Publications by authors named "Matteo Biasotto"

62 Publications

Dental calculus-a reservoir for detection of past SARS-CoV-2 infection.

Clin Oral Investig 2021 May 26. Epub 2021 May 26.

Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.

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http://dx.doi.org/10.1007/s00784-021-04001-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8152705PMC
May 2021

What do we learn from the clinical and biological evaluation of the oral cavity in centenarians?

Maturitas 2021 Mar 6;145:31-37. Epub 2021 Jan 6.

Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy; Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italy; DAME, University of Udine, Udine, Italy. Electronic address:

The number of centenarians is rapidly increasing worldwide and so are the studies on this segment of the population. A general consensus in the literature is that healthy longevity is an outcome of multiple factors, but the interrelationship between good oral health and healthy aging remains not fully understood. As part of the "CaT: Centenari a Trieste" study, a population-based cohort study set in Trieste, Italy, we report here the results of subjective self-reported oral health parameters and objective clinical and biological oral variables and their association with cognitive impairment in 25 centenarians enrolled in the study from September 2017 to May 2019. Oral health-related variables were recorded by means of a self-evaluation questionnaire and a comprehensive oral examination of teeth, prostheses and mucosae conducted by a trained dentist. In addition, 6-n-propylthiouracil (PROP) taste perception and salivary oxidative stress markers, specifically the Total Oxidative Status and Ferric Reducing Ability of Saliva, were measured. Finally, the oral data obtained were compared with the presence or absence of dementia in the enrolled subjects. The centenarians included in our study were generally satisfied with their oral health. Among the causes of discomfort, the most prevalent were difficulties in chewing and biting, with few subjects describing a correlation between their oral health and psycho-social issues. We evaluated possible relations of clinical and biological variables to the likelihood of being demented and did not find significant associations. We found a higher though not statistically significant mean salivary flow and antioxidant capacity of saliva in non-demented subjects. When evaluating the PROP taste perception profile, we found a higher proportion of supertasters compared with previous studies and different taste perception profiles according to dementia. Despite the relatively small number of participants, we believe that our study contributes to a better understanding of the clinical and biological profile of the oral cavity in subjects aged over 100 years, encouraging the inclusion of a comprehensive evaluation of the oral cavity in centenarian studies performed worldwide.
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http://dx.doi.org/10.1016/j.maturitas.2020.12.005DOI Listing
March 2021

Psychological profile and unexpected pain in oral lichen planus: A case-control multicenter SIPMO study.

Oral Dis 2021 Jan 29. Epub 2021 Jan 29.

Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Turin, Italy.

Objectives: To analyze psychological profiles, pain, and oral symptoms in patients with oral lichen planus (OLP).

Materials And Methods: 300 patients with keratotic OLP (K-OLP; reticular, papular, plaque-like subtypes), 300 patients with predominant non-keratotic OLP (nK-OLP; erythematosus atrophic, erosive, ulcerative, bullous subtypes), and 300 controls were recruited in 15 universities. The number of oral sites involved and oral symptoms were recorded. The Numeric Rating Scale (NRS), Total Pain Rating Index (T-PRI), Hamilton Rating Scales for Depression and for Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) were administered.

Results: The OLP patients, especially the nK-OLP, showed higher scores in the NRS, T-PRI, HAM-D, HAM-A and PSQI compared with the controls (p-value < .001 ). A positive correlation between the NRS, T-PRI, HAM-A, HAM-D, and PSQI was found with the number of oral symptoms and number of oral sites involved. Pain was reported in 67.3% of nK-OLP and 49.7% of K-OLP cases with poor correspondence between the site of lesions and the site of the symptoms.

Conclusions: Mood disorders are frequently associated with OLP with an unexpected symptomatology correlated with the number of oral symptoms and with the extension of disease suggesting a peripheral neuropathy.
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http://dx.doi.org/10.1111/odi.13787DOI Listing
January 2021

Antimicrobial activity of amphiphilic nanomicelles loaded with curcumin against Pseudomonas aeruginosa alone and activated by blue laser light.

J Biophotonics 2021 03 18;14(3):e202000350. Epub 2020 Nov 18.

Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.

The aim of this work was to assess the antimicrobial efficacy on Pseudomonas aeruginosa of nanomicelles loaded with curcumin (CUR) alone and activated by blue laser light in an antimicrobial photodynamic therapy (APDT) approach. First, free CUR in liquid suspension and loaded in three amphiphilic nanomicelles (CUR-DAPMA, CUR-SPD and CUR-SPM) were tested both on bacteria and keratinocytes. While free CUR exerted limited efficacy showing moderate cytotoxicity, a strong inhibition of bacterial growth was obtained using all three nanosystems without toxicity on eukaryotic cells. CUR-SPM emerged as the most effective, and was therefore employed in APDT experiments. Among the three sublethal blue laser (λ 445 nm) protocols tested, the ones characterized by a fluence of 18 and 30 J/cm further decreased the antimicrobial concentration to 50 nM. The combination of blue laser APDT with CUR-SPM nanomicelles results in an effective synergistic activity that represents a promising novel therapeutic approach on resistant species.
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http://dx.doi.org/10.1002/jbio.202000350DOI Listing
March 2021

Photobiomodulation modulates inflammation and oral microbiome: a pilot study.

Biomarkers 2020 Dec 1;25(8):677-684. Epub 2020 Oct 1.

Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.

