Vincenzo Grassia

Micro-Raman Spectroscopy for Monitoring Changes in Periodontal Ligaments and Gingival Crevicular Fluid

Micro-Raman Spectroscopy is an efficient method for analyzing biological specimens due to its sensitivity to subtle chemical and structural changes. The aim of this study was to use micro-Raman spectroscopy to analyze chemical and structural changes in periodontal ligament after orthodontic force application and in gingival crevicular fluid in presence of periodontal disease. The biopsy of periodontal ligament samples of premolars extracted for orthodontic reasons and the gingival crevicular fluid samples collected by using absorbent paper cones; were analyzed by micro-Raman spectroscopy. Changes of the secondary protein structure related to different times of orthodontic force application were reported; whereas an increase of carotene was revealed in patients affected by periodontal inflammation.

Early treatment of an ectopic premolar to prevent molar-premolar transposition

Orthodontic treatment is planned on an individual, case-by-case basis after thoroughly considering the patients overall facial and dental characteristics, the expected duration of treatment, costs, patient preferences, and the orthodontists experience. This article reports the treatment of a patient with a maxillary premolar-molar transposition in the permanent dentition that was successfully managed with orthodontic treatment. A girl, aged 10 years 2 months, came for treatment with an ectopic maxillary left premolar. Radiographic analysis indicated a developing complete transposition of the maxillary left premolar. The patient was treated with extraction of the deciduous molar and surgical exposure and ligation of the premolar. Eruption was properly guided, and the correct order of the 2 teeth was restored in the arch. This challenging treatment approach is described in detail, including the mechanics used to align the ectopic premolar. Early treatment can, in many cases, prevent a molar-premolar transposition.

Maxillary arch changes with transpalatal arch treatment followed by full fixed appliances

OBJECTIVE To evaluate short- and long-term maxillary dental arch dimensional changes in patients treated with a transpalatal arch (TPA) during mixed dentition followed by full fixed appliances in the permanent dentition compared with an untreated sample. MATERIALS AND METHODS Dental casts and lateral cephalograms obtained from 36 consecutively treated patients before TPA treatment (T0), after TPA treatment (T1), after fixed appliance treatment (T2), and a minimum of 3 years after fixed appliance treatment (T3) were analyzed. The control group was matched as closely as possible. Arch widths, perimeter, and length, as well as crowding and incisor proclination, were evaluated. RESULTS In the treated group, intercanine, interpremolar, and intermolar widths and arch perimeter increased significantly at T1. At T2, only the intercanine width increase was still significant. At T3 all arch dimensions decreased, remaining larger than they were at T0. The arch length increased after T1, significantly decreased at T2, and slightly decreased at T3. The crowding decreased significantly at T1, was eliminated at T2, and increased at T3. At T3, 50% of the patients showed relapse with crowding ranging from 0.5 to 2 mm. In the control group at T1, only slight changes were noted but crowding increased. At T2, crowding and upper incisor inclination increased but arch length decreased. At T3, intercuspid width, arch perimeter, and arch length continued to decrease, thereby increasing crowding. CONCLUSION Maxillary dental arch dimensions changed significantly after TPA followed by treatment with fixed appliances. Relapse occurred to some extent, especially in intercanine width and arch perimeter, but most of the dental arch changes remained stable.

In vivo confocal microscopy analysis of enamel defects after orthodontic treatment: A preliminary study.

ABSTRACT After orthodontic treatment with fixed appliances, bonded brackets and residual adhesive must be removed. This procedure should lead to restitutio ad integrum of the enamel or, at least, restore the enamel surface as closely as possible to its pre-treatment conditions. The purpose of this study is the in vivo assessment at a microscopic resolution of enamel surfaces after bracket debonding while avoiding the tooth extraction. Nine orthodontic patients who had brackets removed at the conclusion of orthodontic treatment were enrolled. In vivo reflectance confocal microscopy imaging of dental enamel surface after debonding was performed for each patient. Eighteen upper incisors were analyzed, 10 in which the enamel demineralization appeared after the treatment and 8 in which the demineralization was present before the treatment. RCM analyses showed some speckled or roundish dark areas within the enamel. Moreover enamel alterations were detected at different levels of depth. The present in vivo microscopic study allowed for highlighting structural features in dental enamel, after debonding, at a microscopic resolution in real-time and in a non-invasive way, without the need for extraction or processing of the samples.

