The field of immediate loading implantology has grown rapidly, offering quicker solutions for prosthetic rehabilitation. However, the complexity of this technique raises significant medico-legal concerns regarding patient safety, treatment planning, and professional liability. These issues are particularly relevant in elective procedures where failure could lead to litigation. A comprehensive review of current literature, including clinical studies, legal rulings, and malpractice claims, was conducted to assess the legal implications of immediate loading implantology. The analysis focused on professional liability, patient consent, and complications during treatment. The evidence indicates that a high standard of care, including detailed preoperative planning, risk assessment, and clear patient communication, is essential in minimizing legal risks. Malpractice claims often arise from inadequate patient information or failure to follow established protocols. Proper documentation of informed consent and adherence to evidence-based dentistry (EBD) guidelines are crucial to protect both patients and practitioners. Immediate loading implantology offers numerous benefits, but it requires meticulous planning and patient management to avoid medico-legal issues. Ensuring comprehensive patient consent and following evidence-based practices are key to reducing professional liability and improving outcomes. Further studies should explore standardized protocols for reducing complications and legal disputes in implantology.

Traumatic brain injury (TBI) represents a major public health problem, being a leading cause of disability and mortality among young people in developed countries. Head trauma occurs across all age groups, each experiencing consistently high rates of mortality and disability. This review aims to present an overview of TBI epidemiology and its socioeconomic impact, alongside data valuable for prevention, clinical management, and research efforts. Methods: A narrative review of TBI was performed with a particular focus on forensic pathology and public health. In fact, this review highlighted the economic and epidemiological aspects of TBI, as well as autopsy, histology, immunohistochemistry, and miRNA. Results: These data, together with immunohistochemical markers, are crucial for histopathological diagnosis and to determine the timing of injury onset, a fundamental aspect in forensic pathology practice. There is compelling evidence that brain injury biomarkers may enhance predictive models for clinical and prognostic outcomes. By clarifying the cause of death and providing details on survival time after trauma, forensic tools offer valuable information to improve the clinical management of TBI and guide preventive interventions. Conclusions: TBI is one of the most common causes of death today, with high costs for health care spending. Knowing the different mechanisms of TBI, reduces health care costs and helps improve prognosis.

The term artificial intelligence (AI) was coined in the 1950s and it has successfully made its way into different fields of medicine. Forensic sciences and AI are increasingly intersecting fields that hold tremendous potential for solving complex criminal investigations. Considering the great evolution in the technologies applied to forensic genetics, this literature review aims to explore the existing body of research that investigates the application of AI in the field of forensic genetics. Scopus and Web of Science were searched: after an accurate evaluation, 12 articles were included in the present systematic review. The application of AI in the field of forensic genetics has predominantly focused on two aspects. Firstly, several studies have investigated the use of AI in haplogroup analysis to enhance and expedite the classification process of DNA samples. Secondly, other research groups have utilized AI to analyze short tandem repeat (STR) profiles, thereby minimizing the risk of misinterpretation. While AI has proven to be highly useful in forensic genetics, further improvements are needed before using these applications in real cases. The main challenge lies in the communication gap between forensic experts: as AI continues to advance, the collaboration between forensic sciences and AI presents immense potential for transforming investigative practices, enabling quicker and more precise case resolutions.

Periodontitis is a complex disease associated with dysbiotic biofilms, characterized by loss of clinical attachment, periodontal pocketing and bleeding on probing. Between 1990 and 2019, it was calculated that there were approximately 1.1 billion individuals affected by severe forms of periodontitis worldwide. In Italy, recent epidemiological studies have shown a prevalence of severe periodontitis up to 40.78%, with an increased probability of developing the disease in smokers and in subjects under 50 years of age. In response to these alarming data, the scientific community proposed a more modern Classification of periodontal and peri -implant diseases and conditions, to allow a precise diagnosis, without neglecting even mild forms of periodontitis, identifying, through Staging process, 4 Stages of increasing severity and therapeutic complexity, and then introducing consequent guidelines to organize the anticipated therapies. In particular, Stage III and IV periodontitis, due to the severe tissue destruction and need for complex treatment, represent not only a serious threat to the patient's health and quality of life, exposing him to significant biological and economic costs, but also a demanding challenge for the dental team, obliged in the most serious cases to concert a complex multidisciplinary therapeutic approach. The present Dossier deals with some aspects of Stage IV periodontitis: epidemiology and related impact on the patient's systemic health and quality of life, the economic -financial implications, the necessary multidisciplinary therapeutic approach, thus summarizing the cornerstones of the guidelines recently published by the Euro pean Federation of Periodontology with the aim of explaining the appropriate treatment sequence. Conclusions underline the absolute need to institutionalize these guidelines because the increasing prevalence of severe periodontitis requires a prompt response aimed to standardise a predictable treatment.

