Publications by authors named "Maria Rosaria Gatto"

45 Publications

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

Combining apical torsional load and cyclic fatigue resistance of NiTi instruments: New approach to determine the effective lifespan of rotary instruments.

Aust Endod J 2021 Mar 1. Epub 2021 Mar 1.

School of Dentistry, University of Queensland, Herston, Queensland, Australia.

In the described proof-of-principle experiments, we introduced a novel testing device to investigate how different concurrent torsional loads influence the cyclic fatigue (CF) resistance of a nickel-titanium (NiTi) instrument. The device was designed to test CF resistance of NiTi files with a standardized load on the apical 5 mm; a movable cylinder controlled by a lever provided a uniform real-time load. Thirty-three NiTi instruments 25.04 (F360, Komet, Lemgo, Germany) were rotated until fracture at 30° curvature under three different torsional loads (n = 11 each); Group A: 2.5 Ncm; Group B: 5 Ncm; Group C: 10 Ncm. anova, multiple comparisons Tamhane tests, regression and Kaplan-Meyer analysis were performed to contrast means. Resistance to cyclic fatigue differed significantly among groups (P = 0.0001). Increased torsional loads led to a decrease in time to failure. An inverse correlation (r = -0.721, P = 0.001) was observed between time and torsional load, with higher torsional loads correlated to shorter times to fracture.
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http://dx.doi.org/10.1111/aej.12495DOI Listing
March 2021

Assessment of impression material accuracy in complete-arch restorations on four implants.

J Prosthet Dent 2021 Jan 29. Epub 2021 Jan 29.

Assistant Professor of Oral and Maxillo-Facial Prosthodontics, Section of Prosthodontics, Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Bologna, Italy. Electronic address:

Statement Of Problem: New polyvinyl siloxane (PVS) materials with enhanced properties have been developed to improve and facilitate implant impression techniques. However, studies on their accuracy are lacking.

Purpose: The purpose of this in vitro study was to determine the accuracy and precision of implant impressions made with some recently introduced materials on a simulated patient requiring an all-on-4 implant-supported prosthesis. Well-established polyether materials were also evaluated as a comparison. The variables considered were material type, consistency, splinting or not splinting techniques, and implant angulation.

Material And Methods: A reference master model was made by inserting 4 implants at angles of 0, 5, and 10 degrees. Eighty impressions were made at 37 °C in wet conditions by using a standardized technique. Eight groups (n=10) were created using monophasic, single-viscosity materials (Hydrorise Implant Medium, HIM-ns; Hydrorise Implant Medium, HIM; Honigum Mono, HM; Impregum, IMP), and 2-viscosity materials (Hydrorise Implant Heavy+Light-ns, HIH+L-ns; Hydrorise Implant Heavy+Light, HIH+L; Honigum Heavy+Light, HH+L; and Permadyne and Garant [Heavy+Light, PeH+L]). Hydrorise materials were used with splinting and not splinting (ns) techniques. The reference points located on the connecting platforms of the transfer copings (TCP) were compared with the same points on the implant connecting platforms (ICP) located in the reference model. The accuracy and precision of the impressions were determined as linear 3D errors and standard deviation between each TCP-ICP couple by using an optical coordinate measuring machine (OCMM).

Results: PVS materials were generally better than polyether materials, with Hydrorise materials (HIM and HIH+L) showing significantly better accuracy and precision (30.9 ±14.4 μm and 28.7 ±15.5 μm, respectively) than IMP and PeH+L polyethers (44.2 ±16 μm and 43.8 ±17.6 μm, respectively; P<.001). Honigum materials were statistically similar to Hydrorise materials (P=.765). The values shown by Hydrorise nonsplinted groups (HIH+L-ns and HIM-ns) were not statistically different from those of the splinted polyether impressions (P=.386). The viscosities (monophasic or heavy+light) had no effect on accuracy, but monophasic material positively influenced precision (HIM and HIH+L, P=.001). No correlation was found between implant angulation and accuracy (multilevel analysis and Kendall rank correlation coefficient=-0.065; P=.133).

Conclusions: Recently introduced materials designed for implant impressions showed significantly higher accuracy and precision; even with the unfavorable nonsplinting technique, the new materials performed similarly to, or better than, polyether materials. Although the transfer coping splinting technique generally improved the accuracy and precision of Hydrorise materials, the effect was significant only within HIH+L groups.
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http://dx.doi.org/10.1016/j.prosdent.2020.10.017DOI Listing
January 2021

Craniofacial and occlusal features of children with Noonan syndrome.

Am J Med Genet A 2021 03 13;185(3):820-826. Epub 2021 Jan 13.

Unit of Special Needs Dentistry and Pediatric Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

Craniofacial features of 12 children with Noonan syndrome (NS) were compared with age and gender matched healthy children. Dental history, panoramic radiograph, dental casts, and cephalometric measurements were assessed. The palatal height was significantly increased in the study group compared with the control group (p = .009; paired t-test). The palatal width was significantly reduced in the study group compared with the control group (p = .006; paired t-test). The mean SNB was reduced in the study group compared with the control group (p = .02; paired t-test) and the ANB increased (p = .009; paired t-test). The mean Sum (NSAr + SArGo + ArgoMe) angle and SN-GoMe were increased in the study group compared with the control group (respectively, p = .015 and p = .002; paired t-test). The cephalometric analysis assessed a retruded position of the mandible, skeletal class II characteristics, and a vertical growth pattern. The mandibular hyperdivergency was associated to a positive overbite.
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http://dx.doi.org/10.1002/ajmg.a.62046DOI Listing
March 2021

Effectiveness of physical therapy in addition to occlusal splint in myogenic temporomandibular disorders: protocol of a randomised controlled trial.

BMJ Open 2020 08 13;10(8):e038438. Epub 2020 Aug 13.

