbiological factors and clinical outcomes. More extensive randomized clinical trials are required to better understand the effect of suture materials on surgical outcomes and potential improvements. This study could enhance the safety and effectiveness of this common oral surgical procedure.

Ozonized Hydrogels vs. 1% Chlorhexidine Gel for the Clinical and Domiciliary Management of Peri-Implant Mucositis: A Randomized Clinical Trial

Peri-implant mucositis consists of a reversible inflammation of peri-implant tissues characterized by bleeding on gentle probing in the absence of bone loss. Ozone therapy is being extensively studied for its efficacy in treating different dental conditions. To date, few studies have evaluated ozone as an adjunct to the oral hygiene measures of peri-implant mucositis patients. The aim of the present study is to assess the efficacy of an ozonized gel (Trial group) compared to chlorhexidine (Control group) after a domiciliary protocol of oral hygiene in a 6-month study. According to a split-mouth study design, patients were divided into Group 1 for the application of chlorhexidine gel in peri-implant mucositis sites of quadrants Q1 and Q3, whereas in quadrants Q2 and Q4, the ozonized gel was in-office administered. For Group 2, the quadrants were inverted. At baseline (T0), and after 1 (T1), 2 (T2), and 3 (T3) months, Probing Depth (PD), Plaque Index (PI), SI Suppuration Index (SI), Bleeding Score (BS) and Marginal Mucosa Condition (MMC) were measured. A statistically significant decrease was found for all the variables assessed in each group (p < 0.05), whereas significant intergroup differences were found only for PI, BoP, and BS. Accordingly, both agents tested in this study showed an efficacy in treating peri-implant mucositis. The ozonized gel deserves particular attention, considering the better outcome than chlorhexidine on specific clinical periodontal parameters, as well as its lesser shortcomings.

Floor of the Mouth Hemorrhage Following Dental Implant Placement or Guided Bone Regeneration (GBR) in the Atrophic Interforaminal Mandible

The authors present two cases of mouth floor hemorrhage consequences of implant placement within the atrophic anterior mandible. In one patient, the implant placement was associated with the guided bone regeneration (GBR) technique. This serious complication has been widely described in the literature, especially in the anterior mandible area. In cases of bone resorption, the edentulous ridge becomes closer to the artery, and the risk of vessel injury increases. In both patients, the hematoma rapidly spread in the loose tissues of the mouth floor, displacing the tongue posteriorly and cranially, with airway compromise. The patients were hospitalized with nasotracheal intubation to secure the airway. In both patients, the bleeding stopped spontaneously, and after a few days, the oral floor swallowing was reduced, allowing the endotracheal tube to be removed. In about 2 weeks, the hematoma completely resorbed without surgery. According to the literature, the main cause of floor of the mouth hemorrhage is the mandibular lingual cortical plate perforation during bone drilling with subsequent sublingual-submental artery injury. In fact, in the first patient presented, this surgical error was clearly noticeable on the CT scan. Differently, in the second case reported, no radiological signs of inner cortical perforation were observed, and together with a mouth floor hematoma, a blood collection was also evident on the lower lip, suggesting a different cause of bleeding. Most likely during the periosteal release incision, mandatory in GBR technique, the ascending mental artery was injured, and hematoma spread in the mouth floor through the similar incision done on the lingual flap. Firstly, the mouth floor hemorrhage caused by an injury of a vestibular soft tissue artery during GBR surgery was reported. Strategies and recommendations to avoid this life-threatening event are provided, based on the literature review and the authors' experience.

Oral findings in pediatric patients with allergic rhinitis and asthma: a cohort study of an Italian setting

Allergic rhinitis and asthma are two frequent respiratory clinical entities commonly encountered in pediatric clinical settings. Previous studies have evaluated the influence of these two conditions on oral health, but conflicting results have been obtained. The present cohort study aimed to record oral findings (i.e., caries, plaque, gingival inflammation and mouth breathing) in 50 pediatric patients diagnosed with allergic rhinitis and/or asthma in an Italian pediatric setting and to compare them to a control group of 50 healthy children. The following oral indexes were calculated: Periodontal Screening and Recording (PSR), Plaque Control Record (PCR), and Decayed Missing Filled Teeth (DMFT) Index. The absence or presence of mouth breathing was also recorded. Descriptive and inferential statistics were conducted. Statistically significant differences were found between cases and controls for PSR (p = 0.0051) and PCR scores (p < 0.0001), whereas no significant differences were detected for DMFT. Mouth breathing was found among 20 (40.00%) patients of the Case Group, while in the Control group only in 11 (22.00%) patients, and no significant differences were found between allergic rhinitis and asthma gradings for mouth breathers (p > 0.05). Finally, linear regressions showed a significant influence of PSR (p = 0.0051) and PCR (p < 0.0001) on the Case group. Mouth breathing also significantly influenced PCR scores of the Case group (p = 0.0206). Accordingly, allergic rhinitis and asthma can promote mouth breathing, plaque accumulation, and periodontal inflammation. Based on these considerations, pediatric dentists and physicians are expected to know the influence of respiratory conditions on oral health and consider this aspect when taking care of children.