Introduction: Oral mucositis (OM) is a severe side effect in patients undergoing anticancer therapies, which negatively impacts on their quality of life often leading to either the interruption of the therapy. Photobiomodulation (PBM) is emerging as an effective strategy allowing a faster wound healing.

Objectives: This pilot study aims at verifying whether PBM modulates the inflammatory response in patients and its effect on the oral microbiome composition.

Materials And Methods: Buccal swabs were collected from four patients affected by OM, both on ulcerated and clinically healthy areas, before and on the last day of PBM therapy, as well as on the first day after treatment discontinuation. The concentration of 38 cytokines and the composition of oral microbiome were measured.

Results: Most of the pro-inflammatory cytokines were reduced, whereas anti-inflammatory cytokines resulted up-regulated by PBM. In addition, PBM influenced the composition of oral microbiome, by decreasing the amount of pathogenic species and promoting the growth of commensal bacteria. These changes were even more evident when separately analysing patients who clinically responded to PBM and the only patient who did not respond.

Conclusions: PBM reduces inflammatory burden in patients affected by OM and positively influences the composition of the oral microbiome.
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http://dx.doi.org/10.1080/1354750X.2020.1825812DOI Listing
December 2020

Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020.

Int J Environ Res Public Health 2020 08 18;17(16). Epub 2020 Aug 18.

IAC-ONJ (Italian Allied Committee on ONJ), Temporary Chair at University of Palermo, 90100 Piazza Marina, Italy.

The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons involved in MRONJ prevention (primary and secondary). The present paper reports the update of the conclusions from the Consensus Conference-held at the Symposium of the Italian Society of Oral Pathology and Medicine (SIPMO) (20 October 2018, Ancona, Italy)-after the newest recommendations (2020) on MRONJ were published by two scientific societies (Italian Societies of Maxillofacial Surgery and Oral Pathology and Medicine, SICMF and SIPMO), written on the inputs of the experts of the Italian Allied Committee on ONJ (IAC-ONJ). The conference focused on the topic of MRONJ, and in particular on the common practices at risk of inappropriateness in MRONJ diagnosis and therapy, as well as on MRONJ prevention and the dental management of patients at risk of MRONJ. It is a matter of cancer and osteometabolic patients that are at risk since being exposed to several drugs with antiresorptive (i.e., bisphosphonates and denosumab) or, more recently, antiangiogenic activities. At the same time, the Conference traced for dentists and oral surgeons some easy applicable indications and procedures to reduce MRONJ onset risk and to diagnose it early. Continuous updating on these issues, so important for the patient community, is recommended.
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http://dx.doi.org/10.3390/ijerph17165998DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460511PMC
August 2020

Self-perception and physician's awareness on early detection of tongue cancer: experience of the Oral Medicine Unit of Trieste.

Minerva Stomatol 2020 Apr;69(2):95-99

Unit of Oral Medicine and Pathology, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.

Background: The objective of this retrospective study was to characterize the outpatient oral medicine referral pattern for tongue lesions with particular emphasis on cancer.

Methods: Records of patients referred to the Oral Medicine department for any tongue lesions needing biopsy between 2009 and 2016 were retrospectively analyzed. All cases diagnosed as tongue cancer were screened for medical history, referral pattern, treatment/diagnosis/follow-up.

Results: Among 266 patients, 39 were diagnosed with cancer, 43.6% were smokers and 10.3% alcohol consumers, 38.5% felt pain, 53.8% noticed the lesion or felt its presence, 46.2% were referred from another specialist. For people aware or informed of the lesion. the mean time waited before consultation was 7.9 months. In 53.8% of cases, narrow-band-imaging guided the biopsy. In 29 patients, biopsy was performed the day of the visit. Patients were referred from dentists (42.1%), Primary-care-Physician (10.5%), Emergency-Dental-Unit (7.9%), Radiotherapist (7.9%), Otolaryngologist (7.9%), Dermatologist (26%), infectious diseases unit (2.6%), auto-referral in 18.4%. Lesion was defined by referring doctor as "suspicious" (13.1%), white (10.5%), vegentans (5.3%), Lichen-like (5.3%), ulcerative (2.6%), Tumoral (26.3%), Bollous (2.6%). An unweighted Kappa Value of 0.024, assessed low concordance between referral diagnosis and diagnosis performed by the Oral Medicine specialist before the biopsy.

Conclusions: Patients are not always aware of the risk of oral cancer. Accurate information should be provided to patients as well as to specialists rather than just dentists as regard as the risk factors for oral cancer, the importance of referral to specialized departments and timing. The use of new technologies should be widespread.
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http://dx.doi.org/10.23736/S0026-4970.19.04212-2DOI Listing
April 2020

Blue laser light inhibits biofilm formation in vitro and in vivo by inducing oxidative stress.

NPJ Biofilms Microbiomes 2019;5(1):29. Epub 2019 Oct 9.

1Department of Medical, Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy.

Resolution of bacterial infections is often hampered by both resistance to conventional antibiotic therapy and hiding of bacterial cells inside biofilms, warranting the development of innovative therapeutic strategies. Here, we report the efficacy of blue laser light in eradicating cells, grown in planktonic state, agar plates and mature biofilms, both in vitro and in vivo, with minimal toxicity to mammalian cells and tissues. Results obtained using knock-out mutants point to oxidative stress as a relevant mechanism by which blue laser light exerts its anti-microbial effect. Finally, the therapeutic potential is confirmed in a mouse model of skin wound infection. Collectively, these data set blue laser phototherapy as an innovative approach to inhibit bacterial growth and biofilm formation, and thus as a realistic treatment option for superinfected wounds.
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http://dx.doi.org/10.1038/s41522-019-0102-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785554PMC
June 2020

Analgesic effect of Photobiomodulation Therapy: An in vitro and in vivo study.

