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Aim: To evaluate and compare the maxillary arch expansion obtained in growing patients treated with Class III early treatment protocol (the modified SEC III protocol), or rapid maxillary expansion (RME). Methods: This retrospective observational study included patients in the mixed dentition with maxillary constriction and/ or dental crowding. The first group consisted of 30 patients (11 males and 19 females, mean age 9.4 ±1.7 years) with dentoskeletal Class III malocclusion treated with the modified SEC III protocol. The second group of 30 patients (14 males and 16 females, mean age 9.3 ±1.5 years) with Class I or II malocclusion was treated with a Hyrax-type expander applied to bands on the first upper molars. For each subject, initial (T0) and post expansion (T1) digital dental casts were collected. The intermolar and intercanine widths, the arch lengths at both cusp and gingival levels, the anteroposterior length and the palatal depth were measured at T0 and T1. Results: At T1 there were statistically significant differences for 3-3 occlusal (OC) (P < 0.009), arch-length OC (P

The aim of the present prospective study was to evaluate the effectiveness of elastodontic appliance (EAs) in the treatment of subjects presenting Class II sagittal discrepancy in mixed dentition, and to evaluate palatal morphological development during treatment.The study group, composed of 19 subjects, received treatment with EA for 1 year. The control group consisted of 17 untreated subjects.age between 6 and 11 years, mixed deciduous dentition and skeletal and/or dental Class II malocclusion.previous orthodontic therapy, systemic diseases and signs of temporal dysfunction. Skeletal and dentoalveolar parameters were compared between T0 and T1. A 3D imaging technology was used to compare palatal morphology obtained from intra-oral digital scans between T0 (pre-treatment) and T1 (post-treatment).EAs can successfully mitigate early signs of malocclusion in Class II subjects as well as contribute to the harmonious development of the palate.

AirwayCentric approach to prevention of dentofacial disorders. The correct development of functions is important for the prevention of dentofacial disorders from the first days of life. The first and foremost function, to which all others are adapting, is nasal breathing. The AirwayCentric® method focuses on nasal breathing during early development and throughout childhood to promote: Neurobehavioural development and the brain, development of the craniofacial and respiratory complex, correct dental occlusion, proper and restful sleep and to improve performance and life overall. By working at the same time on orofacial functions and structures, many dentofacial disorders can be prevented.

Culture, industrialisation and the shrinking human face: Why is it important? Over the past 300,000 years, not only has the way we consume food from birth through our lifetime changed, there have also been changes related to the methods of food preparation, availability, processing, and storage. These diet-related factors, along with other epigenetic factors, have led to a widespread increase in orofacial myofunctional disorders (OMDs) and resultant human malocclusion phenotypes (HMPs) worldwide. Currently there is an increasing need for resolution of HMPs in early childhood and associated OMDs. This review will include reports of cases and describe the nature of the problem and strategies for effective solutions.

Aim A systematic literature review on oral and craniofacial manifestations of Ellis-Van Creveld syndrome was performed. Methods From 2 databases were selected 74 articles using as key words "Ellis-Van Creveld" AND "Oral" OR "Craniofacial" OR "Dental" OR "Malocclusion". Prisma protocol was used to create an eligible list for the screening. Data were collected in a table to compare the clinical aspects found. Results From the first research emerged 350 articles, and only 72 of them were selected. Conclusion Through this analysis oral and cranio-facial manifestations of Ellis-Van Creveld syndrome were pointed out. Management of Ellis-Van Creveld syndrome requires a multidisciplinary approach involving different clinicians; dentists play an important role in early diagnosis and treatment of the patients.

SEC III protocol: Early treatment of dentoskeletal Class III malocclusions. The early treatment of dentoskeletal Class III malocclusion is one of the more challenging situations for orthodontists, mainly for the uncertainty of stable long-term results due to the interaction of both environmental and genetic aetiological factors. Several interceptive protocols have been proposed during the past decades. The SEC III protocol includes two occlusal acrylic Splints combined with Class III elastics and chin cup. The protocol was proposed to facilitate Class III dentoskeletal correction by eliminating the intercuspation and the tongue thrust with clockwise mandibular rotation and minimal dentoalveolar compensation. The main difference with all the other appliances is the vertical control, which is crucial in difficult cases such as hyperdivergent Class III malocclusions.

