Burning mouth syndrome is defined as an intraoral burning sensation for which no medical or dental cause can be found. Recently, researchers have demonstrated an altered trophism of the small nerve ...fibres and alterations in the numbers of TRPV-1 vanilloid receptors. Capsaicin is a molecule that is contained in hot peppers and is specifically detected by TRPV-1 vanilloid receptors that are distributed in the oral mucosae. We aimed at verifying if topical capsaicin could prove to be an effective treatment of Burning Mouth Syndrome. A group of 99 BMS patients were recruited. We subdivided the BMS patients into two groups: the collaborative patients, who expressed a predominantly neuropathic pattern of symptoms, and the non-collaborative patients, who were characterised by stronger psychogenic patterns of the syndrome. Both groups underwent topical therapy with capsaicin in the form of a mouth rinse 3 times a day for a long period. After 1 year of treatment, the final overall success rate was approximately 78%, but with a significant difference in the success rates of the two groups of patients (87% and 20% among the collaborative and non-collaborative patients, respectively; p=0.000). The use of topical capsaicin can improve the oral discomfort of BMS patients, especially during the first month of therapy, but it is more effective for those patients in which the neuropathic component of the syndrome is predominant. Our hypothesis is that chronic stimulation with capsaicin leads to decreases in burning symptoms. This phenomenon is called desensitisation and is accompanied by substantial improvements in oral symptoms.
Periodontal disease (PD) is an inflammatory disease of the tissues supporting the teeth. PD affects 65 million adults over the age of 30 years in the USA, and worldwide 5 to 70% of adults. Women who ...develop PD during pregnancy, it's estimated 1 woman in 5, may have a higher risk of adverse pregnancy outcomes. PD during pregnancy starts by dental plaque and is increased by the action of pregnancy hormones. In order to study the effect of PD on adverse pregnancy outcomes, we have performed this narrative review summarising the current studies about the influence of PD on pregnancy. Periodontal pockets are a reservoir of oral microbiota. Modifications in oral microbiota may be considered as a potential mechanism for developing PD during pregnancy. PD is surely caused by bacteria, but the progression and worsening are due to a host immune response. The inflammation caused by PD is not limited to the oral cavity. It is hypothesized that episodes of bacteraemia and dissemination of endotoxins from periodontal pockets can induce the activation of the systemic immune response. In conclusion our narrative review shows that there's no relationship between PD and adverse pregnancy outcomes, and PD treatment during pregnancy does not confer a general protection against adverse pregnancy outcomes.
Cleft palate only (CPO) is one of the most common congenital malformations worldwide. The etiopathogenesis of CPO is not completely understood. Environmental factors, such as smoking, alcohol ...consumption, intake of drugs during pregnancy, advanced paternal age, have been demonstrated to be a risk of CPO, but conflicting results have also been published. Insufficient intake of folic acid during the pregnancy has been suggested to increase the risk for CPO. The demonstrated risk for siblings and the higher risk for monozygotic twins suggest a genetic etiopathogenesis for CPO. In some cases of CPO a prevalent mode of inheritance has been reported, but oligogenic models with reduced penetrance, and the risk related to environmental factors have also been proved. One of the first manifestations associated with CPO is difficulty with feeding. Aerophagia is a problem in these infants with CPO and requires more frequent burping and slower feeding. The inability to generate intraoral breath pressure due to nasal air emission in CPO children frequently manifests as articulation difficulties, particularly consonant weakness, and unintelligible speech. Hearing disorders are prevalent among individuals with CPO, as a result of chronic otitis media with effusion due to eustachian tube dysfunction. A multidisciplinary team is essential to manage the many aspects of CPO. In treating CPO, the reconstructive surgeon works in cooperation with otolaryngologists, dentists and orthodontists, speech pathologists, audiologists, geneticists, psychiatrists, maxillofacial surgeons, social workers, and prosthodontists. CPO can be considered a genetically complex disease, but new knowledge and new therapeutic approaches have greatly improved the quality of life of these children. Prenatal diagnosis is an important step in the treatment of this disease.
