Publications by authors named "Marco Montevecchi"

23 Publications

  • Page 1 of 1

Rapid maxillary expansion on oral breathing children: effects on tongue location, hyoid position and breathing. A pilot study.

Minerva Dent Oral Sci 2021 Jun;70(3):97-102

Dental Service for Disabled Patients, Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna, Bologna, Italy.

Background: Oral breathing and downward tongue position are generally associated with transverse hypo-development of the upper maxilla. Rapid maxillary expansion aims to expand the upper maxilla transversely. This pilot retrospective clinical study evaluates the effects of rapid maxillary expansion therapy on the resting position of the tongue, on the position of the hyoid bone and on clinical respiratory pattern in a group of mouth breathing patients with mono- or bilateral cross-bites due to transversal deficits of the maxilla.

Methods: A total of 39 prepubertal oral breathing subjects with posterior cross-bite (mean age 8.5 year) have been studied. Before (T0) and after treatment (T1), changes in the position of the hyoid bone and tongue were evaluated by comparing latero-lateral radiographs (TLL), while the modification of respiratory patterns by a clinical and anamnestic assessment.

Results: After the treatment, the dorsum of tongue moved closer to the palatine vault, the position of the hyoid bone did not undergo significant variations and the respiratory pattern clinically improved in 64% of subjects.

Conclusions: In patients in early stages of oral respiratory development, rapid maxillary expansion promoted correct tongue position but did not produce significant changes in the position of the hyoid bone. It has been observed a general improvement of the breathing pattern.
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http://dx.doi.org/10.23736/S2724-6329.21.04290-4DOI Listing
June 2021

Evaluation of Floss Remnants After Implant Flossing in Three Different Implant Conditions: A Preclinical Study.

Int J Oral Maxillofac Implants 2021 May-Jun;36(3):569-573

Purpose: The aim of this preclinical study was to evaluate whether implant flossing could leave floss residues in three different implant-prosthetic conditions.

Materials And Methods: Using an anatomical model, three different conditions were studied: correct connection between the implant and abutment and complete insertion of the implant threads into the plaster (control group); misfit of approximately 220 to 230 μm between the implant platform and abutment in the absence of any thread exposure (misfit group); partial exposure of implant threads but absence of misfit (thread group). Twenty-one microstructured tapered threaded implants were divided among the three groups. Each sample was subjected to a flossing procedure using spongy floss, standardized in terms of movement, frequency, time, and pressure. Subsequently, a stereomicroscope examination with a standardized magnification of 10× was performed in order to highlight the possible presence of floss residues on the implant surface.

Results: No floss residue was ever detected for the control group. Both misfit and thread groups showed floss residues that were discernible in two different types: microfilaments and amorphous particles. Statistical analysis showed a significant difference for the presence of floss remnants between the control group and the other two experimental groups (P = .005). No difference was observed between the misfit and thread groups.

Conclusion: This study shows that exposed threads and misfit can induce the release of floss residues during maintenance procedures.
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http://dx.doi.org/10.11607/jomi.8350DOI Listing
June 2021

Development and validation of the Italian version of the 'Parental Perceptions of Silver Diamine Fluoride Dental Color Changes' questionnaire.

Int J Paediatr Dent 2021 May 12. Epub 2021 May 12.

Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Unit of Dental Care for Special Needs Patients and Paediatric Dentistry, University of Bologna, Bologna, Italy.

Background: The original English version of the questionnaire 'Parental Perceptions of SDF's Dental Color Changes' was used among parents in the New York City metropolitan area.

Aim: To develop an Italian version of the questionnaire and to assess its validity.

Design: The construct validity and the internal consistency were assessed in a convenience sample of Italian parents of 251 young healthy children seen at the University of Bologna and Pisa. Forward-backward technique was carried out for the translation of the questionnaire. Kaiser-Meyer-Olkin measure of sampling adequacy was equal to 0.91, and Bartlett's test of sphericity was statistically significant (P = .001), so the items were treated with the exploratory principal component analysis (PCA).

Results: Cronbach's alpha ranged from 0.69 to 0.95. PCA demonstrates that all the items load on the first component (87% of explained variance). All the Spearman correlation coefficients between each subscale (positive scenario: 0.563; negative scenario: 0.665) and the general acceptability showed significant correlation (P = .0001). Different age, educational level, and family income of the parents did not produce statistically significant different scores on any of the subscales (P > .05; Mann-Whitney test).

