Domenico Tripodi

Pediatric dentistry continually seeks effective and efficient treatments for young patients, especially within pediatric endodontics, where cooperation can often be challenging. This in vivo study aimed to evaluate the effectiveness of a novel photodynamic therapy (PDT) protocol using a 5-aminolevulinic acid gel (Aladent, ALAD) combined with light irradiation during the endodontic treatment of primary teeth. This study included primary teeth requiring root canal therapy due to carious lesions or trauma, with clinical symptoms suggesting irreversible pulpitis or acute apical periodontitis. Following local anesthesia and isolation with a rubber dam, carious lesions were excavated, and access to the pulp chamber was established. Canal preparation included determining the working length and using a sequence of k-files. Afterward, ALAD gel was applied, and the patients were divided into two groups based on their visit duration (Group A with a single visit, Group B returning after one week). Microbiological analysis was conducted on the samples taken before and after treatment. The findings demonstrated significant antibacterial efficacy of the PDT protocol in reducing root canal bacterial load, suggesting ALAD-based PDT may serve as an alternative to traditional endodontic treatment in cases where retaining primary teeth is essential for orthodontic or strategic reasons. Clinically, improvement in symptoms and fistula resolution were observed. Treatment time, patient compliance, and protocol safety in pediatric applications are also discussed, highlighting the protocol’s potential to enhance clinical outcomes in pediatric endodontics.

Background: The study exploited, for the first time, Attenuated Total Reflectance-Fourier Transform-InfraRed (ATR-FTIR) spectroscopy on human dental pulps at different timings of root resorption (RR) to deepen the biological mechanisms occurring in deciduous teeth (De) during their replacement with permanent ones. Methods: N:36 dental pulps from sound De were divided into the following: G0 (no RR); G1 (RR less than 1/3 of root length); G2 (RR not exceeding 2/3 of root length); and G3 (RR more than 2/3 of root length). Samples were analyzed by ATR-FTIR, and the spectral data were submitted to univariate (One-way ANOVA and Tukey’s multiple comparison tests; statistical significance set at p < 0.05) and multivariate (Principal Component Analysis, PCA) analyses. Results: PCA displayed good discrimination among groups, ascribable to: (i) the intensity of the peaks of nucleic acids (~1715 cm⁻¹, ~1237 cm⁻¹, ~964 cm⁻¹, and ~815 cm⁻¹) and carbohydrates (~1159 cm⁻¹) which increased from G0 to G3 (p < 0.05); (ii) the relative amount of lipids which decreased from G0 to G3 (p < 0.05); and (iii) the intensity of the peaks at ~1014 cm⁻¹, and ~875 cm⁻¹ (phosphates and carbonates in hydroxyapatite), which decreased from G0 to G3 (p < 0.05). Conclusions: This study confirmed ATR-FTIR as a reliable and quick technique for the characterization of the dental pulp and highlighted a correlation between specific molecular changes in the dental pulp of deciduous teeth and different RR stages, shedding new light on this process and paving the way for future research, which could improve the clinical management of the primary dentition.

This study aimed to evaluate the ability of photodynamic therapy, based on the use of a gel containing 5% delta aminolaevulinic acid (ALAD) for 45′ followed by irradiation with 630 nm LED (PDT) for 7′, to eradicate Candida albicans strains without damaging the gingiva. C. albicans oral strains and gingival fibroblasts (hGFs) were used to achieve these goals. The potential antifungal effects on a clinical resistant C. albicans S5 strain were evaluated in terms of biofilm biomass, colony forming units (CFU/mL) count, cell viability by live/dead analysis, and fluidity membrane changes. Concerning the hGFs, viability assays, morphological analysis (optical, scanning electronic (SEM), and confocal laser scanning (CLSM) microscopes), and assays for reactive oxygen species (ROS) and collagen production were performed. ALAD-mediated aPDT (ALAD-aPDT) treatment showed significant anti-biofilm activity against C. albicans S5, as confirmed by a reduction in both the biofilm biomass and CFUs/mL. The cell viability was strongly affected by the treatment, while on the contrary, the fluidity of the membrane remained unchanged. The results for the hGFs showed an absence of cytotoxicity and no morphological differences in cells subjected to ALAD-aPDT expected for CLSM results that exhibited an increase in the thickening of actin filaments. ROS production was augmented only at 0 h and 3 h, while the collagen appeared enhanced 7 days after the treatment.

