Annalisa Monaco | Università Degli Studi Dell'Aquila (original) (raw)

Papers by Annalisa Monaco

Journal of Periodontology, 2021

Background: Reduced access to dental care may increase cardiovascular risk; however, socioeconomi... more Background: Reduced access to dental care may increase cardiovascular risk; however, socioeconomic factors are believed to confound the associations. We hypothesized that the relation persists despite economic wellness and high education, with reduced access to dental care affecting cardiovascular risk at least in part through its effect on blood pressure (BP), possibly mediated by systemic inflammation. Methods: We first assessed the sociodemographic and clinical characteristics related to last dental visit timing (≤ or >6 months; self-reported) using national representative cross-sectional data. Then, the association of last dental visit timing with clinic BP was selectively investigated in highly educated, high income participants, further matched for residual demographic and clinical confounders using propensity score matching (PSM). The mediating effect of systemic inflammation was formally tested. Machine learning was implemented to investigate the added value of dental visits in predicting high BP over the variables included in the Framingham Hypertension Risk Score among individuals without an established diagnosis of hypertension. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Oral Diseases, 2021

An accumulating body of evidence supports an independent association between high blood pressure ... more An accumulating body of evidence supports an independent association between high blood pressure (BP) and periodontitis, possibly mediated by low-grade inflammation. This joint report by the Italian Society of Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP) working group on Hypertension and Periodontitis (Hy-Per Group) provides a review of the evidence on this topic encompassing epidemiology, biological plausibility, relevance, magnitude, and treatment management. Consensus recommendations are provided for health professionals on how to manage BP in individuals showing signs of poor oral health. In summary, (1) large epidemiological studies highlight that individuals with periodontal diseases have increased risk for high/uncontrolled BP independent of confounders; (2) mechanistically, low-grade inflammation might have a causal role in the association; (3) BP profile and control might benefit from periodontal treatment in pre-hypertensive and hypertensive individuals; (4) oral health status should be evaluated as a potential risk factor for high/ uncontrolled BP, and effective oral care should be included as an adjunct lifestyle measure during hypertension management. Further research is needed to optimize BP management in individuals with poor oral health.

The Open Dentistry Journal, 2019

Background: Antibiotic resistance is an important issue for public health. Objective: The aim of ... more Background: Antibiotic resistance is an important issue for public health. Objective: The aim of this work is to investigate the clinical situations which require the administration of antibiotics in dentistry. Methods: The authors want to do a review of the literature and a comparison of guidelines in dentistry among different countries. The research method was based on the use of Pubmed and the research of indexed articles and documents published by authorities and boards about the antibiotic prescription in dentistry. The paper is an analysis deep inside the physiological and pathological situations that, according to different guidelines, require the use of antimicrobics. The spirit is a clinical one because this paper wants to be a guide for dentists, especially before the administration, in order to moderate the use of antimicrobials. We must remember that the World Health Organisation organizes each year the World Antibiotic Awareness Week, in order to fight against the impro...

Hypertension (Dallas, Tex. : 1979), Oct 22, 2018

Periodontal disease is a chronic inflammatory disorder of the tissues surrounding the teeth, with... more Periodontal disease is a chronic inflammatory disorder of the tissues surrounding the teeth, with evidence of systemic effects. Some studies showed the benefit of periodontal therapy on blood pressure (BP), but the impact of periodontitis on BP control is unknown. We retrospectively analyzed cross-sectional, nationally representative data from treated hypertensive adults aged ≥30 years with and without periodontitis. BP was examined as both continuous (mm Hg) and categorical (treatment goal achievement status according to guidelines: at goal and above goal) variable according to the presence or absence of periodontitis and its clinical parameters (probing depth, clinical attachment loss, and disease severity [mild, moderate, and severe]). Systolic BP means and odds ratios for uncontrolled BP according to the presence and severity of periodontitis were calculated using progressively adjusted models. Among treated hypertensive adults, mean systolic BP was about 2.3 to 3 mm Hg higher i...