Conclusion: The Italian version of the questionnaire showed high internal consistency and construct validity and was appropriate to be used in an Italian population.
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http://dx.doi.org/10.1111/ipd.12841DOI Listing
May 2021

Variation of Efficacy of Filtering Face Pieces Respirators over Time in a Dental Setting: A Pilot Study.

Dent J (Basel) 2021 Mar 24;9(4). Epub 2021 Mar 24.

Department of Biomedical and Neuromotor Sciences-Unit of Dentistry, University of Bologna, 40100 Bologna, Italy.

Since aerosol continuously persists in dental settings, where different procedures and patients come in succession, the use of oronasal masks is highly recommended. Among them, respirators known as Filtering Face Pieces (FFP) show a protective superiority compared to surgical masks. Even concerning respirators classified as non-reusable, it is not known how many hours of use are necessary to compromise their filtering capacity. The aim of this study is to investigate the variations of filtering capacity of an FFP2 respirator over time, in order to safely optimize the timing of its use. Five respirators were worn by the same operator during clinical activity for different usage times (8, 16, 24, 32, 40 h), and one respirator was kept unused. All respirators underwent a bacterial filtration efficacy (BFE) test. T-test for paired data with Bootstrap technique and Wilcoxon test for paired data compared BFE values of the five tested FFP2s respectively at each time, and the areas with the corresponding values of the control respirator (FFp2-F). A generalized linear mixed effect model (GLM) was applied considering type of respirator and time as fixed effects and intercept as random effect. No significant statistical differences were present in the BFE of each time. Data obtained by the present study highlight the important ability of FFP2s to maintain their BFE over time, suggesting a long lasting protective function.
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http://dx.doi.org/10.3390/dj9040036DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063922PMC
March 2021

The influence of root surface distance to alveolar bone and periodontal ligament on periodontal wound healing.

J Periodontal Implant Sci 2016 Oct 20;46(5):303-319. Epub 2016 Oct 20.

Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna School of Dentistry, Bologna, Italy .

Purpose: The purpose of this animal study was to perform a 3-dimensional micro-computed tomography (micro-CT) analysis in order to investigate the influence of root surface distance to the alveolar bone and the periodontal ligament on periodontal wound healing after a guided tissue regeneration (GTR) procedure.

Methods: Three adult specimens were used. The study sample included 6 teeth, corresponding to 2 third mandibular incisors from each animal. After coronectomy, a circumferential bone defect was created in each tooth by means of calibrated piezoelectric inserts. The experimental defects had depths of 3 mm, 5 mm, 7 mm, 9 mm, and 11 mm, with a constant width of 2 mm. One tooth with no defect was used as a control. The defects were covered with a bioresorbable membrane and protected with a flap. After 6 months, the animals were euthanised and tissue blocks were harvested and preserved for micro-CT analysis.

Results: New alveolar bone was consistently present in all experimental defects. Signs of root resorption were observed in all samples, with the extent of resorption directly correlated to the vertical extent of the defect; the medial third of the root was the most commonly affected area. Signs of ankylosis were recorded in the defects that were 3 mm and 7 mm in depth. Density and other indicators of bone quality decreased with increasing defect depth.

Conclusions: After a GTR procedure, the periodontal ligament and the alveolar bone appeared to compete in periodontal wound healing. Moreover, the observed decrease in bone quality indicators suggests that intrabony defects beyond a critical size cannot be regenerated. This finding may be relevant for the clinical application of periodontal regeneration, since it implies that GTR has a dimensional limit.
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http://dx.doi.org/10.5051/jpis.2016.46.5.303DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5083814PMC
October 2016

Is Implant Flossing a Risk-Free Procedure? A Case Report with a 6-year Follow-up.

Int J Oral Maxillofac Implants 2016 May-Jun;31(3):e79-83

This study reports a case of peri-implantitis correlated with floss fibers trapped by the implant-prosthetic macrostructure. Discrepancy between the radiographic feature and probing depth was the starting point for a correct evaluation. The minimally invasive removal of the trapped material with the aid of a periodontal endoscope resulted in a complete resolution of the peri-implantitis with a stable long-term result (6 years). This case report argues for some reconsiderations in hygienic, diagnostic, and therapeutic approaches in oral implantology.
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http://dx.doi.org/10.11607/jomi.4263DOI Listing
March 2017

Microbiological Distribution of Six Periodontal Pathogens Between Untreated Italian and Dutch Periodontal Patients.