J Biophotonics 2019 10 9;12(10):e201900043. Epub 2019 Jul 9.

Institute for Maternal and Child Health, IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy.

Laser therapy, also known as Photobiomodulation (PBM) is indicated to reduce pain associated with different pathologies and applied using protocols that vary in wavelength, irradiance and fluence. Its mechanisms of action are still unclear and possibly able to directly impact on pain transmission, reducing nociceptor response. In our study, we examined the effect of two specific laser wavelengths, 800 and 970 nm, extensively applied in the clinical context and known to exert important analgesic effects. Our results point to mitochondria as the primary target of laser light in isolated dorsal root ganglion (DRG) neurons, reducing adenosine triphosphate content and increasing reactive oxygen species levels. Specifically, the 800 nm laser wavelength induced mitochondrial dysregulation, that is, increased superoxide generation and mitochondrial membrane potential. When DRG neurons were firstly illuminated by the different laser protocols and then stimulated with the natural transient receptor potential cation channel subfamily V member 1 (TRPV1) ligand capsaicin, only the 970 nm wavelength reduced the calcium response, in both amplitude and frequency. Consistent results were obtained in vivo in mice, by subcutaneous injection of capsaicin. Our findings demonstrate that the effect of PBM depends on the wavelength used, with 800 nm light mainly acting on mitochondrial metabolism and 970 nm light on nociceptive signal transmission.
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http://dx.doi.org/10.1002/jbio.201900043DOI Listing
October 2019

Campaign to Increase Awareness of Oral Cancer Risk Factors Among Preadolescents.

J Cancer Educ 2020 06;35(3):616-620

Division of Oral Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, Trieste, Italy.

Oral squamous cell carcinoma (OSCC) represents one of the most common but scarcely known malignancies worldwide. The etiology of OSCC is strongly related to lifestyle habits and behavior, especially tobacco smoking and alcohol abuse. The mean age of individuals who start smoking and drinking alcohol is decreasing; thus, the aim of our campaign was to test the awareness and increase knowledge of oral cancer and its risk factors among young preadolescents. Six schools with 460 students aged 12-14 years were included in the campaign. A lecture about carcinogenesis and oral cancer was provided. Anonymous questionnaires were submitted to the students before and after the lecture, to test their knowledge, awareness, and understanding. Before the lecture, the students showed very little awareness of oral cancer (26.8%), although almost all of them identified tobacco smoking as a risk factor (92.2%). After the lecture, the students showed a significant understanding of the provided information, thus increasing their awareness. On scales of 1-10, the students rated the appropriateness of the campaign at 8.9 and their overall appreciation at 8.7. Social campaigns, especially among young students, seem to be appreciated and may represent a powerful strategy for increasing knowledge about cancer risk factors, especially when they are highly related to lifestyle habits and behavior.
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http://dx.doi.org/10.1007/s13187-019-01504-7DOI Listing
June 2020

Mannose-Binding Lectin 2 (MBL2) combined genotypes deficiency is associated with susceptibility for Oral Lichen Planus.

Genet Mol Biol 2019 Jan-Mar;42(1):9-14. Epub 2019 Feb 21.

Department of Surgical, Medical and Health Sciences, University of Trieste, Trieste, Italy.

Oral Lichen Planus (OLP) is an oral inflammatory condition, mediated by host immune system reaction, presenting basal membrane damages with inflammatory lesions in the mouth and/or skin. In this study, the role of functional polymorphisms in the MBL2 gene, encoding for Mannose-Binding Protein C (MBP-C), a member of the innate immune response and an acute-phase protein able to activate the complement cascade, was investigated to assess a possible association with OLP susceptibility in Italian patients. Two variations at the promoter region (called H/L and X/Y) and three at the first exon (at codon 52, 54, and 57) of the MBL2 gene were analyzed in 69 OLP patients and 244 healthy controls from northeastern Italy. Considering the polymorphisms singularly, the MBL2 X allele and C/T genotype of the D allele (correlated with low MBP-C expression) were associated with susceptibility to develop OLP. Moreover, when taking into account MBL2 combined genotypes, more OLP patients were deficient MBP-C producers than not deficient, who were more represented among healthy controls. MBL2 combined genotypes, responsible for deficient MBP-C production, are associated with an increased risk of developing OLP.
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http://dx.doi.org/10.1590/1678-4685-GMB-2018-0015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428121PMC
February 2019

Photobiomodulation at Multiple Wavelengths Differentially Modulates Oxidative Stress and .

Oxid Med Cell Longev 2018 11;2018:6510159. Epub 2018 Nov 11.

Department of Medical, Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy.

