77 results on '"Nucera, R."'
Search Results
2. The digitally assisted miniscrew insertion system: A simple and versatile workflow
- Author
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Lo Giudice, A., Rustico, L., Campagna, P., Portelli, M., and Nucera, R.
- Subjects
Bone Screws ,Orthodontic Anchorage Procedures ,Humans ,Workflow - Published
- 2022
3. Asymmetry index for the photogrammetric assessment of facial asymmetry
- Author
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Blasi, A., Nucera, R., Ronsivalle, V., Candida, E., Grippaudo, C., Blasi A., Grippaudo C. (ORCID:0000-0002-9499-0556), Blasi, A., Nucera, R., Ronsivalle, V., Candida, E., Grippaudo, C., Blasi A., and Grippaudo C. (ORCID:0000-0002-9499-0556)
- Abstract
Introduction: Facial asymmetry is common and can be clinically related to dental malocclusion, facial bone development, muscular imbalance, and soft tissues thickness, which should be assessed during diagnosis to choose proper treatment options. This study aimed to quantify the amount of symmetry/asymmetry in previously defined symmetrical and asymmetrical subjects, analyzing full-face 3-dimensional images. Methods: Seventy-six orthodontic patients’ 3-dimensional face images were obtained with the 3dMD Trio-system (Atlanta, Ga) and processed with the Geomagic Control (64-bit; 3D Systems, Rock Hill, SC) software. Patients were divided into symmetrical and asymmetrical groups through a surface-based technique. Sixteen facial landmarks were positioned, an asymmetry index was calculated for each landmark, and an evaluation diagram of facial asymmetry was created through the asymmetry index mean and standard deviation of symmetrical and asymmetrical landmarks. Results: The asymmetry index mean varied from 0.05 to 1.51 in the symmetrical group and from 0.05 to 2.84 in the asymmetrical group. This study suggests that landmarks located in the lower third of the face have a greater asymmetry index than other landmarks. Conclusions: The landmark-based technique does not exhibit statistically significant differences among asymmetrical and symmetrical patients for some landmarks. This approach provides useful information about the localization and the extension of asymmetry, in which bilateral landmarks showed a higher amount of asymmetry than median landmarks.
- Published
- 2022
4. KINESIOGRAPHIC INVESTIGATIONS IN CHILDREN WITH INCREASED NASAL AIRWAYS RESISTAN CE
- Author
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Cordasco, G., Cicciú, D., Lo Giudice, G., Matarese, G., Nucera, R., and Mazza, M.
- Subjects
oscillometry ,nasal airways resistance ,mouth breathing ,kinesiography ,electromiography - Abstract
The aim of this study is to evaluate by means of the kinesiographic test, how the muscular alteration, linked with mouth breathing, modifies mandibular dynamics. From a sample of children aged.between 8-11 years, on the basis of increased nasal airways resistance measured with the forced oscillation technique, we selected a group of 14 subjects. These children underwent kinesiographic examination (K-System Biotronic) and they were compared to a control group. Certainly, the speeds reduction in the pathological group emerged as the most significant data. The mastication tracings on the frontal plane, in the group with increased nasal airways resistance, moreover appeared to be reduced in width, elongated in shape and sometimes irregularly square, compared to the bell shape typical of subjects without any dysfunctional pathologies. Considering that each subject responds in a personal manner to an increase of tbe nasélJ resistances, due to the extremely variable individual adaptability, the kinesiographic test, together with the electrorniographic one, in our opinion, can assist anarnnesis, clínica! examination and other instrumental investigations, in the identification of those subjects in which the increase of the nasal airways resistance interferes with muscular function, laying the basis for possible modifications in the craniofacial growth.