The purpose of this work was to present a review of the literature concerning obstructive sleep apnea syndrome, and the role of the dentist in this pathology, both to identify elements useful for a good diagnosis and to apply the available therapeutic strategies. In literature there is no unanimous opinion on the treatment of OSAS. The multidisciplinary approach is necessary, creating teams made up of dentists, otolaryngologists and medical experts in sleep disorders, in order to develop a cooperation-based treatment plan for the disease. In this review, the importance of early diagnosis, orthodontic therapy in order to restore normal function is underlined, since OSAS is linked to a high risk of hypertension, cardiovascular diseases, daytime sleepiness, domestic and work accidents, with consequent deterioration of the quality of life.

This review focuses on Computer-Controlled Local Anaesthesia Delivery systems (CCLAD), in comparison with conventional carpule anaesthesia in means of pain and anxiety.Medline, Embase, Web of Science and Cochrane Database for Systematic Reviews were searched up to August 2018. Only cross-over split-mouth design studies aimed to clinically compare CCLAD with a conventional carpule anaesthesia are included. Data about pain and anxiety associated with anaesthesia were sought. The authors performed meta-analysis where appropriate.A total of 20 studies are included in the systematic review (n = 973 subjects). Quantitative synthesis (conducted on VAS scores from 8 studies) shows that pain intensity is over 9 points lower in CCLAD than in conventional anaesthesia on a scale from 0 to 100 (95% confidence interval, ?12.90 to ?5,53; P.001). The systematic review showed no differences between the two techniques according to the physiological parameters of pain (heart rate or blood pressure), and the data about anxiety are inconsistent.CCLAD results in significantly slightly less pain perception with respect to conventional injection and is a promising device to help patients. The literature needs to be expanded, mostly regarding anxiety.

Background: In this project the authors use a narrative medicine (NM) approach to assess the promotion of trust in the relationship between physicians and their asthma patients. Methods: Following a NM educational course for physicians, a research was carried out in which at least 5 written narratives (parallel charts) for each participating physician were collected and qualitatively analysed according to Bury’s classification and the Grounded Theory. Results: The results of this study were of speculative and clinical interest. In particular, 66 participants wrote 314 narratives (246 on adult and 68 on paediatric patients). As a result of applying the NM approach, when the relationships remained problematic, many physicians wrote with a moral style about their adult (67%), and paediatric patients (33%) - especially in cases of asthmatic children’s or adolescents’ overprotective or absent families (40%) -. On the contrary, physicians who were able to listen to their patients with empathy (35%) made more shared decisions with patients, even with those they initially had a bad relationship. The used words of welcome, interest and acceptance were promoting patients’ trust that lead to restoring their activities in 45% of cases, according to physicians self-reporting. Conclusions: These approaches of NM are useful in daily clinical practice, with the goal of improving the quality of life (QOL) of patients with severe asthma, even in cases in which the doctor-patient relationship isn’t initially good.

Both rapid and slow maxillary expansion protocols may produce different effects on the palatal suture, on the periodontium, and on alveolar anatomy such as lateral flexion of the alveolar processes, root resorption, bone fenestration and the anchorage teeth can show different degrees of inclination and dislocation. In order to reduce these side effects, maxillary expansion devices anchored to deciduous teeth or miniscrew-supported appliances should beconsidered.

Dentinogenesis imperfecta (DI) is an autosomal dominant genetic disease that affects both deciduous and permanent teeth, with an incidence of 1 out of 6,000 to 1 out of 8,000. Teeth affected with DI type II present bulbous crowns, short and constricted roots, marked cervical constriction, translucent enamel and amber dentin. Also, they present a partial or total obliteration of pulp space, due to continuous dentin production. SEM analysis has shown an undulated dentin-enamel junction (DEJ) with irregularities and locally wide spaces between the two structures instead of a strict junction and a regular linear surface. Treatment options for patients affected by DI-II are intended to protect and restore function and aesthetics of both posterior and anterior teeth. In literature are presented many different therapies, but mainly centered on cemented prosthetic restorations instead of adhesive restorative procedures. We present in this paper a DI-II case successfully treated in 2005 with extensive adhesive rehabilitation.The 13 years follow-up proves the reliability of adhesion to dentine and enamel for indirect adhesive restorations even on this kind of anomalous substrates.

