Purpose\ud – The purpose of this paper is to analyse intellectual capital (IC) in SMEs. In particular two research questions are posed: how SMEs acquire or develop knowledge and intangible resources; and how they manage and exploit IC.\ud \ud Design/methodology/approach\ud – An in-depth case study of an Italian SME operating in the automobile industry is carried out in order to answer the two research questions.\ud \ud Findings\ud – The case study evidences the impossibility to sharply divide all of the knowledge-related elements of a firm into the three generally accepted categories of human, organisational (structural) and relational capital. The analysis of IC as a set of stock of resources is important but really partial due to the fact that IC and knowledge continuously change. In this light, the focus on activities and processes help in understating how the firm manages IC. In the studied SME, formal and informal knowledge coexist but in different areas of the firm. Again, the relationships with external stakeholders, suppliers and clients especially, are the source for improving IC. The case study also supports the important role that dialogue and familiarity play in knowledge management. However the focus of management is not knowledge per se, but the solution to problems the firm must deal with, IC and knowledge being just one of the issues to be considered in order to solve problems.\ud \ud Research limitations/implications\ud – The paper is useful since it addresses the management of IC in SMEs which is a topic under-researched with respect to the economic importance of SMEs. The conclusions of the work, emerging from an individual case study analysis, cannot be generalised. However, they offer support for other studies findings and highlight some specificities of the way SMEs manage IC.\ud \ud Practical implications\ud – The paper explores the characteristics of IC management in SME in order to contribute towards the differentiation of the view of IC in relation to the “size” of the firm. Approaches originally developed for larger firms fail to consider SMEs characteristics, which indeed are not smaller large firms; therefore, it is in general impossible to think of SME management systems as simpler or smaller than those adopted by large firms. The key point is in fact that SMEs (at least the one here analysed) have management systems which are ontologically different.\ud \ud Originality/value\ud – Besides the relevant role of SMEs in economy, very few papers have been published on the way IC is developed and managed in SMEs. A gap therefore exists between the economic importance of SME and the attention IC research has given to them, which calls for more research on this area. The paper is a step forward on the way of reducing that gap, since it provides a case study on knowledge and IC management within an Italian SME. Finally, the analysis reinforces similar results of other studies adopting a dynamic perspective for the analysis of IC, which found IC management in SMEs to be more based on informal...

The implementation of the EU Directive on non-financial information determines the transition from a voluntary to a mandatory disclosure setting. This paper is a first attempt to investigate if this transition influences the value relevance of non-financial information, which relates to the environmental, social and governance disclosure (ESG) requirements of the Directive. Italy provides an interesting setting as non-financial information was generally voluntary before the Directive, which was implemented with the Italian Legislative Decree 254/2016. To this extent, we examine the non-financial, environmental and social disclosure practices of 231 Italian listed firms in the pre-(2016) and post-(2017) Legislative Decree application. Our results do not show any relevant increase of such disclosures after the Legislative Decree application, as Italian listed firms limit such disclosure to a minimum requirement. Further, this finding is confirmed also for those firms voluntarily providing a non-financial report (sustainability or integrated report) before the Legislative Decree application. Our regression analysis shows that accounting numbers are associated with share prices, while non-financial, environmental and social information are not value-relevant with reference to the pre-and post-Legislative Decree application. This means that the non-financial, environmental and social information beyond the financial accounting information do not explain any incremental value-relevant information to investors in the non-financial mandatory disclosure setting required by the new regulation. Our results enrich previous evidence concerning the value relevance of non-financial and ESG disclosure mainly focused on Anglo-Saxon contexts.

