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Biomedical subjects

S Petti

Publications and source records attributed to S Petti.

At least 19 recordsLinked to original sources

Caries-preventive effect of chlorhexidine gel applications among high-risk children.

Evidence on the caries-preventive effect of chlorhexidine (CHX) among high-risk children is inconclusive, possibly because obscured by fluoride exposure. We investigated the effect of CHX among initially 3-year-old subjects whose baseline d(3)ft was = 0 and whose only regular fluoride exposure came from toothpaste. The subjects were assigned to three groups: high-risk test (HRT, n = 70), high-risk control (HRC, n = 71), and low-risk control (LRC, n = 70). Risk classification was based on salivary mutans streptococcal levels (MS, </>or=1.0 x 10(5) cfu/ml). Basic measures (oral hygiene, dietary counselling every 4 months) were given to all groups. HRT also underwent CHX gel applications for 3 consecutive days at 3-month intervals for 15 months. Eighteen months after baseline d(3)ft increments and proportions of children with d(3)ft increment >or=1 (%d(3)ft increment >or=1) among all groups were assessed. Anti-MS effect on high-risk children and caries-preventive effect on all children were statistically analysed by residual change analysis (MS), non-parametric tests and logistic regression analysis (caries). No differences were found between the groups in basic programme compliance. CHX significantly reduced MS levels. %d(3)ft increment >or=1 and mean d(3)ft increments were 34.3%, 0.56 (HRT), 32.4%, 0.54 (HRC) and 11.4%, 0.11 (LRC), with HRT/HRC values statistically significantly higher than LRC values and no significant difference between HRT and HRC. HRT children were not less likely to show new lesions than HRC children (OR = 1.09; 95% confidence interval 0.54-2.19), while high-risk children were 4 times more likely to show new lesions than low-risk children (OR = 3.71; 95% confidence interval 1.53-9.03). CHX gel applications showed moderate anti-MS effect but negligible caries-preventive effect.

Anti-Infective Agents, Local↗

An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year) dental students.

OBJECTIVE: To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students. DESIGN: Cross-cultural survey of dental students. SETTING: 18 cultural areas. PARTICIPANTS AND METHODS: 904 first-year dental students completed the Hiroshima University-Dental Behavioural Inventory (HU-DBI) translated into their own languages. Individual areas were clustered by similarity in responses to the questions. RESULTS: The first group displayed an 'occidental-culture orientation' with the exception of Brazil (Cluster 1 comprised: Australia, United Kingdom, Ireland, Belgium and Brazil, Cluster 2: Germany, Italy, Finland and France). The second group displayed an 'oriental-cultural orientation' with the exception of Greece and Israel (Cluster 3 comprised: China and Indonesia, and Cluster 4: Japan, Korea, Israel, Hong Kong, Malaysia, Thailand and Greece). Australia and United Kingdom were the countries that were most alike. Ireland was the 'neighbour' to these countries. Greece and Malaysia had similar patterns of oral health behaviour although geographic conditions are very different. Although it was considered that in Hong Kong, occidental nations have affected the development of education, it remained in the oriental-culture group. Comparison with the data from the occidentals indicates that a higher percentage of the orientals put off going to the dentist until they have toothache (p < 0.001). Only a small proportion of the occidentals (8%) reported a perception of inevitability in having false teeth, whereas 33% of the orientals held this fatalistic belief (p = 0.001). CONCLUSIONS: Grouping the countries into key cultural orientations and international clusters yielded plausible results, using the HU-DBI.

Asia↗

A randomized clinical trial of the effect of yoghurt on the human salivary microflora.

Yoghurt is active against some human pathogens, so this experiment tested whether it is also active against the salivary microflora. A clinical trial was designed, with volunteers aged between 23 and 37 years. Initially, for 8 weeks, they consumed neither yoghurt nor casein-free soybean ice cream (phase 1). They were then split randomly into test (yoghurt) and control (ice cream) groups and required to consume 125 g of these foods twice daily for 8 weeks (phase 2) and then to avoid them for the following 2 weeks (phase 3). Many potential sources of microbial fluctuation were standardized. Salivary samples were then collected at regular intervals of 2 weeks. For each group and phase, the mean logarithms of the salivary counts for total viable flora, oral streptococci, mutans streptococci, lactobacilli and Candida were calculated. The prevalence of Streptococcus thermophilus and Lactobacillus bulgaricus was also assessed. Twenty test and 22 control participants completed the study. At phase 2, the mean for mutans streptococci was lower in the test than in the control group (3.6 vs. 4.0 log colony-forming units/ml; P=0.02). Moreover, the mean had decreased in all test participants with high phase 1 means for lactobacilli as compared to only 36.4% of those with low phase 1 means (P=0.01). L. bulgaricus was transiently detected in three test participants during phase 2. These results suggest that yoghurt does have some activity against the salivary microflora, but this does not seem to be due to the installation of yoghurt microorganisms in the mouth.