Oral Health Prev Dent 2016 ;14(4):329-37

Purpose: To compare prevalence and microbial load of six periodontal pathogens between Italian and Dutch patients affected by chronic periodontitis, using oligonucleotide probe technology.

Materials And Methods: Subgingival plaque samples data from 352 Italians and 115 Dutch periodontal patients were analysed and compared. Bleeding on probing, suppuration, probing pocket depth, clinical attachment level, age, gender, ethnicities and smoking habits were recorded. Presence and level of bacterial species were determined by realtime polymerase chain reaction under the identical microbiological protocol. Statistical analysis was performed using the chi-square test, Mann-Whitney U-test and binary unconditional logistic regression (α = 0.05).

Results: Between populations, only Treponema denticola and Porphyromonas gingivalis differed significantly, being more prevalent in the Italian group (p = 0.0001). Except for Tannerella forsythia, all bacterial loads differed significantly: Treponema denticola (p = 0.0001) and Prevotella intermedia (p = 0.001) were higher in Italians, while Porphyromonas gingivalis (p = 0.001), Fusobacterium nucleatum (p = 0.03) and Aggregatibacter actinomycetemcomitans (p = 0.001) were higher in Dutch patients.

Conclusions: Significant differences in prevalence and bacterial load of periodontal pathogens exist between Italian and Dutch patients affected by chronic periodontitis. The microbiological profile, and particularly the bacterial load of pathogens, varied significantly between populations.
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http://dx.doi.org/10.3290/j.ohpd.a35618DOI Listing
December 2016

Evaluation of clinical effectiveness and subjective satisfaction of a new toothbrush for postsurgical hygiene care: a randomized split-mouth double-blind clinical trial.

ScientificWorldJournal 2015 16;2015:828794. Epub 2015 Mar 16.

Department of Oral Sciences, University of Trieste, 34100 Trieste, Italy.

The aim of this RCT was to evaluate plaque control and gingival health promotion effectiveness of a new toothbrush with extra-soft filaments in postsurgical sets. Ten consecutive patients with at least two scheduled symmetrical periodontal surgeries were selected. Following the first periodontal surgery, a test (TB1) or control (TB2) toothbrush was randomly assigned. After the second surgery, the remaining toothbrush was given. Patients were asked to gently wipe the surgical area from days 3 to 7 postoperatively and to gently brush using a roll technique from day 7 till the end of the study. Baseline evaluation took place on the day of surgery and follow-ups were performed at days 7, 14, and 30 postoperatively. A more evident PI reduction was recorded for test toothbrush where a regular decrease was observed till day 14; then, this parameter tended to stabilize, remaining however lower than that recorded for the control toothbrush. There were no statistical differences in the GI between test and control toothbrushes. All patients introduced the test toothbrush at surgical site at third day; the control toothbrush was introduced within a mean of 9 days. The introduction of the test toothbrush 3 days after periodontal surgery may be recommended.
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http://dx.doi.org/10.1155/2015/828794DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378704PMC
January 2016

Prevalence of six periodontal pathogens in subgingival samples of Italian patients with chronic periodontitis.

New Microbiol 2014 Oct 1;37(4):517-24. Epub 2014 Oct 1.

Unit of Odontostomatological Sciences, Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.

The aim of this study was to investigate the subgingival prevalence of six periodontal pathogens in 352 Italian patients with chronic periodontitis. Possible correlations with clinical parameters, age, gender and smoking status were also investigated. At first visit a pooled subgingival plaque sample was obtained for each subject by using the paper-point method. The samples were processed and analysed according to a commercially available quantitative real time polymerase chain reaction assay (Meridol® Perio Diagnostics, GABA International, Switzerland). Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn) and Aggregatibacter actinomycetemcomitans (Aa) were investigated. Fn resulted the most frequently detected (95%) while Tf showed the highest load (12x105 cells/plaque sample). Aa was the less represented bacteria for load and presence. Bacterial load of Pg, Td, Tf and Fn showed a direct correlation to Bleeding On Probing (BOP) and presence of suppuration (p=0.0001). The bacterial load was always directly correlated to Probing Pocket Depth (PPD) (p=0.0001). Among the investigated variables, PPD resulted the most important risk indicator for periodontal pathogens. BOP appeared as a risk indicator for Td, Tf, Pg detection. Few studies have described the microbiological pattern of chronic periodontal disease in the Italian population. Considering the different forms of periodontitis, similar investigations in other countries are needed to disclose any microbiological differences among populations, which may lead to more specific approaches to prevention and therapy.
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October 2014