Ai fini della radioprotezione delle attivita sperimentali svolte utilizzando fasci pulsati di neutroni a 14 MeV prodotti da un generatore commerciale del tipo D-T si e condotta l'analisi dei rischi derivanti dalle radiazioni ionizzanti: una prima valutazione teorica della dose del fascio emesso per stimare l'esposizione degli operatori e stata e:fef ttuata utilizzando i1 coefficiente di dose eflicace per fluenza neutronica a 14 MeV dell'ICRP 2010 e i dati forniti da1 costruttore del generatore. La valutazione ha consentito di definire, seppure in via approssimata, l'entita delle schermature necessarie in considerazione dei carichi di lavoro e dell'occupazione delle aree limitrofe. Per effettuare una puntuale valutazione del rischio ed ottimizzare la radioprotezione e stata inoltre eseguita una determinazione della distribuzione spaziale dei neutroni emessi da1 generatore mediante i1 codice MCNP, Monte Carlo N-Particle code, sviluppato presso i1 Laboratorio Nazionale di Los Alamos, codice di trasporto per neutroni, fotoni ed elettroni che utilizza i1 metodo Monte Carlo. Le analisi effettuate hanno consentito di validare la sicurezza dell'installazione e sono alla base della definizione delle procedure di esercizio e intervento che fanno parte del sistema di sorveglianza fisica.

Histologic and clinical studies confirm that laser-microtextured implant collars favor the attachment of connective fibers and reduce probing depth and periimplant bone loss when compared with machined collars. This prospective study aimed at assessing the alveolar dimensional changes after immediate placement of a transmucosal implant with a Laser-Lok microtextured collar associated with bone regenerative procedures. Thirteen implants were placed immediately into single-rooted extraction sockets. Peri-implant defects were treated with bovinederived xenografts and resorbable collagen membranes. At 6-month surgical reentry, the Laser-Lok microtextured collar provided more favorable conditions for the attachment of hard and soft tissues and reduced the alveolar bone loss.

Whether Phobos is a captured asteroid or it formed in situ around Mars, is still an outstanding question within the scientific community. The proposed Japanese Mars Moon eXploration (MMX) sample return mission has the chief scientific objective to solve this conundrum, reaching Phobos in early 2020s and returning Phobos samples to Earth few years later. Nonetheless, well before surface samples are returned to Earth, there are important spectral datasets that can be mined in order to constrain Phobos' surface properties and address implications regarding Phobos' origin. One of these is the MRO-CRISM multispectral observations of Phobos. The MRO-CRISM visible and infrared observations (0.4-2.5 micron) are here corrected for incidence and emission angles of the observation. Unlike previous studies of the MRO-CRISM data that selected specific regions for analyses, we apply a statistical technique that identifies different clusters based on a K-means partitioning algorithm. Selecting specific wavelength ranges of Phobos' reflectance spectra permits identification of possible mineralogical compounds and the spatial distribution of these on the surface of Phobos. This work paves the way to a deeper analysis of the available dataset regarding Phobos, potentially identifying regions of interest on the surface of Phobos that may warrant more detailed investigation by the MXX mission as potential sampling areas. Acknowledgments: M. Pajola was supported for this research by an appointment to the NASA Postdoctoral Program at the Ames Research Center administered by USRA.

