BackgroundTo evaluate the relationship between gender, ethnicity/citizenship, clinical phenotype, total prevalence, and the various congenital malformations associated with oral clefts (OC) in Italy across the period 2001–2014.MethodsA retrospective analysis (2001–2014) was conducted based on the National Congenital Malformation Registries network of Italy (Emilia-Romagna Registry of Birth Defects [IMER] and Registro Toscano Difetti Congeniti [RTDC]), which were analyzed to investigate time trends, geographical/ethnic clusters, topography, sex ratio, and associated congenital anomalies of OC phenotypes.ResultsAmong 739 registered cases, 29.8% were syndromic or had multi-malformed associated anomalies, compared with 70.2% having isolated orofacial cleft. Cleft lip (CL) was observed in 22%, cleft palate (CP) in 40%, and cleft lip and palate (CLP) in 38% of live births, stillbirths, and terminations of pregnancy for fetal anomaly cases. Other associated conditions were major anomalies of cardiovascular defects (39%), followed by defects of the limbs (28%), neuroectodermal defects (23%), and urogenital malformations (10%).Male-to-female sex ratio was 1:1.14 in CP, 1.22:1 in CL, and 1.9:1 in CLP. Foreigners were represented by 29% from Southeast Asia, 25% from Balkans, 25% from North-Central Africa, 9% from the East, 7% from Western Europe, and 5% from South America. Total prevalence of OC cases ranged from 0.9 (RTDC) to 1.1 (IMER) of 1000 births.ConclusionsThis retrospective study provides a population-based, clinical-epidemiological description of the orofacial cleft phenomenon. As a relatively frequent congenital malformation, its social and economic impact is worthy of further study. These abnormalities can cause significant problems that may be solved or minimized by early diagnosis and treatment.

Objectives To compare, using an ex vivo model, the biofilm removal of three surface decontamination methods following surgical exposure of implants failed for severe peri-implantitis. Materials and methods The study design was a single-blind, randomized, controlled, ex vivo investigation with intra-subject control. Study participants were 20 consecutive patients with at least 4 hopeless implants, in function for >12 months and with progressive bone loss exceeding 50%, which had to be explanted. Implants of each patient were randomly assigned to the untreated control group or one of the three decontamination procedures: mechanical debridement with air-powder abrasion, chemical decontamination with hydrogen peroxide and chlorhexidine gluconate, or combined mechanical-chemical decontamination. Following surgical exposure, implants selected as control were retrieved, and afterwards, test implants were decontaminated according to allocation and carefully explanted with a removal kit. Microbiological analysis was expressed in colony-forming-units (CFU/ml). Results A statistically significant difference (p < 0.001) in the concentrations of CFU/ml was found between implants treated with mechanical debridement (531.58 ± 372.07) or combined mechanical-chemical decontamination (954.05 ± 2219.31) and implants untreated (37,800.00 ± 46,837.05) or treated with chemical decontamination alone (29,650.00 ± 42,596.20). No statistically significant difference (p = 1.000) was found between mechanical debridement used alone or supplemented with chemical decontamination. Microbiological analyses identified 21 microbial species, without significant differences between control and treatment groups. Conclusions Bacterial biofilm removal from infected implant surfaces was significantly superior for mechanical debridement than chemical decontamination. Clinical relevance The present is the only ex vivo study based on decontamination methods for removing actual and mature biofilm from infected implant surfaces in patients with peri-implantitis.

Background:The aim of this cross-sectional study was to investigate the association between carotid intima-media thickness (c-IMT) values and periodontal and peri-implant diseases in a sample of patients with hypertension. Methods: A total of 151 participants with presence of at least one dental implant in function for >5 years were recruited. Anthropometric measurements, 24-h ambulatory blood pressure monitoring, ultrasound assessment of carotid arteries (c-IMT and presence of plaque) were recorded and venous blood samples obtained. An oral examination was performed by calibrated examiners to ascertain prevalence and severity of periodontal and peri-implant diseases. Binomial logistic regression was performed to investigate the potential association between various measures of exposure of dental diseases and predictors of cardiovascular risk (c-IMT > 0.9 mm and presence of plaque or their combination). Results: Diagnosis of periodontitis (OR 6.71, 95% CI: 2.68-16.76, P < 0.001), cumulative mucosal/gingival inflammation (Periodontal Screening and Recording score) (OR 1.25, 95% CI:1.12-1.41, P < 0.001), and mucositis (OR 3.34, 95% CI:1.13-9.85, P < 0.05) were associated with c-IMT > 0.9 mm and/or plaque presence independent of age, sex, smoking, 24 h systolic blood pressure and body mass index differences. No statistically significant results were noted for peri-implantitis. Linear regression models confirmed a positive association of cumulative mucosal/gingival inflammation (β = 0.011, SE 0.002, P < 0.001), diagnosis of periodontitis (β = 0.114, SE 0.020, P < 0.001), and peri-implant diseases (β = 0.011, SE 0.002, P < 0.001) with increased c-IMT values. Conclusions:This study confirms a positive association between mucosal/ gingival inflammation and subclinical atherosclerosis assessed by c-IMT values and the presence of carotid plaque in patients with hypertension, independent of traditional cardiovascular risk factors. Future studies are needed to further characterize this relationship.

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