Francesca De Angelis

Patients with deficit, nondeficit, and negative symptom schizophrenia: Do they differ during episodes of acute psychotic decompensation?

The aims of this study were (1) to test the hypothesis that the clinical profiles of deficit, nondeficit, and negative symptom patients are difficult to distinguish during episodes of acute psychotic decompensation; and (2) to compare these groups of schizophrenic patients in terms of sociodemographic and anamnestic variables. Patients admitted for acute psychotic decompensation were retrospectively diagnosed as having deficit (N = 18) or nondeficit (N = 40) forms of schizophrenia and their symptom profiles were evaluated cross-sectionally by using various rating scales (SAPS, SANS, and PANSS). As a whole, nondeficit patients were clearly differentiated from deficit patients by lower severity of negative symptoms. However, the subgroup (N = 24) of nondeficit patients with prominent negative symptoms that were secondary and/or nonenduring showed a symptom profile largely overlapping with that of deficit patients. Attentional impairment was the only measure distinguishing deficit and negative symptom patients. As for trait variables, deficit patients had lower education than the other two groups and, among male subjects, there was a higher percentage of left-handers in the deficit group than in the negative symptom subgroup. These results confirm the importance of diagnosing the deficit syndrome during periods of clinical stability in order to avoid the risk of misclassifying negative symptom patients into the deficit group.

Comparison of Conventional Methods and Laser-Assisted Rapid Prototyping for Manufacturing Fixed Dental Prostheses: An In Vitro Study

This study assessed whether there are differences in marginal fit between laser-fusion and conventional techniques to produce fixed dental prostheses (FDPs). A master steel die with 2 abutments was produced to receive a posterior 4-unit FDPs and single copings. These experimental models were divided into three groups (n = 20/group) manufactured: group 1, Ni-Cr alloy, with a lost-wax casting technique; group 2, Co-Cr alloy, with selective laser melting (SLM); and group 3, yttria-tetragonal zirconia polycrystal (Y-TZP), with a milling system. All specimens were cut along the longitudinal axis and their adaptation was measured at the marginal and shoulder areas on the right and left sides of each abutment. Measurements were made using a stereomicroscope (×60 magnification) and a scanning electron microscope (×800 magnification). The data were analyzed using one-way analysis of variance and the Bonferroni post hoc test, with a significance cutoff of 5%. Significant differences (P < 0.05) were observed between group 3 and the other groups. The marginal opening was smallest with Co-Cr alloy substructures, while the shoulder opening was smallest with Ni-Cr alloy substructures. Within the limitations of this study, the marginal fit of an FDP is better with rapid prototyping (RP) via SLM than conventional manufacturing systems.

Subtle alterations of excitatory transmission are linked to presynaptic changes in the hippocampus of PINK1-deficient mice

Homozygous or heterozygous mutations in the PTEN‐induced kinase 1 (PINK1) gene have been linked to early‐onset Parkinsons disease (PD). Several neurophysiological studies have demonstrated alterations in striatal synaptic plasticity along with impaired dopamine release in PINK1‐deficient mice. Using electrophysiological methods, here we show that PINK1 loss of function causes a progressive increase of spontaneous glutamate‐mediated synaptic events in the hippocampus, without influencing long‐term potentiation. Moreover, fluorescence analysis reveals increased neurotrasmitter release although our biochemical results failed to detect which presynaptic proteins might be engaged. This study provides a novel role for PINK1 beyond the physiology of nigrostriatal dopaminergic circuit. Specifically, PINK1 might contribute to preserve synaptic function and glutamatergic homeostasis in the hippocampus, a brain region underlying cognition. The subtle changes in excitatory transmission here observed might be a pathogenic precursor to excitotoxic neurodegeneration and cognitive decline often observed in PD. Using electrophysiological and fluorescence techniques, we demonstrate that lack of PINK1 causes increased excitatory transmission and neurotransmitter release in the hippocampus, which might lead to the cognitive decline often observed in Parkinsons disease. Synapse 70:223–230, 2016.