A proposed new index for clinical evaluation of interproximal soft tissues: the interdental pressure index.

Int J Dent 2014 1;2014:345075. Epub 2014 Apr 1.

Department of Medical Sciences, University of Trieste, Piazza dell'Ospitale 1, 34100 Trieste, Italy.

The interdental pressure index (IPI) is introduced to specifically evaluate clinical interproximal-tissue conditions and assess the effect of interproximal hygiene stimulation. This index scores clinical responses of periodontal tissues to the apical pressure of a horizontally placed periodontal probe. It is negative when gingival tissues are firm, bleeding-free, and slightly ischemic by the stimulation; otherwise it is positive. The clinical validation showed high intraoperator agreement (0.92; 95% CI: 0.82-0.96; P = 0.0001) and excellent interoperator agreement (0.76; 95% CI: 0.14-1.38; P = 0.02). High internal consistency with bleeding on probing (κ = 0.88) and gingival index (Cronbach's α = 0.81) was obtained. Histological validation obtained high sensitivity (100%) and specificity (80%) for IPI+ toward inflammatory active form. The same results were recorded for IPI- toward chronic inactive form. IPI results as a simple and noninvasive method with low error probability and good reflection of histological condition that can be applied for oral hygiene motivation. Patient compliance to oral hygiene instructions is essential in periodontal therapy and IPI index can be a practical and intuitive tool to check and reinforce this important aspect.
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http://dx.doi.org/10.1155/2014/345075DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3995173PMC
May 2014

Comparison of the antibacterial activity of an ozonated oil with chlorhexidine digluconate and povidone-iodine. A disk diffusion test.

New Microbiol 2013 Jul 30;36(3):289-302. Epub 2013 Jun 30.

Department of Periodontology and Implantology, School of Dentistry, Alma Mater Studiorum.

Ozonated oils are antiseptics obtained from the chemical reaction between ozone and unsaturated fatty acids of vegetable oils. The aim of this study was to investigate the antimicrobial effectiveness of a commercially available ozonated oil (O3-Oil), in comparison with 0.2% chlorhexidine digluconate (CHX) and 10% povidone-iodine (PVP-I) through a disk diffusion test. For each antiseptic a series of two-fold dilutions was made, obtaining seven dilutions: 1:2, 1:4, 1:8, 1:16, 1:32, 1:64 and 1:128. The undiluted antiseptics and the seven dilutions were tested against two freeze-dried bacterial strains: Staphylococcus aureus (Sa) and Porphyromonas gingivalis (Pg). O3-Oil showed significantly greater diameters of growth inhibition (p<0.01) than CHX and PVP-I in all dilutions for both tested strains. CHX lost any antibacterial efficacy when diluted more than 1:32. At the highest dilution, the diameters of growth inhibition against Sa were 20.67±0.58 mm and 15.33±0.58 mm, for O3-Oil and PVP-I, respectively. At the same dilution, the diameters of growth inhibition against Pg were: 19.00 mm for O3-Oil and 13.67±0.58 mm for PVP-I. The promising results obtained for the O3-Oil, against the opportunistic Sa, and Pg, one of the main periodontal pathogens, suggest its potential applicability for periodontal treatment. Further preclinical and clinical investigations are warranted.
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July 2013

Management of a deeply impacted mandibular third molar and associated large dentigerous cyst to avoid nerve injury and improve periodontal healing: case report.

J Can Dent Assoc 2012 ;78:c59

University of Bologna, Bologna, Italy.