Clinical Applications for Dentistry and Oral Health

In the last few years, dentistry has expanded the scope of its research and increased its cooperation with other disciplines [...]

Laser and remineralising agents in dental erosion: a systematic review and meta-analysis

AIM

This systematic review aimed to evaluate, by means of statistical comparison between selected studies, the effectiveness of laser irradiation on dental erosion applied alone or in combination with anti-erosive agents (fluoride, Acidulated phosphate fluoride APF and CPP-amorphous calcium fluoride phosphate CPP-ACFP), through optical profilometry and microhardness measurement.

METHODS

The searching strategy was conducted according to the International PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, to answer research ques-tions regarding the effectiveness of lasers used in the context of dental erosion (such as Nd:YAG, CO2, Er:YAG, Er,Cr:YSGG, Diode, and Argon Ion lasers). A comprehensive and unrestricted sys-tematic searching was performed using the electronic databases of PubMed and Cochrane Library, for all articles published up to the end of January 2023. The review record was registered by the International prospective register of systematic reviews (PROSPERO) under the identification number CRD408639.

CONCLUSION

Change in microhardness for the lasers group, irrespective of the type of laser used in the sample, was significantly greater compared with the one in the control group. Regards microhardness, the combination of Laser and APF gel showed promising results compared to APF gel agent.

Multibraided Fixed Retainers with Different Diameters after Magnetic Resonance Imaging (MRI): In Vitro Study Investigating Temperature Changes and Bonding Efficacy

OBJECTIVES

Orthodontists are often asked to remove fixed retainers before patients undergo magnetic resonance imaging (MRI). The present in vitro study was designed to analyze the heating and bonding efficacy of stainless steel multibraided fixed retainers after 1.5- and 3-tesla (T) MRI.

MATERIALS AND METHODS

A total of 180 human mandibular incisors were used to create 45 specimens of four teeth each, divided into nine groups. Handmade multibraided fixed retainers of three different sizes, defined by the diameter of the initial wire used (0.008″, 0.010″ and 0.012″), were tested. Three groups underwent MRI at 1.5 T, another three groups underwent MRI at 3 T and the last three groups did not undergo MRI. Temperature was assessed before and after MRI. Shear bond strength (SBS) and adhesive remnant index (ARI) were assessed after MRI for all groups. Data were statistically analyzed (p < 0.05).

RESULTS

After 1.5 T exposure, no significant temperature increase from T0 to T1 was observed in any of the groups (p > 0.05). Regarding the 3 T groups, a significant difference from T0 to T1 was found for all the groups (p < 0.05). Temperature changes were not clinically relevant, as they were less than 1 °C for all groups except for group 3 (ΔT0-T1: 1.18 ± 0.3 °C) and group 6 (ΔT0-T1: 1.12 ± 0.37 °C). Furthermore, there were no significant differences between the temperature variations associated with different wire diameters (p > 0.05).

CONCLUSIONS

No significant changes in SBS or ARI were found (p > 0.05).

CLINICAL SIGNIFICANCE

Since overheating was irrelevant and adhesion values did not change, the tested devices were concluded to be safe for MRI examinations at 1.5 T and 3 T.

