M. Picciotti

Cervical necrotizing fasciitis of odontogenic origin involving the temporal region – A case report

Necrotizing fasciitis (NF) is a soft-tissue infection, usually polymicrobial, that causes necrosis of fascia and subcutaneous tissue while sparing skin and muscle. We report a case of cervical NF complicating dental infection in a 50-year-old woman, who presented with infection involving mucosa of the right mandible and temporal muscle, and masticator spaces, requiring extensive surgery and antibiotic therapy. Prompt diagnosis and immediate aggressive surgical debridement of all compromised tissues are critical to reducing morbidity and mortality in these rapidly progressive infections.

Does a transverse maxillary deficit affect the cervical vertebrae? A pilot study.

INTRODUCTION The aim of this pilot study was to analyze the morphology of the cervical vertebrae of subjects with transverse maxillary constriction. METHODS The study population included 40 subjects (7-11 years of age) undergoing palatal expansion to correct transverse maxillary constriction, and a control group of 40 subjects (7-11 years of age) without transverse maxillary constriction. Two observers assessed cervical morphology on lateral cephalograms by means of templates showing cervical maturation sequences. Round angles and concave vertebral body edges were classified as vertebral anomalies that could not be associated with physiologic vertebral growth. Agreement between the data collected by the observers was assessed with the Cohen kappa test, and the data of the 2 groups were compared with the Fisher exact test (P <0.05). RESULTS The 2 observers agreed in their assessments (k >0.5). The greater percentage of vertebral defects in the study group was significant (P <0.05) according to both observers. Rounding of the anterosuperior angle of the vertebral body was the most common defect in the study group. Vertebral defects of the study group were mainly at vertebrae C4 and C5. CONCLUSIONS A statistically significant correlation, worthy of further study, was found between transverse maxillary constriction and cervical vertebral defects.

L’attività antimicrobica dei fitoterapici in odontoiatria

Riassunto Obiettivi L’obiettivo dello studio e fornire un quadro delle diverse applicazioni terapeutiche antimicrobiche che i fitoterapici possono avere in campo odontoiatrico, nonche degli effetti collaterali che alcune terapie a base di erbe possono indurre a livello del cavo orale. Materiali e metodi E stata condotta un’attenta revisione della letteratura scientifica internazionale a partire dal 1995 in PubMed, Embase e Scopus mediante l’utilizzo di appropriate parole chiave. Risultati e conclusioni Gli studi esaminati hanno mostrato importanti proprieta medicinali delle piante per uso odontoiatrico. Ulteriori ricerche sono pero necessarie per valutare meglio l’efficacia clinica dei fitoterapici (trial clinici, studi prospettici), la tossicita, gli effetti collaterali, le interazioni con altre categorie di farmaci, al fine di possedere basi scientifiche sempre piu valide.

Rhinofibroscopic and Rhinomanometric Evaluation of Patients with Maxillary Contraction Treated with Rapid Maxillary Expansion. A Prospective Pilot Study

OBJECTIVE The aim of this study was to evaluate through nasal fiber optic endoscopy and rhinomanometry the patency of upper nasal airways in patients treated with rapid palatal expansion Study design: 30 patients (12 males and 18 females) aged 7-11 years with transverse maxillary constriction underwent rhinomanometric and fiberoptic examination before (T0) and after rapid palatal expansion (T1).The amount of nasopharynx obstruction was quantified with reference to the full choanal surface. Nasal resistance was recorded separately for right and left sides, and combined for both sides. The differences in nasopharynx obstruction and in nasal resistance between T0 and T1 were statistically evaluated. RESULTS The amount of nasopharynx obstruction significantly decreased after palatal expansion (p<0.001). Total nasal inspiration and expiration resistance significantly decreased at T1 (p<0.001). The reduction ranged between 0. 23 and 0. 66 Pa/cm3/s for inspiration and between 0. 20 and 0,.58 Pa/cm3/s for expiration. A statistically significant positive correlation existed between the T1-T0 differences in the amount of nasopharynx obstruction and the T1-T0 differences in expiration nasal airway resistance (Spearmans correlation coefficient rho = 0.38; p = 0.03). CONCLUSIONS Rapid maxillary expansion has an influence on nasal resistance and improves the patency of upper airways in patients with minor or moderate breathing problems.