Adult↗

Salivary levels of mutans streptococci associated with restorations: a case-control study.

Our aim was to estimate whether restorative therapy with amalgam and composite resin could decrease salivary mutans streptococcal level, thus also decreasing the risk for other caries development. We selected a case group of 93 children with detectable salivary mutans levels (i.e., at least 1x10(4) cfu/ml), and a control group (n=93 subjects) with undetectable levels. Children had the same age (12 years), no extracted teeth, crowns, temporary fillings, and restorations other than amalgam and composite resin, and the two groups had similar gender distribution. We clinically examined children and recorded active caries, restorations and oral hygiene level by means of gingival bleeding on probing; we also investigated sucrose intake at breakfast. The case group had statistically significant higher prevalence of restorations (36.6% vs. 18.3%), active caries (44.1% vs. 12.9%), and bad oral hygiene (84.9% vs. 68.8%) than the control group. However, the logistic regression analysis showed that presence of active caries was the only significant variable associated with mutans streptococci (OR=4.0; p=0.0002), while the effects of sucrose intake and of restorations were marginally significant. This apparent contrast between statistical analyses was due to the concomitant presence, in children with detectable mutans streptococci level, of restorations and decayed teeth at the same time, and, on the basis of the multivariate analysis, presence of mutans streptococci in these children was explained by the presence of active caries, more than restorations.

Case-Control Studies↗

Nutritional variables related to gingival health in adolescent girls.

In order to study the nutritional variables associated with gingival health, a case-control study was designed to control strong variables whose effect on gingival status may obscure the potential effect of weaker ones, such as nutrition. Two groups of 27 gingivitis-affected and -unaffected female adolescents were selected. All were aged 17-19 years, with mean age of the two groups statistically not different. All were non-smokers, all reported daily toothbrushing frequency of twice/day or more, and none had clinical signs of hyponutrition. Mean DMFT of the two groups was statistically not different. The effect of nutritional variables, obtained by a three-day food record and by assessing the nutritional status of the girls, on presence/absence of gingivitis was evaluated by a variety of stepwise logistic regression analyses. Age (positive correlation), riboflavin, calcium and frequency of fibre intake (negative correlations) significantly explained the risk for gingivitis. Strong intercorrelation between riboflavin and calcium was also found, due to the high quantity of milk consumed by the girls, since this food provided the main source of riboflavin and calcium. The data suggest that some dietary measures may be useful for the maintenance of healthy gingival status.

Adolescent↗

Rampant early childhood dental decay: an example from Italy.

OBJECTIVES: This study sought to estimate the prevalence and related prediction factors for dental caries in 3- to 5-year-old children in Rome, Italy. METHODS: From a sample of 2,025 children, 1,494 (73.8%) were included in the analysis. Children with at least two primary maxillary incisors showing evidence of caries experience were considered affected by rampant early childhood dental decay (RECDD). Behavioral and socioeconomic variables, mutans streptococci counts, diet, and nutritional status were investigated for their association with RECDD using regression analysis. RESULTS: The prevalence of any caries was 27.3 percent, and was 7.6 percent for RECDD. Among all children, mean dft and dt scores per person were 1.1 (SD = 2.4) and 0.9 (SD = 2.3), respectively; among those classified as having RECDD, scores were 6.9 (SD = 4.2) and 6.7 (SD = 4.3), respectively. Children with RECDD had 56 percent of all the decayed teeth in the sample. Low and medium social classes, use of a baby bottle filled with sweetened beverages, high salivary mutans streptococcal levels, and malnutrition were directly associated with RECDD; milk and yogurt consumption and low Plaque Index scores were inversely associated with the condition. CONCLUSIONS: The high prevalence of RECDD suggests that the implementation of preventive programs should be a priority for dental public health. Because of its high prevalence among children as young as 3 years of age, preventive measures targeted toward pregnant women and toddlers should be developed and tested, while kindergarten students could be used for monitoring RECDD prevalence and for detection of communities at risk.

Animals↗

Variables affecting salivary Streptococcus mutans counts in a cohort of 12-year-old subjects.