Photobiomodulation (PBM) is emerging as an effective strategy for the management of multiple inflammatory conditions, including oral mucositis (OM) in cancer patients who receive chemotherapy or radiotherapy. Still, the poor understanding of the mechanisms by which the light interacts with biological tissues and the heterogeneity of light sources and protocols employed worldwide significantly limits its applicability. Reactive oxygen species (ROS) are massively generated during the early phases of OM and play a major role in the pathogenesis of inflammation in general. Here, we report the results of a clinical and experimental study, aimed at evaluating the effect of laser light at different wavelengths on oxidative stress in oncologic patients suffering from OM and in two cell types abundantly present within the inflamed oral mucosa, neutrophil polymorphonuclear (PMN) granulocytes, and keratinocytes. In addition to standard ROS detection methods, we exploited a roGFP2-Orp1 genetically encoded sensor, allowing specific, quantitative, and dynamic imaging of redox events in living cells in response to oxidative stress and PBM. We found that the various wavelengths differentially modulate ROS production. In particular, the 660 nm laser light increases ROS production when applied either before or after an oxidative stimulus. In contrast, the 970 nm laser light exerted a moderate antioxidant activity both in the saliva of OM patients and in both cell types. The most marked reduction in the levels of ROS was detected in cells exposed either to the 800 nm laser light or to the combination of the three wavelengths. Overall, our study demonstrates that PBM exerts different effects on the redox state of both PMNs and keratinocytes depending on the used wavelength and prompts the validation of a multiwavelength protocol in the clinical settings.
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http://dx.doi.org/10.1155/2018/6510159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252186PMC
January 2019

Gadolinium tissue deposition in the periodontal ligament of mice with reduced renal function exposed to Gd-based contrast agents.

Toxicol Lett 2019 Feb 23;301:157-167. Epub 2018 Nov 23.

Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy. Electronic address:

Gadolinium deposition in tissue is linked to nephrogenic systemic fibrosis (NSF): a rare disorder occurring in patients with severe chronic kidney disease and associated with administration of Gd-based contrast agents (GBCAs) for Magnetic Resonance Imaging (MRI). It is suggested that the GBCAs prolonged permanence in blood in these patients may result in a Gd precipitation in peripheral or central organs, where it initiates a fibrotic process. In this study we investigated new sites of retention/precipitation of Gd in a mouse model of renal disease (5/6 nephrectomy) receiving two doses (closely after each other) of a linear GBCA. Two commercial GBCAs (Omniscan® and Magnevist®) were administered at doses slightly higher than those used in clinical practice (0.7 mmol/kg body weight, each). The animals were sacrificed one month after the last administration and the explanted organs (kidney, liver, femur, dorsal skin, teeth) were analysed by X-ray fluorescence (XRF) at two synchrotron facilities. The XRF analysis with a millimetre-sized beam at the SYRMEP beamline (Elettra, Italy) produced no detectable levels of Gd in the examined tissues, with the notable exception of the incisors of the nephrectomised mice. The XRF analyses at sub-micron resolution performed at ID21 (ESRF, France) allowed to clearly localize Gd in the periodontal ligaments of teeth both from Omniscan® and Magnevist® treated nephrectomised mice. The latter results were further confirmed by laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS). The study prompts that prolonged permanence of GBCAs in blood may result in Gd retention in this particular muscular tissue, opening possibilities for diagnostic applications at this level when investigating Gd-related toxicities.
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http://dx.doi.org/10.1016/j.toxlet.2018.11.014DOI Listing
February 2019

Efficacy of ultramicronized palmitoylethanolamide in burning mouth syndrome-affected patients: a preliminary randomized double-blind controlled trial.

Clin Oral Investig 2019 Jun 25;23(6):2743-2750. Epub 2018 Oct 25.

Department of Medical, Surgical and Health Sciences, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy.

Objectives: This preliminary randomized double-blind controlled trial was performed to test the efficacy of ultramicronized palmitoylethanolamide treatment in the burning mouth syndrome.

Materials And Methods: Patients with referred burning mouth intensity greater than 4, according to the Numeric Rating Scale, were included in the study according to established inclusion and exclusion criteria. Patients were randomized into two groups and received either placebo or ultramicronized palmitoylethanolamide 600 mg twice daily for 60 days. Patients were assessed at baseline, 30 and 60 days after treatment start, and 4 months after treatment discontinuation. In order to evaluate the change in the burning mouth sensation over time, the generalized linear mixed model was employed.

Results: A total of 35 patients were considered eligible, among which 6 withdrew prior to the end of treatment. A statistically significant reduction of burning mouth sensation (p < 0.0132) was registered at the end of the active treatment in the ultramicronized palmitoylethanolamide group compared to the placebo one. Any side effect related to the active treatment was neither observed nor reported both by patients and by physicians.

Conclusions: The significant decrease of burning sensation in the ultramicronized palmitoylethanolamide group compared to the placebo group suggests to consider this naturally occurring molecule as a viable therapy in the management of burning mouth syndrome.

Clinical Relevance: The use of an effective compound to manage the burning mouth syndrome, devoid of adverse effects for the patient and that does not interfere with other pharmacological therapies, could find wide employability from clinicians.
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http://dx.doi.org/10.1007/s00784-018-2720-7DOI Listing
June 2019

Multicenter randomized, double-blind controlled trial to evaluate the efficacy of laser therapy for the treatment of severe oral mucositis induced by chemotherapy in children: laMPO RCT.

Pediatr Blood Cancer 2018 08 4;65(8):e27098. Epub 2018 May 4.

Pediatric Hemato-Oncology Unit, IRCCS materno infantile Burlo Garofolo, Trieste, Italy.