Ethical, legal and social implications (ELSIs) in forensic genetics investigations (FGIs) also involve conducting a careful assessment of the potential benefits and responsible use of genetic information. FGIs have become an invaluable tool in solving crimes and identifying individuals in various legal and investigative contexts. Moreover, forensic geneticists are called on to manage a series of controversial aspects during the daily practice of forensic investigation, including informed consent, cases of unintended genetic findings, the proband’s privacy, post-mortem sample collection, misinterpretation of results, and the correct management of genetic databases. In this scenario, this article aims to discuss the main aspects of ELSIs regarding FGIs, providing an opportunity to delve into the complexities and nuances of ethical decision-making in the context of FGIs, considering that justice should be served while upholding the highest ethical standards. To date, ELSIs in FGIs involve respecting human dignity, safeguarding privacy, ensuring justice, promoting social solidarity, and carefully weighing up risks and benefits. By adhering to these principles, the forensic geneticist can advance criminal justice while upholding individual rights and privacy. In this way, the development of clear guidelines and protocols can help navigate this ethical dilemma and ensure that FGIs are conducted with integrity, transparency, and respect for individual autonomy.

This paper is a scientific contribution on basic safety standards, related to protection against hazards arising from exposure to ionizing radiation: medico-legal issues resulting from the research of the University of Campania and the study conducted by the Italian Society of Medical and Interventional Radiology are reported.

Spinal trauma is an important cause of disability worldwide. Injury to the cervical spine (CS) occurs frequently after major trauma. 5–10

This paper is a scientific contribution on basic safety standards, related to protection against hazards arising from exposure to ionizing radiation: medico-legal issues resulting from the research of the University of Campania and the study conducted by the Italian Society of Medical and Interventional Radiology are reported.

Medical progress and the consequent gradual ageing of the population increase the number of people in Europe who require continuous care, as they suffer from chronic diseases or senility. This demand is disproportionate if compared to the economic resources of health systems and is, therefore, heavily supported by the activity of the so-called “informal caregivers”. With our article we propose to depict the current scenario in Italy, dwelling on the safeguards, to date, aimed at informal caregivers, which are insufficient to correct the criticalities associated with the burdensome assistance provided by such figures. Such critical issues result in a real risk for the health of informal caregivers and their loved ones and require urgent action by the health system. If it is true that health welfare is not able to protect the increasing number of people who are not self-sufficient, it is necessary to invest at least on specific measures to preserve the health and skills of those who are at the forefront of this hidden welfare. (www.actabiomedica.it)

Background: Cervical spine manipulations (CSM) have been performed for centuries and are a widely practiced intervention to manage cervical spine musculoskeletal disorders. We aimed to perform an overview of the literature concerning the effects and the adverse events of CSM in the Physical and Rehabilitation Medicine (PRM) field with a forensic medicine perspective. Methods: A search in the scientific literature (PubMed, Google Scholar, PEDro and Cochrane) was carried out from inception until October 2020. Results: Fourteen articles were included in this narrative summary. The possible development of side effects requires a careful mandatory balance of benefits and risks even when there is an indication for this approach. Moreover, a qualified professional is essential to perform CSM–a non-invasive therapeutic procedure that can be potentially harmful. Conclusions: In conclusion, it is essential to perform the diagnosis, to treat, and to manage complications within the PRM field, both for the reduction of malpractice claims and, most importantly, for the safety of the patient.

