Silvia Caruso

Effectiveness of platelet-rich plasma as an adjunctive material to bone graft: a systematic review and meta-analysis of randomized controlled clinical trials

The use of platelet-rich plasma (PRP) has become a strategic therapy in tissue regeneration medicine. PRP represents a good source of growth factors. Due to this property, it has been considered a reliable adjunctive material in bone augmentation procedures, such as the sinus lift technique. The aim of this review was to assess the scientific evidence on the effectiveness of PRP as an adjunctive material in the sinus floor elevation technique. The following databases were searched for relevant published studies: Medline, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL, Science Direct, ISI Web of Knowledge, and SCOPUS. Only randomized controlled clinical trials comparing a group receiving PRP as an adjunctive material to a control group without PRP, involving adult human subjects (age >18 years) with no systemic disease, were included. Of the studies identified, only one reported a significant difference in bone augmentation in favour of the adjunctive use of PRP, while four studies did not find any significant difference. None of the studies included reported a significant difference in the implant survival rate. Further randomized clinical trials are needed to clarify the effectiveness of adjunctive PRP.

Innovative approach for the in vitro research on biomedical scaffolds designed and customized with CAD-CAM technology:

Introduction: Studies on biomaterials involve assays aimed to assess the interactions between the biomaterial and the cells seeded on its surface. However, the morphology of biomaterials is heterogeneous and it could be tricky to standardize the results among different biomaterials and the classic plastic plates. In this light, we decided to create, by means of computer-aided design (CAD) technology, a standardized sample model, with equal shape and sizes, able to fit into a classic shape of a 96-wells tissue culture plate (TCP). Methods: The design of this sample consists of a hole in the top in order to allow the injected cells to settle without them being able to slip from the sides of the sample to the bottom of the TCP wells. This CAD project is made using the software Pro-Engineer. The sample will totally fill the wells of the 96-well TCP. Dental pulp stem cells have been used to assess the ability of the different sample to support and promote the cell proliferation. Results: Twelve titanium, 12 gold–palladium, and 12 zirconium oxide customized samples were designed by means of the software cam powermill, by importing the .stl file created in Pro-Engineer software. The proliferation rate of the tested scaffolds showed to be similar to the control in the group with the customized shape. Conclusion: We think that our method can be useful to test different types of scaffolds when a greater accuracy of the measurements is desirable in order to verify the cell behavior of these scaffolds. Our innovative method can improve the standardization process in the evaluation of cell behavior on different biomaterials to open the way to more reliable tests on biomatrices functionalized with drugs or growth factors applied to the future regenerative medicine.

Temporomandibular Joint Anatomy Assessed by CBCT Images

Aim. Since cone beam computed tomography (CBCT) has been used for the study of craniofacial morphology, the attention of orthodontists has also focused on the mandibular condyle. The purpose of this brief review is to summarize the recent 3D CBCT images of mandibular condyle. Material and Methods. The eligibility criteria for the studies are (a) studies aimed at evaluating the anatomy of the temporomandibular joint; (b) studies performed with CBCT images; (c) studies on human subjects; (d) studies that were not clinical case-reports and clinical series; (e) studies reporting data on children, adolescents, or young adults (data from individuals with age ≤ 30 years). Sources included PubMed from June 2008 to June 2016. Results. 43 full-text articles were initially screened for eligibility. 13 full-text articles were assessed for eligibility. 11 articles were finally included in qualitative synthesis. The main topics treated in the studies are the volume and surface of the mandibular condyle, the bone changes on cortical surface, the facial asymmetry, and the optimum position of the condyle in the glenoid fossa. Conclusion. Additional studies will be necessary in the future, constructed with longitudinal methodology, especially in growing subjects. The limits of CBCT acquisitions are also highlighted.

Temporomandibular clinical exploration in Italian adolescents

Abstract Objective: This study investigated the prevalence of the signs and symptoms of temporomandibular disorders (TMD) among Italian adolescents. Methods: The data were recorded from 567 subjects (246 males and 321 females; age range 11–19 years), grouped according to age and molar class relationship. Results: Forty-four point one percent of subjects showed at least one sign or symptom of TMD, which were significantly more frequent in the 16–19 year-old group (52.9%) in respect to the 11–15 year-old group (39.8%) (χ 2 = 8.78; p = 0.003). Signs and/or symptoms were about 1.6 times more frequent in subjects with Class II/1 malocclusion (χ 2 = 13.3, p = 0.0003), mostly for TMJ sounds (χ 2 = 1.444; p = 0.036). Myalgia was more frequent in females than in males (χ 2 = 3.882; p = 0.049). Conclusion: TMD signs and/or symptoms among Italian adolescents seem diffused (44.1%). Therefore, all adolescents should be screened thorough medical history and clinical examination.