Objectives: To demonstrate the efficacy of laser photobiomodulation (PBM) compared to that of placebo on severe oral mucositis (OM) in pediatric oncology patients. The primary objective was the reduction of OM grade (World Health Organization [WHO] scale) 7 days after starting PBM. Secondary objectives were reduction of pain, analgesic consumption, and incidence of side effects.

Methods: One hundred and one children with WHO grade > 2 chemotherapy-induced OM were enrolled in eight Italian hospitals. Patients were randomized to either PBM or sham treatment for four consecutive days (days +1 to +4). On days +4, +7, and +11, OM grade, pain (following a 0-10 numeric pain rating scale, NRS) and need for analgesics were evaluated by an operator blinded to treatment.

Results: Fifty-one patients were allocated to the PBM group, and 50 were allocated to the sham group. In total, 93.7% of PBM patients and 72% of sham patients had OM grade < 3 WHO on day +7 (P = 0.01). A significant reduction of pain was registered on day +7 in the PBM versus sham group (NRS 1 [0-3] vs. 2.5 [1-5], P < 0.006). Reduced use of analgesics was reported in the PBM group, although it was not statistically significant. No significant adverse events attributable to treatment were recorded.

Conclusions: PBM is a safe, feasible, and effective treatment for children affected by chemotherapy-induced OM, as it accelerates mucosal recovery and reduces pain.
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http://dx.doi.org/10.1002/pbc.27098DOI Listing
August 2018

Blue diode laser: a new strategy for the management of lichen sclerosus et atrophicus.

G Ital Dermatol Venereol 2018 Apr;153(2):289-291

Department of Dermatology and Venereology, University of Trieste, Trieste, Italy.

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http://dx.doi.org/10.23736/S0392-0488.17.05506-7DOI Listing
April 2018

Effect of Laser Therapy on Defensins' Gene Expression in TR146 Epithelial Cell Line.

Protein Pept Lett 2018 ;25(4):326-329

Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.

Introduction: Laser Therapy (LT) has been employed for the treatment of Oral Mucositis (OM) due to its anti-inflammatory, analgesic and bio-stimulatory effects.

Objective: This pilot study investigated the effect of LT on the expression of DEFB1, DEFB4, DEFB103 genes encoding for the human β-defensins 1, 2 and 3.

Materials And Method: TR146 epithelial cell line, used to mimic oral mucosa, was irradiated with different LT protocols. β-defensins gene expression was evaluated using TaqMan probes on Real- Time PCR platform.

Results And Conclusion: In this cellular model LT decreased mRNA defensins' expression 30 minutes after irradiation but not 24 hours later, suggesting that LT is able to influence β -defensins production immediately after treatment, while its efficacy decreases over time.
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http://dx.doi.org/10.2174/0929866525666180221123249DOI Listing
April 2019

Tailored resections in oral and oropharyngeal cancer using narrow band imaging.

Am J Otolaryngol 2018 Mar - Apr;39(2):197-203. Epub 2017 Nov 10.

ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Integrata di Trieste, Strada di Fiume 447, 34149 Trieste, Italy. Electronic address:

Purpose: In a previous pilot study we observed that intra-operative narrow-band imaging (NBI) helps achieve clear superficial resection margins. The aim of this study was to verify if the use of intra-operative NBI can help to obtain tailored resections and if it is influenced by the lesion site, aspects not investigated in our previous study.

Materials And Methods: The resection margins of 39 oral and 22 oropharyngeal squamous cell carcinomas were first set at 1.5cm from the macroscopic lesion boundary (white light, WL, tattoo). Then, the superficial tumor extension was more precisely defined with NBI, giving rise to three possible situations: NBI tattoo larger than the WL tattoo, NBI tattoo coinciding with the WL tattoo, or NBI tattoo smaller than the WL tattoo. For each of these situations the space comprised between the NBI and WL tattoos was defined "NBI positive", "NBI null", and "NBI negative", respectively. Resections were performed following the outer tattoo. The number of clear superficial resection margins, and the pathological response on the "NBI-positive" and the "NBI-negative" areas were recorded.

Results: We obtained 80.3% negative superficial resection margins. NBI provided a more precise definition of superficial tumor extension in 43 patients. Sensitivity, specificity, positive and negative predictive values were 94.4%, 64%, 79.1% and 88.9%, respectively; a test of proportions demonstrated they were not influenced by tumor site.

Conclusions: NBI could allow for real-time definition of superficial tumor extension with possible tailored resections and fewer positive superficial resection margins; it is not influenced by tumor site.
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http://dx.doi.org/10.1016/j.amjoto.2017.11.004DOI Listing
September 2018

Blue diode laser versus traditional infrared diode laser and quantic molecular resonance scalpel: clinical and histological findings after excisional biopsy of benign oral lesions.

J Biomed Opt 2017 12;22(12):121602

Division of Oral Medicine and Pathology, Dental Clinic, Ospedale Maggiore, Trieste, ItalybUniversity of Trieste, Department of Surgical, Medical and Health Sciences, Trieste, Italy.