Self-contained underwater breathing apparatus (SCUBA) diving deaths have always been a challenge for forensic pathologists. Post-mortem computer tomography (PMCT) allows intracorporeal gas visualization, contributing to identify the cases in which the cause of death is arterial gas embolism (AGE). However, in the literature, it is indicated to perform the radiological examination within 24 h after death. In this retrospective study, 32 cases of death who had undergone PMCT 24–48 h after death/corpse finding between January 2011 and March 2021 were analyzed, including ten cases of SCUBA divers who died of AGE. All cases’ radiological images were reviewed to localize the intracorporeal gas distribution alongside other findings that are usually related to SCUBA diving death. A semi-quantitative evaluation was also performed. Most of the divers showed gas within the left heart and the arteries. In addition, the semi-quantitative evaluation revealed that the divers presented a higher mean amount of intraarterial gas compared to the fresh corpses. On the other hand, the putrefied corpses presented gas within the portal system and generalized subcutaneous emphysema with higher frequency and quantity than the divers and fresh corpses. Our cases suggested that the PMCT, even when performed 24–48 h after death, remains a valuable tool to diagnose AGE in cases of SCUBA diving deaths. In addition, with the limit of the small sample size, our data showed that at least a medium quantity of intraarterial gas, when not associated with a high amount of gas within the portal system and subcutaneous emphysema, could be considered a diagnostic criterion of AGE.

The emphasis on timely coronary reperfusion in the setting of ST-segment elevation Myocardial Infarction (STEMI) comes from older studies suggesting a significant reduction in mortality among patients treated with fibrinolytic therapy during the first hours after onset of symptoms and a progressive increase in fatal events in those presenting later [...]

Introduction: The number of people with migrant status living in Europe is proliferating. Most of the refugees in Italy come from war zones, and many of them denounce having been victims of persecutory acts in their country of origin. Highly cultured migrant populations have shown better results and oral health behaviour than those who were poorly cultured. The PROTECT project aimed to build a network for the early management of head and neck pathologies among refugees and migrants, promoting the dissemination of correct information about the prevention and treatment of these pathologies. Materials and methods: A national cross-sectional study among the refugees and migrant population in the Lazio region, Italy, from February 2018 to September 2021 was performed. The oral health of 3023 participants was investigated within a network of 56 reception centres and cultural associations. Data collected via an oral health survey questionnaire gathered information on participants’ demographic factors, migration status and dental behaviours and clinical examinations of the participants with the help of mouth mirrors, periodontal probes and artificial light. Results: The mean age was 31.6 ± 13.1, and among all the subjects, 2058 were male (68.1%) and 965 were women (41.9%). Most participants were born in Nigeria, followed by Bangladesh, Pakistan, Somalia, Mali and Senegal. The overall oral pain prevalence was 48.2%. The prevalence of patients claiming poor oral hygiene was 32.4%; 36.2% of the subjects consumed high amounts of sugar; and 26.7% saw their dentist for a check-up in the last year. At the clinical examination, 68.9% of patients had caries experience (considering decay of deciduous teeth, and caries of permanent teeth and teeth with fillings), with 32.2% showing pulpal involvement. Low levels of oral hygiene were also found at the clinical examination, with 46.5% of patients presenting plaque and calculus. The trend of the DMFT index was found to be 5.41. Good periodontal health (CPI = 0) was present in approximately 33.5% of patients. The CPI = 1 index reported bleeding from gingivitis in 37% of patients; tartar was found in 27% of patients (CPI = 2). The percentage of patients with CPI = 3 was 3.6%. Just over half (52.2%) of the migrants examined had malocclusion, and only 0.7% had a malocclusion in treatment. Conclusions: The goal to be achieved is to develop education and prevention programs for head–neck diseases, and perhaps even more. The first step towards this goal can be removing the obstacles migrants encounter in accessing health care.

Musculoskeletal ultrasound involves the study of many superficial targets, especially in the hands, wrists, and feet. Many of these areas are within the first 3 cm of the skin surface and are ideal targets for ultra-high-frequency ultrasound. The high spatial resolution and the superb image quality achievable allow foreseeing a wider use of this novel technique, which has the potential to bring innovation to diagnostic imaging.