Department of Biomedical and Neuromotor Sciences (DIBINEM) Phisical Therapy, Alma Mater Studiorum University of Bologna, Bologna, Emilia-Romagna, Italy.

Introduction: Temporomandibular disorders (TMDs) are considered a collection of musculoskeletal conditions involving the masticatory muscles, the temporomandibular joint and associated structures. The myogenous group appears to represent the most frequently diagnosed category. In the context of a multimodal approach, splint therapy and musculoskeletal physiotherapy are often considered as a preferred therapy. The purpose of this study will be to investigate the effects of musculoskeletal physiotherapy combined with occlusal splint and education versus occlusal splint and education alone in the treatment of chronic myogenous TMD on pain and mandibular range of motion.

Methods And Analysis: All consecutive adults complaining of TMDs presented to the Department of Biomedical and Neuromotor Sciences of the University of Bologna will be considered eligible. Inclusion criteria shall be based on the presence of myogenous TMDs, as diagnosed through clinical examination in reference to the international diagnostic criteria of TMDs. Randomisation, concealed allocation, blinded assessment and intention-to-treat analysis will be employed. The splint therapy will consist of the use of the splint every night and concurrent delivery of an educational programme; the protocol shall have a duration of three consecutive months. The combined musculoskeletal physiotherapy, splint therapy and education will additionally consist of manual therapy techniques and exercise; such protocol shall consist of a duration of three consecutive months, inclusive of 10 sessions for the enhanced elements. All outcome measures will be collected at baseline, after treatment and at a 6 months follow-up.

Ethics And Dissemination: Ethical approval has been obtained from the Independent Ethic Committee in Clinical Research of AUSL Bologna-Italy (47/2018/SPER/AUSLBO). Pursuant to applicable rules,we will obtain informed consent from each participant and collect data anonymously to maintain privacy. Results will be disseminated to clinicians and researchers through peer-reviewed publications and conferences.

Trial Registration Number: NCT03726060.
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http://dx.doi.org/10.1136/bmjopen-2020-038438DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7430414PMC
August 2020

Manufacturing of Metal Frameworks for Full-Arch Dental Restoration on Implants: A Comparison between Milling and a Novel Hybrid Technology.

J Prosthodont 2019 Jun 21;28(5):556-563. Epub 2019 May 21.

Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.

Purpose: To determine the trueness and precision of frameworks manufactured with a selective laser melting/milling hybrid technique (SLM/m) and conventional milling by comparing the implant-platform/framework interface with those of the original computer-aided design (CAD).

Materials And Methods: Using a virtual 6-implant-supported full-arch framework CAD drawing, 27 titanium replicas were manufactured by 3 independent manufacturing centers (n = 9/center) using a hybrid SLM/m technology (labs 1 and 2) or the conventional milling technique (lab 3). Using an opto-mechanical coordinate measuring machine, the frameworks' misfit distribution and patterns were analyzed, and the position error between paired platform positions within each framework was evaluated to calculate the misfit tendency for each group. A multilevel analysis using a mixed-effects model was conducted (α = 0.05). The trueness was evaluated as the dimensional difference from the original, while the precision as the dimensional difference from a repeated scan.

Results: The 3 dimensional misfits differed significantly among the 3 groups, with the milled group exhibiting the least accurate outcome (p = 0.005). The mean 3D positioning errors ranged from 8 to 16 µm and from 9 to 22 µm for the SLM/m technique (labs 1 and 2, respectively), and from 20 to 35 µm for conventional milling (lab 3). Regarding the misfit distribution pattern, the misfit increased with the distance between paired platform positions in all groups.

Conclusions: All groups had 3D misfits well within the error limits reported in the literature. The 3D misfits of new hybrid (SLM/milling) and conventional (milling) procedures differed significantly among them, with the milling technique the less accurate and precise. The largest errors in all groups were found between the most distant implants, resulting in a correlation between the framework span and the inaccuracies.
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http://dx.doi.org/10.1111/jopr.13067DOI Listing
June 2019

Correction to: The fate of root canals obturated with Thermafil: 10-year data for patients treated in a master's program.

Clin Oral Investig 2019 08;23(8):3407

Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Via San Vitale 59, 40125, Bologna, Italy.

The author names in the original version of this article were inadvertently interchange. Correct presentation of author names is reflected here.
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http://dx.doi.org/10.1007/s00784-019-02882-4DOI Listing
August 2019

Applicability of Demirjian's method for age estimation in a sample of Italian children with Down syndrome: A case-control retrospective study.

Forensic Sci Int 2019 May 15;298:336-340. Epub 2019 Mar 15.

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

Age estimation is widely applied in several clinical and forensic fields. The radiographic evaluation of dental development is one of the most accepted tools for this purpose. Among the different methods proposed, Demirjian's method was the most extensively used and tested in the medical literature revealing that the original standards for the French-Canadian population tends to over-estimate the age of different population groups. The aims of this study were to evaluate the applicability of the Demirjian method in a sample of Italian children with Down syndrome (DS) and to compare the data with age and gender matched healthy subjects (non-DS). A retrospective study was performed on 146 orthopantomograms of DS individuals aged 6.3-16 years. The mean chronological age (CA) and the mean dental age (DA) were calculated. Using Cohen's kappa statistics, the inter- and intra-examiner agreement was reported as good (k = 0.75) and very good (k = 0.86). The differences between CAs and DAs were statistically significant for males and females (Wilcoxon Signed Rank test; p < 0.05). The median overestimation was 0.6 years in males and 0.9 years in females. Demirjian's method is unsuitable for dental age estimation in DS individuals. The same trend in overestimation was found in the control group. Comparing DS and non-DS subjects, the differences between DAs were not statistically significant for both males and females revealing that the dental development process is similar.
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http://dx.doi.org/10.1016/j.forsciint.2019.03.015DOI Listing
May 2019

Coronectomy: A Surgical Option for Impacted Third Molars in Close Proximity to the Inferior Alveolar Nerve-A 5-Year Follow-Up Study.

