Root canal treatment represents a significant challenge as current cleaning and disinfection methodologies fail to remove persistent bacterial biofilms within the intricate anatomical structures. Recently, the field of nanotechnology has emerged as a promising frontier with numerous biomedical applications. Among the most notable contributions of nanotechnology are nanoparticles, which possess antimicrobial, antifungal, and antiviral properties. Nanoparticles cause the destructuring of bacterial walls, increasing the permeability of the cell membrane, stimulating the generation of reactive oxygen species, and interrupting the replication of deoxyribonucleic acid through the controlled release of ions. Thus, they could revolutionize endodontics, obtaining superior results and guaranteeing a promising short- and long-term prognosis. Therefore, chitosan, silver, graphene, poly(lactic) co-glycolic acid, bioactive glass, mesoporous calcium silicate, hydroxyapatite, zirconia, glucose oxidase magnetic, copper, and zinc oxide nanoparticles in endodontic therapy have been investigated in the present review. The diversified antimicrobial mechanisms of action, the numerous applications, and the high degree of clinical safety could encourage the scientific community to adopt nanoparticles as potential drugs for the treatment of endodontic diseases, overcoming the limitations related to antibiotic resistance and eradication of the biofilm.

Mandibular advancement devices (MAD) are effective in reducing apnea episodes and they are frequently used as first-line therapy in obstructive sleep apnea (OSA) patients. The MAD must be used every night for a lifetime and since it performs its function discharging the forces on dental elements the aim of this systematic review was to identify the dental and skeletal long-term side effects of MAD therapy and to evaluate the influence of time on them in OSA or snoring patients. An electronic search was performed in MEDLINE, Cochrane Database, Google Scholar Beta, Scopus, and LILACS. Studies until 4 April 2018 were analysed, without language restrictions. Randomized controlled trials and cohort studies investigating dental and/or skeletal side effects on adult patients wearing MAD for OSA or snoring treatment with at least 2 years follow-up were included and independently evaluated by two investigators. The quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) and the risk of bias by means of Cochrane’s tools. For each study included and for each dental and/or skeletal parameter, the difference in means and 95% CI was calculated between baseline and follow-up. Twenty-one studies with follow-up between 2 and 11 years were included. The side effects reported were a reduction in overjet, overbite, and in the upper incisor inclination, and an increase in lower incisor inclination, A point-Nasion-B point, and anterior facial height. The meta-regression analysis showed that the side effects were influenced by the therapy duration for all parameters (P < 0.05). The quality of evidence was low/moderate. MAD therapy produces time-related dental and skeletal side effects. After a long period of treatment, the dental side effects are clinically relevant and therefore the clinician should inform the patients about this issue. Since the side effects are progressive, patients need to be continuously monitored over time. The study protocol was not registered.

Antimicrobial resistance is a growing phenomenon, often associated with the improper prescription of antibiotics, prescribed by those who do not follow the guidelines for antibiotic stewardship. The aim of this study was to evaluate the current attitude towards antibiotic prescribing and antimicrobial resistance awareness among Italian dentists. An online questionnaire was distributed to Italian dentists from September to December 2021. The questionnaire was composed of three main sections. The first part was focused on demographic characteristics, the second part on prescription habits, and the third part on the dentists’ knowledge regarding the phenomenon of antimicrobial resistance. A chi-square test was used to find associations between different variables. The level of significance was set at p < 0.05. A total of 382 dentists completed the questionnaire. The main reasons for antibiotic prescribing were for abscesses (39.6%), extractions (24.5%), and pulpitis (14.1%). The majority of participants (85.3%) reported prescribing macrolides in the case of a penicillin allergy. Most dentists (98.9%) were aware of the antimicrobial resistance phenomenon, but only 7.4% of them consulted the guidelines for prescribing antibiotics. This study demonstrates that the same trend exists in Italy as in other countries in terms of the high prevalence of misuse and overuse of antibiotics, and that Italian dentists utilize a range of antibiotic management strategies.