Periodontitis or periodontal disease is a chronic inflammatory destruction of tissue surrounding the teeth caused by specific an-aerobic pathogens contained in dental plaque organized on the tooth surface. Its progression leads to bone loss and it is the pri-mary cause of edentulism among adults. Over 40% of adults in in-dustrialized countries show clinical signs of periodontal disease, and severe form of disease are described in more than 10% of population. A growing body of evidence has also demonstrated a significant association between systemic inflammation due to periodontal disease and increased risk of systemic comorbidities, in-cluding cardiovascular diseases and diabetes. A number of surveys conducted among the Italian population from 2016 to 2020 have found that, al-though awareness of periodontitis has increased in recent years, the discrepancy between patients with periodontal problems and the actual diagnoses and therapies of this conditions is still high. There is dramatic need of periodontal treatment in the population and very often this disease is not prop-erly diagnosed and/or treated, with aesthetic, functional and psy-chological problems for patients. Treatment of advanced form of periodontitis very often require complex prosthetic treatment with dental implant application, with significant cost for patients. The present Dossier highlights the current concepts of periodontitis and describes its social impact in the Italian population. Further-more, the adoption of clinical guidelines focused on evidence based medicine is strongly rec-ommended in order to improve patient safety in diagnosis and treatment of periodontitis and to reduce the socio-econom-ic-health impact of this disease.

Periodontitis or periodontal disease is a chronic inflammatory destruction of tissue surrounding the teeth caused by specific anaerobic pathogens contained in dental plaque organized on the tooth surface. Its progression leads to bone loss and it is the primary cause of edentulism among adults. Over 40% of adults in industrialized countries show clinical signs of periodontal disease, and severe form of disease are described in more than 10% of population. A growing body of evidence has also demonstrated a significant association between systemic inflammation due to periodontal disease and increased risk of systemic comorbidities, including cardiovascular diseases and diabetes.A number of surveys conducted among the Italian population from 2016 to 2020 have found that, although awareness of periodontitis has increased in recent years, the discrepancy between patients with periodontal problems and the actual diagnoses and therapies of this conditions is still high. There is dramatic need of periodontal treatment in the population and very often this disease is not properly diagnosed and/or treated, with aesthetic, functional and psychological problems for patients. Treatment of advanced form of periodontitis very often require complex prosthetic treatment with dental implant application, with significant cost for patients.The present Dossier highlights the current concepts of periodontitis and describes its social impact in the Italian population. Furthermore, the adoption of clinical guidelines focused on evidence based medicine is strongly recommended in order to improve patient safety in diagnosis and treatment of periodontitis and to reduce the socio-economic-health impact of this disease.

Enactment of law n. 24, 8th March 2017, (so-called "Gelli-Bianco" law), has given rise to substantial innovations in the realm of medical liability: on the one hand, an attempt has been made towards redefining the boundaries of professional liability, for the purpose of curbing the use of "defensive medicine"; on the other hand, there is the effort to delineate good medical conduct by means of "institutionalization" and a greater degree of consistency of guidelines and good clinical health care practices. There are, however, thought-provoking cues concerning the relationship between the two concepts, which can be sensibly developed, even in light of international scientific literature. This paper has been designed to critically analyze both principles and their relation within the framework of the newly enacted piece of legislation denominated "Gelli-Bianco", in light of the Italian jurisprudence while at the same time, searching for common ground in international law, particularly Anglo-Saxon countries, aiming to clarify the lawmakers' ultimate goal as well as the law's practical scope of application.

The authors aim to put into context the recently passed piece of Italian legislation known as "Gelli-Bianco", in an effort to highlight the root causes and the underlying motives that led to its enactment. The new law's innovative aspects are elaborated on, in terms of treatment safety and civil liability of health care professional and providers. The report's main purpose is to shed light on the alleged benefits, against the backdrop of the worrisome data from recent years, gathered from case-based analysis of adverse events and related costs, without overlooking the likely challenges associated with innovations that are meant to affect complex systems with conflicting interests at play.