J Oral Maxillofac Surg 2019 Jun 31;77(6):1116-1124. Epub 2018 Dec 31.

Assistant Professor, Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy.

Purpose: The extraction of third molars is the most common surgical procedure performed in the oral cavity. Coronectomy is a surgical protocol to reduce the risk of neurologic lesions to the inferior alveolar nerve (IAN). We evaluated early (up to 1 month) and late (from 2 to 60 months) postoperative complications.

Materials And Methods: This prospective cohort study enrolled patients treated at the Unit of Oral and Maxillofacial Surgery, University of Bologna. The predictor variable was the time after coronectomy with up to 5 years' follow-up. To assess the rate of postoperative complications, the outcome variables were neurologic injuries, postoperative pain, swelling, fever, alveolitis, pulpitis, and root exposure. The success rate, need for a second surgical procedure, probing pocket depth, and bleeding on probing also were investigated. Univariate and bivariate descriptive statistics, Kaplan-Meier analysis, and Cox hazards modeling were performed to evaluate the variables.

Results: We performed 116 coronectomies in 94 healthy patients (37 men and 57 women; mean age, 28.99 ± 8.9 years). At 5 years' follow-up, we re-evaluated 63 patients with 76 coronectomies. In total, 30 complications were verified. No cases of neurologic lesions to the IAN or lingual nerve were observed after surgery. In the first 3 years, the surgeons extracted migrated roots in 5 cases (6%) without any neurologic lesions to the IAN. No complications were observed from the third to fifth year.

Conclusions: This prospective study on coronectomy of third molars in a close relationship with the mandibular canal found no cases of neurologic lesions, no cases of late infection of the retained roots at 5 years, and a low rate of immediate postoperative complications. Further investigations should include a follow-up study at 10 years and more research about the mechanism of pulp healing.
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http://dx.doi.org/10.1016/j.joms.2018.12.017DOI Listing
June 2019

The fate of root canals obturated with Thermafil: 10-year data for patients treated in a master's program.

Clin Oral Investig 2019 Aug 5;23(8):3367-3377. Epub 2018 Dec 5.

Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Via San Vitale 59, 40125, Bologna, Italy.

Objectives: Retrospective description of the 10-year success rate of endodontic treatments with Thermafil (TF).

Materials And Methods: Patients treated by postgraduate students in an Endodontics Master's Program (2006-2008) were enrolled. All treated root canals were filled with TF and AH Plus. Teeth satisfying the inclusion criteria (206 teeth in 89 patients) were reexamined clinically and radiographically to estimate a 10-year survival and periapical health. Demographic and medical data were registered; collected information included pre-, intra-, and postoperative variables. Teeth were classified as "healthy" (PAI ≤ 2 in absence of signs/symptoms), "endodontically diseased" (presenting at least one of the following: PAI ≥ 3, signs/symptoms, retreated in the course of the follow-up, or extracted for endodontic reasons), or "non-endodontically diseased" (extracted for non-restorable fractures or periodontal disease). For teeth lost during the 10-year follow-up, details and reason of extraction were analyzed. Two PAI-calibrated examiners assessed outcomes blinded to preoperative status. Bivariate and multilevel analyses were performed (α level set at 0.05).

Results: At 10 years, 179 (87%) teeth survived and 27 were extracted: 20 for non-endodontic reasons (excluded from success analysis) and 7 for endodontic reasons (considered "endodontically diseased"). Multilevel analysis revealed that the probability of extraction was increased by the presence of preoperative pain (odds ratio = 6.720; 95% confidence interval, 1.483-30.448) and by maxillary location (odds ratio = 2.950; 95% confidence interval, 1.043-8.347). Concerning periapical status, 159/186 teeth (85%) were assessed as "healthy." Multilevel analysis confirmed that maxillary location (odds ratio = 3.908; 95% confidence interval, 1.370-11.146), presence of flare up (odds ratio = 9.914; 95% confidence interval, 2.388-41.163), and fracture occurrence (odds ratio = 35.412; 95% confidence interval, 3.366-372.555) decreased the odds of healing, respectively.

Conclusions: After 10 years, teeth filled with Thermafil in a specialist master's program presented a survival and a periapical health comparable to cohorts where root canals were filled with other obturation techniques.

Clinical Relevance: Carrier-based techniques provide time savings for clinicians while satisfying clinical quality criteria for the root filling and consequently the clinical outcome.
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http://dx.doi.org/10.1007/s00784-018-2756-8DOI Listing
August 2019

In vitro assessment of the accuracy of digital impressions prepared using a single system for full-arch restorations on implants.

Int J Comput Assist Radiol Surg 2018 Jul 2;13(7):1097-1108. Epub 2018 Mar 2.

Section of Prosthodontics, Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Via S. Vitale 59, 40125, Bologna, Italy.

Purpose: This study describes a method for measuring the accuracy of the virtual impression.

Methods: In vitro measurements according to a metrological approach were based on (1) use of an opto-mechanical coordinate measuring machine to acquire 3D points from a master model, (2) the mathematical reconstruction of regular geometric features (planes, cylinders, points) from 3D points or an STL file, and (3) consistent definition and evaluation of position and distance errors describing scanning inaccuracies. Two expert and two inexpert operators each made five impressions. The 3D position error, with its relevant X, Y, and Z components, the mean 3D position error of each scanbody, and the intra-scanbody distance error were measured using the analysis of variance and the Sheffe's test for multiple comparison.

Results: Statistically significant differences in the accuracy of the impression were observed among the operators for each scanbody, despite the good reliability (Cronbach's [Formula: see text] = 0.897). The mean 3D position error of the digital impression was between 0.041 ± 0.023 mm and 0.082 ± 0.030 mm.