Cranio : the journal of craniomandibular practice, Jan 16, 2017

Objective To compare the clinical efficacy of two techniques for fabricating a Bimler device by a... more Objective To compare the clinical efficacy of two techniques for fabricating a Bimler device by assessing the patient's surface electromyography (sEMG) activity at rest before treatment and six months after treatment. Methods Twenty-four patients undergoing orthodontic treatment were enrolled in the study; 12 formed the test group and wore a Bimler device fabricated with a Myoprint impression using neuromuscular orthodontic technique and 12 formed the control group and were treated by traditional orthodontic technique with a wax bite in protrusion. The "rest" sEMG of each patient was recorded prior to treatment and six months after treatment. Results The neuromuscular-designed Bimler device was more comfortable and provided better treatment results than the traditional Bimler device. Conclusion This study suggests that the patient group subjected to neuromuscular orthodontic treatment had a treatment outcome with more relaxed masticatory muscles and better function ver...

Journal of oral science, 2015

We compared flexural strength (FS) in four resin composites before and after three protocols for ... more We compared flexural strength (FS) in four resin composites before and after three protocols for thermal cycling aging. Four resin composites were evaluated: Enamel Plus Hri, Gradia Direct Posterior, Grandioso, and Grandioso Flow. Sixty specimens (2 × 2 × 25 mm) were fabricated using a split metallic mold and light-cured for 30 s. The specimens were then randomly divided into four groups and tested using one of the following thermal cycling procedures: 1) storage in deionized water for 24 h (control group), 2) 15,000 cycles, 3) 30,000 cycles, and 4) 45,000 cycles. Each thermal cycling procedure was conducted between 5°C and 55°C, with a dwell time of 30 s. All specimens were subjected to a three-point bending test, to determine FS (0.5 mm/min). "Material" and "thermal aging" were significantly associated with FS (P < 0.001). A statistically significant interaction between the two factors was also detected (P < 0.001). In the non-aged groups, nanohybrid comp...

International journal of clinical and experimental medicine, 2014

Patients with cognitive deficit have poor oral health and fewer teeth than cognitive normal elder... more Patients with cognitive deficit have poor oral health and fewer teeth than cognitive normal elderly. The aim of the study was to investigate potential differences in masticatory function between elderly with dementia and those with normal cognitive function. Fifty-five patients (age >61; 82.05 ± 3.53) were enrolled in the study. Twenty-five subjects cognitively normal (10 females/15 males; 81.04 ± 4.89 years), were randomly selected and were assigned to Control Group. Thirty subjects (15 females/15 males; 83.16 ± 6.017 with cognitive impairments were randomly selected from hospitalized patients (Medically Assisted Residences RSA) and were assigned to Test Group. MMSE test, B-ADL and number of teeth were evaluated for each subject. The number of teeth in relation to levels of schooling is not resulted significative. In the cognitively impaired group 26 subjects had fewer than 20 teeth (86.6%); in the cognitively normal group 9 subjects had fewer than 20 teeth (36%). The correlatio...

Annali di stomatologia, 2013

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Minerva stomatologica, 1999

In this work the authors consider TMJ disorders in children, evaluating the epidemiological, etio... more In this work the authors consider TMJ disorders in children, evaluating the epidemiological, etiopathogenetic and diagnostic aspects compared to the TMJ pathology in adults and with reference to recent literature. In order to achieve a better understanding of TMJ disorders in children and to promote an appropriate prevention and therapeutic approach, four questions are raised: 1) What are the signs and the symptoms of TMJ disorders during the growth? 2) What factors are associated with TMJ disorders? 3) What is the prognostic meaning of the signs and the symptoms? 4) What is the importance of TMJ disorders in a protocol which considers treatment needs and priority?

