Maddalena Coniglio

Background/Objectives: New devices such as surface electromyography (sEMG) have been proposed to support traditional gnathological examination and diagnostic protocols. The aim of this study is to investigate whether sEMG can be considered a diagnostic instrument to discriminate between healthy subjects and patients with temporomandibular disorders (TMDs) of an articular or muscular nature. Methods: A systematic review was conducted according to PRISMA guidelines using literature searches of MEDLINE (via PubMed), Scopus, and Web of Science. Inclusion criteria: recent clinical studies (≤10 years) in English or Italian, involving electromyography in TMD diagnosis, with a control group of healthy patients. Data considered to be homogenous were subjected to meta-analysis (95% confidence interval [CI]; α = 0.05). Hedge g was calculated because all variables were continuous. Articles meeting the inclusion criteria were checked for further consideration, and relevant data were collected into two tables. In total, 18 studies were included after full-text reading. Meta-analyses were carried out for the static impact index (IMP), percentage overlapping coefficient (POC), and torque coefficient, and dynamic Symmetrical Mastication Index (SMI). Results: Patients with TMD had lower values in all parameters except IMP. sEMG registered a reduction in masseter activity, lower chewing efficiency, and an increase in fatigue during contractions in TMD patients. Conclusions: sEMG is not reliable to distinguish healthy from TMD patients, but despite the limitations related to the high variability in the studies (type of electromyography, static or dynamic tests, and population characteristics), the sEMG results are reliable considering the POC and SMI parameters, encouraging more in-depth studies for a predictable clinical practice. Patients with TMD had lower values in the dynamic index SMI and in static indexes POC and torque coefficient, except IMP. EMG might performs better if employed in muscle forms.

Objectives The aim of this review was to analyze mechanical and biological properties of resin materials used with subtractive or additive techniques for oral appliances fabrication and compare them to those conventionally manufactured. Materials and methods The protocol was registered online at Open Science Framework (OSF) registries (https://osf.io/h5es3) and the study was based on the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). An electronic search was conducted on MEDLINE (via PubMed), Scopus, and Web of Science from 1 February 2022 to 1 May 2022. Inclusion criteria: in vitro and in vivo studies published in the last 10 years, with CAD-CAM or 3D printed resins for occlusal splints. Data considered homogenous were subjected to meta-analysis (95% confidence interval [CI]; α = 0.05) with Stata17 statistical software. Since all variables were continuous, the Hedge g measure was calculated. A fixed-effects model was used for I² = 0%, while statistical analysis was conducted using a random-effects model with I² > 0%. Results 13 studies were included after full-text reading. The mechanical properties most studied were wear, flexural strength, surface hardness and surface roughness, while only 1 study investigated biological properties, performing the XTT viability assay. For the meta-analysis, only surface roughness, volume loss, and flexural strength were selected. Considering surface roughness, the subtractive specimen had a lower average value compared to traditional ones (Hedge’s g with 95% CI = -1.25[ -1.84, − 0.66]). No significant difference was detected in terms of volume loss (P > 0.05) between the groups (Hedge’s g with 95% CI = -0.01 [-2.71, − 2.68]). While flexural strength was higher in the control group (Hedge’s g with 95% CI = 2.32 [0.10–4.53]). Conclusion 3D printed materials showed properties comparable to conventional resins, while milled splint materials have not shown better mechanical performance compared with conventional heat-cured acrylic resin. Polyetheretherketone (PEEK) have great potential and needs to be further investigated. Biological tests on oral cell populations are needed to confirm the long-term biocompatibility of these materials. Clinical relevance The use of “mixed splints” combining different materials needs to be improved and evaluated in future research to take full advantage of different characteristics and properties.

Aim Public and private health services, which provide both preventive and health promotion interventions, were forced to suddenly stop their activities to limit the risk of infections during the pandemic emergency. Oral health administration, including that of children, was affected by these planned medical service closures, from both therapeutic and preventive perspectives. This study aims to analyse the consequences, at the oral cavity level, of failures to treat patients of childhood age, considering the impact of carious pathology on quality of life and incorrect eating and oral hygiene habits, which may occur in this age group. Methods This is a cross-sectional, single -center, observational study. One hundred patients from the Odontostomatological University Center (C.O.U.) of Perugia were randomly enrolled. Results The dmft/DMFT index values obtained from the results of follow-up visits were 2.14, while the results of the first visit was 3.2. Periodontal Screening and Recording (PSR) values maintained the same trend. Conclusions Oral health status of the examined sample is satisfactory overall, considering the clinic's interruption of treatments with the resulting long period of no follow-up and the emotional and economic stress generated by the pandemic condition for both the young patients and their caregivers.

Aim When treating patients with Autism Spectrum Disorder (ASD) the doctor-patient relationship can be very challenging. The dentist is often forced to work under general anaesthesia or conscious sedation. Children with ASD are patients with an increased risk of caries due to poor oral hygiene, a cariogenic diet and the use of xerostomal drugs. In this work therapeutic strategies used to treat this kind of patients are evaluated and a new method to treat children with ASD is presented in order to increase awareness about this condition in the dental field. Methods The Atlas Center (a non-profit organisation in Peurgia, Italy) has developed a software, called paINTeraction, that allows these special children to immerse themselves in a virtual reality with the help of an operator. Through this system the child can explore the dental office (and all its sounds and noises) before the real dental visit, thus connecting to the dental professional, achieving greater compliance and reducing anxiety. Results The literature shows that performing treatments on ASD patients is complex due to their insufficient cooperation, communication and behavioural difficulties, and hypersensitivity to sensory stimuli. Conclusions paINTeraction, with the use of digital technology tools, may be particularly well suited to introduce patients to the therapeutic environment, particularly in the dental setting.

To analyze the effects of four universal adhesives (Optibond Solo Plus—OB, Universal Bond—UB, Prime&Bond Active—PBA, FuturaBond M + —FB) on human gingival fibroblasts in terms of cytotoxicity, morphology and function. After in vitro exposure for up to 48 h, fibroblast viability was determined by the MTT assay determined, morphology by phase-contrast microscopy and migration by the scratch wound assay. Expression levels of IL1β, IL6, IL8, IL10, TNFα and VEGF genes were assessed by RT-PCR and their protein production by Western blot analysis. Apoptosis and cell cycle were analyzed by flow cytometry. OB and UB induced early morphological changes on fibroblasts (3 h) with extended cell death at 24 h/48 h. Gene expression of collagen type I and fibronectin increased fivefold compared with controls, elastin disappeared and elastase increased threefold, indicating gingival tissue tended to become fibrotic. Only UB and OB increased gene expression of inflammatory markers: IL1β at 3 and 48 h (up to about three times), IL6 and IL8 at 3 h (up to almost four times) which corresponded to the increase of the activated form NF-kB. All adhesives showed an effect on the functionality of fibroblasts with cytotoxic effect time and concentration dependent. Among all the OB and UB adhesives, they showed the greatest cell damage. The in-depth analysis of the effects of universal adhesives and possible functional effects represents an important information for the clinician towards choosing the most suitable adhesive system.