As dentigerous cysts increase in size, the risk of postsurgical complications increases as well. Emphasis is usually placed on the risk of neurologic damage caused by trauma during and after surgical removal and of mandibular fracture resulting from the large residual bone defect. However, influence on the periodontal status of neighbouring teeth should also be taken into account. In this article, we present an interdisciplinary, safe, minimally invasive approach to treating large dentigerous cysts associated with deeply impacted third molars. A dentigerous cyst is an epithelial-lined pathologic cavity that develops in association with the crown of an unerupted tooth and appears radiographically as a well-circumscribed pericoronal radiolucency. The cyst not only inhibits the eruption of the associated tooth (usually, a mandibular third molar), but can also carry it to unusual positions in the jaw. Dentigerous cysts may enlarge causing extensive bone resorption and even pathologic fracture. The greater the size of the cyst, the higher the risk of neurologic damage caused by trauma during and after surgical removal and of mandibular fracture resulting from the postoperative bone defect.7,8 Moreover, the removal of large cysts can lead to a severe infrabony defect at the root surface of adjacent teeth, jeopardizing their long-term periodontal health. "Orthodontic extraction" is a combined orthodontic-surgical approach that decreases the risk of neurologic complications and facilitates the surgical extraction of impacted mandibular third molars that are in close contact with the mandibular canal, even when associated with cystic lesions.13 This case report shows that the interdisciplinary approach is also effective in preventing periodontal breakdown on the distal surface of the adjacent second molar.
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September 2012

The use of a disclosing agent during resective periodontal surgery for improved removal of biofilm.

Open Dent J 2012 6;6:46-50. Epub 2012 Feb 6.

Department of Periodontology and Implantology, School of Dentistry, Alma Mater Studiorum - University of Bologna, Italy.

A total removal of the bacterial deposits is one of the main challenges of periodontal therapy. A surgical approach is sometimes required in order to allow a correct access to the areas not thoroughly reached during the initial therapy. The present study focuses on the surgical scaling effectiveness in root deposits removal; the potential support of a disclosing agent during this procedure is also evaluated. Forty surgical periodontal patients were randomly divided between surgeries where the operator was informed about a final examination of the residual root deposits and surgeries where the operator was not informed. Straight after scaling procedures a supervisor recorded the O'Leary Plaque Index of the exposed roots by mean of a disclosing agent and the percentage of teeth with residual biofilm. After the stained deposits removal, a second chromatic examination was performed and new data were collected. Mann-Whitney U-test and Wilcoxon test for paired samples were used for comparisons respectively between the two surgery groups and the first and the second chromatic examination; one-sided p-value was set at 0.05. At first examination no significant differences between the two groups were observed regarding Plaque Index (p=0.24) and percentages of teeth with residual biofilm (p=0.07). The 100% removal of roots deposits was never achieved during the study but a significant reduction of 80% of root deposits was observed between first and second examination (p=0.0001). Since root deposits removal during periodontal surgery resulted always suboptimal, the use of a disclosing agent during this procedure could be a useful and practical aid.
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http://dx.doi.org/10.2174/1874210601206010046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282890PMC
August 2012

Variables Affecting the Gingival Embrasure Space in Aesthetically Important Regions: Differences between Central and Lateral Papillae.

Open Dent J 2011 29;5:126-35. Epub 2011 Jul 29.

Department of Periodontology and Implantology, School of Dentistry, Alma Mater Studiorum - University of Bologna, Bologna, Italy.

This study evaluated different variables to determine their role in the appearance of the central and lateral upper jaw papillae. 292 interdental embrasures were examined. Personal variables were: age, smoke, and use of interproximal hygiene devices. The clinical characteristics were: tooth shape, periodontal biotype and papilla appearance. Radiographic measurements were: root to root distance at the cemento-enamel junction (horizontal distance), and bone crest to interdental contact point distance (vertical distance). The papilla recession increased with patient age. The horizontal distance of the central papilla was always greater (up to 1 mm) than that of the other papillae. The vertical distance of the central papilla was greater (up to 2 mm) than that of the other papillae for each class except for the normal one (Nordland & Tarnow classification). For vertical distances ≤5 mm, papillae were almost always present; for distances up to 6 mm, the lateral papillae belonging to the normal class disappeared, while the central papilla remained in 11% of cases; central papillae of class 1 were present in larger proportions until a vertical distance of 8 mm. The present observational study shows that differences on clinical and radiographic determinants do exist between central and lateral papillae. This variance should be strictly taken in account for a harmonious and stable treatment outcome on this highly aesthetic area.
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http://dx.doi.org/10.2174/1874210601105010126DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162192PMC
November 2011

Failure after closed traction of an unerupted maxillary permanent canine: Diagnosis and treatment planning.