To evaluate the causes of Early Childhood Caries.A statistical comparison of two groups of patients, aged between 3 and 6, and their parents, in the 3-year period 2013-2015 was performed. Two groups of patients were selected: 40 children with early childhood caries (ECC group) and 40 children with no decay (controls). Parents were asked to fill out a questionnaire on food habits, oral hygiene habits, fluoride prophylaxis and family history of caries. A dental visit of children and parents was performed (collection of dmft and DMFT index). The saliva features of the two groups of children (concentration of Streptococcus mutans, pH of the oral cavity and buffer capability of stimulated saliva) were examined by means of salivary tests. The distribution of the population was analysed and parametric and non-parametric tests for continuous and non-continuous variables, were used when appropriate. The statistical significance was set at p0.005.The average age, gender and BMI index of children of the two groups was similar. The difference between the two groups is statistically significant for pH (p=0.000) and buffer capability (p=0.001). The DMFT index in the group of mothers of ECC children is higher compared to the mothers of controls (p=0.004). The comparison among the means, for the parameters connected to the consumption of fruit juice, tea, soft drinks, candies, use of pacifier dipped in sugar or honey and the length (in months) of consumption of candies show statistically significant differences (p0.05). The pH is higher in those children (24) who never consumed fruit juice, tea, soft drinks before the information received (p0.05).Children developing Early Childhood Caries have a diet characterised by high free sugars intake. Diet and, in particular, the consumption of drinks containing free sugars is the most important factor in determining the onset of ECC, being able to affect the oral environment and, in particular, saliva. There is a relationship between maternal and child's oral health, with a DMFT higher in mothers of ECC subjects than in controls' mothers.

Agenesis of mandibular incisors can lead to compromised dental and facial aesthetics and therefore requires appropriate treatment. When retained primary incisors are associated to this condition, a medium-term restoration may be provided before any definitive treatment to provide aesthetic relief to the young patient.The aim of this paper is to discuss the aesthetic management of a case with bilateral congenital agenesis of permanent incisors and retained primary incisors, which were successfully treated with direct composite restorations.This appears a viable technique that restores function and aesthetics with a very conservative approach.

The roles of nitric oxide (NO) synthase (NOS) enzyme in pathological mechanisms of the oral cavity are still incompletely understood. The aim of this study was to investigate the expression of the endothelial, neuronal and inducible isoforms of NOS (eNOS, nNOS and iNOS) in oral lichen planus (OLP) development in humans. OLP and healthy oral mucosa biopsies were taken for mRNA and protein analysis of NOS isoenzymes by RT-PCR, western blot and immunohistochemistry. The mRNA and protein levels of eNOS and nNOS were present in all samples, with a significant increase only for eNOS in OLP. The normal oral mucosa exhibited only small amounts of iNOS mRNA and protein, while it showed a significant rise in OLP samples. These results were confirmed by immunohistochemical analysis. Our findings suggest that NO produced by increased eNOS and iNOS expression may have circulatory and immune functions in the development of OLP. The roles of nitric oxide (NO) synthase (NOS) enzyme in pathological mechanisms of the oral cavity are still incompletely understood. The aim of this study was to investigate the expression of the endothelial, neuronal and inducible isoforms of NOS (eNOS, nNOS and iNOS) in oral lichen planus (OLP) development in humans. OLP and healthy oral mucosa biopsies were taken for mRNA and protein analysis of NOS isoenzymes by RT-PCR, western blot and immunohistochemistry. The mRNA and protein levels of eNOS and nNOS were present in all samples, with a significant increase only for eNOS in OLP. The normal oral mucosa exhibited only small amounts of iNOS mRNA and protein, while it showed a significant rise in OLP samples. These results were confirmed by immunohistochemical analysis. Our findings suggest that NO produced by increased eNOS and iNOS expression may have circulatory and immune functions in the development of OLP

Prolidase Deficiency (PD) is a rare hereditary disease consisting in developmental delay, mental retardation, facial dysmorphism, splenomegaly, recurrent pulmonary infections and skin lesions.The present study reports a case of PD treated in the Paediatric Section of the Department of Dentistry and Surgery at the University of Bari. A special diagnostic and clinical approach to the patient was useful to improve his quality of life and identify some new aspects of this systemic disease. In particular, clinical features never described before are reported: low hair line, decreased osteotendinous reflexes, long upper lip, microrhinia, dentoskeletal Class III, dental age (Proffit) older than chronological age, fusion of 2nd and 3rd cervical vertebrae, incomplete atlanto-occipital fusion.