Aim Periodontitis is a relapsing–remitting disease. Compared with bleeding on probing (BoP), expression of disease activity, periodontal inflamed surface area (PISA), incorporates chronic disease parameters. We tested the association of PISA and BoP with blood pressure (BP) in NHANES III. Materials and methods A total of 8,614 subjects (≥30 years) with complete periodontal and BP examinations were enrolled. PISA was derived from periodontal probing depth and BoP. The association of PISA and BoP with high/uncontrolled BP was examined by multiple‐adjusted models. Inflammatory markers were tested as possible mediators. A machine learning (ML) approach was used to define the relative importance of PISA and BoP and estimate the power of BP status prediction. Results Compared to no inflammation, severe PISA and BoP were associated with 43% (p < .001) and 32% (p = .006) higher odds of high/uncontrolled BP (≥130/80 mmHg), and with higher systolic BP by ≈4 (p < .001) and 5 (p < .001) mmHg, respectively. Inflammatory markers appeared to mediate this association with various extents, without threshold effect. BoP predicted high/uncontrolled BP more efficiently than PISA using ML. Conclusion PISA and BoP describe the association of periodontal inflammation and hypertension with subtle differences. The contribution of local inflammation to the global inflammatory burden might explain the observed findings.

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SUMMARY:Along with the emerging needs of the dental patients, numerous techniques for oral tissue stimulation and regeneration were developed to be employed in the modern implant rehabilitation therapies. The Concentrated Growth Factors (CGF) are a relatively new therapeutic presidium that can be used for this purpose, enhancing the regenerative potential property of blood cells. Although literature presents numerous studies evaluating the CGF for their clinical uses and efficacy, data regarding their biological characteristics are very few. The present study evaluates and describes the CGF structural morphology by means of classical histological methods, using haematoxilin-eosin and azan mallory stains. A three layers organization with a fibrin complex network was noted, with blood corpuscular elements entrapped, especially in the most external layer. These descriptions enrich the knowledge about this new type of membrane, showing the bio-morphological side of the regenerative techniques. These findings will be useful in clinical practice for the choice of the most suitable technique in each implant rehabilitation.

In the analysis of the characteristics of a pleasant smile, a gummy smile has negative components, which most affect the esthetics of non-verbal communication. For this purpose a proposed classification based upon etiopathogenetic criteria as useful indications for a therapeutical approach is given.The nature of a high smile line can be: dento-gingival, connected to an abnormal dental eruption, which is revealed by a short clinic crown; muscular, caused by an hyperactivity of the elevator muscle of the upper lip; dento-alveolar (skeletal), due to an excessive protuberance or vertical growth of the jawbone (maxillary); lastly, a mixed nature, in the presence of more than one of the above described factors.The diagnosis of gummy smile must be precocious and based, with reference to specific parameters, upon a careful analysis of the etiopathogenetic factors and the degree of seriousness of the alteration. A correct treatment plan must contemplate the possibility of an orthognatodontic, orthopedic and/or surgical therapeutic resolution considering the seriousness and complexity of the gums exposures (high smile line) in connection with the age of the subject.

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.

Invisible orthodontic aligners (IOAs) have been introduced in the orthodontic field as an innovative alternative for fixed brackets, in relation to their ability to be easily inserted/removed from the oral cavity without affecting the chewing ability and the aesthetic of the patients. The paper provides a complete physicochemical and mechanical characterization of thermoplastic materials in the form of disks used for commercial IOAs. A wide palette of specific techniques is considered, from tensile tests and dynamic-mechanical analysis, to X-Ray diffraction (XRD), differential scanning calorimetry (DSC), Fourier transformation infrared spectroscopy (FTIR-ATR) analyses and water absorption tests. The disks are investigated before and after immersion into staining beverages (red wine, coffee, nicotine and artificial saliva), in terms of colour variations, transparency, and microscopic surface modifications by means of colorimetry, UV-VIS absorbance and scanning electron microscopy (SEM). Among all the samples, polyurethane (PU) exhibited the highest crystallinity and the highest values of mechanical and thermal resistance, while the poly(ethylene terephthalate)-glycol (PETG) samples presented better transparency and less ability to absorb water. Moreover, red wine and coffee give noticeable colour variations after 14 days of immersion, together with a slight reduction of transparency.