Am J Orthod Dentofacial Orthop 2011 Jul;140(1):121-5

Department of Orthodontics, School of Dentistry, University of Bologna, Italy.

This report describes the treatment of a 13-year-old girl with unerupted maxillary permanent canines. It illustrates how recognizing an unexpected problem influenced the decision-making process. Despite 6 months of closed-eruption traction, the left canine had not erupted. However, the neighboring teeth were intruded, suggesting a diagnosis of canine ankylosis. When the site was surgically reopened, the wire chain used for the orthodontic traction appeared to be osseointegrated. It was renewed, and traction was applied for another 16 months, and the tooth was successfully brought into the arch. Bone tissue passing through the chain might have prevented forced eruption. In young patients with unerupted maxillary permanent canines, failure of closed traction can be attributed to ankylosis, and this accounts for tooth extraction as the treatment of choice. However, this clinical report suggests that additional measures might be warranted before the definitive diagnosis of ankylosis can be made and the tooth extracted.
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http://dx.doi.org/10.1016/j.ajodo.2009.09.025DOI Listing
July 2011

The relationship between bleeding on probing and subgingival deposits. An endoscopical evaluation.

Open Dent J 2009 Jul 28;3:154-60. Epub 2009 Jul 28.

Department of Periodontology and Implantology, School of Dentistry, Alma Mater Studiorum - University of Bologna. Bologna, Italy.

Background: Bleeding on probing (BOP) is an indicator of tissue inflammatory response to bacterial pathogens. Due to anatomical limitations, the entity and physical state of microbial aggregations located under the gingival margin and their relations to BOP have been hardly investigated till now. The recent introduction of the endoscopy has allowed clinicians to observe the subgingival environment in a non-traumatic way. The aim of this study is to evaluate the correlation between BOP and subgingival deposits by using this new technology.

Methods: 107 teeth (642 individual sites) from 16 periodontal patients, treated with scaling and root planing, were evaluated for plaque index (PI), gingival index (GI), probing pocket depth (PPD), bleeding on probing (BOP), endoscopic biofilm index (EBI), and endoscopic calculus index (ECI) at one-month revaluation.

Results: A linear association between BOP and PD, EBI, and ECI was detected. The BOP provided a high level of specificity but quite low sensitivity values both for ECI (sensitivity 40%, specificity 86%) and EBI (sensitivity 37%, specificity 89%). The BOP sensitivity was directly linked to the amount of subgingival deposits.

Conclusions: This study demonstrates a direct relationship between BOP and presence/amount of subgingival deposits. More investigations on larger samples are, however, needed.
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http://dx.doi.org/10.2174/1874210600903010154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724644PMC
July 2009

A modified papilla preservation technique, 22 years later.

Quintessence Int 2009 Apr;40(4):303-11

Department of Periodontology and Implantology, School of Dentistry, University of Bologna, Bologna, Italy.

The contour of the interdental tissues, as well as the color and texture of the keratinized tissues, are essential elements of anterior esthetics. Tissue loss in the interproximal regions, with related esthetic concerns, phonetic difficulties, and food impaction, can occur for a variety of reasons, including treatment of periodontal diseases. In periodontal surgical procedures, the soft tissues require elevation and resection to gain access to the root surfaces and osseous supporting structures. Compromised esthetics in the anterior region of the mouth could be a serious consequence of periodontal surgical procedures. Several articles have been devoted to flap designs and surgical techniques to maintain full papillary form and preserve the soft tissues during surgical access. Unfortunately, very little evidence of long-term results is available. The aims of the present article are to report a 22-year follow-up case of surgical interdental papilla preservation, discuss the anatomic variables that conditioned the outcome, and review and compare existing surgical techniques for maintaining the interproximal soft tissues.
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April 2009

Bilaminar technique in the treatment of a deep cervical abrasion defect.