BACKGROUND: Several factors such as toothbrushing, diet, acidogenic potential of the mutans streptococci strain and site of the carious lesion can modify the salivary Streptococcus mutans (Sm) counts. In the present investigation the effect of some behavioural, clinical and microbiological variables on Sm salivary counts was evaluated in a cohort of 12-year-olds. METHODS: Forty subjects were examined by two calibrated examiners (GC, AL). The number of surfaces either decayed occlusal, decayed smooth or filled and the number of bleeding sextants, (clinical index for oral hygiene) were reported. Saliva was collected using a tongue depressor and was plated onto mitis salivarius agar with bacitracin and 20% sucrose. The presumptive Sm colonies were counted and the concentrations were logarithmically transformed. One Sm strain per subject was identified and the cariogenic potential evaluated as the minimum pH value recorded, during 5 hrs of incubation in 5% sucrose solution. The children's parents or guardians completed a questionnaire concerning the frequency of toothbrushing, the consumption of sweet foods and soft drinks and at what age the children started brushing their teeth. The effect of the explanatory variables on Sm count logarithms was evaluated by stepwise multiple regression. RESULTS: The regressors with significant additional explanatory power were cariogenic potential (b = -1.335, p = 0.00001, R2 increment = 0.312), decayed smooth surfaces (b = -0.456, p = 0.009, R2 increment = 0.114) and bleeding sextants (b = -0.113, p = 0.004, R2 increment = 0.062), whereas the power of filled surfaces was marginally significant (p = 0.08). CONCLUSIONS: On the basis of these results, it is suggested that acidogenicity is not only a cariogenic factor, but also a factor promoting colonization of oral sites by Sm, especially in subjects with a high frequency of sugar consumption.

Age Factors↗

Intra-individual variations of salivary microbial levels in young adults.

The variations of salivary levels of total viable flora, oral streptococci, Streptococcus mutans, Lactobacillus and Candida in twenty-three subjects, over a 6-month period, trying to control many potential sources of variability, were investigated. Most subjects showed log count variations of the microbial parameters larger than 1. They were 95.6% (total flora), 91.2% (oral streptococci), 73.9% (lactobacilli), 60.8% (Strep. mutans) and 30.3% (Candida). The intra-individual fluctuations were larger than the fluctuations of the means of the counts between samples. This suggests that the shifts in levels of these micro-organisms were more frequent intra-individually than at a population level. Strep. mutans levels significantly explained Streptococcus-Oral (inverse correlation), Lactobacillus and Candida variability. The reported variations were due to technical and biological factors and suggest that, in order to assess the salivary level of some microbial parameters in an individual, the mean count and the range of counts, obtained by more than two samples taken under the same conditions, should be considered.

Adult↗

Effect of sucrose and glucose on the susceptibility of Streptococcus mutans to cephalosporins.

The effect of the type of sugar used as substrate on the susceptibility of Streptococcus mutans to antibiotics was evaluated. Thirty strains, grown in excess of sucrose (s-MIC) and in excess of glucose (g-MIC), were tested for susceptibility to four cephalosporins. About 21% of the strains were sensitive in the presence of sucrose and resistant in the presence of glucose, whereas only 3% of the strains showed the opposite situation. The mean values of the s-MICs of the four cephalosporins were significantly lower than those of the g-MICs. These findings may also be explained by the synthesis, in excess of sucrose, of insoluble glucan by Streptococcus mutans which increases the interbacterial distance and promotes antibiotic diffusion. Given the susceptibility of Streptococcus mutans grown in excess of sucrose to cefotaxime and cefepime, these antibiotics may be used in the primary prevention of infective endocarditis, when subjects predisposed to endocarditis need invasive dental therapy.

Anti-Bacterial Agents↗

Salivary distribution of Streptococcus mutans in schoolchildren from Rome (Italy).

Five-hundred-seventy-seven, 6 year old schoolchildren from Rome were examined. 67.8% of them harboured 1 x 10(5) or more Streptococcus mutans CFU per milliliter of saliva. This value was higher than values reported by other Authors. However, the caries prevalence of the subjects in this study was lower than values shown by some of the other study-populations, suggesting that different S. mutans distributions of different populations are not entirely explained by the differences in caries prevalence and, in order for the comparison to be possible, the other factors affecting mutans distributions should be considered.

Child↗

The effect of milk and sucrose consumption on caries in 6-to-11-year-old Italian schoolchildren.