Introduction: Thanks to the great development of digital technology, viaCAD (computer-aided design) and CAM (computer-aided manufacturing) systems, digital models canbe used as an aid for orthodontic planning decision-making processes as there are numerous studies in the literature that support the validity ofthe digital model measurements of anterior teeth and the total coefficient of Bolton analysis. The aim of the present study isto compare the average length value of the current upper and lower arches with that of a hypothetical nickel–titanium wire and to confirm the reliability and accuracy of digitally taken measurements of the anterior and total Bolton coefficients.In this retrospective study, dental casts of 138 Caucasian adolescent patients were scanned with an extraoral scanner, and Ortho3Shape software was adopted for the following dental cast measurements: actual and ideal lengths of the lower arches and anterior and total Bolton coefficients.In the present study, we found that the mean value of the anterior coefficients of the Bolton index was compatible with those of previous studies, confirming the reliability of digital measurements.Therefore, digital CAD/CAM models may be a viable alternative to plaster models, as they can facilitate model preservation and recovery. For future studies, it would be better to use intraoral scanners (IOSs) to ensure greater accuracy, since they only require one step and allow obtaining better results for the patients.

Introduction: Due to the great development of digital technology, through CAD (Computer - Aided Design) and CAM (Computer - Aided Manufacturing) systems, digital models could be used in orthodontic treatment planning decision-making, as there are numerous studies in the literature that support the validity of measurements of digital models of anterior teeth and the total coefficient of Bolton analysis. The aim of the study was to compare the average length value of the current upper and lower arches with that of a hypothetical nickel-titanium wire and the accuracy of the Bolton index measurement. In the present study, 138 dental casts were analyzed using Ortho3Shape software. Using the Ortho3Shape software, it was possible to measure the real and ideal lower arch lengths and, with regard to Bolton analysis, the values of the anterior and total Bolton coefficients. By comparing the values obtained with those of the study by A. Anand Kumar et al. using CBCT and plaster casts, the reliability of the measurements obtained with such CAD/CAM orthodontic software was evaluated. Considering the validity of digital measurements demonstrated by the studies and systematic reviews in the literature, it can be stated that CAD/CAM digital models can be a viable alternative to plaster models in the coming years, as they can facilitate model preservation and retrieval. For future studies and research, it would be preferable to use intra-oral scanners (IOS) in order to ensure greater accuracy, requiring only one step and ensuring a better outcome for the patient.

Background: In this ex vivo study, the aim was to evaluate the effects of ALAD and red light on Enterococcus faecalis in infected root canals using a special intracanal fiber. Methods: A total of 70 extracted, single-rooted teeth were used. The teeth were decoronated at the length of the roots to approximately 15 mm and then instrumented. The apical foramen was sealed by composite resin, and the root canals were infected with a pure culture of E. faecalis ATCC 29212 for eight days at 37 °C. Following the contamination period, the roots were divided into seven groups, including the positive and negative control groups, and treated as follows: ALAD 45 min; red light activation 7 min; ALAD 45 min and red-light activation 7 min; sodium hypochlorite 2.5% 15 min; sodium hypochlorite 1% 15 min. The samples were taken by three sterile paper points, transferred to tubes containing 1 mL of PBS, and immediately processed for the number of colony-forming units and the cell viability by using live/dead. Results: The best treatment is obtained with 2.5% NaOCl. Except for ALAD + red light vs. 1% NaOCl, a statistically significant difference is recorded for all treatments. The combination of 2.5% NaOCl and ALAD + 7 min irradiation produces an evident killing effect on the E. faecalis cells. On the other hand, 1% NaOCl is ineffective for the viability action, with 25% of dead cells stained in red. Conclusions: This ex vivo study shows that ALAD gel with light irradiation is an efficacious protocol that exerts a potent antibacterial activity against E. faecalis in infected root canals.

Aim Patient compliance is of paramount importance for proper dental treatment, which can be difficult to achieve in children due to anxiety and fear, hindering the therapeutic procedure. In addition to well-known sedation methods (pharmacological and nitrous oxide), further methods of approach are being tested, such as hypnotherapy. Materials and methods The sample consisted of 150 children (90 males, 60 females). Paper questionnaires, frequency meter, nitrous oxide dispenser in association with the use of the television were exploited. At the end of treatment, subjective pain was assessed using the VAS scale, while objective pain was assessed using the FLACC scale and heart rate. This made it possible to compare two experimental groups, one treated with nitrous oxide, and the other with hypnotherapy. The control group was treated with classic behavioural approach techniques. The results obtained were analysed by SPSS Software (Statistical Package for Social Science, version 27) and the inferences between the results were calculated for confirmation.Results Significant differences were found between the two experimental groups and the control group (p=0.05). The results show that patients in the nitrous oxide group perceived less pain unlike the others, most likely because the nitrous oxide is a pain reliever. Furthermore, during treatment, the heart rate of the patient treated with hypnotherapy is low, similarly to that of patients treated with nitrous oxide.Conclusions Hypnotherapy can be a valid substitute for nitrous oxide in paediatric dentistry.