- Published
- 2021
5. Maxillary Orthodontic Expansion Assisted by Unilateral Alveolar Corticotomy and Low-Level Laser Therapy: A Novel Approach for Correction of a Posterior Unilateral Cross-Bite in Adults
- Author
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Caccianiga, G, Lo Giudice, A, Paiusco, A, Portelli, M, Militi, A, Baldoni, M, Nucera, R, Caccianiga G, Lo Giudice A, Paiusco A, Portelli M, Militi A, Baldoni M, Nucera R, Caccianiga, G, Lo Giudice, A, Paiusco, A, Portelli, M, Militi, A, Baldoni, M, Nucera, R, Caccianiga G, Lo Giudice A, Paiusco A, Portelli M, Militi A, Baldoni M, and Nucera R
- Abstract
Introduction: The treatment of a true unilateral posterior crossbite often requires asymmetric maxillary expansion; however, this is challenging to achieve with conventional expansion methods because of several biomechanical limitations. In this paper, we introduce a new protocol for the treatment of a unilateral posterior crossbite in adults based on maxillary orthodontic expansion assisted by corticotomy and low-level laser therapy (LLLT) performed on the crossbite side. Methods: The study sample included 15 adults (8 females, 7 males) affected by a true unilateral posterior crossbite, with a mean age of 21.6 ± 3.1 years at the at the beginning of treatment. After the application of orthodontic appliances (palatal expander and self-ligating brackets), corticomy was performed at the buccal aspect of the crossbite side while LLLT was monthly administered up to the correction of the crossbite. The efficacy of the technique was evaluated through measurements performed on maxillary digital models. Results: All subjects reported successful correction of the posterior unilateral crossbite, and functional occlusion was achieved as well. The average expansion was greater at the crossbite side compared to the unaffected side and such difference was significant at the levels of first premolars (P < 0.05), second premolars (P < 0.05) and first molars (P < 0.05). Conclusion: Orthodontic maxillary expansion assisted by unilateral corticotomy and LLLT was effective in the treatment of the true unilateral crossbite.
- Published
- 2019
6. Laterolateral teleradiography of the skull as a screening method for OSA/OSAS, in patients in orthodontic treatment
- Author
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Tersigni U., Spinuzza P., Militi A., Nucera R., Pizzo G., Giuliana G, Di Fede, O., Fiorentino, E, and Tersigni, U., Spinuzza, P., Militi, A., Nucera, R., Pizzo G., Giuliana G
- Subjects
Laterolateral teleradiography, OSA, OSAS, orthodontic treatment, screening ,Settore MED/28 - Malattie Odontostomatologiche - Abstract
Aim: Obstructive sleep apnea syndrome (OSAS) is the most common type of sleep apnea and it is caused by complete or partial obstruction of the upper airway. Adenotonsillar hypertrophy, obesity, cranio-facial anomalies and neuromuscular diseases are the main risk factors for the development of OSAS in the pediatric age. Specially several studies identify the relationship between respiratory disorders in sleep and obesity, and, in particular, between OSAS and obesity, designing a prevalence of OSAS among obese subjects between 14 and 78%. The diagnosis of OSAS in the child is of great importance as it can lead to neurocognitive and behavioral complications, growth retardation, systemic arterial hypertension, pulmonary hypertension, cardiovascular disease and metabolism. The WHO (World Health Organization) has established the new criteria for the classification of Obesity on the basis of BMI and the risk of comorbidities, identifying a moderate risk for underweight subjects, a very low risk for normal weights and an increased risk from severe to severe for overweight and obese individuals respectively. According to that the aim of this study is to evaluate the correlation between obstructive sleep apnea syndrome and cephalometric variables in children considering age and BMI. Materials and methods: Children aged 7–10 years and 11-14 years with no genetic