Although rare, oral manifestations of hypersensitivity reactions in orthodontic patients pose a significant clinical challenge due to their heterogeneous presentations, and can cause discomfort and pain, possibly impacting patients’ quality of life and orthodontic treatment duration and outcomes. This comprehensive review aimed to elucidate the oral, perioral, and systemic manifestations of hypersensitivity reactions in orthodontic subjects, focusing on patients with fixed appliances, removable appliances, and clear aligners, and detailing their epidemiology, macroscopic and microscopic features, allergy testing, clinical implications, and specific management strategies. Oral and extra-oral manifestations of (immediate and delayed) hypersensitivity reactions occur rarely and are due to the release of metal and non-metal ions from orthodontic appliances. They typically present as erythema, erosive–ulcerative lesions, and gingival hyperplasia, with histopathological findings showing inflammatory infiltrates. Nickel is a significant allergen, and diagnostic tests like patch tests are essential for managing these reactions. Likely due to prolonged contact with oral tissues, fixed orthodontic appliances pose a higher risk compared to removable appliances and clear aligners. Early identification and removal of allergenic materials, combined with effective treatments, can resolve symptoms and prevent recurrence. Keeping dental and medical records updated and knowing family and personal medical histories helps clinicians choose appropriate materials and counsel patients about potential risks. Proper patient education, regular monitoring, and using hypoallergenic materials are key strategies for managing these reactions.

The COVID-19 pandemic has profoundly changed our lives. Since the SARS-CoV-2 was discovered, many studies have been done on the transmission mode, its replication within humans, and its survival even in the outside environment and on inanimate surfaces. Undoubtedly, health care workers have faced the greatest risks because of their close contact with potentially infected patients. Of these, dental health care professionals are certainly among the most vulnerable categories, precisely because infection occurs with the airborne virus. The treatment of patients within the dental office has changed profoundly, respecting all preventive measures towards the patient and the practitioners themselves. The aim of this paper is to understand whether the protocols changed for the prevention of SARS-CoV-2 infection among dentists remained even after the most acute phase of the pandemic. In particular, this study analyzed habits, protocols, preventive measures, and any costs incurred in the COVID-19 era for the prevention of SARS-CoV-2 infection among dental workers and patients.

(1) Background: Parents’ awareness of malocclusion and their attitude towards early evaluation and interventions influence children’s orthodontic management. This cross-sectional study investigates factors that affect the perceived orthodontic needs and the attitude towards interceptive orthodontics among a sample of one-thousand eight-hundred and six (1806) parents of children aged between 6 and 11 years. (2) Methods: The investigation was carried out thought a 18-items online questionnaire divided as follows: characteristics of respondents; perceived child’s orthodontic needs; attitude toward early orthodontic evaluation and interventions. The associations between responses were assessed with a Chi-square test. (3) Results: Two-thirds of the respondents referred to having consulted an orthodontist for their child, and more than half of them initiated the required orthodontic treatment. In 44% of cases, the orthodontic consultation occurred after the age of 7 years. Parents’ higher education and history of orthodontic treatment were associated with a greater awareness of orthodontic needs. Parents’ perception of the impact of teeth on their child’s personality was significantly associated with the decision to start the orthodontic treatment (p < 0.001). (4) Conclusions: Although the parents’ level of awareness of their child’s orthodontic needs was generally satisfactory, the results of the present study pointed out the need for a better education regarding the importance of an early orthodontic assessment.

Background/Objective: This cross-sectional study assessed the prevalence of temporomandibular disorders (TMD) among Italian university students and their association with emotional factors and parafunctional behaviors. Methods: A total of 321 students participated in this study. TMD signs and symptoms were evaluated using the DC/TMD criteria through clinical examinations and self-report questionnaires: physical (Symptom Questionnaire), psycho-emotional (PHQ-9, PHQ-15, PHQ-4, and GAD-7), and wake-state oral behaviors (Oral Behavior Checklist, OBC). The Mann–Whitney U test assessed associations between TMD, sociodemographic data, oral behaviors, and psychological vulnerability (p < 0.05). Results: Pain-related symptoms were present in 37% of students (male/female ratio 1:2.7; p < 0.001), and joint dysfunction in 28%, with no gender differences. The median score of PHQ-9 (2.0; interquartile range IQR 5.0), PHQ-15 (2.0; IQR 5.0), PHQ-4 (3.0; IQR 6.0), and GAD-7 (3.00; IQR 6.0) suggested negligible severity of anxious mood, depressed mood, and somatic symptoms among the university students. However, all scores were noticeably higher in students with pain-related TMD compared to pain-free ones (p < 0.05). OBC scores were significantly related to PHQ (p < 0.001), GAD-7 (p < 0.001), and pain symptoms (p < 0.001). Science faculty students (S) showed higher OBC scores than humanities ones (H; S: 20.0; IQR 13.0 vs. H: 16.0; IQR 14.0; p < 0.001), and an H/S ratio of 1:2 was found in pain prevalence (p < 0.05). Conclusions: This study found a high prevalence of TMD signs and symptoms, particularly pain-related, among university students, strongly linked to emotional factors and oral behaviors.

Periodontal diseases in pediatric subjects represent a challenging and relatively underexplored area compared to the extensive data available about periodontal diseases in adults. The present narrative review aims to explore the periodontal status and the related subgingival and/or salivary microbial profiles in pediatric subjects (≤18 years), focusing also on the state of health or systemic diseases. In healthy periodontium, early colonizers, such as Streptococcus and Actinomyces spp., dominate the subgingival microbiota, supporting an eubiosis state. Low levels of Candida albicans and latent Herpesviridae may be detected. In gingivitis, the microbial profile shifts towards more pathogenic species, including Prevotella intermedia and Fusobacterium nucleatum. In necrotizing gingivitis, typically affecting systemically compromised children, the microbial profile is characterized by spirochetes, Fusobacterium, and Prevotella intermedia. Viral coinfections—especially with HSV, CMV, and EBV—are more frequently detected. In periodontitis, the microbiota was dominated by red complex pathogens along with Aggregatibacter actinomycetemcomitans in the aggressive forms, especially in systemically compromised children, as Herpesviridae reactivation and co-infections. Fungal involvement is less well characterized; Candida albicans may be present, particularly in cases of severe immune suppression. Nevertheless, the lack of pediatric longitudinal studies investigating periodontal disease progression after periodontal treatment and related changes in microbiological composition limited the understanding and exploration of the oral microbiota over time.

Pisano M, et al. Restor Dent Endod. 2024 Sep;49:e33. https://doi.org/10.5395/rde.2024.49.e33