Craniofacial morphology in pediatric patients with Prader–Willi syndrome: a retrospective study

OBJECTIVE To investigate craniofacial characteristics in pediatric patients with Prader-Willi syndrome (PWS). SETTING AND SAMPLE POPULATION A retrospective sample of 20 consecutive patients with PWS who had lateral and antero-posterior (AP) cephalograms (14 males and six females; average age 10.2 ± 3 years) was compared to 20 controls matched for age and sex (14 males and six females; average age 10.5 ± 3.7 years). MATERIALS AND METHODS Cephalometric skeletal measurements were performed twice at a 1-week interval by one calibrated operator, and random error was calculated using Dahlbergs formula. Mean values and standard deviations were computed for all variables. Students t-test for independent samples was used to determine significant differences between PWS and controls. The level of significance was set at p < 0.05. RESULTS Cephalometric values for the length of the maxilla (p < 0.01), mandibular length (p < 0.05) at both the ramus (p < 0.05) and the mandibular body (p < 0.01), and posterior and anterior facial height (p < 0.01) were significantly lower in patients with PWS compared to controls. The AP cephalometric analysis revealed a significant reduction (p < 0.01) in maxillary skeletal width, mandibular skeletal width, and interzygomatic distance. CONCLUSIONS Pediatric patients with PWS seem to have a general reduction in certain craniofacial skeletal parameters (i.e., maxillary and mandibular length) compared to controls, but this study did not assess the overall craniofacial characteristics.

Orthodontic treatment of an unerupted mandibular canine tooth in a patient with mixed dentition: a case report

BackgroundThe aim of this case report was to describe the surgical–orthodontic treatment of an unerupted mandibular canine tooth in a 9-year-old girl.Case presentationA 9-year-old white girl presented with an unerupted right mandibular canine tooth. Combined surgical–orthodontic treatment was performed to correct dental impaction and to achieve good aesthetic and functional results.ConclusionOrthodontic treatment achieved all of the required objectives.

Molar incisor hypomineralization treatment with casein phosphopeptide and amorphous calcium phosphate in children

BACKGROUND The purpose of this study was to evaluate the sensitivity of teeth with MIH in children before and after the use of a tooth mousse containing casein phosphopeptide and amorphous calcium phosphate (CPP-ACP). METHODS Forty patients, both males and females, aged from 8 to 13 years old that had a molar with MIH hypersensitivity were included in this study. In the test group (20 subjects), a tooth mousse with CPP-ACP was used while fluoride toothpaste was used in the control group. Dental sensitivity to mechanical and thermal stimuli was evaluated before (T0) and 120 days after the beginning of the treatment (T1). RESULTS In the test group, the thermal sensitivity decreased significantly (P<0.05) from T0 to T1 (2.4±0.6 to 1.1±0.4) while in the control group resulted very similar (from 2.3±0.5 to 2.2±0.4). Similarly, mechanical sensitivity decreased significantly (P<0.05) from 7.8±1 to 3.8±0.6 while in the control group decreased not significantly (from 7.5±1.3 to 7.2±0.8). No significant difference (P>0.05) was observed by comparing males with females. CONCLUSIONS The use of the remineralizing agent containing CPP-ACP resulted in a significant improvement in dental sensitivity in patients with MIH.

Association of Visual Defects and Occlusal Molar Class in Children

Purpose The purpose of this cross-sectional study is to evaluate the presence of any correlations between dysfunctions related to visual impairments and dental occlusion. Methods The test group included 34 subjects (21 males and 13 females; mean age 11 ± 2 years) randomly selected with the following inclusion criteria: absence of any diagnosis for problems at visual level except those related to refractive defects, visual acuity of at least 1.0, absence of any syndrome or malformation in the craniofacial area, good general health, and absence of any systemic disease able to influence the vision or the craniofacial growth. They underwent visual clinical tests to evaluate the presence of fusional vergence defects and amplitude. Each patient underwent an orthodontic clinical exam and the occlusal molar relationship of each subject was recorded and considered as occlusal variable. A statistical analysis with Chi-Squared test was performed in order to analyze the associations between the visual defects and the occlusal variable. Results A statistically significant association between the molar occlusal relationship and the occurrence of exodeviations was observed. The percentage of subjects presenting fusional amplitudes with convergence lower of the cut-off value was statistically significantly higher in the group of occlusal molar second class. Conclusions The results obtained show that there is an association between occlusal second molar class and fusional vergence defects.

Index of Orthodontic Treatment Need in Obese Adolescents

Aim. This case-control retrospective study is aimed at assessing if obese adolescents need more orthodontic treatment in comparison with normal-weight patients of the same age. Methods. The test group included 100 obese subjects (50 males and 50 females; average age: 13.09 ± 1.19 years old) and the control group included 100 normal-weight patients matched for age and sex (50 males and 50 females; average age: 13.07 ± 1.26 years old). Clinical examinations were conducted on dental casts to assess the need of orthodontic treatment, by using the Index of Orthodontic Treatment Need (IOTN) (DHC, dental health component; AC, aesthetic components). Results. No statistically significant difference (P > 0.05) was observed between the two groups with regard to AC. Obese females showed a significant (P < 0.05) higher percentage of DHC 3 (32%) in comparison to the normal-weight girls (22%); for the other grades of DHC and for the single kind of malocclusion, no significant difference was found. Conclusions. Obese adolescents showed a similar need for orthodontic treatment compared to normal-weight patients of the same age. However, in obese females, a slightly greater need for orthodontic treatment was observed, compared to normal-weight patients.

Bilateral Central Giant Cell Granuloma of the mandibular angle in three females from the same family

In literature there are few reports about multiple CGCG. But this is the first report of bilateral CGCG of the mandibular angles in three females from the same family.This report describes three cases of females from the same family - a mother and two young daughters - with bilateral CGCG in their jaw angles. All the lesions were surgically removed and the histopathologic diagnosis was always identical: giant cell central granulomas, with patterns that were absolutely superimposable between them and with that of the mother.The hypothesis is that this presentation of CGCG may be defined as hereditary bilateral CGCG of the mandibular angles (or also, cherubism-like lesions).