syndrome, previous otorhinolaryngologic or orthodontic therapy treatments are being selected from our Departments of Paediatric Dentistry, University of Palermo, and from the Department of Orthodontics, University of Messina (Italy). All patients so far recruited and visited for orthodontic problems were in mixed or early permanent dentition phase, with the first upper molars fully erupted and presented to the history of several symptoms of Osas, such as recurring episodes of shallow or paused breathing during sleep, waking up frequently to urinate, morning headaches, memory or learning problems and not be able to concentrate or feeling irritable. Dental records and lateral cephalometric radiographs were obtained for all of the patients and than they have been subjected to paediatric, otolaryngology and polysomnography visits. Subject with a positive diagnosis of Osas were studied and they were divided in group based on their BMI. In all groups the inter-molar distance in dental records was measured, and the cephalometric traces have been calculated. As reported by the study by Galeotti et al. the cephalometric measurements analysed are S-PNS, ad1-PNS, and ad2-PNS for the nasopharynx; p-pp and pa for oropharynx; H-H’ for the Hyoid bone; SNA for the maxilla; SNB;ANB and Go-Me for the mandible; S-Go, N-Me and P-A for facial Height; SN for cranial base; SN-MP and PP-MP for the typology, and angle ArGoMe for Growth prevision. At the time that children are still in the way of recruitment the results may not yet be defined; however it is necessary to emphasize the importance of the study, because in the child respiratory disturbances in the sleep, and in particular the OSAS, are often underestimated, despite representing the third place between the threats of health after the smoke and the excess of weight.
- Published
- 2019
7. A Comparative Assessment of the Efficiency of Orthodontic Treatment With and Without Photobiomodulation During Mandibular Decrowding in Young Subjects: A Single-Center, Single-Blind Randomized Controlled Trial
- Author
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Lo Giudice, A, Nucera, R, Leonardi, R, Paiusco, A, Baldoni, M, Caccianiga, G, Lo Giudice, Antonino, Nucera, Riccardo, Leonardi, Rosalia, Paiusco, Alessio, Baldoni, Marco, Caccianiga, Gianluigi, Lo Giudice, A, Nucera, R, Leonardi, R, Paiusco, A, Baldoni, M, Caccianiga, G, Lo Giudice, Antonino, Nucera, Riccardo, Leonardi, Rosalia, Paiusco, Alessio, Baldoni, Marco, and Caccianiga, Gianluigi
- Abstract
Objective: To assess if photobiomodulation (PBM) improves the efficiency of orthodontic treatment with fixed appliance during the alignment stage. Methods: Eighty-nine subjects were included in this trial and randomly assigned for treatment with fixed appliance and PBM group or with fixed appliance only (control group). Inclusion criteria were as follows: (1) age between 13 and 30 years, (2) permanent dentition, (3) class I malocclusion, (4) lower 6-6 mild crowding measured on dental cast, (5) no spaces or diastema in the lower arch, (6) no ectopic teeth, (7) nonextractive treatment plan, and (8) no previous orthodontic treatment. PBM was administered in the PBM group every 14 days using the ATP38® (Biotech Dental, Allée de Craponne, Salon de Provence, France) (72 J/cm2 of fluency for each session). Dental alignment was assessed by visual inspection, and treatment time was defined in days as T2 (date of assessment of complete dental alignment)-T1 (date of brackets bonding). The number of monthly scheduled appointments was also recorded. All the data underwent statistical analysis for comparison between groups. Results: Treatment time was significantly shorter (p < 0.001) in the PBM group (203 days) compared with the control (260 days). Consequently, control visits (p < 0.001) were lower in the PBM group (7) compared with the control group (9). Conclusions: The present findings would confirm that PBM can be used to enhance the efficiency of orthodontic treatment during dental decrowding.