Personalized Treatment of Periodontitis in a Patient with McArdle's Disease: The Benefits from Probiotics

INTRODUCTION

McArdle's disease is a severe glycogen storage disease characterized by intolerance to exercise; patients have a syndrome of muscle intolerance to stress, associated with myalgia, cramps, fatigue, and muscle weakness. Periodontal disease is a multifactorial pathology of the supporting tissues of the teeth: one of the main factors is the formation of bacterial biofilm; its control favors the prevention and the maintenance of good health of the oral cavity; and some systemic pathologies can worsen the periodontal disease and hinder its therapy. This case report concerns a woman with McArdle's disease diagnosed with periodontal disease. Material and Methods. A 54-year-old female patient with McArdle's disease has been diagnosed with Stage 3 generalized periodontitis, Grade B. At the baseline, the patient had 82 pockets with probing pocket depth (PPD) equal to or greater than 4 mm. The patient was instructed in the correct methods of oral hygiene and was advised toothpaste and mouthwash based on probiotics; subsequently, a debridement was performed to remove etiological factors using Dental-Biofilm Detection Topographic Technique (D-BioTECH).

RESULTS

After 60 days, the number of pockets was reduced from 82 to 14 overall with PPD ≥ 4 mm and from 50 to 2 pockets with PPD ≥ 5 mm. Full mouth bleeding score (FMBS) increased from 48% to 15% and full mouth plaque score (FMPS) from 73% to 15%.

CONCLUSIONS

In this case, the use of a correct brushing method combined with the D-BioTECH has reduced the disease state, with the use of probiotics at home to restore and maintain a healthy oral microbiome.

Robot-assisted rehabilitation of people with breast cancer developing upper limb lymphedema: protocol of a randomized controlled trial with a 6-month follow‑up

Upper limb lymphedema (ULLy) is an external (and/or internal) manifestation of lymphatic system insufficiency and deranged lymph transport for more than 3 months and frequently affects people as a consequence of breast cancer (BC). ULLy is often underestimated despite diminished motor skills, mood, and cognitive-behavioral complaints negatively condition the health-related quality of life (HRQoL) of persons. BC can also metastasize to the jawbone, further impacting on the HRQoL. In time, the implementation of robot-assisted rehabilitation (RR) for neurological diseases has grown to improve HRQoL and pain. This study aims to evaluate the effectiveness of a RR program in the treatment of individuals who develop an ULLy; as a further analysis, the study will assess the effectiveness of the same program in people with jawbone metastases from BC who will also develop ULLy. A randomized, parallel-group superiority-controlled trial will be conducted. 44 participants will be randomly allocated to either the experimental (receiving a RR program) or the control group (regular rehabilitation). Both groups will follow individual-based programs three times a week for 10 weeks. The main outcome measure will be the Lymphedema Quality of Life Questionnaire. Secondary outcomes will be a pain intensity numerical rating scale and the Cranio-Facial Pain Disability Inventory. Evaluations are before and after training and 6 months later. Findings may provide evidence on the effectiveness of a RR program on inducing improvements in the HRQoL and pain of individuals with ULLy due to BC. People with ULLy and jawbone metastases from BC are expected for similar or higher improvements as per the same comparisons above. This trial might contribute towards defining guidelines for good clinical rehabilitation routines and might be used as a basis for health authorities' endorsements.Trial registration OSF REGISTRIES, osf-registrations-jz7ax-v1 . Registered on 26 June 2023.

Lung Cancer Cells Infiltration into a Mandibular Follicular Cyst

INTRODUCTION

The oral cavity is a rare site for other organs' tumor metastases. The incidence rate ranges from 1% to 3% of all oral malignancies. Metastases more frequently localize in the mandible, especially in the molar area. Metastases within odontogenic cysts are extremely rare, thus in the literature, only a few cases have been reported. The follicular cyst is one of the most frequent cysts of the jaws. Radiologically it shows as a unilocular lesion with a sclerotic border, characterized by a homogenous radiolucency that incorporates the crown of the unerupted tooth.

METHODS

A 76-year-old female patient, affected by stage IV of lung adenocarcinoma, reported pain on the left mandible border, alongside lip dysesthesia. The ortho-panoramic radiograph showed a follicular cyst in the posterior left side of the mandible, with involvement of the ascending branch region. The cyst was surgically removed together with the impacted tooth. A histopathological examination of the specimen confirmed the diagnostic suspect of a follicular cyst, but in the cystic wall, focal infiltration of epithelial neoplastic cells was also found. The immunohistochemical analysis showed the presence of three different markers: CK 7+, TTF1+/-, and P40-. These markers identify the cells as metastatic lung carcinoma.

RESULTS

Secondary tumor spreading in the jaws' area is rare (3% of all malignant lesions). Despite odontogenic cysts can undergo a dysplastic transformation (affecting the epithelial covering in ≤1% of the cases), infrequently these neoplastic cells can be related to secondary tumor spreading in a cystic wall. This report describes a metastatic localization within a mandibular follicular cyst.