This paper represents the outcome of the meetings of the Committee composed by Pedodontists (SIOI - Italian Society of Paediatric Dentistry) and Paediatricians (FIMP - Italian Association of Paediatricians) with the aim to share an evidence- based common approach in caries prevention during childhood and adolescence. The most important topic was an update on fluoride administration methods in order to minimise the risk of fluorosis and maximise its caries-preventive effect.The conclusions of this work are exposed in a synoptic table.

To assess the microbial level of Streptococcus Mutans and Lactobacillus spp. during rapid palatal expansion, and compare the data with untreated control patients.Thirty patients aged between 6-9 years were enrolled in this study (15 males and 15 females). The patients were divided into three groups: 10 patients were treated with rapid palatal expander (RPE) (Test Group 1), 10 patients were treated with Mc Namara expander, and 10 patients were enrolled in the control untreated group. Whole stimulated saliva was collected from each patient at three time points: before initiation of expansion therapy (baseline at T0), after 3 months (T1), after initiation of treatment, and after 6 months from T0 (T2). The protocol of rapid palatal expansion for the two groups was as follows: at placement of the expander 4 activations were performed by the orthodontist (1 mm expansion), followed by 4 activations per day by the parents (two in the morning and two in the evening, 1 mm per day total) to be repeated for 7 days.Statistics: In this study a different trend in the microbial colonisation for the two treated groups was observed. In the Test Group 1, in which patients were treated with the RPE, there was a significant difference between Strp T0 T1 and between Strp T0 and T2 (p0.05). There was also a significant difference between LAC T1 T0 and LAC T2 and T0 (p0.05). In the Test Group 2, treated with McNamara expanders, it was found was a significant difference between LAC T2 T0 and LAC T1 T0. In the same group it was also found a significant difference between Strp T2 T0; T1 T0; T1 T2 (p0.05).The level of the various species of bacteria changes during rapid palatal expansion, and this seems to depend on the type of orthodontic expander. During rapid palatal expansion treatment it is also advisable a periodical microbial monitoring using in-office bacteria tests.

This report describes the scientific aims and potentials as well as the preliminary technical design of IRIDE, an innovative tool for multi-disciplinary investigations in a wide field of scientific, technological and industrial applications. IRIDE will be a high intensity 'particle factory', based on a combination of a high duty cycle radio-frequency superconducting electron linac and of high energy lasers. Conceived to provide unique research possibilities for particle physics, for condensed matter physics, chemistry and material science, for structural biology and industrial applications, IRIDE will open completely new research possibilities and advance our knowledge in many branches of science and technology. IRIDE will contribute to open new avenues of discoveries and to address most important riddles: What does matter consist of? What is the structure of proteins that have a fundamental role in life processes? What can we learn from protein structure to improve the treatment of diseases and to design more efficient drugs? But also how does an electronic chip behave under the effect of radiations? How can the heat flow in a large heat exchanger be optimized? The scientific potential of IRIDE is far reaching and justifies the construction of such a large facility in Italy in synergy with the national research institutes and companies and in the framework of the European and international research. It will impact also on R&D work for ILC, FEL, and will be complementarity to other large scale accelerator projects. IRIDE is also intended to be realized in subsequent stages of development depending on the assigned priorities., 270 pages

We introduce fractal social organizations-a novel class of socio-technical complex systems characterized by a distributed, bio-inspired, hierarchical architecture. Based on a same building block that is recursively applied at different layers, said systems provide a homogeneous way to model collective behaviors of different complexity and scale. Key concepts and principles are enunciated by means of a case study and a simple formalism. As preliminary evidence of the adequacy of the assumptions underlying our systems here, we define and study an algebraic model for a simple class of social organizations. We show how despite its generic formulation, geometric representations of said model exhibit the spontaneous emergence of complex hierarchical and modular patterns characterized by structured addition of complexity and fractal nature-which closely correspond to the distinctive architectural traits of our fractal social organizations. Some reflections on the significance of these results and a view to the next steps of our research conclude this contribution. Copyright © 2013 John Wiley & Sons, Ltd.