- Published
- 2020
8. IS STATIC FRICTION AFFECTED BY AGING AND AMOUNT OF ELASTOMERIC LIGATURES IN ORTHODONTIC SLIDING MECHANICS? AN IN-VITRO INVESTIGATION
- Author
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Antonino Lo Giudice, Portelli, M., Militi, A., Spinuzza, P., Bellocchio, A. M., Nucera, R., Marcolina, M., Ghilardi, G., Manuelli, M., Lucchese, A., LO GIUDICE, A, Portelli, M, Militi, A, Spinuzza, P, Bellocchio, Am, Nucera, R, Marcolina, M, Ghilardi, G, Manuelli, M, and Lucchese, A
- Subjects
Elastomers ,Friction ,Orthodontic Brackets ,Materials Testing ,Orthodontic Wires ,Saliva, Artificial - Abstract
In straight-wire mechanics, friction can significantly influence the forces expressed by wires. The aim of this study is to assess whether the aging and the sum of elastomeric ligatures affect the static friction during orthodontic space closure. A 0.017x 0.025-in SS was drawn throughout a 3-bracket experimental model and engaged with elastomeric ligatures. Before performing the test, the ligatures were soaked in artificial saliva for 48 hours (Group 1), 2 weeks (Group 2) and 4 weeks (Group 3); brand-new ligatures were also tested as control group (Group 4). The resistance to sliding (RS) was recorded at 3 different numerical configurations of ligatures using a customized testing machine and tests were repeated for ten times. Data of RS were statistically analysed by using two way analysis of variance (ANOVA) and Tukey’s multiple comparison tests. RS was found to increase systematically when more elastomeric ligatures were included in the wire engaging system. At two weeks of immersion in artificial saliva elastomeric ligatures showed the lowest values of RS while they became significantly more frictional after immersion for 4 weeks. The results of this study showed that in multi-bracket orthodontic therapy, the RS increases with the number of elastomeric ligatures involved for arch-wire engagement. Differently from the frictional behavior of elastomeric modules, the aging of these ligatures does not influence their incremental effect of frictional forces.
- Published
- 2018
9. Evaluation of mandibular symmetry and morphology in adult patients with unilateral posterior crossbite: a CBCT study using a surface-to-surface matching technique
- Author
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Leonardi, Rosalia, primary, Muraglie, Simone, additional, Lo Giudice, Antonino, additional, Aboulazm, K S, additional, and Nucera, R, additional
- Published
- 2020
- Full Text
- View/download PDF
10. Is Low-Level Laser Therapy an Effective Method to Alleviate Pain Induced by Active Orthodontic Alignment Archwire? A Randomized Clinical Trial
- Author
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Lo Giudice, A, Nucera, R, Perillo, L, Paiusco, A, Caccianiga, G, Lo Giudice, Antonino, Nucera, Riccardo, Perillo, Letizia, Paiusco, Alessio, Caccianiga, Gianluigi, Lo Giudice, A, Nucera, R, Perillo, L, Paiusco, A, Caccianiga, G, Lo Giudice, Antonino, Nucera, Riccardo, Perillo, Letizia, Paiusco, Alessio, and Caccianiga, Gianluigi
- Abstract
Objective: The aim of this study is to assess if low-level laser therapy (LLLT) alleviates pain after the placement of orthodontic alignment archwire and if there could be a specific indication for the usage of LLLT according to the amount of dental crowding. Materials and Methods: Ninety subjects were included and randomly assigned to the tested group (orthodontic treatment and LLLT), placebo group (orthodontic treatment and simulated LLLT), and control group (orthodontic treatment only). Inclusion criteria are age between 13 and 30 years, completely erupted mandibular teeth, and lower crowding of ≥3 mm. Exclusion criteria are spaces or diastema in the lower arch, ectopic teeth, treatment plan including extractions or the use of auxiliary devices, and previous orthodontic treatment. Patients reported the pain experienced by using a numeric rating scale, ranging from 0 to 10, at specific time intervals, that is, 2 hours, 6 hours, 24 hours, and from day 2 to 7. Kruskal–Wallis H Test was used to assess differences in the maximum pain and pain experienced at each time interval among the three groups and in the maximum pain reported among subjects with different degree of crowding. Results: The final sample consisted of 84 patients, 41 male and 43 female patients, with a mean age of 16.5 ± 2.8 years. The pain experienced at each time interval and the maximum pain score were significantly lower in the tested group, whereas no differences were found between control and placebo groups. Moreover, no differences were found in the pain experienced among subjects with mild, moderate, and severe incisor crowding in all groups. Conclusions: LLLT is effective in alleviating the intensity and duration of pain experienced by patients after the engagement of alignment archwire. However, there is no specific indication for the usage of LLLT according to the amount of crowding.