Dental implants placed in patients with mechanical risk factors: A long-term follow-up retrospective study

Objectives: Risk factors in oral implantology are defined as local or systemic conditions that increase failure rates. The purpose of this paper is to evaluate the long-term survival rate of dental implants placed in patients presenting mechanical risk factors. Materials and Methods: This retrospective study was conducted only with patients presenting at least one of the following risk factors were included: Bruxism; crown-to-implant (C/I) ratio <0.8; abutment angulation. The overall implant survival was estimated using Kaplan–Meier analyses. Risk factors for implant failure were identified using the Cox proportional hazard regression models. Results: Eighty-nine eligible patients were enrolled in this study: They were both male (n = 56, 62.92%) and female (n = 33, 37.08%), with an average age of 53.24 (23–76 years), with 227 dental implants inserted. The mean follow-up was 13.6 years (range: 10–16 years). The overall 10-year Kaplan–Meier survival estimate with associated 95% confidence intervals was 86.34% (82.8, 87.1). Bruxism was the only variable that showed a statistically significant association with implant failure (P < 0.05) and a hazard ratio of 2.9, while both Crown to-implant and abutment angulations reported lower values of failure (P > 0.05). Conclusions: Within the limitations of this study, can be concluded that data suggested an evident relationship between bruxism and dental implant failure but further studies, with a larger sample and a different design are required to assess this relationship.

Conservative surgical approach to restore necrotic columella in patients undergoing neonatal usage of nasogastric tube

Context: A common complication, related to the use of nasogastric tube during the 1st day of life, is the necrosis of the columella. Esthetic damage in the early age typically leads to a healing request with very high result expectations. Aims: We aimed to develop and use an innovative surgical technique.Settings and Design: We used our technique in four cases. Subjects and Methods: Our technique requires two flaps designed with two paramedian release incisions. The two flaps will be sutured to what remains of the fibrous septum; finally, the two flaps will be sutured together in the medial region. Results: Postoperative course was devoid of any complication. All patients gained esthetic improvements and an increase in the volume of the columella on the sagittal and frontal planes. Conclusions: This technique allows a conservative approach with low donor site morbidity and rapid postoperative course.

Unusual Case of Osseointegrated Dental Implant Migration into Maxillary Sinus Removed 12 Years after Insertion

Displacement of dental implants into the maxillary sinus is not an uncommon event in implant dentistry and may lead to serious complications, such as sinusitis. To avoid systemic problems, performing the removal of the foreign body as soon as possible is suggested. Despite the fact that early implants dislocation has been reported several times, late migration into maxillary sinus has been described by just a few studies. The purpose of this study was to report a rare case of dental implant migration into maxillary sinus after 12 years of function. A 61-year-old woman came to our attention in June 2015 after being visited by an otolaryngologist and being diagnosed with sinusitis and presence of a foreign body into the right maxillary sinus. A panoramic radiograph and a CT scan showed the migration of dental implant sited in 1.6 positions into the maxillary sinus. The implant was removed following a Caldwell-Luc procedure under local anesthesia. Postoperative course was uncomplicated and the patient reported no symptoms of sinusitis after 12 months of follow-up.

Influence of the oral status on cardiovascular diseases in an older Italian population

Oral diseases have been adversely associated with cardiovascular diseases (CVD), which are also the most frequent cause of death in older population. The aim of this study was to investigate the association among oral status indexes and CVD in patients aged more than 65 years attending in the Oral department of a public hospital Policlinico Umberto 1 of Rome. The study population consisted of 533 patients. Dental status was detected measuring the Decayed, Missing, and Filled Teeth (DMFT) and Community Periodontal Index (CPI) indexes. The chi-square test with a 95% confidence level was used to assess qualitative variables. Odds ratios (ORs) and stepwise logistic regression were used to calculate risk estimates; the independent variables: age, gender, DMFT, CPI index, Geriatric Oral Health Assessment Index (GOHAI) score, and tooth loss were included in the statistical model. P value <0.05 was considered a statistically significant cut-off. No differences were found between females and males for DMFT and CPI. GOHAI data were worst for females. Patients with CVD had less education and oral care (P < 0.05), and higher CPI index and number of missing teeth (P < 0.05). Data show that patients with more than 18 missing teeth have 2.5 times greater risk of CVD. CVDs are associated with type 2 diabetes mellitus, underweight, and obesity (P < 0.05). From the findings of this study, it can be confirmed a significant link between CVD and oral health. A cooperation among geriatrician, cardiologist, and dentist is suitable to counteract the development of CVD and to early identify patients at risk of CVD.

