Special needs patients: the University of Milano Bicocca guidelines in management of patients with special needs in pediatric, adult and geriatric age for dentistry A shift in the conceptualization of patients with special needs in dentistry outlining a new comprehensive and exhaustive management protocol of treatment

The strength and innovative challenge of a National Health System is measured, among all parameters, also by its capacity to take care of that portion of the population that presents greater socio-health vulnerabilities. In fact, the direction of national and international socio-political demands, in collective health matters, is precisely that of identifying the volume of the population concerned, not only in epidemiological terms to quantify the necessary services, but above all in terms of definition. The aim of this article is to provide an analysis of the evolution of the definition of vulnerable, fragile and disabled patient, up to the present day, and to present the clinical protocol for the management of the patient with special needs, elaborated and adopted within the IRCCS San Gerardo dei Tintori Dental Clinic in Monza (Italy), in collaboration with the School of Specialization in Oral Surgery of the University of Milan-Bicocca.