Conclusions: Within the limitations of this in vitro study, which was performed using a single commercial system for preparing digital impressions and one test configuration, the data showed that the digital impressions had a level of accuracy comparable to that reported in other studies, and which was acceptable for clinical and technological applications. The distance between the individual positions (#36 to #46) of the scanbody influenced the magnitude of the error. The position error generated by the intraoral scanner was dependent on the length of the arch scanned. Operator skill and experience may influence the accuracy of the impression.
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http://dx.doi.org/10.1007/s11548-018-1719-5DOI Listing
July 2018

Outcome of secondary root canal treatment filled with Thermafil: a 5-year follow-up of retrospective cohort study.

Clin Oral Investig 2018 Apr 9;22(3):1363-1373. Epub 2017 Oct 9.

Department of Biomedical and Neuromotor Sciences (DIBINEM), School of Dentistry, Endodontic Clinical Section, Master in Clinical Endodontology, Alma Mater Studiorum University of Bologna, Via San Vitale 59, 40125, Bologna, Italy.

Objectives: The aim of the present retrospective cohort study was to assess the 5-year outcome and survival of secondary root canal treatments (2°RCT), exploring the influence of pre-, intra-, and post-operative variables.

Materials And Methods: One hundred thirty-two endodontically retreated teeth were radiographically and clinically re-examined after 5 years. 2°RCT had been performed during a Masters program following standardized protocols and filled with AH Plus/Thermafil (TF). Pre-, intra-, and post-operative data were collected. The 5-year outcome was blindly evaluated and categorized as healed/diseased on the basis of the periapical index. Bivariate analysis and chi-square test evaluated the association between outcome and 31 demographic/clinical parameters. Multilevel analysis was performed at both patient and tooth level. Statistical significance was calculated at 5% level.

Results: At 5-year evaluation, survival rate was 80% with 7.5% lost for endodontic reasons. Eighty-three percent of the teeth were classified as healed. Multilevel analysis identified significant predictors of increased survival: female gender (p = 0.012), absence of a pre-operative metal post (p = 0.017), conservative apical preparation (diameter size < #35) (p = 0.039), teeth restored with a crown (p = 0.009), and final PAI (after 5 years) ≤ 2 (p = 0.001). Multilevel analysis identified as predictor healing: not being a smoker (p = 0.048) and conservative apical preparation < size #35 (p = 0.037).

Conclusions: Outcome of 2°RCT filled with Thermafil was successful at 5 years, showing a high rate of survived and healed teeth comparable to that reported previously for other obturation techniques.

Clinical Relevance: Present findings confirm 2°RCT as a valid therapeutic option to retain natural teeth.
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http://dx.doi.org/10.1007/s00784-017-2229-5DOI Listing
April 2018

Immediate Early and Delayed Implants: A 2-Year Prospective Cohort Study of 131 Transmucosal Flapless Implants Placed in Sites With Different Pre-extractive Endodontic Infections.

Implant Dent 2017 Oct;26(5):654-663

*Full Professor, Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, Bologna, Italy. †PhD Student, Department of Biomedical and Neuromotor Sciences, Endodontic Clinical Section, School of Dentistry, University of Bologna, Bologna, Italy; Laboratory of Biomaterials and Oral Pathology, Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, Bologna, Italy. ‡PhD, Department of Biomedical and Neuromotor Sciences, Endodontic Clinical Section, School of Dentistry, University of Bologna, Bologna, Italy. §Researcher, Laboratory of Biomaterials and Oral Pathology, Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, Bologna, Italy. ¶Professor, Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy. ‖Professor, Laboratory of Biomaterials and Oral Pathology, Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, Bologna, Italy.

Introduction: To evaluate clinical outcome of early, immediate, and delayed transmucosal implants placed in patients affected by acute/chronic endodontic lesions.

Materials And Methods: Eighty-five consecutive patients received 131 titanium implants with zirconium-oxide blasted surface. Pre-extractive diagnosis represented the main criteria for implant placement timing, following "best treatment" criteria. Implants were placed with flapless transmucosal technique. Hopeless teeth with chronic periapical lesions received atraumatic extraction, and an implant was immediately placed (Immediate Group, n = 29). Teeth with acute periapical lesion/abscess were extracted and implants placed after 8 to 12 weeks (Early Group, n = 29). Implants placed 10- to 12-month after extraction constituted the control group (delayed group, n = 73). Implants were loaded 3 months after insertion with provisional resin crowns and after approximately 15 days with definitive ceramic crowns. Marginal bone loss (MBL) was measured in a single-blind manner on periapical radiographs at 1, 3, 6, 12, and 24 months.

Results: Multilevel analysis described exploring factors associated with MBL. Survival rate was 100%. MBL after 24 months was 0.78 ± 0.70 (95% confidence interval [CI]: 0.20 to -1.37) at immediate, 0.48 ± 0.70 at early (95% CI: -0.006 to -0.961), and 1.02 ± 1.01 (95% CI: 0.61 to -1.43) at delayed groups. Implant groups (immediate/early/delayed) and location (maxillary/mandibular) showed statistically significant results. Early group showed the lowest MBL values. The immediate group demonstrated less MBL than the delayed group.

Conclusion: Early implant placement technique preserves periimplant marginal bone level more than immediate and delayed techniques.
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http://dx.doi.org/10.1097/ID.0000000000000666DOI Listing
October 2017

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

Periodontal Healing Distally to Second Mandibular Molar After Third Molar Coronectomy.

J Oral Maxillofac Surg 2017 Jan 17;75(1):21-27. Epub 2016 Sep 17.

Assistant Professor, Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy.

Purpose: Coronectomy of mandibular third molars is a procedure that still raises a number of questions. The aim of the present study was to answer one unsolved question: the periodontal healing distal to the mandibular second molar after third molar coronectomy.