Partially or totally edentulous jaws frequently undergoes from moderate to severe bone atrophy with problems of prosthetic rehabilitation. The inability to make a prosthetic rehabilitation on ...implants may led to the use of a partial or total removable denture with difficulties in eating and speech, ulcerations of the oral mucosa and loss of facial vertical dimension. These problems may be solved performing bone augmentation procedures. Bone grafts and distraction osteogenesis brought implant dentistry from an experimental practice to become a consolidate dental procedure. Bone grafts, in particular, are currently a valuable treatment modality for the prosthetic rehabilitation. Numerous biomaterials have been developed for the rehabilitation of partially or totally edentulous jaws with fixed or removable dentures. The aim of this paper is to describe biomaterials for bone augmentation. Biomaterials are gradually resorbed by the osteoclasts and replaced by new bone formed through osteoblastic activity. Many biomaterials have been studied, but the most common are as follows: Allogro®, Algipore®, Osteobiol®, Peptide-15, Engipore®, Medpore®, Osteoplant®, Calcium sulfate, Perioglass®, Bio-Oss®, Calcium phosphate.
Periodontal disease (PD) is a multifactorial illness in which environment and host interact. The genetic component plays a key role in the onset of PD. In fact the genetic compound can modulate the ...inflammation of the mucous membranes and the loss of alveolar bone. The genetics of PD is not well understood. Previous studies suggest a strong association between PD occurrence and individual genetic profile. The role of genetic susceptibility could impact on the clinical manifestations of PD, and consequently on prevention and therapy.
Genetic polymorphisms of VRD, IL6 and IL10 were investigated in Italian adults affected by PD. 571 cases classified according the criteria of the American Academy of Periodontology were included. All patients were Italian coming from three areas according to italian institute of statistics (ISTAT) (www.istat.it/it/archivio/regioni). The sample comprised 379 patients from North (66%), 152 from Central (26%) and 40 of South (8%).
No significant differences were found among allele distribution.
Chronic PD is a complex disease caused by a combination of genetic susceptibility, patients habits (oral hygiene, smoking, alcohol consumption) and oral pathogens. In our report no differences were detected among three Italian regions in allele distribution.
Primordial odontogenic tumour (POT) is a novel entity that was described in 2014 and that is included in the group of benign mixed epithelial and mesenchymal odontogenic tumours. In recent years, ...several papers have added new cases with some clinical and histopathological aspects that slightly differ from those described in the original report. The aim of this systematic review is to update all available data on POT published in the literature and to identify those features of the neoplasm that require further investigation.
A systematic review of literature was conducted using PubMed, Embase, Web of Science and Scopus. Additional sources were also checked. Publications reporting cases with enough clinicopathological information were included, without any time or language restrictions. Histopathological or radiological studies were considered for qualitative analysis.
A total of 30 publications were included. Seventeen papers were used for quantitative analysis while 13 papers were used only for qualitative analysis. A total of 18 cases of POT were identified. Some clinical, radiographic, histopathological and therapeutic features were common in all reported cases, while other aspects of the neoplasm were inconsistent through published cases. This inconsistency was particularly remarkable when dealing with the histopathological features of the neoplasm.
Some issues about POT remain unclear and deserve to be clarified by future reports. The description of the odontogenic epithelium covering the ectomesenchyme is often contradictory, while it remains debatable whether peripheral ameloblastic epithelial islands or hard dental tissue deposition can occasionally occur within the tumour.