Pathogenesis and Treatment of Periodontitis, 2012

On a planetary scale, Metabolic Syndrome (MetS) is the third cause of inability after malnutritio... more On a planetary scale, Metabolic Syndrome (MetS) is the third cause of inability after malnutrition and nicotinism, even higher than water shortage and sedentariness. In the USA, the prevalence is estimated at over 25% of the population; in Italy, it involves approximately 25% of men and even 27% of women. These are very high figures, corresponding to approximately 14 million affected individuals. The prevalence is alarming and must not be underestimated, particularly in the dental field, where more than one patient out of four sitting in a dentist's chair is affected. The etiology of periodontal disease has not yet been clarified, and recently the idea to consider it as a multifactor pathology has been developed. Cofactors such as the formation of free radicals of oxygen (ROS), oxidative stress, lipid peroxidation, and formation of glycation end-products (AGEs) probably play an important role in the onset of periodontal disease. The AGEs are compounds physiologically produced by the cells. However, they accumulate and cause pro-inflammatory conditions, when the cellular clearance fails, or in hyperglycemic and oxidative states. All these conditions can be clinically summarized as Metabolic Syndrome. The purpose of this literature review is to establish a relationship between two pathologies with very high prevalence: Metabolic Syndrome and Periodontal Disorder. The literature seems to have clarified that MetS involves a pro-oxidation status, which induces AGE formation. AGEs playa very important role in the course and severity of periodontal diseases.

La Pediatria Medica e Chirurgica, 2012

Introduzione: l'amoxicillina è uno degli antibiotici più utilizzati in età pediatrica per il trat... more Introduzione: l'amoxicillina è uno degli antibiotici più utilizzati in età pediatrica per il trattamento delle infezioni dell'alto tratto respiratorio ed in modo particolare per il trattamento dell'otite media, patologia frequente nella prima e seconda infanzia. da alcuni studi emerge che l'utilizzo di amoxicillina durante i primi anni di vita potrebbe essere associato ad una particolare forma di fluorosi dentale le cui lesioni si localizzano principalmente a livello dei primi molari permanenti e, seppure meno frequentemente a livello degli incisivi. gli effetti dell'amoxicillina sembrano essere indipendenti da altri fattori di rischio come assunzione di fluoro, prematurità alla nascita, ipossia, ipocalcemia, esposizione alla diossina, varicella, otite media, febbre alta e potrebbero avere un impatto significativo sulla salute orale per l'ampio uso di questo farmaco in questo periodo della vita. Obiettivo: lo scopo del nostro studio era quello di revisionare l'attuale letteratura riguardo l'associazione tra amoxicillina e fluorosi. Metodi e Risultati: e' stata effettuata una revisione della letteratura nei database PubMed e Cochrane usando le seguenti parole chiave: amoxicillin*, dental fluorosis*, dental enamel* e Mih*. dopo aver selezionato gli studi sono stati inclusi nel-la revisione solo tre articoli rilevanti, pubblicati tra il 1966 e il 2011. Conclusione: la presenza di numerosi problemi metodologici non ci permette di trarre conclusioni basate su evidenza scientifica. Sono necessari ulteriori studi per stabilire un'eventuale relazione tra amoxicillina e fluorosi. Sulla base dei dati attuali potrebbe essere comunque considerato un atteggiamento prudente quello di limitare la prescrizione di questo farmaco per infezioni ricorrenti delle alte vie respiratorie, specialmente per l'otite media, durante i primi due anni di vita, somministrando quando è possibile trattamenti antibiotici alternativi.

PLoS ONE, 2013

Background: Studies have suggested controversial results regarding a possible association between... more Background: Studies have suggested controversial results regarding a possible association between pre-eclampsia (PE) and periodontal disease (PD) and no meta-analysis has been performed to clarify this issue. Methods: A literature search of electronic databases was performed for articles published through March 24, 2013, followed by a manual search of several dental and medical journals. The meta-analysis was conducted according to the recommendations of the Cochrane Collaboration and PRISMA. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed with the x 2-based Cochran Q test and I 2 statistic. The level of significance was set at P,0.05. Results: Fifteen studies were included, including three cohort and 12 case-control studies. A positive association was found between PE and PD (OR 2.17, 95% CI 1.38-3.41, P = 0.0008). However, a high and significant heterogeneity was found (x 2 = 62.42, P,0.00001, I 2 = 75%). In most cases, subgroup analysis had low power to detect significant differences between PE and non-PE groups. Conclusion: Based on the findings of the meta-analysis, PD appears to be a possible risk factor for PE. However, given the important differences in the definitions and diagnoses of PD and PE among the studies, as well as their lack of good methodological quality, future trials are needed to confirm the results of the present meta-analysis.