Antibacterial and antibiofilm properties of restorative dental materials may improve restorative treatment outcomes. The aim of this in vitro study was to evaluate Streptococcus mutans capability to adhere and form biofilm on the surface of three commercially available composite resins (CRs) with different chemical compositions: GrandioSO (VOCO), Venus Diamond (VD), and Clearfil Majesty (ES-2). Disk-shaped specimens were manufactured by light-curing the CRs through two glass slides to maintain a perfectly standardized surface topography. Specimens were subjected to Planktonic OD_600nm, Planktonic CFU count, Planktonic MTT, Planktonic live/dead, Adherent Bacteria CFU count, Biomass Quantification OD_570nm, Adherent Bacteria MTT, Concanavalin A, and Scanning Electron Microscope analysis. In presence of VOCO, VD, and ES2, both Planktonic CFU count and Planktonic OD_600nm were significantly reduced compared to that of control. The amount of Adherent CFUs, biofilm Biomass, metabolic activity, and extracellular polymeric substances were significantly reduced in VOCO, compared to those of ES2 and VD. Results demonstrated that in presence of the same surface properties, chemical composition might significantly influence the in vitro bacterial adhesion/proliferation on resin composites. Additional studies seem necessary to confirm the present results.

The use of a new gel containing aminolevulinic acid and red light (ALAD–PDI) was tested in order to counteract bacterial biofilm growth on different titanium implant surfaces. The varying antibacterial efficacy of ALAD–PDI against biofilm growth on several titanium surfaces was also evaluated. A total of 60 titanium discs (30 machined and 30 double-acid etched, DAE) were pre-incubated with saliva and then incubated for 24 h with Streptococcus oralis to form bacterial biofilm. Four different groups were distinguished: two exposed groups (MACHINED and DAE discs), covered with S. oralis biofilm and subjected to ALAD + PDI, and two unexposed groups, with the same surfaces and bacteria, but without the ALAD + PDI (positive controls). Negative controls were non-inoculated discs alone and combined with the gel (ALAD) without the broth cultures. After a further 24 h of anaerobic incubation, all groups were evaluated for colony-forming units (CFUs) and biofilm biomass, imaged via scanning electron microscope, and tested for cell viability via LIVE/DEAD analysis. CFUs and biofilm biomass had significantly higher presence on unexposed samples. ALAD–PDI significantly decreased the number of bacterial CFUs on both exposed surfaces, but without any statistically significant differences among them. Live/dead staining showed the presence of 100% red dead cells on both exposed samples, unlike in unexposed groups. Treatment with ALAD + red light is an effective protocol to counteract the S. oralis biofilm deposited on titanium surfaces with different tomography.

Athletes’ oral health appears to be poor in numerous sport activities and different diseases can limit athletic skills, both during training and during competitions. Sport activities can be considered a risk factor, among athletes from different sports, for the onset of oral diseases, such as caries with an incidence between 15% and 70%, dental trauma 14–70%, dental erosion 36%, pericoronitis 5–39% and periodontal disease up to 15%. The numerous diseases are related to the variations that involve the ecological factors of the oral cavity such as salivary pH, flow rate, buffering capability, total bacterial count, cariogenic bacterial load and values of secretory Immunoglobulin A. The decrease in the production of S-IgA and the association with an important intraoral growth of pathogenic bacteria leads us to consider the training an “open window” for exposure to oral cavity diseases. Sports dentistry focuses attention on the prevention and treatment of oral pathologies and injuries. Oral health promotion strategies are needed in the sports environment. To prevent the onset of oral diseases, the sports dentist can recommend the use of a custom-made mouthguard, an oral device with a triple function that improves the health and performance of athletes. During training, the sports dentist must monitor the athletes and the sports examination protocol must be implemented with the inclusion of the clinical examination, quantitative and qualitative analysis of saliva and instructions on the use, cleansing and storage of the mouthguard.