Recent data indicates limited awareness and compliance on infection prevention procedures by dental offices and by dental laboratories. Guidelines for infection prevention in dentistry have been published by Centres for Disease Control and Prevention since 2003; the section “IX-Special consideration” includes a subsection concerning the prevention in dental laboratories, but it has not been modernised in later versions to fit the needs of traditional and computer-aided technology. Traditional techniques required disinfecting items (impression, chewing waxes, and appliances) with well-suited products, which are also chosen for limiting impression changes or appliance deterioration. Effective procedures are available with difficulties. Some of these contain irritant or non-eco-friendly disinfectants. The transport of impression, to dental laboratories, is often delayed with limited precautions for limiting cross-infection. Gypsum casts are frequently contaminated mainly by bacteria and their antibiotic-resistant strains and even stored for long periods during dental implant supported restoration and orthodontic therapy, becoming a hidden source of infection. Nowadays, computer-aided design/computer-aided manufacturing technology seems to be an interesting way to promote both business and safety, being more comfortable for patients and more accurate than traditional technology. A further advantage is easier infection prevention since, for the most part, mainly digital impression and casts are not a source of cross-infection and the transport of contaminated items is reduced and limited to try-in stages. Nevertheless, a peculiar feature is that a digital electronic file is of course unalterable, but may be ruined by a computer virus. Additionally, the reconditioning of scanner tips is determinant for the optical characteristics and long term use of the scanner, but information for its reconditioning from producers is often limited. This study focuses on some critical points including (a) insufficient guidelines, (b) choice of proper procedure for scanner reconditioning, and (c) data protection in relation to patient privacy.

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No agreement exists on the most appropriate timing of orthodontic treatment in patients with cleft lip and palate. The aim of this study is to investigate the effect of early orthodontic treatment on development of the dental arches and alveolar bone.A dental casts analysis was performed on 28 children with cleft lip and palate before orthodontic treatment (T0; mean age, 6.5 ± 1.7) and at the end of active treatment (T1; mean age, 9.2 ± 2.1 years). The considered variables were: intercanine and intermolar distances; dental arch relationships, evaluated according to the modified Huddart/Bodenham system.The study group was divided into 2 samples according to the age at T0: Group A (age < 6 years) and Group B (age ≥ 6 years). A statistical comparison of the treatment effects between the 2 samples was performed.Patients in Group A exhibited a greater increase of intercanine distance (8 mm versus 2.7 mm; P<0.001), intermolar distance (7.2 mm versus 5 mm; P = 0.06), and Huddart/Bodenham score (7.1 versus 3; P < 0.05) when compared with patients in Group B.Early orthodontic treatment strongly improved the dental arch relationship, since subjects starting the therapy before the age of 6 had a better response in terms of anterior maxillary expansion.

The early high condylectomy (HC), removing the overgrowing area of the condyle, may be indicated for condylar hyperplasia. However, in young patients, when the HC removes the pathological overgrowing tissue the contralateral condyle is still growing. May this surgical procedure, in these growing patients, stop the operated side growth creating the conditions for an opposite asymmetry? Authors investigate the way the operated mandible develops after the early HC, both as a symmetry percentage and in an absolute value related to the unaffected side. A sample of 8 consecutive growing patients, 1 male and 7 females, referred to the Maxillofacial Surgery Department of Parma University for HC were investigated. Patients were longitudinally studied with 3 orthopantomographies at: T0 (diagnosis: mean age, 13 years; range, 11 years 2 months to 13 years 8 months), T1 (after surgery: mean age, 15; range, 13-18 years) and T2 (follow-up: mean age, 18 years; range, 17-20 years). The x-ray is used to study the condyle, ramus, and total vertical structures length by Mattila tracing method. The data were analyzed by the Student t test and Wilcoxon matched pairs test; P value was set at 0.5. The operated side was overcorrected by HC and; during the investigated period, its growth decreased from T0 to T1 and restarted from T1 to T2. The whole T0-T2 growth of the operated side was not statistically different from the one of the healthy side (P < 0.05). These results suggest that the operated side growth may continue in a more normal way after condylectomy.

Context: The Centers for Disease Control and Prevention has recently published its "Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care", but information concerning compliance, occupational hazards, and specific recommendations for orthodontic facilities is less widely available. Evidence Acquisition: We searched electronic English articles published in PubMed and Google Scholar databases (2010-May 2016) using various combinations of the key indexing terms. Results: 95 articles were selected for comprehensive reading according to the inclusion criteria. Problems and difficulties for orthodontic offices in applying the recommendations have been divided into nine focus areas concerning the quality of supplies, the procedures necessary to adhere to the standard precautions of hand hygiene, the use of personal protective equipment (PPE), respiratory hygiene/cough etiquette, sharps safety, orthodontic instrument reconditioning, cleaning and disinfecting clinical contact surfaces and dental unit water lines, and impression disinfection. Conclusions: On the basis of our experience in a university department of orthodontics and private orthodontic offices, we believe that innovative thinking based on better knowledge, education and training, ergonomics, and task-specific, evidence-based guidelines and resources are required to improve compliance with infection control recommendations.

Our data indicate that SAE miniscrews have higher bone retention than MA miniscrews, although the effects of mechanical loading of these devices on cortical bone require further investigations.

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