CONCLUSIONS

Malignant cancers' metastasis in the oral district remains a rare and unexplored condition, especially when metastases are located in odontogenic cysts. In this circumstance, surgical removal and histopathological examination are strongly recommended.

Evaluation of the Efficacy of Low-Particle-Size Toothpastes against Extrinsic Pigmentations: A Randomized Controlled Clinical Trial

Stain-removing domiciliary protocols are focused on the elimination of dental extrinsic pigmentations by the application of abrasive toothpastes, extensively available in commerce. The goal of the present study is to evaluate the efficacy of two different stain removal molecule-formulated toothpastes by the reduction of clinical parameters: the micro-cleaning crystals and activated charcoal. A total of 40 participants with extrinsic dental pigmentations were enrolled and divided into two groups: a Control group, assigned to a toothpaste with micro-cleaning crystals (Colgate Sensation White); and a Trial group, with microparticle-activated charcoal toothpaste (Coswell Blanx Black). At T0 (baseline), T1 (10 days), T2 (1 month), and T3 (3 months), clinical parameters, including Lobene stain index calculated for intensity and extension, plaque control record, and bleeding on probing, were measured. Statistically significant differences were found in both groups (p < 0.05): a reduction of extrinsic pigmentation, both in intensity and extension, was obtained in the Control group, but their total elimination could be achieved only in the Trial group with the activated charcoal molecule, though without significant difference between the groups (p > 0.05). No intergroup differences were found for each timeframe for PCR, BoP, LSI-I, and LSI-E. Both tested toothpastes can be recommended for domiciliary oral hygiene of patients with extrinsic pigmentations.

New Materials and Techniques for Orthodontics

Orthodontics is a specialty of dentistry dealing with the prevention, diagnosis, and treatment of mispositioned jaws and teeth [...].

Evaluation of Ozonized Gel Application for Stain Removal on Dental Composite Resins

Staining removal is an issue of interest in dentistry. Current treatments deal with staining removal on enamel, while few studies concentrate on resin composites. The aim of the current study is to evaluate the efficacy in staining removal of an ozonated gel on dental composites. The study sample consisted of 40 specimens of restorative composites: 20 specimens were stained for 1 day in tea solution (tea group) and 20 specimens were stained for 1 day in physiological solution (NaCl group). Both the tea and NaCl groups underwent the experimental treatment as follows: five specimens underwent ozonized gel application, five specimens underwent an ozonized spray, five specimens underwent an application of olive oil, and five specimens were not treated. A colorimetric evaluation was performed with a spectrophotometer, using CIEDE2000 data elaboration at the baseline (T0), after staining (T1), and after staining removal (T2). In the T0–T1 time frame, significantly different color changes (ΔE00) were found between tea groups and NaCl groups (p < 0.05), except for control groups (p > 0.05). After staining removal in the T1–T2 period, no significant differences in ΔE00 were found (p > 0.05). Higher values were found for groups treated with ozonized gel, denoting a stain removal effect. The groups treated with olive oil, instead, exhibited higher ΔE00 values, showing a greater staining effect. In conclusion, the ozonized gel tested showed staining removal activity on restorative resin composites. Future clinical applications are required to validate the in vitro results obtained.

[SILVIO PALAZZI (1892-1979), A PIONEER OF MODERN ITALIAN DENTISTRY]