The effect of milk on dental caries was studied on a sample of 6-to-11-year-old Italian schoolchildren. The daily amount of milk consumed and the frequency of consumption of sucrose-containing foods were obtained by a 24-hour dietary diary. In the subsequent oral examination, the level of visible plaque and the number of decayed, extracted and filled teeth (both primary and permanent) of the children were recorded. 439 children (217 boys) who did not use fluoride prophylaxis and with poor oral hygiene were selected from among 890 children. They were divided into three groups according to the frequency of sucrose consumption. The data were statistically analysed using multiple logistic regression. The children consumed a daily average of 209 +/- 133 ml of milk and there were no differences among the three groups in this respect. As expected, the dental health of the children with low sucrose frequency was significantly better than that of the children with high sucrose frequency. The regression on the whole sample showed a weak, significant, negative association between milk consumption and caries (p < 0.05). In the group of high sucrose-consuming children a negative, highly significant association was found (p < 0.001), while in the two groups of low and moderate sucrose-consuming children no association was found. These data suggest that, in the present sample of children who did not use fluoride and with poor oral hygiene, milk has a caries preventive effect only on those subjects with a high daily sucrose-consuming frequency.

Analysis of Variance↗

Childhood obesity: a risk factor for traumatic injuries to anterior teeth.

The relationship between obesity and traumatic dental injuries was evaluated in a study population of 938 6- to 11-year-old schoolchildren from Rome, Italy, and it was suggested by the lifestyle and the physical activity of obese children, which, according to many authors, is different from the lifestyle of other children. The subjects were examined at school: presence and type of dental injury, overjet, incisor protrusion, upper lip incompetence and presence of obesity were recorded. Trauma predisposition was evaluated with a questionnaire investigating the behaviour which may predispose to impacts. Six out of eight questions in this questionnaire concerned the children's lifestyle and the trauma predisposition score was therefore also considered an estimate of lifestyle and physical activity. The dental injury prevalence of the study population was 21.3% and obesity prevalence was 11.4%. Of the obese children 30.8% had dental injuries vs. only 20.0% of non-obese subjects (P = 0.007). Obese children had only enamel and enamel-dentine fractures and the main reported trauma cause was indoor play; conversely, lean children also had other types of injuries and the most frequently reported cause was outdoor play. The main predisposing factors significantly affecting the probability of dental injury, evaluated with multiple logistic regression, were upper lip uncoverage (OR: 1.23; P = 0.02), overjet larger than 3 mm (OR: 1.68; P = 0.001) and obesity (OR: 1.45; P = 0.01). Surprisingly, trauma predisposition was a protective factor (OR: 0.50; P = 0.00001). The results of this study were explained by the significant inverse correlation between obesity and trauma-predisposing behaviour, thus suggesting that subjects frequently playing sports and lively games were not only less obese but also more skillful and, for this reason, less prone to trauma when they fell or sustained impacts.

Accident Proneness↗

Effect of orthodontic therapy with fixed and removable appliances on oral microbiota: a six-month longitudinal study.

The present study evaluated microbiological and clinical changes occurring during the first six months of orthodontic therapy with fixed and removable appliances and the consequent risk for gingivitis and periodontal disease. This study was justified by the disagreement among different authors: only some of them reported gingivitis development and changes in dental plaque composition during orthodontic therapy with fixed appliances, others did not. Thirty, 7-to-15-year-old children, fifteen with fixed and fifteen with removable appliances, previously motivated to oral hygiene, completed the study. They were clinically examined by a dentist at baseline and at the end of the study. Three supra and subgingival microflora samples were collected from the first molars, when the appliances were inserted (T0), 6-8 weeks later (T1) and 6-7 months later (T2). Microflora was examined using dark-field and light microscopes and cultural methods. An indicator of healthy status (percentage of Gram positive cocci in total bacterial count) and some risk indicators for gingivitis (bacterial count evaluated with light microscope, percentage of Gram negative rods) and for periodontitis (motile rod and spirochete percentages, presumptive Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis prevalence) were investigated. Patients with fixed appliances were clinically healthy at T2; yet they showed significantly increased counts, motile rods, subgingival spirochetes and a decrease of Gram positive cocci. At T2, patients with removable appliances were clinically healthy and the only significant microbiological changes were supragingival motile rods and subgingival spirochetes. These data suggest that in the oral hygiene motivated patients of the present study, gingivitis and periodontitis do not occur, during the first six months of treatment: the significant modification of oral microbiota, shown by subjects with fixed appliances, however, suggests that the risk for gingivitis in the following months of therapy is still high and the risk for periodontitis cannot be excluded.

Adolescent↗

[Use of a microwave device for dental instrument sterilization: possibilities and limitations].