Materials And Methods: A prospective cohort study was performed of 30 patients treated at the Unit of Oral and Maxillofacial Surgery of the Department of Biomedical and Neuromotor Science of the University of Bologna. The predictor variables were the probing pocket depth (PPD), the distance between the marginal crest (MC) and the bottom of the osseous defect (BOD), and the distance between the cementum enamel junction (CEJ) and the BOD. These clinical indexes were recorded on 3 points of the distal surface of second molar: the distobuccal (DB), distomedial (DM), and distolingual (DL) sites. The other variables evaluated included root migration and postoperative complications. The Wilcoxon test for paired data and Kendall's tau-b correlation coefficient was used to evaluate all variables. The significance level was set at P = .05.

Results: The cohort was composed of 30 patients with 34 high-risk mandibular third molars (9 men and 21 women), with a mean age of 28 ± 7 years. At 9 months, a statistically significant reduction in the PPD of 2 ± 3, 1 ± 2, and 2 ± 2 mm and a statistically significant reduction in the MC-BOD distance of 4 ± 4, 4 ± 4, and 4 ± 5 mm for the DB, DM, and DL sites, respectively, was observed (P = .001). Also, the intraoperative CEJ-BOD distance showed a statistically significant reduction for the DB, DM, and DL sites.

Conclusions: After coronectomy, restoration of a clinical healthy periodontium distal to the second molar was observed. However, further studies are necessary to confirm these preliminary clinical results and to compare periodontal healing between coronectomy and complete extraction.
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http://dx.doi.org/10.1016/j.joms.2016.09.011DOI Listing
January 2017

Maxillary first premolar inclination in 8- to 11-year-old children: An observational cross-sectional study on panoramic radiographs.

Am J Orthod Dentofacial Orthop 2016 May;149(5):657-65

Professor, Department of Orthodontics, School of Dentistry, University of Brescia, Brescia, Italy.

Introduction: In this study, we examined first premolar inclination in a large sample.

Methods: First premolar inclination, canine inclination, and mesiodistal location were measured on 797 panoramic radiographs of orthodontically untreated children (ages, 8-11 years; 381 boys, 416 girls). The sample comprised 1496 premolars and 1496 canines. A linear mixed-effects model was used to determine the contribution of age, sex, canine inclination, canine sector location, second molar maturational stage (D-G), and dental arch side on premolar inclination.

Results: First premolar inclination values (medians and interquartile ranges) were 12.76° (8.12°-19.05°) at 8 years, 11.82° (7.87°-16.04°) at 9 years, 10.40° (6.38°-15.46°) at 10 years, and 9.03° (5.42°-12.81°) at 11 years; 13.86° (8.60°-18.78°) at stage D, 10.56° (7.39°-14.77°) at stage E, 10.43° (6.08°-15.09°) at stage F, and 8.00° (4.62°-10.74°) at stage G. The following equation was selected (Akaike information criteria = 424.99): first premolar inclination (°) = -2.211 + 2.240 (8 years) + 1.363 (9 years) + 0.955 (10 years) + 0.387 (canine inclination) + 0.902 (right side) + 2.320 (stage D) + 6.320 (sector 1) + 5.446 (sector 2) + 3.803 (sector 3). There was no difference between percentiles constructed by age and maturational stage.

Conclusions: First premolar inclination decreases during the mixed dentition and is moderately correlated with canine inclination.
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http://dx.doi.org/10.1016/j.ajodo.2015.10.022DOI Listing
May 2016

A 3-Year Prospective Cohort Study on 132 Calcium Phosphate-Blasted Implants: Flap vs Flapless Technique.

Int J Oral Maxillofac Implants 2016 Mar-Apr;31(2):413-23

Purpose: To evaluate the survival rate and marginal bone loss (MBL) of a calcium phosphate-blasted titanium implant inserted by a flap or flapless technique and to study the morphochemical characteristics of the implant surface.

Materials And Methods: Sixty out of 85 patients who received one or more implants were selected as eligible for this prospective longitudinal cohort clinical study. Titanium implants (n = 132) were placed in human healthy subjects using either a flap or flapless technique, selected on the basis of the best practice. The survival rate and MBL were evaluated after 3 months (preloading stress-free healing period) and after 6, 12, 24, and 36 months in relation to implant diameter, location, sex, and smoking habits. Surface morphochemical analyses were performed by environmental scanning electron microscopy connected with energy-dispersive x-ray (ESEM/EDX).

Results: The overall survival rate was 97.72%. After 3 and 36 months, MBL was 0.36 ± 0.66 mm and 1.09 ± 1.10 mm for the flapless group and 0.29 ± 0.51 mm and 1.03 ± 0.92 mm for the flap group. MBL showed a statistically significant increase with time (P = .0001), and differences were found at all times since 6 months. No statistical differences between the flapless and flap groups and sex were observed at any time, while MBL was significantly higher in the maxillary versus mandibular location (6, 12, and 24 months) and in smokers versus nonsmokers (6 months). Higher MBL in both groups was found for a smaller diameter (3.5 mm) than larger diameter (4.1, 5 mm). The surface showed a Ti-Al-V alloy displaying a uniform nanotexture.

Conclusion: The implant system showed a high survival rate and markedly lower MBL considering the limits for acceptable progression. Flapless and flap techniques demonstrated similar results of MBL at the preloading healing period and at the 6 months to 3 years postloading periods. Both surgical procedures induced an early MBL during the preloading stress-free period. Implant diameter, mandibular/maxillary location, preloading stress-free period, and smoking habits affect MBL more than the type of surgery after both short- and long-term follow-up.
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http://dx.doi.org/10.11607/jomi.4623DOI Listing
November 2016

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

Pressure pain threshold of the cervico-facial muscles in healthy elderly people: the role of gender, age and dominance.

Gerodontology 2015 Dec 10;32(4):274-80. Epub 2014 Feb 10.

