Cleft of the lip with or without cleft palate (CL/P) represents one of the commonest congenital malformations in Western countries. Based on their association with specific malformative patterns or their presence as isolated defects, CL/P can be classified as syndromic and nonsyndromic, respectively. Both forms of CL/P are characterized by a strong genetic component. Syndromic forms are in many cases due to chromosomal aberrations or monogenic diseases. Among these, the Van der Woude syndrome, caused by mutation of the IRF6 gene, represents the commonest form of syndromic CL/P, accounting for about 2% of all cases. On the other hand, nonsyndromic CL/P is a multifactorial disease derived by the interaction between genetic and environmental factors. In recent years, great efforts have been made to identify the genes involved in the susceptibility to nonsyndromic CL/P and to disclose their relationship with specific environmental risk factors, to get information about the pathogenic mechanism leading to the malformation. In this article, we will review the most recent findings about the genes involved in the pathogenesis of syndromic and nonsyndromic CL/P, to provide information about the opportunity in the future to use specific genetic testing for the identification of at-risk mothers and the prevention of the disease based on a personalized approach.

Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors that include obesity, impaired glucose tolerance or diabetes, hyperinsulinemia, hypertension, and dyslipidemia. Recently, more attention has been reserved to the correlation between periodontitis and systemic health. MetS is characterized by oxidative stress, a condition in which the equilibrium between the production and the inactivation of reactive oxygen species (ROS) becomes disrupted. ROS have an essential role in a variety of physiological systems, but under a condition of oxidative stress, they contribute to cellular dysfunction and damage. Oxidative stress may act as a common link to explain the relationship between each component of MetS and periodontitis. All those conditions show increased serum levels of products derived from oxidative damage, promoting a proinflammatory state. Moreover, adipocytokines, produced by the fat cells of fat tissue, might modulate the balance between oxidant and antioxidant activities. An increased caloric intake involves a higher metabolic activity, which results in an increased production of ROS, inducing insulin resistance. At the same time, obese patients require more insulin to maintain blood glucose homeostasis – a state known as hyperinsulinemia, a condition that can evolve into type 2 diabetes. Oxidation products can increase neutrophil adhesion and chemotaxis, thus favoring oxidative damage. Hyperglycemia and an oxidizing state promote the genesis of advanced glycation end-products, which could also be implicated in the degeneration and damage of periodontal tissue. Thus, MetS, the whole of interconnected factors, presents systemic and local manifestations, such as cardiovascular disease and periodontitis, related by a common factor known as oxidative stress.

It is difficult to find research papers collecting comparative results about characterization studies of clear aligners. Therefore, the aim of this paper is to provide the first comparative analysis of most commercial clear aligners, in terms of their stability towards intra-oral staining agents, their physicochemical and optical properties, as well as their water absorption behavior. Five types of aligners, characterized by different techniques, are considered: Erkodur, Essix Plastic, Ghost Aligner, Zendura, and Invisalign. The obtained results show that clear aligners are made up of PETG, semi rigid PU, and a mixture of PU and PETG, with different degrees of crystallinity which affect the transparency of each aligner. In particular, the PETG-based materials reveal the highest value of short-range order and the highest properties in terms of transparency in the visible range. After 14 days of immersion into red wine and coffee, PETG and PU-based aligners reveal a perceivable change in color (NBS values from 1.5 to 3), corresponding to a loss of transparency due to the deposition of impurities on the surface. These results are particularly marked for Invisalign, showing changes towards other colors (NBS up to 35), probably due to the thermoforming process which led to the formation of a wrinkled surface entrapping the impurities.

Aim: This study aimed to investigate salivary concentrations of Streptococcus mutans (S. mutans) and some Lactobacilli, and plaque index (PI) in patients wearing fixed versus removable orthodontic appliances.Methods: A sample of 90 orthodontic patients (56 males and 34 females) was included in the study: 30 subjects (aged 21.5±1.5 years) were treated with removable clear aligners (CA), while for other 30 cases (aged 23.3±1.6 years) a fixed multibrackets appliance (MB) were utilized, and 30 patients (aged 18.2 ±1.5 years) wearied a removable positioner (RP). Salivary concentrations of S. mutans and Lactobacilli and PI were evaluated prior to start of the orthodontic treatment, after 3 months and 6 months.Results: After 6 months, 40% of MB patients (12 subjects over 30) showed a concentration of S. mutans associated to high risk of developing tooth decay (CFU/ml>10⁵), differently from participants wearing removable appliances (odds ratio = 5.05; 95% C.I. = 1.72‐14.78; chi‐square = 9.64; p = 0.0019). The same trens was observed for the concentration of Lactobacilli (odds ratio = 4.33; 95% C.I. = 1.53‐12.3; chi‐square = 8.229; p = 0.004).In addition, over the duration of the study, CA patients maintained PI at 0 level, while MB patients experienced a statistically significant increasing trend of PI over time, and their PI became clinically/statistically relevant after 6 months, respect to CA and RP patients.Conclusions: Comparing all the data, while, after 6 months, only about 10% of CA patients and 13.3% of RP patients achieved a microbial colonization which may lead to high risk of caries development, about 40% of MB patients ‐ and 20% after 3 months ‐ showed a high level of vulnerability to developing caries, which require additional strategies for plaque control and microbial colonization to be employed.