The impact of temporomandibular joint arthritis on functional disability and global health in patients with juvenile idiopathic arthritis

OBJECTIVES The objective of the study was to evaluate the impact of temporomandibular joint (TMJ) arthritis on the functional disability and quality of life in patients affected by juvenile idiopathic arthritis (JIA). MATERIALS AND METHODS Sixty-two consecutive patients with JIA with or without TMJ arthritis and 35 healthy control subjects were enrolled in the study. The demographic data, disease activity and clinical characteristics were obtained from all patients. The functional disability was assessed using the Italian version of the Childhood Health Assessment Questionnaire (C-HAQ). The oral health-related quality of life (OHRQoL) was assessed using the Child Perception Questionnaire (CPQ11-14). Possible determining factors of TMJ arthritis comprised demographic, disease characteristics and scores derived from questionnaires that were assessed by a uni and multivariable logistic regression analysis. RESULTS Compared with patients without TMJs arthritis, JIA patients with TMJ arthritis presented higher functional disability. The multivariable logistic regression analysis performed showed that female subjects (OR = 1.5, P = 0.041), with a JIA duration over 3.9 years (OR = 2.7, P = 0.033) and presenting higher C-HAQ and CPQ11-14 scores (OR = 2.7, P = 0.012 and OR = 2.9, P = 0.015, respectively) were the greatest determining factors for TMJ arthritis. CONCLUSIONS JIA patients with TMJ arthritis presented higher functional disability and lower OHRQoL scores compared with JIA patients without TMJ arthritis. TMJ arthritis was strongly associated with JIA duration and activity, especially in female patients.

Customized bracket placement chart and indirect bonding using FAQ.FIX®: a technical note and a case report

Dott. Edoardo MARCHESE • Laureato in Medicina e Chirurgia e specializzato in Chirurgia Maxillo-Facciale presso la II Facoltà di Medicina e Chirurgia di Napoli • Membro gruppo ‘FACE’; socio RWISO; socio SIDO • Autore di pubblicazioni scientifiche e relatore in corsi e convegni nazionali ed internazionali • Ha brevettato FAQ.FIX, un posizionatore di precisione di attacchi ortodontici • Responsabile culturale della sistematica AD2 per “Continuing Education”

Salivary microRNAs as new molecular markers in cleft lip and palate: a new frontier in molecular medicine

MicroRNAs (miRNAs) are endogenous non-coding RNAs of about twenty-two nucleotides that regulate gene expression through post-transcriptional control. The purpose of the present study was to identify and describe the salivary miRNAs in cleft lip and palate (CLP) patients comparing them with a control healthy group. Twelve patients (mean age 11.9 ± 2.42 years; 6M/6F) formed the study group. The control group was created selecting twelve healthy subjects matched for age and sex with study group. We recorded differences in miRNA expression profile between the saliva of CLP patients and the control group. Specifically, miR-141, miR-223, and miR-324-3p were mostly deregulated between the study and control groups. Interestingly, these three miRNAs are the regulators of the following genes correlated to cleft palate and lip development: MTHFR, SATB2, PVRL1. The present study showed that collecting saliva samples is a non-invasive procedure and is well accepted by CLP patients. MiRNAs can be easily isolated and identified. The differences in regulation of miR-141, miR-223 and miR-324-3p between the two groups of salivary samples suggest that these molecules are valid prognostic biomarkers and therapy dynamic response indicators, also for the accuracy and non-invasive sampling and dosing system.

Comparison between rapid and mixed maxillary expansion through an assessment of arch changes on dental casts

BackgroundAim of this retrospective observational study was to compare upper and lower dental changes in patients treated with Rapid Maxillary Expansion (RME) and Mixed Maxillary Expansion (MME), assessed by dental cast analysis.MethodsTreatment groups consisted of 42 patients: the RME group (n = 21) consisted of 13 female and 8 male subjects with the mean age of 8.8 years ± 1.37 at T0 and 9.6 years ± 1.45 at T1; the MME group (n = 21) consisted of 12 female and 9 male patients with a mean age of 8.9 years ± 2.34 at T0 and 10.5 years ± 2.08 at T1. The upper and lower arch analysis was performed on four dental bilateral landmarks, on upper and lower casts; also upper and lower arch depths were measured. The groups were compared using independent sample t-test to estimate dental changes in upper and lower arches.ResultsBefore expansion treatment (T0), the groups were similar for all examined variables (p>0.05). In both RME and MME group, significant increments in all the variables for maxillary and mandibular arch widths were observed after treatment. No significant differences in maxillary and mandibular arch depths were observed at the end of treatment in both groups. An evaluation of the changes after RME and MME (T1) showed statistically significant differences in mandibular arch depth (p<0.001) and maxillary intercanine widths (p<0.05). Differences in maxillary arch depth and arch width measurements were not significant.ConclusionsRME and MME can be considered two effective treatment options to improve transverse arch dimensions and gain space in the dental arches. A greater lower arch expansion was observed in the MME group, which might be attributed to the “lip bumper effects” observed in the MME protocol.