It is not easy to analyse a complex figure like Silvio Palazzi (1892-1979). Without a doubt, he was one of the most prominent figures in the Italian odontostomatology scene for about fifty years and one of the absolute protagonists of the transition of Italian dentistry from the pioneering era to the scientific. He was certainly a precursor and a man with an open mind, endowed with a broad vision. Palazzi had an eclectic, versatile personality, from certain points of view even brilliant but also unpredictable and difficult to understand. He was at the centre of Italian dentistry’s academic and professional life; few can boast of a didactic, clinical, scientific activity like his. Having become, at a young age, the director of a clinic that was still little more than a dental practice, he was able to make it grow, revitalise it, bring it to a level of excellence that had no comparison in Italy but that could be compared to that of the great European dental clinics. He was the author of a “Treaty of Odontology” (which had seven editions) on which entire generations of dentists were formed, and he wrote over five hundred scientific publications in all the fields of Odontostomatology. He particularly favoured histological and histochemical investigations, as he often recalled, for having been trained in this sense by his attendance at the Institute of General Pathology of Pavia directed by Camillo Golgi (1843-1926, Nobel Prize for Medicine in 1906). In the clinical field, every sector of the dental discipline saw him as an attentive and passionate scholar, in particular of Endodontics and Periodontology. Furthermore, he was a pioneer of implantology when this branch received more criticism than success and began research on the prophylactic action of fluoride when many were against it. He fought assiduously for a different Italian dental legislation: he was a convinced supporter of a special Degree Course for the preparation of the future dentists, already in the Fifties. Since this project seemed difficult to carry out, he proposed, if nothing else, the requirement of a post-graduate specialisation to guarantee suitable training to dental practitioners. Despite this, due to his often aggressive and argumentative attitude, he lost the friendship of many colleagues and created numerous enemies. Certainly, he was a character who cannot go unnoticed and who, forty years after his death, deserves a careful historical evaluation.

Clinical and Technological Evaluation of the Remineralising Effect of Biomimetic Hydroxyapatite in a Population Aged 6 to 18 Years: A Randomized Clinical Trial

The aim of this randomized clinical trial was to evaluate the efficacy of two different remineralising toothpastes in preventing dental caries and promoting oral health. Patients aged 6-18 years old with healthy and fully erupted first permanent molars (C1 and C2 DIAGNOdent scores) were enrolled and randomized into two groups according to the home-hydroxyapatite-based remineralising treatment used: the Trial group used zinc carbonate hydroxyapatite-based treatment (Biorepair Total Protective Repair), while the Control group used magnesium strontium carbonate hydroxyapatite conjugated with chitosan toothpaste (Curasept Biosmalto Caries Abrasion & Erosion). Dental and periodontal parameters were measured over a six-month period, including the DIAGNOdent Pen Index (primary outcome), BEWE Index, Plaque Index, Bleeding Score, Schiff Air Index, and ICDAS assessed with DIAGNOcam. A total of 40 patients were equally allocated in the two groups and finally analyzed. A significant reduction in the DIAGNOdent Pen score was reported in the Trial group after 1 month of treatment, while in the Control group, no significant change was found. The Trial group also showed a significant reduction in plaque levels after 3 months of treatment, while in the Control group, it occurred after 1 month. However, the Bleeding Score and Schiff Air Index showed no significant differences between the groups, suggesting that additional measures may be required to address gingival inflammation and hypersensitivity. The ICDAS index also showed no statistically significant changes, due to the limited duration of this study. Overall, zinc-hydroxyapatite-based toothpaste was more effective than magnesium strontium carbonate hydroxyapatite toothpaste in enhancing enamel remineralisation in the short-term period. The assigned treatments did not result in significant improvements in the oral indexes assessed in this study.

Beniamino De Vecchis (1886-1972) Italian Dentist and Historian

Beniamino De Vecchis (1886-1972) took his Medicine Degree at the University of Naples and then moved to the University of Philadelphia to carry out experimental studies in dental science. He had been Professor of Dentistry at the University of Rome in the second half of twentieth century and was an author of important essays about dentistry and history of dentistry. Moreover, he was the first author of an Italian treatise about orthodontics and dentofacial orthopedics. In this paper we propose to analyze and evaluate his contributions to dentistry in his country of Italy.

Relationship Between Vertical Facial Patterns and Palatal Morphology in Class I and Class II Malocclusion

(1) The purpose of this study is to relate the bidimensional and tridimensional measures of the palate to the vertical facial pattern defined by the angle “SN-MP” between the mandibular plane and the anterior cranial base (Sella–Nasion/mandibular plane angle) in skeletal Class II untreated patients. Furthermore, the same palatal measures were used to compare Class II with Class I subjects. (2) A sample of 197 Class II Caucasian subjects (112 females and 85 males) with untreated skeletal Class II was collected retrospectively (from a private dental clinic specialized in orthodontics) and divided into two main groups according to the ANB angle: 74 Class I patients (0° ≤ ANB ≤ 4°) and 123 Class II patients (ANB > 4°). Class II subjects were furthermore divided into three groups depending on the angle SN-MP. Lateral cephalograms and digital 3D maxillary dental scans were available. Bidimensional and tridimensional measures were taken on each maxillary dental scan. The differences among the groups were analyzed for significance using a variance analysis. (3) A decrease in the posterior palatal height and an increase in the palatal surface area in Class I subjects were reported. The results showed a change in upper arch form, with a greater intermolar width in patients with a low SN-MP angle and a smaller one in high-angle patients. The more a Class II subject tended towards high-angle divergence, the narrower the palate was. (4) A greater posterior palatal height was found in Class II malocclusion, while greater surface area was noted in Class I malocclusion. In addition to this result, another statistical significance was detected in Class II malocclusion: the intermolar distance was greater in hypodivergent than in hyperdivergent patients. Similar volume values were noted across different malocclusions and vertical divergence groups. Palatal width seemed to be related to vertical facial pattern, while palatal height and area seemed to be related to sagittal malocclusions. These findings underscore the importance of considering palatal morphology variations in designing individualized orthodontic treatments, thereby improving patient-specific outcomes and broadening our understanding of skeletal Class II malocclusion.