This study aims to compare the use of the innovative blue diode laser (BLUE group) with two traditional surgical techniques: the infrared diode laser (IR group) and the quantic molecular resonance scalpel (QMR group) in the excision of benign oral lesions. Ninety-three patients underwent surgical excision of a benign oral lesion and were followed up for 30 days for pain (0 to 10 visual analogue scale), bleeding, and painkillers’ assumption (yes/no). A blind pathologist evaluated the thermal damage along the cutting margin. Although referred pain was lowest in the BLUE group from day 7 on (p<0.05), all patients referred minimum discomfort after surgery. The BLUE group reported minimum bleeding and necessity of sutures (p<0.000). The QMR group showed the highest bleeding during surgery (p<0.000), while after 14 and 30 days no patient bled. Most of the patients in all groups did not need painkillers. The lowest thermal damage (p<0.000) was found in the BLUE group (71.3±51.8???m), whereas the IR group proved the highest (186.8±82.7???m) compared both with the BLUE and QMR (111.4±55.4???m) groups. All the techniques allowed correct histological sampling. All the experimented techniques offer interesting advantages, although the blue laser minimizes risk of bleeding with limited thermal damage.
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http://dx.doi.org/10.1117/1.JBO.22.12.121602DOI Listing
December 2017

DEFB1 polymorphisms and salivary hBD-1 concentration in Oral Lichen Planus patients and healthy subjects.

Arch Oral Biol 2017 Jan 12;73:161-165. Epub 2016 Oct 12.

Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', Trieste, Italy. Electronic address:

Objectives: The aetiology of Oral Lichen Planus (OLP), a chronic inflammatory disease of oral mucosa, is not yet well understood. Since innate immunity may be hypothesized as involved in the susceptibility to OLP, we studied human beta defensin 1 (hBD-1) an antimicrobial peptide constitutively expressed in the saliva, looking at functional genetic variants possibly able to diminish hBD-1 production an consequently conferring major susceptibility to OLP.

Design: We analysed three DEFB1 polymorphisms at 5' UTR, -52G>A (rs1799946), -44C>G (rs1800972), -20G>A (rs11362) and two DEFB1 polymorphisms at 3'UTR, c*5G>A (rs1047031), c*87A>G (rs1800971), with the aim of correlating these genetic variants and hBD-1 salivary level in a group of OLP patients and in healthy subjects. We also evaluated hBD-1 salivary concentrations, using ELISA, in OLP and healthy controls.

Results: We compared hBD-1 concentrations in OLP and healthy subjects: hBD-1 concentration was significantly higher in OLP patients respect to control. When considering the correlation between DEFB1 polymorphisms genotypes and hBD-1 expression levels, significant results were obtained for SNPs -52G>A (p=0.03 both in OLP patients and healthy individuals) and -44C>G (p=0.02 in OLP patients).

Conclusions: hBD-1 production was different between OLP and healthy subjects (not age-matched with OLP). DEFB1 gene polymorphisms, -52G>A and -44C>G, correlated with hBD-1 salivary concentrations.
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http://dx.doi.org/10.1016/j.archoralbio.2016.10.008DOI Listing
January 2017

The diagnostic performance parameters of Narrow Band Imaging: A preclinical and clinical study.

Oral Oncol 2016 09 2;60:130-6. Epub 2016 Aug 2.

Ambulatorio di Patologia e Medicina Orale, Clinica Odontoiatrica e Stomatologica, Ospedale Maggiore, Trieste, Italy; Dipartimento di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, Italy. Electronic address:

Objectives: The oral carcinoma is a widespread pathology and still presents poor prognosis. Among the available procedures for its early detection, Narrow Band Imaging technique allows to assess potential vascular network abnormalities. The reliability of this technique in the detection of dysplastic and neoplastic oral lesions was evaluated in a preclinical and clinical study.

Materials And Methods: In the preclinical study, a chemical oral carcinogen was administered to 50 mice to induct both dysplastic and neoplastic oral lesions. In the clinical study 91 patients, bearing suspicious premalignant and malignant oral lesions, have been included. Images of animals' and patients' lesions were acquired under white and Narrow Band Imaging light prior to biopsy. Two expert raters examined the images and classified lesions, which were eventually compared to the histological diagnosis. The diagnostic performance included sensitivity, specificity, positive likelihood ratio, positive and negative predictive values, accuracy, percentages and degree of agreement between raters' evaluation and the histological report.

Results: In the preclinical study sensitivity ranged from 0.57 to 1, specificity from 0.85 to 0.99, positive likelihood ratio from 6.54 to 65.04, positive predictive values from 0.32 to 0.96, negative predictive values from 0.91 to 1 and accuracy from 0.86 to 0.98. In the clinical study sensitivity ranged from 0.63 to 0.99, specificity from 0.89 to 1, positive likelihood ratio from 8.45 to 61.47, positive predictive values from 0.59 to 0.96, negative predictive values from 0.78 to 1 and accuracy from 0.82 to 0.99.

Conclusion: Narrow Band Imaging is an accurate technique, which holds a great potential for tumour angiogenesis evaluation and for the subsequent early detection of suspicious premalignant and malignant oral lesions.
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http://dx.doi.org/10.1016/j.oraloncology.2016.07.001DOI Listing
September 2016

Laser Therapy Inhibits Tumor Growth in Mice by Promoting Immune Surveillance and Vessel Normalization.

EBioMedicine 2016 Sep 25;11:165-172. Epub 2016 Jul 25.