Int J Periodontics Restorative Dent 2008 Feb;28(1):63-71

Department of Periodontology and Implantology, University of Bologna, Italy.

New materials (restorative and adhesive) for the treatment of cervical abrasions have produced better results in terms of esthetics (choice and stability of colors) and duration (marginal fit and wear resistance). Nevertheless, conservative restoration of cervical abrasion cannot be considered the most suitable treatment in certain clinical situations: (1) when the abrasion defect involves the root surface, either exclusively or primarily; (2) when a site has difficult esthetic demands resulting from excessive tooth length with gingival recession; and (3) in the presence of root caries. The aim of this case report is to describe the application of the bilaminar technique to treat a deep cervical abrasion associated with a recession-type defect. The bilaminar surgical approach shown here consisted of a connective tissue graft covered by a coronally advanced pedicle flap. The connective tissue graft was placed inside the root concavity to compensate the abrasion space and to prevent soft tissue flap collapse internally. The graft, by acting as a "biologic filler" or space maintainer inside the concave abrasion area, stabilized the covering flap and helped restore a correct tooth emergence profile.
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February 2008

Clinical efficacy of two toothbrushes with different bristles.

Int J Dent Hyg 2007 Nov;5(4):242-6

Department of Periodontology and Implantology, School of Dentistry, Alma Mater Studiorum University of Bologna, Bologna, Italy.

Objective: The purpose of this single-blind clinical study was to evaluate the efficacy of an innovative manual toothbrush versus a traditional one.

Methods: The toothbrushes were randomly assigned to 30 volunteers in a student population of the Dental School of the University of Bologna, Italy, divided into 15 test and 15 control subjects. A clinical examination assessing Plaque Index (PI), Gingival Index (GI) and buccal Gingival Recessions was performed at baseline, 3 and 6 months. During the baseline examination, each subject received dental debridement, oral hygiene instructions and a standard kit containing: three standard tubes of toothpaste, 1 hourglass (2 min) and one plaque disclosing solution; each subject of the test group received three innovative toothbrushes, while each subject of the control group received three traditional toothbrushes.

Results: During the 6 months of observation both groups presented a PI and GI decrease. A more evident improvement of both indices was observed in the test group (PI P = 0.0001, GI P = 0.0001). The greatest part of recessions remained stable (0-3 months: 70% test group, 60% control group and 3-6 months: 86% test group, 94% control group). Some amplitude modifications (0.5 mm) were mainly detected in the first 3 months (control group chi(2) = 17.55, P = 0.0001 and test group chi(2) = 3.31, P = 0.07). They always increased in the control group and decreased in the study group.

Conclusions: The innovative manual toothbrush is more likely to be effective in reducing PI and GI compared to the traditional one and widely safe on periodontal tissues during the period of observation.
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http://dx.doi.org/10.1111/j.1601-5037.2007.00258.xDOI Listing
November 2007

Efficacy of three face masks in preventing inhalation of airborne contaminants in dental practice.

J Am Dent Assoc 2005 Jul;136(7):877-82

Department of Periodontology, School of Dentistry, University of Bologna, Vin San Vitale, Italy.

Background: Up-to-date studies are needed on the protection provided by face masks used by dentists. We assessed the relative filtering efficacy of two currently used surgical face masks (one a molded mask, the other a tie-on mask) and a certified personal particulate respirator, all made by a single manufacturer.

Methods: The authors sprayed bicarbonate particulate against a porcelain surface (representing the patient's mouth) and collected it via a mannequin head (representing the dentist's head) placed 40 centimeters away and a tube with two airflow rates (0.5 cubic meters per hour and 9 m3/hour). They calculated the dry residue weight. They performed three separate runs for each mask and three runs with no mask at the two airflow rates with and without aerosol.

Results: With no mask (control), the authors recorded significant weight gains at both airflow rates with and without vaporization. With vaporization, the three masks were associated with different dry residue weights (P < .03 with the Kruskal-Wallis test at both flow rates), the respirator propviding the lowest amount. The respirator provided an efficiency of 94 to 96 percent, compared with 90 to 92 percent and 85 to 86 percent for the molded and tie-on surgical masks, respectively.

Conclusions: These data provide independent evidencependent evidence that a certified personalthat a certified personal respirator can be more effective than high quality surgical masks in dental settings.