Clinical Applications for Dentistry and Oral Health, 2nd Volume

In recent years, dentistry has extended the aspects of its research and its cooperation with other disciplines [...]

Effects of Froggy Mouth Appliance in Pediatric Patients with Atypical Swallowing: A Prospective Study

Atypical swallowing has a high incidence in growing subjects. Orthopedic treatment with orthodontic appliances and speech therapy are the main approaches to this problem. The aim of this prospective study was to evaluate the changes in the dental arches induced by one year of treatment with the Froggy Mouth myofunctional appliance designed to correct atypical swallowing. In total, 16 patients with atypical swallowing were instructed to use the Froggy Mouth appliance. A digital intraoral impression was taken at baseline (T0). The Froggy Mouth appliance had to be used for 15 min/day throughout the treatment period. At the end of the first year of treatment (T1), another impression was taken with the same intraoral scanner. Digital casts of the T0 and T1 impressions were obtained using software and the two casts were superimposed to record the following measurements: upper intercanine distance, upper arch diameter, upper arch width, overbite and overjet. The data were statistically analyzed (significance threshold: p < 0.05). Student's t-test was used to compare pre- and post-treatment measurements. Linear regressions were performed to assess the influence of arch width on anterior and posterior diameters. A significant increase was found for the upper arch diameters (p < 0.05), whereas no statistically significant difference was found for the incisor relationship (overjet/overbite) (p > 0.05). To date, the efficacy of this appliance has not been extensively studied. According to the present prospective study, the Froggy Mouth protocol could be a valuable method as a myofunctional therapy for atypical swallowing, but further studies are needed to confirm these preliminary results.

Musculoskeletal Disorders in the Clinical Practice of Dental Hygienists and Dentists, Prevention and Awareness among Italian Professionals: Focus on Enlarging Systems

(1) Background: Musculoskeletal disorders of the upper limbs are a common medical condition among dental hygienists and dentists, making them a common occupational risk for dental professionals. The purpose of the work was to collect information about the dental professions and their habits to highlight what can be good practices to be carried out to prevent any musculoskeletal disorders. (2) Methods: To identify habits and problems inherent in the professional activity of dental hygienists and dentists, a questionnaire was formulated on the use of enlarging systems. (3) Results: The questionnaire was completed by 241 dental professionals. As for the use of magnifiers, 72.6% of participants use them: among dental hygienists, 67.8% use magnifiers, among dentists, 80.9% use magnifiers; there is a statistically significant difference. There is no statistically significant difference between professions regarding muscle disorders. (4) Conclusions: For a clearer assessment, it would be appropriate to submit the questionnaire to a wider sample of professionals, to define better the correlation between musculoskeletal disorders, work activity and the type of enlarging systems used.

Orthodontic repositioning of a lingually positioned transmigrated mandibular canine

This case report presents the successful orthodontic repositioning of a transmigrated and lingually positioned mandibular canine with conventional mechanics. Treatment began with the aim of creating space for the four permanent canines that had not yet erupted. Cervical headgear, mesial slice, and extraction of the deciduous teeth were executed, but only the right canines erupted; moreover, the mandibular left canine had become lingually transmigrated. Multibracket therapy was performed with the orthodontic repositioning of both left canines in 2 steps. They were repositioned, and good alignment was obtained. To our knowledge, this is the first case report describing the orthodontic repositioning of a lingually transmigrated canine with conventional double-arch mechanics. This treatment was successful and without significant complications, even though this approach can be challenging and time-consuming.