Cardiovascular Biology, International Centre for Genetic Engineering and Biotechnology (ICGEB), Padriciano 99, 34149 Trieste, Italy; Department of Medical, Surgical and Health Sciences, University Hospital of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy. Electronic address:

Laser therapy, recently renamed as photobiomodulation, stands as a promising supportive treatment for oral mucositis induced by oncological therapies. However, its mechanisms of action and, more importantly, its safety in cancer patients, are still unclear. Here we explored the anti-cancer effect of 3 laser protocols, set at the most commonly used wavelengths, in B16F10 melanoma and oral carcinogenesis mouse models. While laser light increased cell metabolism in cultured cells, the in vivo outcome was reduced tumor progression. This striking, unexpected result, was paralleled by the recruitment of immune cells, in particular T lymphocytes and dendritic cells, which secreted type I interferons. Laser light also reduced the number of highly angiogenic macrophages within the tumor mass and promoted vessel normalization, an emerging strategy to control tumor progression. Collectively, these results set photobiomodulation as a safety procedure in oncological patients and open the way to its innovative use for cancer therapy.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5049921PMC
http://dx.doi.org/10.1016/j.ebiom.2016.07.028DOI Listing
September 2016

Combined Orofacial Aspergillosis and Mucormycosis: Fatal Complication of a Recurrent Paediatric Glioma-Case Report and Review of Literature.

Mycopathologia 2016 Oct 27;181(9-10):723-33. Epub 2016 Jun 27.

Division of Oral Medicine, Dental Science Department, University of Trieste, Piazza dell'Ospitale 2, 34125, Trieste, Italy.

Mucormycosis and aspergillosis are two opportunistic fungal infections, which can evolve into life-threatening complications. They generally affect patients with relevant risk factors such as immunocompromisation or long-term use of antibiotics or corticosteroids. Treatment usually combines medical and surgical approaches, often including extended necrosectomies, although the prognosis of generalized fungal infections is very poor. In this paper, we present the case of a 17-year-old girl affected by combined aspergillosis and mucormycosis, following treatment of a recurrent glioma. The patient was hospitalized for a suspected cellulitis of the right hemi-face, involving frontal maxillary area and the upper airways and was immediately put on intravenous antibiotic therapies; after performing nasal septum and maxillary biopsies, concomitant mucormycosis and aspergillosis were diagnosed and antimycotic therapy with liposomal B-amphotericin was administered. After evaluation by the oral surgeon and otolaryngologist, surgical cranio-facial necrosectomy was suggested, but refused by the parents of the patient. The girl died only few days later, due to a respiratory arrest. Awareness of this pathology with prompt diagnosis and early treatment may improve the outcome of these infections and reduce the mortality.
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http://dx.doi.org/10.1007/s11046-016-0021-8DOI Listing
October 2016

Diagnostic and therapeutic features associated with modification of quality-of-life's outcomes between one and six months after major surgery for head and neck cancer.

Braz J Otorhinolaryngol 2016 Sep-Oct;82(5):548-57. Epub 2015 Dec 18.

University of Trieste, Hospital of Cattinara, ENT Clinic, Head and Neck Department, Trieste, Italy.

Introduction: Treatments used in head and neck cancer greatly impact the physical, psychological and functional state of patients. Evaluation of quality of life has become an integral part of the treatment.

Objective: This retrospective study evaluates features involved in changes in quality of life after major surgery for head and neck cancer within six months, according to self-reported outcomes.

Methods: One hundred and thirty patients completed the University of Washington Quality of Life questionnaire one and six months after major surgery for head and neck cancer. A multivariate model was used to evaluate which diagnostic and therapeutic features were related to improvement of quality of life within a six-month period.

Results: Significant improvement in most features related to quality of life was already recognizable at six months. Patients submitted to more invasive treatment had the biggest improvement in quality of life between time-points, as well as those patients with bigger tumors.

Conclusion: After major surgery, patients may undergo fast recovery, with overall quality of life likely to improve in the short-term. Clinicians must be aware of the importance of dealing with treatment-related issues immediately after surgery, with hopeful possibility of on-the-upgrade results.
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http://dx.doi.org/10.1016/j.bjorl.2015.10.013DOI Listing
December 2016

Same strategy for pitfalls of radiotherapy in different anatomical districts.

Lasers Med Sci 2016 Apr 21;31(3):471-9. Epub 2016 Jan 21.

Division of Oral Medicine and Pathology, Ospedale Maggiore, Piazza dell'Ospitale, 34100, Trieste, Italy.

Oral mucositis (OM) and radiodermatitis (RD) are serious side effects of radiotherapy (RT), often leading to its suspension, need for analgesics, and enteral/parenteral nutrition. Laser therapy is becoming a recommended treatment option. This prospective study aimed at demonstrating the beneficial effect of class IV laser therapy (HPLT) on RT-induced OM, an off-label use of HPLT to treat RD in breast cancer patients. Fifty-three cancer patients, during/after RT and/or chemotherapy (CT), affected by OM, were treated with HPLT during four consecutive days (970 ± 15 nm, 5 W (50 %), 35-6000 Hz, 240 s). Assessment of OM (Grading Objective Scale, WHO-SCALE), pain (visual analogue scale, VAS), functional ability, subjective parameters, and site/severity of OM were recorded over time. Similarly, 27 breast cancer patients affected by RD were treated by HPLT and monitored over time for grade, discomfort, itching, and bleeding. Progressive improvement of WHO-SCALE from day 7 on, and of VAS from day 2 on (p < 0.000) was registered. All patients' functional capacity improved on day 4 (p < 0.05). All subjective parameters improved on day 14 (p < 0.001) except for voice, which improved on day 21 (p < 0.000). Ulcerations' dimension and erythema's severity significantly decreased in all sites examined (p < 0.05). Similarly, HPLT proved to be beneficial in managing RD for all the parameters considered (p < 0.002). Regardless of OM grade/site and of kind/site of tumor, HPLT proved to be effective in healing OM as well as RD. In both cases, effective treatment can improve life quality through a safe, easy, innovative approach. Therefore, HPLT may become an integral part of everyday practice in the management of RT adverse effects.
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http://dx.doi.org/10.1007/s10103-015-1857-8DOI Listing
April 2016

Narrow band imaging in the intra-operative definition of resection margins in oral cavity and oropharyngeal cancer.

