Pietrina Francesca Lugliè

Risk factors for oral mucositis in paediatric oncology patients receiving alkylant chemotherapy

BackgroundWe describe the risk indicators for oral mucositis (OM) in paediatric oncology patients hospitalised in the Institut Gustave Roussy (Villejuif-Paris) and treated with alkylant chemotherapy with autologous peripheral blood progenitor cells.MethodsThe sample was selected using PIGAS software. Three groups of subjects received different chemotherapy regimens: A. Melphalan, B. Busulfan and C. other alkylant protocols. The degree of mucositis was recorded by CTC version 2.0 (Common Toxicity Criteria). Descriptive statistics were performed. The association between mucositis and risk indicator variables was tested using a χ2 test. The association between case status and covariates was tested using unconditional logistic regression analysis.ResultsOf the 337 children enrolled, 241 showed mucositis (group 1) and 96 did not show mucositis (group 2) during alkylant chemotherapy. There was a higher prevalence of male patients in both groups. The three different chemotherapy regimen groups are correlated with the appearance of oral mucositis (χ2 = 22.42, p < 0.01). Weight loss was higher in group 1 (χ2 = 6.31, p = 0.01). The duration of aplasia was lower in the Busulfan protocol (7.5 days) than in the Melphalan group (9.3 days) or the other regimens (8.6 days). The use of Bufulfan® was directly associated with case status (presence of oral mucositis): odds ratio [OR] = 2.1 and confidence interval [95%CI] = 1.3–3.0. Also, occurrences of germinal tumours and secondary bacterial infections were directly linked with case status: [OR] = 1.4 and 1.8, confidence interval [95%CI] = 1.2 – 1.7 and 1.1 – 2.5, respectively.ConclusionThe presence of OM was associated with the three different chemotherapy regimens considered; in particularly patients treated with Busulfan had the highest prevalence.

Lack of association between maternal periodontal status and adverse pregnancy outcomes: a multicentric epidemiologic study

Objective(s): The aim of this study was to explore the relationship between periodontal health and pregnancy outcomes in a large cohort of Italian postpartum women. Methods: 750 postpartum women were enrolled in a case–control study within 5 days from delivery at three Italian obstetric clinics. Cases were defined as those mothers who delivered an infant weighing under 2500 g (LBW) and/or had premature delivery and/or delivered small for gestational age newborns (SGA) and/or experienced preeclampsia/pregnancy induced hypertension (PE/PIH) or preterm premature rupture of membranes (pPROM) during pregnancy. All women received comprehensive oral and dental examination. Associations between adverse pregnancy outcome and exposures of interest were evaluated by the use of multivariate logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: There was no significant difference between cases and controls with respect to country of birth, age, place of residence, educational achievement, smoking, and periodontal status. By definition, infant birth weight [2,750 g (IQR = 2,300–3,200 g) and 3,275, (IQR = 3,010–3,538 g) p < 0.001, respectively] and gestational age at delivery [259 days (IQR = 245–273) and 273 days (IQR = 266–280), p < 0.01, respectively] were significantly lower in cases than in controls. In multivariate analyses, a borderline association was found between poor obstetric outcomes and current smokers (OR: 1.5; 95% CI: 0.1–2.5). Finally, after adjusting for smoking status neither country of birth, nor age or place of residence or education or periodontitis were associated with a significantly increased risk of adverse pregnancy outcome. Conclusion(s): Our data failed to demonstrate the association between periodontitis and an adverse pregnancy outcome such as preterm birth, low birth weight, preeclampsia, intrauterine growth restriction, and premature rupture of membranes.

Molecular identification of Mycobacterium avium subspecies paratuberculosis in oral biopsies of Crohn’s disease patients

Oral lesions may be found in patients with Crohn’s disease (CD), in a percentage up to 20%. The aim of this study was to investigate a possible relationship between Mycobacterium avium subsp. paratuberculosis (MAP) and oral lesions in CD patients. 23 oral biopsies were examined performing IS900 Nested PCR; 9 of them were positive: 8 from CD patients and 1 from a control. Our purpose is to go on with this study, amplifying the number of subjects examined and testing subjects with oral lesions related to diseases other than CD to verify the specific association between MAP and oral lesions in CD patients.

