Giulia Vallogini

Background: Juvenile idiopathic arthritis (JIA) is an autoimmune disease that can involve the temporomandibular joint (TMJ). Objectives: To investigate the association between clinical signs and symptoms of temporomandibular disorders (TMD) and TMJ inflammation, as detected by magnetic resonance imaging (MRI) in children and adolescents with JIA. Methods: Monocentric cross‐sectional observational study. Consecutive JIA patients underwent clinical dental examination following the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and performed MRI examination when the presence of signs and/or symptoms was detected. TMJ involvement was assessed using MRI parameters. Data were analysed with descriptive statistics, using parametric statistical tests for normally distributed data and non‐parametric statistical tests for other variables. Associations between TMD signs/symptoms and MRI findings were investigated using appropriate statistical tests. Adjustment for multiple comparisons was performed using a false discovery rate approach. A p ‐value < 0.05 after correction was considered statistically significant. Results: Seventy‐six JIA patients were included. In unadjusted analyses, multiple associations emerged between clinical findings and MRI signs of TMJ involvement. After correction for multiple comparisons, TMJ sounds remained significantly associated with protrusion limitation, and mandibular deviation patterns were significantly associated with inflammatory MRI findings, particularly synovial thickening and bone marrow edema. Other associations did not retain statistical significance after adjustment and should be considered exploratory. Conclusions: Dental and TMD evaluations revealed correlations with MRI findings of TMJ involvement. Application of TMD screening at JIA onset might make it possible to detect TMJ‐related early signs of arthritis in patients with JIA.

Fixed appliance (FA) therapy predisposes patients to white spot lesions (WSLs). The F-ACP complex (amorphous calcium phosphate nanoparticles enriched with carbonate and fluorine and coated with citrate) has been effective for in vitro enamel remineralization. The aim of this study was to evaluate the efficacy of the F-ACP complex in remineralizing WSLs after FA therapy. One hundred and six adolescents (aged 12–20 years) were randomized into study and control groups after FA therapy. Patients in the study group were advised to use dental mousse containing F-ACP applied within Essix retainers for six months. The presence of WSLs was recorded at baseline (T0), 3 months (T1), and 6 months (T2) according to the International Caries Detection and Assessment System (ICDAS). Visual Plaque Index (VPI) and Gingival Bleeding Index (GBI) were recorded. Among 106 study participants, 91 (52 and 39 in study and control groups, respectively) completed the study. The results showed that the ICDAS score was significantly lower (p < 0.001) in the study group than in the control group between T0 and T2. The application of mousse containing the F-ACP complex inside Essix retainers for six months is effective in remineralizing white spot lesions in patients after FA therapy without side effects.

(1) Background: the variety of autism spectrum disorder makes the definition of guidelines for dental care a challenging task. The aim of this review was to evaluate the literature concerning the use of conscious sedation for dental treatments in pediatric autistic patients. (2) Methods: we searched MEDLINE/PubMed, EMBASE, Cochrane databases in order to identify pertinent studies. The search strategy was based on these areas of interest: autistic spectrum disorder, pediatric patients, dentistry, tranquilizing agents, and conscious sedation. (3) Results: the search yielded 177 non-duplicated articles, of which 24 articles were retrieved for full text review, and 2 were found to address our review aim. The first paper was a retrospective study that included 83 autistic patients sedated either with an oral premedication combined with nitrous oxide/oxygen inhalation or with nitrous oxide/oxygen inhalation alone; the second article was a prospective trial on the effectiveness of 0.3 mg/kg of oral diazepam with 0.5 mg/kg of oral midazolam in 13 sedated uncooperative autistic patients. (4) Conclusions: this review highlights the insufficiency of studies that can provide concrete indications for the dental treatment in conscious sedation of pediatric patients with autism. New studies are needed to better define the appropriate drugs, dosages, sedation level and evaluate patient cooperation.