Oral Oncol 2015 Oct 26;51(10):908-13. Epub 2015 Jul 26.

ENT Clinic, Head and Neck Department, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy. Electronic address:

Objectives: In oncological surgery, a three-dimensional resection 1.5-2 cm from the gross tumour edge is currently considered appropriate, and the status of resection margins is the most reliable indicator of radicality. Awareness of "field cancerization" calls for a re-evaluation of the benchmarks of tumour resection; however, its identification is not simple because the dysplastic areas may be far from the main lesion and difficult to recognize macroscopically. New technologies such as narrow band imaging (NBI) could improve the detection of neoplastic and pre-neoplastic areas, ensuring more precise resections. The main purpose of this study was to investigate the value of NBI in detecting pre-cancerous areas and/or cancer around the tumour bulk intra-operatively, to achieve adequate resection of the tumour.

Materials And Methods: The resection margins of 8 oral cavity and 8 oropharyngeal cancers were first drawn by macroscopic evaluation and then re-defined using NBI. Resections were performed following the NBI-drawing if extemporaneous histological examinations of the NBI-defined enlargements were positive for dysplasia or cancer. The number of clear margins was evaluated.

Results: Resections margins were free of tumour or dysplasia at extemporaneous examination; on definitive histology, two patients had a margin positive for cancer and dysplasia, respectively. Among the NBI-defined enlargements, 25% were positive for dysplasia and 75% for cancer. The sensitivity, specificity, positive and negative predictive values were 100%, 88.9%, 100% and 87.5%, respectively.

Conclusion: The method we propose could be useful for obtaining free surgical margins and reducing the potential development of tumour foci resulting from incomplete resection.
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http://dx.doi.org/10.1016/j.oraloncology.2015.07.005DOI Listing
October 2015

Erratum to: Open questions and novel concepts in oral cancer surgery.

Eur Arch Otorhinolaryngol 2016 Aug;273(8):1987-1988

Division of Otolaryngology and Head and Neck Surgery, Cattinara Hospital, University of Trieste, Trieste, Italy.

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http://dx.doi.org/10.1007/s00405-015-3695-5DOI Listing
August 2016

Harmonic Scalpel and Electrothermal Bipolar Vessel Sealing System in Head and Neck Surgery: A Prospective Study on Tissue Heating and Histological Damage on Nerves.

Ann Otol Rhinol Laryngol 2015 Nov 15;124(11):852-8. Epub 2015 Jun 15.

Department of Otorhinolaryngology, Cattinara Hospital, University Medical Center of Trieste, Trieste, Italy

Objectives: Define and compare the thermal nerve injury caused by 3 different vessel sealing and dissection devices: the harmonic scalpel (HS), the electrothermal bipolar vessel sealing system (EBVS), and the bipolar electrosurgery unit (BE).

Methods: First we recorded the heating variations in pig tissue caused by a BE unit, HS, and EBVS after an activation for 5, 10, and 15 seconds at minimum and at maximum power. In the second part, we evaluated the histological damage caused by HS and EBVS on 20 in vivo human nerves, 10 per device. The 2 scalpels were placed and activated at 3 different distances from the nerve (1, 3, and 5 mm). The extension and the degree of the nerve lesion was then calculated.

Results: The instrument determining the highest rise in temperature was the BE unit, followed by HS and then EBVS. Comparison between the extension and degree of nerve injury caused by the 2 scalpels showed no statistically significant differences. Based on these evaluations, we established a relative safety limit at 3 mm and an absolute safety limit at 5 mm for both scalpels.

Conclusions: Our data suggest EBVS and HS can be considered valid and safe devices for ENT surgery.
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http://dx.doi.org/10.1177/0003489415588556DOI Listing
November 2015

Open questions and novel concepts in oral cancer surgery.

Eur Arch Otorhinolaryngol 2016 Aug 24;273(8):1975-85. Epub 2015 May 24.

Division of Otolaryngology and Head and Neck Surgery, Cattinara Hospital, University of Trieste, Trieste, Italy.

The persistence of cancerous cells after surgery in oral squamous cell carcinoma (OSCC) represents a major challenge, as it often leads to local recurrences and secondary primary tumors, which are eventually responsible for a large proportion of deaths. This persistence is currently evaluated by histological analyses. In this review we discuss some important pitfalls of the histopathological analysis, such as margin evaluation, specimen shrinkage and T staging. In addition, we critically analyze the appropriateness of current surgical techniques in relation to the concept of field cancerization. Finally, we describe some novel imaging and molecular approaches, which might be useful in tailoring surgical resections and encourage the use of OSCC animal models to explore and provide proof of concept of the feasibility and potential clinical utility of innovative surgical protocols.
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http://dx.doi.org/10.1007/s00405-015-3655-0DOI Listing
August 2016
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