Department of Medicine - DIMED, Geriatrics Division, University of Padova, Padova, Italy.

Objective: The aim of this study was to assess the impact of age on pressure pain threshold (PPT) of cervico-facial muscles in healthy geriatric subjects and to investigate the role of gender and dominance on nociception.

Background: Musculo-skeletal pain is common in the elderly, but being subjective, it risks to be underdiagnosed and undertreated. A useful method for assessment of local pain is determining PPT through pressure algometry. Ageing process seems to increase PPTs, but reference values for the assessment of pain in geriatric subjects are lacking.

Methods: In this study, PPTs in temporal muscle, masseter, sternocleidomastoid, occipital and splenius capitis of 97 healthy elderly subjects were measured using Fischer algometer. Participants were divided by age in four classes (years 65-69; 70-74; 75-79; ≥80).

Results: Women had lower PPTs in all muscles compared with men. Comparing PPTs obtained from the right and the left side, no significant differences were recorded neither in men nor in women. When dividing subjects by age class and education, in both genders no significant differences were observed in PPTs among the groups, neither in the right nor in the left sides.

Conclusion: In conclusion, the present study reports reference PPT values for the cervico-facial muscles that can be applied to a population of healthy elderly subjects. After 65 years of age, further ageing does not influence PPTs in cervico-facial muscles whereas female gender has lower PPTs.
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http://dx.doi.org/10.1111/ger.12117DOI Listing
December 2015

Posterior jaws rehabilitated with partial prostheses supported by 4.0 x 4.0 mm or by longer implants: Four-month post-loading data from a randomised controlled trial.

Eur J Oral Implantol 2015 ;8(3):221-30

Purpose: To evaluate whether 4.0 x 4.0 mm dental implants could be an alternative to implants at least 8.5 mm long, which were placed in posterior jaws in the presence of adequate bone volumes.

Materials And Methods: One hundred and fifty patients with posterior (premolar and molar areas) mandibles having at least 12.5 mm bone height above the mandibular canal or 11.5 mm bone height below the maxillary sinus, were randomised according to a parallel group design, in order to receive one to three 4.0 mm-long implants or one to three implants which were at least 8.5 mm long, at three centres. All implants had a diameter of 4.0 mm. Implants were loaded after 4 months with definitive screw-retained prostheses. Patients were followed up to 4-month post-loading and outcome measures were prosthesis and implant failures, any complications and peri-implant marginal bone level changes.

Results: No patients dropped-out before the 4-month evaluation. Three patients experienced the early failures of one 4.0 mm-long implant each, in comparison to two patients who lost one long implant each (difference in proportion = 0.01; 95% CI -0.06 to 0.09; P = 0.50). Consequently, two prostheses in each group could not be delivered as planned (difference in proportion = 0; 95% CI -0.07 to 0.07; P = 0.69), and one patient from each group is still waiting to have their prostheses delivered. Three short implant patients experienced three complications versus two long implant patients (difference in proportion = 0.01; 95% CI -0.06 to 0.09; P = 0.50). There were no statistically significant differences in prosthesis failures, implant failures and complications. Patients with short implants lost on average 0.38 mm of peri-implant bone at 4 months and patients with long mandibular implants lost 0.42 mm. There were no statistically significant differences in bone level changes up to 4 months between short and long implants (mean difference = 0.04 mm; 95% CI: -0.041 to 0.117; P = 0.274).

Conclusions: Four months after loading, 4.0 x 4.0 mm implants achieved similar results as 8.5 x 4.0 mm-long or longer implants in posterior jaws, however 5 to 10 years post-loading data are necessary before reliable recommendations can be made.
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February 2016

What Are the Types and Frequencies of Complications Associated With Mandibular Third Molar Coronectomy? A Follow-Up Study.

J Oral Maxillofac Surg 2015 Jul 29;73(7):1246-53. Epub 2015 Jan 29.

Professor and Head, Department of Oral and Dental Science, University of Bologna, Bologna, Italy.

Purpose: Coronectomy has been proposed for impacted third molars in close proximity to the inferior alveolar nerve (IAN) to avoid neurologic injury. Immediate (up to 1 month) and late (2 to 36 months) postoperative complications were investigated.

Materials And Methods: A prospective cohort study was performed on healthy patients treated in the dental clinic of the Department of Oral Surgery, University of Bologna. The predictor variables examined were experience of the surgeon (<10 vs ≥10 yr), length of surgery, type of mandibular third molar inclusion, and patient age. To assess the rate of postoperative complications, outcome variables were neurologic injuries, postoperative pain, swelling, fever, alveolitis, pulpitis, and root exposure. The success rate and need for a second surgery also were investigated. Univariate and bivariate descriptive statistics, Kaplan-Meier analysis, and Cox hazards modeling were performed to evaluate the variables.

Results: The study involved 94 healthy patients (mean age, 28.99 ± 8.9 yr; range, 17 to 56 yr; 37 men and 57 women) who had 116 third mandibular molars treated with coronectomy. During the 3-year follow-up period, 28 patients (29 coronectomy procedures) dropped out of the study. There was no case of neurologic injury to the inferior alveolar nerve (IAN) or to the lingual nerve (LN). In total, 30 complications were observed (25 within 1 month; 5 at 2 to 12 months). Surgeons with less than 10 years of training exposed patients to a greater risk of complications (hazard ratio = 2.069; 95% confidence interval, 1.004-4.263). An overall success rate of 74% at 6 months was estimated, and a second surgery was needed in 6% of cases. Of the retained roots analyzed, 80% showed postoperative root migration.