Legionella spp. are ubiquitous in aquatic habitats and water distribution systems, including dental unit waterlines. Surveys have shown that the percentage of samples taken at different dental sites ...that were positive for Legionella spp. were highly variable and ranged from 0% to 100%. Cultivation is the principal approach to evaluating bacterial contamination employed in the past, but applying this approach to testing for Legionella spp. may result in false-negative data or underestimated bacterial counts. PCR and direct fluorescent counts can detect viable non-cultivable bacteria, which are not counted by plating procedures. Legionella spp., commonly form such viable non-culturable cells and it is likely that they contribute to the difference between plate count results and those of PCR and fluorescent-antibody detection. However, studies have shown that Legionella is present in the municipal water source in spite of the current filtration and chlorination procedures. Once Legionella reaches the building water system, it settles down into a biofilm layer of stagnant water. By means of this layer, Legionella can protect itself from antimicrobial agents and then multiply. Dental unit waterlines may be contaminated with opportunistic bacteria. The water quality in the dental units should be controlled to eliminate opportunistic pathogens and to provide water for dental treatment that meets public health standards for potable water.
This study has tested the effects of hyperbaric oxygen in periodontal structures in agreement with the theories supported by literature research. Eight patients, from 30 to 50 years-of-age, were ...tested with pure oxygen inhalation, at the 2.5 ATA absolute pressure. Main approved tests of periodontal health were evaluated before and after HBOTs cycles. The results in all patients treated with HBOT, have founded clear improvement of clinical and instrumental parameters.
Implant dentistry has become one of the most successful techniques for oral rehabilitation over the last 20 years. The success rate of implant oral rehabilitation is above 80% while peri-implant ...disease (PID) is the most important complication of implant dentistry. The main cause of PID is considered bacterial leakage at the implant-abutment connection of a two-piece implant system. Prevention and control of bacterial leakage at the implant-abutment connection is mandatory for reducing inflammation process around implants neck and achieving bone stability. Since bacteria leakage at implant-abutment connection level is the main cause of PID, a microbiological test should be important to identify bacteria that cause PID. According with the conclusion of workshop of the European Federation on Periodontology, a test that detects the most frequent bacterial species involved in the onset of PID (Actinobacillus actinomycetecomitans, Porphyromonas gengivalis, Tannnerella forsythia, Treponema denticola) should be used in clinical practice. In fact, PID progression depends on the typology, quantity and composition of bacterial flora in peri-implant pockets, so controlling PID onset and progression, is a keystone for preventing implant failures and consequently forensic conflicts. The effort to prevent PID and consequently assurance or forensic conflicts have become one of the main focal points of all dental professionals. Behind these efforts lie, above all, ethical but also economic reasons, as well as a desire to prevent PID, improving implant care quality and increasing the legal security of health care professionals themselves. Since the legal decisions in our society influence how we practice dentistry, especially in the fast-evolving field of implant dentistry, using diagnostic tools that will allow dentists to demonstrate that they have acted correctly in accordance with the knowledge of modern medicine, it is of great importance to defend themselves in the case of legal-legal disputes.
The aim of the present study was to evaluate the prevalence of some periodontal pathogens in Italian adults with chronic periodontitis.
The sample consisted of 2992 patients with a clinical diagnosis ...of chronic periodontitis, based on the criteria of the American Academy of Periodontology, sampled in the period 2013-2016: 2108 patients were from Northern, 690 from Central and 194 from Southern Italy.
and
were investigated in all patients of the present study, while
and
only in 2514 (84%) patients. Subgingival plaque samples of the four sites of greatest probing depth in each patient were used to obtain subgingival microbiota and then processed by quantitative polymerase chain reaction.
Periodontal pathogens had the following presence respect to all amount of patients:
16.1%,
73.4%,
93.8%,
65.5%,
66.4%, and Tannerella forsythia 72.7%. There are no significant statistical differences among geographic areas both for the total bacterial and the single species except for
and
which prevalence was significantly higher in Southern Italy (P value <.05). The other investigated species were equally distributed among different regions.
was the rarer species detected in this study, while
was the commonest. No differences among areas where observed as regard of the mean bacterial load except for F. Nucleatum whose prevalence in Northern Italy was lower then both in Central and Southern Italy (P value <.05).
The results of our study didn't show different geographic distribution of periodontal pathogens among Italian population of the three areas investigated. The homogeneity of the results could be related to genetic and environmental factors.
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