BACKGROUND: The aim of the present study was the evaluation of the effectiveness as sterilizer of a modified version of a microwave device, which was previously tested by the same authors and found unsatisfactory. MATERIALS AND METHODS: Dental mirrors were contaminated by 10(4)-10(9) microorganisms of Stapbylococcus aureus and spores of Bacillus subtilis and Bacillus stearothermophilus. The inocula used were both wet and dry. The duration of the treatment was 4 minutes. Three series of tests were made: 1) microwaves and "adjuvant" solution (as suggested by the producer of the device); 2) microwaves only (in place of the "adjuvant" solution, a Na Cl 0.9% was used); 3) "adjuvant" solution only (into an oven at 25 degrees C). RESULTS: In the 1st and 3rd series of tests all the microorganisms and the spores were killed. In the 2nd series of tests a bactericidal effect against some, not all, microorganisms of the S. aureus species and against spores of B. subtilis and B. stearothermophilus was found. CONCLUSIONS: The results of this study suggest that the device tested has a sterilizing activity, which, however, is not due to the activity of microwaves only; but to the combined activity of microwaves, "adjuvant" solution and temperature (since inside the device, at the end of the treatment the temperature on the mirrors was 94 degrees C).

Dental Instruments↗

Traumatic injuries to anterior teeth in Italian schoolchildren: prevalence and risk factors.

In the present study, the prevalence of traumatic injuries to anterior teeth in 824, 6- to 11-year-old, schoolchildren from Rome (Italy) and the relationship between injuries and predisposing factors were evaluated. Prevalence value of the study-population was 20.26%. This value is higher than those reported in surveys performed in Italian emergency dental services, but it is similar to those of retrospective studies from other countries. The highest prevalence was found among 9-year-old boys (33.69%); the M/F ratio was 1.64. The percentage of injuries with unknown cause (21.46%) was higher than that of other studies. This may be because most of injuries were slight (64.39% of injuries were enamel fractures) and it is likely that children and their parents were not worried about them, when they happened, so that they did not seek urgent dental care-this helps to explain the prevalence values of this and other retrospective studies, which are higher than those from emergency services-and, when interviewed, they did not remember the circumstances of the traumatic event. Using the Mantel-Haenszel's Odds Ratios stratified for age and sex, injuries were related to individual predisposing factors (overjet larger than 3 mm: OR = 2.57, p = 0.0001, short upper lip: OR = 2.23, p = 0.0001 and upper medial incisor protrusion: OR = 3.95, p = n.s.), but not to children's trauma predisposing behaviour (OR = 0.92, p = n.s.). Serious injuries, however, happened to children without predisposing factors and were caused by strong impacts, suggesting that individual risk factors may not affect these type of injuries.

Age Distribution↗

Effect of sucrose consumption on level of Streptococcus mutans in saliva.

The aim of the present paper was to study whether sucrose consumption may affect the level of salivary Streptococcus mutans. The study was justified by the disagreement between results of "in vitro", animal and human experiments and results of epidemiological studies made on study-populations. According to experimental research, sucrose availability promotes Streptococcus mutans selection and development in the oral cavity. On the other hand, the results of epidemiological studies run counter to these experiments. In the present study, the main reasons for this disagreement were investigated and identified. From this, an epidemiological study was performed, taking into account these potentially confounding factors. The results show that sucrose consumption is actually able to promote Streptococcus mutans selection and development in the oral cavity, thus increasing the risk of dental caries.

Child↗

[The prevalence of anterior tooth trauma in children 6 to 11 years old].

The aim of the present paper was the study of prevalence of traumatic dental injuries to the anterior teeth of Italian schoolchildren. 519, 6- to 11-year-old children from two primary schools in Rome were examined, in order to evaluate dental injuries on canines and incisors. Traumatic injuries were classified according to Garcia-Godoy et al.; this classification is the most appropriate for retrospective studies. Dental injury prevalence was 21.0%, this value was higher than values shown by surveys made in the emergency services, but similar to those of other retrospective studies made in other countries. Male/female ratio was 1.69, statistically significant at 99% level. The age distribution showed that the higher prevalence was among the 9 year-old children (26.9%), the lower among the 8-year-old children (14.3%); the 9 year-old incidence value was the highest. 74.6% of the teeth involved were maxillary central incisors. Enamel fractures were the most frequent trauma type (67.0%), followed by enamel-dentine fractures (19.3%) and concussions (8.3%). No serious fracture was found. Play was the major dental trauma cause (64.2%), followed by sports (17.4%). 16.5% of traumatized children and their parents did not report the cause. Traffic accidents were not reported as causes. In conclusion, the high prevalence of dental traumas in schoolchildren, involving more than one fifth of subjects, is emphasized. Most of traumas were, however, slight, so that sometimes the cause was not reported. Serious dental injuries were more uncommon. Traffic accidents and violent impacts, which often cause these traumas, were also uncommon.

Age Distribution↗