Clinical Implications: Dentists should be aware that a certified particulate respirator can provide them with superior filtering protection.
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http://dx.doi.org/10.14219/jada.archive.2005.0288DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093848PMC
July 2005

A technique to remove epulis: case reports.

Int J Periodontics Restorative Dent 2004 Oct;24(5):470-5

Department of Periodontology, School of Dentistry, University of Bologna, Italy.

The purpose of this study was to describe an alternative surgical approach to removing epulis while preserving and improving the mucogingival complex. After scaling and root planing, six patients underwent surgical treatment to remove the growths. A subepithelial connective tissue graft was interposed between the bone and epulis using a pedicle flap. The lesion was always preserved. The epulis disappeared after several months, with minor variations in healing time among patients. At 60-month follow-up visits, all patients exhibited good gingival health, with no recurrence.
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http://dx.doi.org/10.11607/prd.00.0597DOI Listing
October 2004

Reliability of panoramic radiography in evaluating the topographic relationship between the mandibular canal and impacted third molars.

J Am Dent Assoc 2004 Mar;135(3):312-8

Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Bologna, Italy.

Background: The authors conducted a study to evaluate the predictive value of five radiographic markers on the panoramic radiograph, or PR, to point out the relationship between the mandibular canal and the impacted third molar.

Methods: The authors evaluated the accuracy of the radiographic markers by comparing the PR with an axial computed tomographic, or CT, scan. They identified a sample of 73 third molars that showed a close relationship between the tooth roots and the mandibular canal on the PR, and then classified them on the basis of five radiographic markers. They also detected contact between the third molar and the mandibular canal on the CT scan.

Results: The distribution of the five radiographic markers was as follows: 37 teeth exhibited increased radiolucency, 13 exhibited superimposition, 14 exhibited interruption of the radiopaque border, 14 exhibited narrowing of the canal and seven exhibited diversion of the canal. In 11 cases, two or more markers were recognizable. The predictive values of a positive test result were as follows: increased radiolucency, 73 percent; superimposition, 38.5 percent; interruption of the radiopaque border, 71.4 percent; narrowing, 78.6 percent; and diversion, 100 percent. The authors detected contact in all of the cases that exhibited two or more markers.

Conclusion: Increased radiolucency, narrowing and interruption of the radiopaque border, as well as the concomitant presence of two or more radiographic markers, on the PR were highly predictive of contact between the third molar and the mandibular canal. An axial CT scan probably is indicated in such cases.

Clinical Implications: The results of this study may lead to some guidelines for oral surgeons evaluating whether to obtain an axial CT scan for further investigation after examining an impacted mandibular third molar via PR.
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http://dx.doi.org/10.14219/jada.archive.2004.0179DOI Listing
March 2004

Retrospective study of tooth loss in 92 treated periodontal patients.

J Clin Periodontol 2002 Jul;29(7):651-6

Department of Oral Surgery, School of Dentistry, University of Bologna - Alma Mater Studiorum, Italy.

Background/aims: In this retrospective study, the efficacy of periodontal therapy and maintenance in preventing tooth loss was evaluated.

Methods: The study included 92 patients with 2310 teeth diagnosed with chronic adult periodontitis and observed over a mean period of 6.7 years, with each patient receiving surgical therapy in two or more quadrants. The group was divided into two subgroups: those who complied with the recommended maintenance schedule and those whose compliance was erratic. Individual tooth prognosis was assigned according to radiographic parameters.

Results: At the completion of active periodontal therapy, 2184 teeth were present. During the maintenance period, 44 teeth were lost due to periodontal reasons. Tooth mortality revealed a mean annual adjusted tooth loss rate of 0.07/year. Molars were the teeth most frequently lost; canines the least. The number of teeth lost in the three prognostic categories was: one (0.07%) for teeth with good prognoses, 21 (3.63%) for questionable prognoses and 22 (11.34%) for hopeless prognoses. Patients complying erratically with supportive periodontal therapy were at a 5.6 times greater risk for tooth loss following active therapy than regularly compliant patients.

Conclusions: The results demonstrated a low tooth mortality rate in periodontal patients following active treatment combined with a strict maintenance program.
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http://dx.doi.org/10.1034/j.1600-051x.2002.290710.xDOI Listing
July 2002
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