Maurizio Manuelli

Efficacy and effects of palifermin for the treatment of oral mucositis in patients affected by acute lymphoblastic leukemia

Abstract This randomized-controlled trial studied the efficacy of palifermin, administered as a dose during hematopoietic stem cell transplant (HSCT) therapy, as primary prophylaxis on pediatric patients with acute lymphoblastic leukemia in order to reduce oral mucositis (OM). Patients in the palifermin group were randomly assigned to receive palifermin, 60 μg/kg, intravenously as a single dose 3 days before and 0, +1, and +2 post autologous HSCT infusion. The patients in the control group received only a placebo treatment. OM-related assessments were the WHO oral-toxicity scale and the patient-reported outcomes. There was a statistically significant reduction in the incidence of OM grade 3 and 4 in the palifermin group compared to the control group. There was also a reduction in the degree of severity of OM in the palifermin group (1.65 grade respect to 2.33 in the control group). Palifermin could prevent the recurrence of severe OM and improve the quality of life in patients with acute lymphoblastic leukemia (ALL).

Histomorphometric Evaluation of Two Different Bone Substitutes in Sinus Floor Augmentation Procedures.

The aim of this study is to compare the histomorphometric data of deproteinized bovine bone (DBB) and a fully synthetic bone substitute, poly (lactic-co-glycolic) acid/hydroxyapatite (PLGA/HA) applied for sinus floor augmentation technique. Twelve maxillary atrophic ridges of 8 patients requiring major maxillary sinus floor augmentation were studied; the sites were randomly assigned to the study groups and reexamined at 6 months after grafting using cone beam computed tomography scans and biopsy samples harvested during dental implant placement. Total bone volume, residual graft material volume, and new bone volume were assessed. Measurable biopsies were available from 67% of test sites and 100% of control sites. Poly (lactic-co-glycolic) acid/hydroxyapatite grafts showed no trace of graft material, whereas DBB grafts had a mean graft area of 16.60%. Mean percent of newly formed bone tended to be greater for PLGA/HA than for DBB group. Mean total bone volume percent did not differ significantly: PLGA/HA = 44.45% (CI, 16.42-72.48), DBB = 44.11% (CI, 36.61-51.60). Deproteinized bovine bone and PLGA/HA produced similar total bone volumes. Poly (lactic-co-glycolic) acid/hydroxyapatite appeared to be completely replaced by newly formed bone, whereas DBB presented significant amounts of residual graft material. Poly (lactic-co-glycolic) acid/hydroxyapatite necessitates of more clinical trials to be considered suitable for sinus floor augmentation.

Comparison between fiber-reinforced polymers and stainless steel orthodontic retainers

Objective The aim of this study was to examine the properties of fiber-reinforced composite and stainless steel twisted retainers for orthodontic retention. Methods Three different span lengths (5.0, 8.0, and 14.0 mm) of fiber-reinforced composite were investigated. The three fiber-reinforced composite retainer groups were subdivided according to the storage condition (dry and wet), resulting in a total of six groups. Each stainless steel and fiber-reinforced composite group was comprised of six specimens. The three-point bending flexural test was conducted using a universal testing machine. ANOVA was used to assess differences in the maximum load and maximum stress according to the span length, material, and storage condition. Post-hoc comparisons were performed if necessary. Results The maximum stress and maximum load were significantly (p < 0.001) associated with the span length, material, and storage condition. The significant interaction between the material and span length (p < 0.001) indicated the differential effects of the material for each span length on the maximum stress and maximum load, with the difference between materials being the highest for the maximum span length. Conclusions Our findings suggest that fiber-reinforced composite retainers may be an effective alternative for orthodontic retention in patients with esthetic concerns or allergy to conventional stainless steel wires.

Changes in oral microbiota due to orthodontic appliances: a systematic review

ABSTRACT Background: Oral microbiota has been at the center of cultural attention in recent years. In daily clinical practice, orthodontic appliances may be associated with an increased cariogenic risk and a worsening of preexisting periodontal diseases. Objective: The purpose of this review is to investigate the available evidence regarding the association between orthodontic appliances and changes in the quality and quantity of the oral microbiota. Design: The research included every article published up to October 2017 featuring the keywords ‘Orthodontic appliance* AND (microbiological colonization OR periodontal pathogen* OR Streptococcus mutans OR Lactobacillus spp. OR Candida OR Tannerella forsythia OR Treponema denticola OR Fusobacterium nucleatum OR Aggregatibacter actinomycetemcomitans OR Prevotella intermedia OR Prevotella nigrescens OR Porphyromonas gingivalis)’ and was conducted in the major medical databases. The methodological quality of selected papers was scored using the ‘Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies’ (SBU) method. Results: Orthodontic appliances influence the oral microbiota with an increase in the counts of S. mutans and Lactobacillus spp. and in the percentage of potentially pathogenic gram-negative bacteria. Conclusions: There is moderate/high evidence regarding the association between orthodontic appliances and changes in the oral microbiota. PROSPERO registration number CRD42018091589.

Artrite idiopatica giovanile: implicazioni odontostomatologiche

Riassunto Obiettivi Lo scopo di questo studio e stato valutare le caratteristiche, le alterazioni morfostrutturali e le conseguenze disfunzionali dell’articolazione temporomandibolare (ATM) in pazienti affetti da artrite idiopatica giovanile (AIG). Materiali e metodi Lo studio e stato condotto su 45 soggetti di eta compresa tra 7 e 19 anni, affetti da AIG. Tutti i pazienti arruolati sono stati sottoposti a valutazione clinico-gnatologica (anamnesi, parametri di laboratorio, tipo di terapia) e strumentale mediante l’imaging a risonanza magnetica delle ATM. Risultati Dei 45 pazienti del campione, il 37,8% presentava interessamento dell’ATM. Tra questi pazienti (17 pazienti, 13 femmine e 4 maschi) si sono riscontrate: forma poliarticolare 41,2% (7 casi), forma oligoarticolare 35,3% (6 casi), artrite sistemica 11,8% (2 casi), artrite psoriasica 5,9% (1 caso), sindrome entesite- artrite (SEA) 5,9% (1 caso). I principali sintomi riportati erano: click temporomandibolare monolaterale e bilaterale, limitazione funzionale monolaterale e bilaterale associata a dolore, click bilaterale e monolaterale durante la masticazione e laterodeviazione mandibolare associata a sintomatologia delle ATM. Conclusioni I risultati ottenuti in questo studio suggeriscono l’utilita di un’attenta valutazione gnatologica all’esordio dell’AIG. Controlli periodici associati a una diagnosi precoce sono infatti in grado di ridurre e migliorare le problematiche funzionali ed estetiche in questi giovani pazienti.