Bone Healing in Extraction Sockets Covered With Collagen Membrane Alone or Associated With Porcine-Derived Bone Graft: a Comparative Histological and Histomorphometric Analysis

ABSTRACT Objectives The present paper reports data of a randomized study aimed to analyse and compare the histologic and histomorphometric aspects of bone healing in extraction sites covered with collagen membrane alone or associated with porcine-derived bone graft. Material and Methods Thirty patients, with single extraction sockets without severe bone wall defects in the premolar/molar region, were included. Ten extraction sockets were grafted with porcine-derived bone and covered with collagen membrane (group 1), 10 sites were covered with collagen membrane alone (group 2), and 10 sites healed spontaneously (group 3). After 4 months of healing, 26 (8 in group 1, 9 in group 2, and 9 in group 3) bone core specimens were harvested for histologic evaluation, then dental implants were placed. Results Sites in the group 1 and in the group 2 showed similar histologic and histomorphometric results without significantly differences in the percentage of vital bone (57.43% [SD 4.8] vs. 60.01% [SD 3.2]), and non-mineralized connective tissue 22.99% (SD 5.3) vs. 18.53% (SD 6.2). In group 1 a 16.57% (SD 3.8) of residual material was found. Conclusions Results showed that the use of collagen membrane alone or associated to porcine-derived bone improves the healing bone process compared to that of extraction sites spontaneously healed. Moreover, histomorphometric data related to bone quality, indicated that extraction sites without severe walls defects and with a vestibular bone thickness > 1.5 mm, treated with a low resorbtion rate collagen membrane alone, do not need more than 4 months for dental implant insertion.

Extraction Socket Preservation Using Porcine-Derived Collagen Membrane Alone or Associated with Porcine-Derived Bone. Clinical Results of Randomized Controlled Study

ABSTRACT Objectives The aim of present randomized controlled clinical trial was to clinically evaluate hard tissue changes after extraction socket preservation procedures compared to natural spontaneous healing. Material and Methods Thirty patients were enrolled in the present study and underwent single-tooth extraction in the premolar/molar areas. Ten sites were grafted with porcine-derived bone covered by collagen membrane, 10 covered by porcine-derived collagen membrane alone, and 10 underwent natural spontaneous healing. Vertical and horizontal bone changes after 3-month were evaluated at implant placement. Results The vertical and horizontal bone changes at the extraction sockets treated with collagen membrane alone (vertical: -0.55 [SD 0.11] mm, and horizontal: -1.21 [SD 0.69] mm) and collagen membrane plus porcine-derived bone (vertical: -0.37 [SD 0.7] mm, and horizontal: -0.91 [SD 0.53] mm) were found significantly lower (P < 0.001), when compared to non-grafted sockets (vertical: -2.09 [SD 0.19] mm, and horizontal: -3.96 [SD 0.87] mm). In type 1 extraction sockets, in premolar sites, and in presence of vestibular bone thicknesses ≥ 1.5 mm, the use of collagen membrane alone revealed similar outcomes to those with additional graft material. Conclusions At the re-entry surgery, extraction sockets grafted with porcine-derived bone and covered by collagen membrane, and extraction sockets covered by porcine-derived collagen membrane alone, showed significantly lower vertical and horizontal bone changes, compared to extraction sockets sites underwent natural spontaneous healing. However, a complete prevention of remodelling is not achievable, irrespective of the technique used.

Dental students' knowledge of medication-related osteonecrosis of the jaw

Objectives: The aim of this study was to evaluate and assess knowledge and attitude of dental students about medication-related osteonecrosis of the jaw (MRONJ), to optimize future training programs in this field. Materials and Methods: A cross-sectional study was administrated. Ninety-eight participants agreed to complete an anonymous questionnaire. It was divided into two sections: the first section was about general information such as interviewers gender and date of birth; the second section included questions about bisphosphonates (BPs), others medication associated to osteonecrosis of the jaw (ONJ), risk factors, and prevention of osteonecrosis. Descriptive statistics were computed and the odds ratio was used to compare the odds for the groups. Results: Ninety-nine percent of participants declared to know BPs, but only 26.9% of 4th year and 34.8% of 6th year students knew the correct definition of MRONJ. Almost all of students identified the importance to report, in anamnesis, the use of BPs, as well as to check-up patients before the beginning of treatment; on the other hand, the knowledge about how invasive dental treatment might be carried out in patients under therapy was not adequate. In addition, half of the students did not recognize any active principle or commercial name of BPs. The situation was even worse regarding alternative drugs involved in ONJ. Conclusions: These findings are alarming and the lack of knowledge about MRONJ suggests that greater educational efforts should be performed about this pathology at undergraduate level.