Nutrition & Metabolism, 2012

Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors that include obesity, impai... more 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 ...

Lasers in Medical Science, 2012

To investigate whether the adjunctive use of diode laser provides additional benefits to scaling ... more To investigate whether the adjunctive use of diode laser provides additional benefits to scaling root planning alone in patients with chronic periodontitis, a metaanalysis was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement and the Cochrane Collaboration. A literature search was performed on seven databases, followed by a manual search. Weighted mean differences and 95 % confidence intervals were calculated for the clinical attachment level, probing depth, and changes in the plaque and gingival indices. The I 2 test was used for interstudy heterogeneity. Visual asymmetry inspection of the funnel plot, Egger's regression test, and the trim-and-fill method were used to investigate publication bias. All outcomes were evaluated at 6 months. No significant differences were observed for any investigated outcome of interest. No evidence of heterogeneity or publication bias was detected. These findings suggested that the use of diode laser as an adjunctive therapy to conventional nonsurgical periodontal therapy did not provide additional clinical benefit. However, given that few studies were included in the analysis, and that three of the five included studies had a high risk of bias, the results should be interpreted with caution. Important issues that remain to be clarified include the influence of smoking on clinical outcomes, the effectiveness of adjunctive diode laser on microbiological outcomes, and the occurrence of adverse events. Future longterm well-designed parallel randomized clinical trials are required to assess the effectiveness of the adjunctive use of diode laser, as well as the appropriate dosimetry and laser settings.

Lasers in Medical Science, 2011

Background: Chronic periodontitis is attributed to oral microbial imbalance and host inflammatory... more Background: Chronic periodontitis is attributed to oral microbial imbalance and host inflammatory reaction.

Lasers in Medical Science, 2013

A meta-analysis was conducted to investigate whether the use of Nd:YAG laser adjunctive to scalin... more A meta-analysis was conducted to investigate whether the use of Nd:YAG laser adjunctive to scaling root planing (SRP) could provide additional benefits compared to SRP alone in patients with chronic periodontitis. The meta-analysis was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) statement and the recommendations of the Cochrane Collaboration. A literature search was performed on seven databases, followed by a manual search. Weighted mean differences and 95 % confidence intervals were calculated for the clinical attachment level (CAL), probing depth (PD), and changes in plaque index (PI) and gingival crevicular fluid (GCF). Inter-study heterogeneity was assessed by the I 2 test, and publication bias was analyzed by the visual inspection of the funnel plot for asymmetry, Egger's regression test, and trim-and-fill method. All outcomes were evaluated from baseline to the end of follow-up. Significant differences in PD and GCF reduction were observed in favor of SRP+Nd:YAG; no significant differences were observed in CAL gain or PI change. The findings of this meta-analysis suggest that use of the Nd:YAG laser as an adjunctive therapy to conventional nonsurgical periodontal therapy could potentially provide additional benefits. However, all included studies were not at low risk of bias, and only three studies were included in the meta-analysis. As a result, the evidence is insufficient to support the effectiveness of adjunctive Nd:YAG to SRP. Future long-term well-designed parallel randomized clinical trials are required to assess the effectiveness of the adjunctive use of Nd:YAG laser. These trials should also include microbiological and adverse events analyses. Keywords Chronic periodontitis. Neodymium yttrium aluminum garnet. Scaling root planing. Non-surgical periodontal treatment. Meta-analysis F. Sgolastra (*) : M. Severino : A.