Eating Disorders: Assessment of Knowledge on a Dentist’s Sample

Results: In total, 150 dentists were enrolled (a representative sample). After questionnaire evaluation, the following results were obtained: 80.7% (121) of the participants had a degree in dentistry and 19.3% (29) had degrees in medicine with a dentistry master of science diploma, 46% (69) were males and 54% (81) were females, their age range was 25-62 (mean, 36.1) years, and the average work experience was 11.5 (range, 1-36) years. More than 90% of the participants defined eating disorders only as bulimia and anorexia. Of the dentists, 77.3% (116) correctly identified Western populations as the most affected, whereas 52.7% identified only whites as the most affected people. In total, 80% of the dentists recognised dental erosion and abrasion as typical oral manifestations. Only 62% stated that salivary pH decreases in these conditions, and 63% did not recognise parotid gland tumefaction as a clinical sign. Regarding operator experience, 60.7% (91 dentists) had clinical experience of patients with eating disorders: 43.9% of them had made diagnoses from oral manifestations, 51.3% (77) were not able to treat these patients, and 69.3% (104) would refer patients to specialized centres for treatment. Moreover, 119 (79.3%) considered that a dental hygienist was a valid collaborator for the treatment of oral cavity manifestations. Regarding prophylaxis, 16.7% (25) suggested fluoride prophylaxis and 21.3% (32) oral hygiene education. Only 1.3% indicated the use of bicarbonate to change salivary pH values, suggested conservative or prosthetic restorations, suggested the use of saliva substitutes, or the sealing of permanent teeth. Difficulties in clinically treating these patients were related to a lack of knowledge for 72% (108) of participants. Of them, 36.7% (55) had studied the clinical aspects of this pathology while attending dental school and 24.7% (37) after their degree. In total, 94.7% (142) expressed the need for further information and only 2% (3) considered they had sufficient clinical knowledge. Conclusions: It is evident that there is a lack of knowledge regarding the problem and there would seem to be an urgent need to provide more training programs and to establish guidelines for the diagnosis and treatment of eating disorders among dentists. In our opinion, the acquisition of such knowledge will change the approach to related pathology, improving clinical skills, and subsequently diagnosis and treatment.

Valutazione clinica e radiografica di due prodotti per la terapia canalare di denti decidui necrotici

Riassunto Obiettivi Lo scopo di questo lavoro e stato quello di valutare clinicamente e radiograficamente l’efficacia di due cementi canalari nel trattamento endodontico di denti decidui necrotici. Materiali e Metodi Sono stati selezionati 20 denti decidui necrotici in un campione di bambini di eta compresa fra 3 e 8 anni. Tutti i denti selezionati sono stati trattati endodonticamente e otturati con Vitapex® (Neo Dental International Inc., Federal Way, WA, United States) e Calcicur® (Voco, Cuxhaven, Germany) e sono stati monitorati clinicamente e radiograficamente per un periodo di 12 mesi. Risultati Il tasso di successo a 12 mesi dei due cementi canalari e stato rispettivamente del 100% e del 91%. Conclusioni I due cementi canalari hanno fornito risultati incoraggianti. Tuttavia ulteriori studi con follow-up piu lunghi sono necessari per valutare eventuali effetti sulla dentatura permanente.

Oral Characteristics of Trisomy 8 and Monosomy 18: A Case Report

Several reports described various mosaic chromosomal syndromes characterized by alterations originated by either an excess or deficit in the number of chromosomes. A case of mosaic trisomy 8 and monosomy 18 with significant involvement of the oral cavity is described, both in terms of general medicine and from a dental-oral perspective, and the treatment plan was planned and discussed. Regular follow-up visits enabled to verify significant improvement in all parameters of the patient’s oral health, which urged us to press on with our quest to protect the right to health of patients affected by disabilities.