Conclusions: In this study, coronectomy of mandibular third molars did not result in temporary or permanent injury to the IAN or LN. Coronectomy showed a low rate of postoperative complications. However, within the first year, a second surgery was needed in 6% of coronectomy procedures to remove migrated root fragments. Additional studies with larger patient samples are recommended to further investigate differences in postoperative complications in relation to patient age.
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http://dx.doi.org/10.1016/j.joms.2015.01.016DOI Listing
July 2015

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

Effects of experimental insoles on body posture, mandibular kinematics and masticatory muscles activity. A pilot study in healthy volunteers.

J Electromyogr Kinesiol 2015 Jun 11;25(3):531-9. Epub 2015 Feb 11.

Department of Neurosciences, Section of Orthodontics and Gnathology, University of Naples "Federico II", Italy.

Background: It has been hypothesized that different plantar sensory inputs could influence the whole body posture and dental occlusion but there is a lack of evidence on this possible association.

Objectives: To investigate the effects of experimental insoles redistributing plantar pressure on body posture, mandibular kinematics and electromyographic (EMG) activity of masticatory muscles on healthy subjects.

Methods: A pilot study was conducted on 19 healthy volunteers that wore custom-made insoles normalizing the plantar pressure distribution for 2 weeks. Body posture parameters were measured by means of an optoelectronic stereophotogrammetric analysis; mandibular kinematics was analyzed by means of gothic arch tracings; superficial EMG activity of head and neck muscles was performed. Measurements were carried out 10 days before the insertion of the insoles, immediately before the insertion, the day after, 7 and 14 days after, in four different exteroceptive conditions.

Results: The outcomes of the present study show that insoles do not modify significantly over time the parameters of body posture, SEMG activity of head and neck muscles and mandibular kinematics.

Conclusions: In this pilot study the experimental insoles did not significantly influence the body posture, the mandibular kinematics and the activity of masticatory muscles during a 14-day follow up period.
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http://dx.doi.org/10.1016/j.jelekin.2015.02.001DOI Listing
June 2015

A laboratory based investigation of a new elastic toothbrush head.

ScientificWorldJournal 2014 18;2014:763968. Epub 2014 Nov 18.

Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna School of Dentistry, Via San Vitale 59, 40125 Bologna, Italy.

Purpose: To demonstrate the noninferiority of a new toothbrush head with retractile bristles compared to traditional toothbrush heads on dental models.

Methods: The new toothbrush head, mounted on manual and electrical handles, presents retractile bristle groups that can singularly retract over its entire length and offer calibrated resistance. Fourteen gypsum models of dental arches, twelve with and two without anatomical impairments, were spread with a "plaque simulator." Each arch was brushed twice with each of the four toothbrushes, one minute by the same operator, blinded to the study. The plaque index (PI) was recorded at the end of each brushing session. GLM for repeated measures analysed the data.

Results: On all the casts, the manual prototype and the electric prototype, removed 11% and 14% more "plaque simulator" compared to the standard toothbrush. In presence of dental anomalies, the prototypes removed 13% and 16% more plaque, respectively, compared to standard toothbrushes (P = 0.04). In both situations, the 95% confidence intervals of PI did not include -10% (the minimal margin of clinical relevance).

Conclusions: The prototype is more effective in removing plaque from the casts with anomalies. The noninferiority of the prototype with respect to the standard toothbrushes was demonstrated.
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http://dx.doi.org/10.1155/2014/763968DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251081PMC
September 2015

Accuracy of fibular sectioning and insertion into a rapid-prototyped bone plate, for mandibular reconstruction using CAD-CAM technology.

J Craniomaxillofac Surg 2015 Jan 1;43(1):28-33. Epub 2014 Nov 1.

Maxillofacial Surgery Unit, S. Orsola-Malpighi Hospital, Via Massarenti 9, 40100 Bologna, Italy. Electronic address:

Modern techniques of mandibular reconstruction, such as CAD-CAM technology and rapid prototyping, offer new means by which reconstructive surgery can be planned to optimise aesthetic outcomes and prosthetic rehabilitation. The high degree of accuracy afforded by these approaches is principally attributable to high-precision fibular sectioning and insertion of the bone into a customised bone plate. CAD-CAM mandibular reconstruction procedures using vascularised bone free-flap transfers were performed on 10 patients with benign or malignant neoplasms. Five were not treated with the aid of CAD-CAM technology, and served as the control group. Five were scheduled for maxillofacial surgery using surgical cutting guides and customised bone plates. A generalised linear model for linear measures was used to compare the accuracy of reconstruction between the two groups. A difference, even though not significant, in the lateral shift of the mesial and distal positions of the fibular units was evident between groups. CAD-CAM-generated fibular surgical guides afford improved accuracy when used to restore native anatomy, especially in the context of mandibular arch restoration, and both operating room time and related costs are reduced during fibular sectioning.
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http://dx.doi.org/10.1016/j.jcms.2014.10.005DOI Listing
January 2015

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

Wear and metallographic analysis of WaveOne and reciproc NiTi instruments before and after three uses in root canals.

Scanning 2014 Sep-Oct;36(5):517-25. Epub 2014 Jul 17.

Endodontic Clinical Section, Department of Biomedical and Neuromotor Sciences (DIBINEM), School of Dentistry, University of Bologna-Alma Mater Studiorum, Bologna, Italy.