Journal of Periodontology, 2012

Journal of Periodontal Research, 2013

Metronidazole (MET) has been suggested as an adjunct to scaling and root planing (SRP) in the tre... more Metronidazole (MET) has been suggested as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. However, its clinical effectiveness and effects on periodontal pathogens remain to be defined. The present meta-analysis assessed the scientific evidence concerning the effect of MET adjunctive to SRP as compared to SRP alone. A literature search of electronic databases was performed for articles published through December 16, 2012, followed by a manual search of several dental journals. A meta-analysis was conducted according to recommendations of the Cochrane Collaboration and PRISMA. Weighted mean differences (MDs) and 95% confidence intervals (CIs) were calculated for probing depth reduction, clinical attachment level gain, bleeding on probing index and suppuration. All outcomes were evaluated as changes from baseline to the end of follow-up. Heterogeneity was assessed with the chi-squared-based Cochran Q test and I(2) statistic. The level of significance was set at p < 0.05. After the study selection process, six randomized clinical trials were included in the meta-analysis. The results of the meta-analysis indicated that SRP + MET provided additional benefits when compared to SRP alone in terms of probing depth reduction (MD, 0.18; 95% CI, 0.09-0.28; p < 0.05) and clinical attachment level gain (MD, 0.10; 95% CI, 0.08-0.12; p < 0.05). No evidence of heterogeneity was detected. The meta-analysis results seem to support the effectiveness of adjunctive MET with SRP compared to SRP alone. However, given the low number of included studies and limitations of meta-analysis, future studies are needed to confirm these results.

Journal of Medical Case Reports, 2014

Introduction: We analyzed the etiopathogenetic, clinical, radiographic, and histopathologic aspec... more Introduction: We analyzed the etiopathogenetic, clinical, radiographic, and histopathologic aspects of keratocystic odontogenic tumors, particularly in association with dental anomalies of number, with the aim of providing useful information for their correct diagnosis, treatment, and prognosis within a multidisciplinary approach. Case presentation: A 14-year-old Caucasian girl presented for observation of bilateral agenesis of the upper incisors, which was diagnosed by orthopantomography. Approximately one year after starting orthodontic treatment, the patient went to the emergency department because of a phlegmonous tumefaction of the lateroposterior upper left maxillary region. Diagnostic orthopantomography and axial computed tomography scan results of the facial skeleton revealed a large lesion occupying the left maxillary sinus, rhizolysis of dental elements 26 and 27, and dislocation of dental element 28. The lesion and infected sinus mucosa were removed through surgical antral-cystectomy with the Caldwell-Luc approach. Histological examination of the lesion confirmed the suspected diagnosis of keratocystic odontogenic tumor. The 12-month follow-up orthopantomography and computed tomography scan results showed good trabecular bone formation in the lesion area. The 24-month follow-up results showed optimal healing in the area of the lesion, positive pulp vitality tests for teeth 26 and 27, and good periodontal tissue healing, as verified through periodontal probing. Conclusions: Combined with our observations from a careful review of the literature, the results of the case study suggest that keratocystic odontogenic tumor and dental agenesis probably do not develop through a common genetic cause. More likely, they are caused by related environmental factors. Management of this case required the multidisciplinary collaboration of different specializations and careful planning to devise a correct therapeutic protocol and reach a favorable prognosis.

Journal of Medical Case Reports, 2013

Introduction: Polyarteritis nodosa is a rare disease resulting from blood vessel inflammation (va... more Introduction: Polyarteritis nodosa is a rare disease resulting from blood vessel inflammation (vasculitis), causing damage to organ systems and featuring an extended range of possible symptoms. The cause of polyarteritis nodosa is unknown. Case presentation: In the present report we describe the presentation and treatment of polyarteritis nodosa involving the hard palate in an 88-year-old Caucasian woman. Clinical and laboratory analyses showed stenosis of the greater palatine artery, which led to necrosis of the affected area. At one year after pharmacological treatment, the lesion has regressed completely. Conclusions: We successfully treated a case of polyarteritis nodosa via a pharmacological approach, which we describe here.