Reciprocating instruments made from M-wire alloy have been proposed to reduce the risk of fracture. No information is available on the surface alteration after single and multiple uses in root canals. Two reciprocating NiTi instruments were used on extracted teeth up to three times. ESEM/EDS analysis was conducted to determine defects, alterations, and wear features of the apical third of instruments and metallographic analysis was performed on the cross-section of new and used instruments to compare alloy properties. Topography of apical portion was evaluated by AFM before and after uses. Extracted single-rooted teeth were divided into two groups and instrumented according to the manufacturer's recommendations with: (A) WaveOne Primary and (B) Reciproc R25. Each group was divided into three subgroups according to the number of canals instrumented: 1, 2, and 3, respectively. Chi square test was performed to verify homogeneity of defects distribution and GLM to evaluate the differences of RMS at baseline and after use for both groups (α level 0.05). No instrument fractured and no spiral distortions were observed under optical microscope even when the number of uses increased. Not significant differences were found for WaveOne and Reciproc. Blades presented a wrapped portion in WaveOne group and a more symmetrical feature in Reciproc group. Metallographic analysis revealed in both groups the presence of twinned martensitic grains with isolated flat austenitic areas. Both instruments demonstrated limited alteration, such as tip deformation and wear. This study confirmed the safe clinical use of both instruments for shaping multi-rooted teeth.
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http://dx.doi.org/10.1002/sca.21150DOI Listing
June 2015

Combined effects of repeated oral hygiene motivation and type of toothbrush on orthodontic patients: a blind randomized clinical trial.

Angle Orthod 2014 Sep 18;84(5):896-901. Epub 2014 Mar 18.

a  Visiting Professor, Department of Biomedical and Neuromotor Sciences, Section of Orthodontics, University of Bologna, Bologna, Italy.

Objective: To investigate the effects on plaque index (PI) scores of manual or electric toothbrush with or without repeated oral hygiene instructions (OHI) and motivation on patients wearing fixed orthodontic appliances.

Materials And Methods: One month after the orthodontic fixed appliance bonding on both arches, 60 patients were randomly assigned to four groups; groups E1 (n  =  15) and E2 (n  =  15) received a powered rotating-oscillating toothbrush, and groups M1 (n  =  15) and M2 (n  =  15) received a manual toothbrush. Groups E1 and M1 received OHI and motivation at baseline (T0) and after 4, 8, 12, 16, and 20 weeks (T4, T8, T12, T16, and T20, respectively) by a Registered Dental Hygienist; groups E2 and M2 received OHI and motivation only at baseline. At each time point a blinded examiner scored plaque of all teeth using the modified Quigley-Hein PI.

Results: In all groups the PI score decreased significantly over time, and there were differences among groups at T8, T12, T16, and T20. At T8, PI scores of group E1 were lower than those of group E2, and at T12, T16, and T20, PI scores of groups M1 and E1 were lower compared to those of groups M2 and E2. A linear mixed model showed that the effect of repeated OHI and motivation during time was statistically significant, independently from the use of manual or electric toothbrush.

Conclusions: The present results showed that repeated OHI and motivation are crucial in reducing PI score in orthodontic patients, independent of the type of toothbrush used.
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http://dx.doi.org/10.2319/112113-856.1DOI Listing
September 2014

Effect of fixed orthodontic appliances on salivary properties.

Prog Orthod 2013 Jun 18;14:13. Epub 2013 Jun 18.

Department of Orthodontics, University of Bologna, via San Vitale 59, Bologna 40125, Italy.

Background: So far, a few studies have tried to investigate the relationship between the placement of fixed orthodontic appliances and the change of nonmicrobial salivary properties, mostly with conflicting outcomes and short-term assessment (up to 6 months from bracket placement). The purpose of this study was to evaluate the salivary flow rate, pH and buffer capacity prior to the beginning of therapy and after 1 year from bracket placement using a simple and commercially available chairside saliva check kit.

Methods: The study population consisted of 20 healthy patients (mean age, 16.5±4 years) scheduled for fixed orthodontic treatment. Salivary samples were taken just before bracket bonding (T0; baseline assessment) and after 1 year of treatment (T1; half-treatment assessment) using the GC Saliva-Check Kit (GC Corp., Leuven, Belgium).

Results: No statistically significant difference was detected between T0 and T1 for the salivary parameters examined in the present study.

Conclusions: Under the conditions of this study, the placement of fixed orthodontic appliances did not change the salivary pH, buffer capacity and flow rate after 1 year of treatment if compared with the baseline assessment.
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http://dx.doi.org/10.1186/2196-1042-14-13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4384929PMC
June 2013

The effect of diode superpulsed low-level laser therapy on experimental orthodontic pain caused by elastomeric separators: a randomized controlled clinical trial.

Lasers Med Sci 2015 Jan 11;30(1):35-41. Epub 2013 May 11.

Department of Biomedical Sciences, Section of Orthodontics, University of Bologna, Italy, via san Vitale, 59 40125, Bologna, Italy.

The aim of this study was to evaluate the efficacy of diode superpulsed low-level laser therapy (SLLLT) in reducing experimentally induced orthodontic pain. Overall, 120 subjects (23.01 ± 1.39 years) were enrolled for a clinical trial. Subjects were randomly assigned to upper (U, N = 60) or lower (L, N = 60) jaw groups. All subjects received 4 elastomeric separators mesial and distal to the upper (U group) or lower (L group) right first molar and bicuspids. Each subject of the U and L groups was randomly assigned to laser (Ul, N = 20 and Ll, N = 20), placebo (Up, N = 20 and Lp, N = 20) or control (Uc, N = 20 and Lc, N = 20) sub-groups. Subjects in laser groups received a single GaAs diode SLLLT application (910 nm, 160 mW, beam diameter of 8 mm, applied for 340 s) immediately after placing orthodontic separators. Placebo groups received a simulated SLLLT and controls did not receive any therapy. All participants compiled a survey on pain duration and a 100-mm visual analogue scale immediately after the separators placement and after 12, 24, 36, 48, 72, and 96 h. Pain intensity of laser groups was significantly lower compared to placebo and control groups (p = 0.0001). In the laser group, 70% of subjects felt pain, while in the placebo and control groups all subjects felt pain (p = 0.0001). The end of pain occurred earlier in laser compared to placebo and control groups (p = 0.021). A single-diode SLLLT application appeared to be effective in reducing the intensity and duration of experimentally induced orthodontic pain and could be used in daily orthodontic practice.
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http://dx.doi.org/10.1007/s10103-013-1345-yDOI Listing
January 2015