- Published
- 2019
11. No Compliance Correction of Class II Malocclusion in Growing Patients Whit HERBST Appliance: A Case Report
- Author
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Portelli, M., primary, Militi, A., additional, Cicciù, M., additional, Lo Giudice, A., additional, Cervino, G., additional, Fastuca, R., additional, and Nucera, R., additional
- Published
- 2018
- Full Text
- View/download PDF
12. Does Low-Level Laser Therapy Enhance the Efficiency of Orthodontic Dental Alignment? Results from a Randomized Pilot Study
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Caccianiga, G, Paiusco, A, Perillo, L, Nucera, R, Pinsino, A, Maddalone, M, Cordasco, G, Lo Giudice, A, Caccianiga, G, Paiusco, A, Perillo, L, Nucera, R, Pinsino, A, Maddalone, M, Cordasco, G, and Lo Giudice, A
- Abstract
Objective: To assess if low-level laser therapy (LLLT) enhances the efficiency of orthodontic dental alignment. Background: There is no evidence of the effect of LLLT on the orthodontic treatment time from randomized clinical trials. Methods: Thirty-six subjects were included in this interventional pilot study and randomly assigned for treatment with fixed appliance and LLLT (test group) or with fixed appliance only (control group). A single monthly administration of LLLT was performed intraorally using a Diode laser (980 nm, 1 W, continuous wave, total energy density = 150 J/cm2; Doctor Smile-Lambda Spa). The date of brackets bonding (T1) and the date of complete resolution of dental crowding (T2) were recorded. The alignment treatment time was defined in days as T2 - T1. The number of monthly scheduled control visits was also recorded. Treatment time duration was assessed in both groups with the log-rank (Mantel-Cox) Test for survival analysis. Mann-Whitney U tests was used to compare the number of control visits from T1 to T2 between the two groups. Results: Patients' age, sex, and amount of crowding were equally distributed between the two groups. The alignment treatment time was significantly shorter (p < 0.001) in the tested group (211.8 days) compared to the control (284.1 days). Consequently, control visits (p < 0.001) were lower in the test group (7 visits, median value) compared to the control group (9.5 visits, median value). Conclusions: The results of this pilot study suggest that the administration of LLLT might significantly increase the efficiency of orthodontic treatment during dental alignment.
- Published
- 2017
13. Può l’analisi cefalometrica dei tessuti molli definire la struttura del viso di Leonardo da Vinci?
- Author
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FESTA F, NUCERA R, CAPANO M, TERRASI F., TECCO , SIMONA, Capasso L , Barbatelli N, Festa, F, Tecco, Simona, Nucera, R, Capano, M, and Terrasi, F.
- Published
- 2010
14. Può l’analisi dei tessuti molli contribuire a definire le caratteristiche facciali di Leonardo da Vinci?
- Author
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FESTA F, NUCERA R, NAPOLI C, CORDASCO G., TECCO , SIMONA, Festa, F, Nucera, R, Tecco, Simona, Napoli, C, and Cordasco, G.
- Published
- 2009
15. Analysis of resistance to sliding expressed during first order correction with conventional and self-ligating brackets: An in-vitro study
- Author
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Lo Giudice, A, Nucera, R, Matarese, G, Portelli, M, Cervino, G, Lo Giudice, G, Militi, A, Caccianiga, G, Cicciù, M, Cordasco, G, Lo Giudice, A, Nucera, R, Matarese, G, Portelli, M, Cervino, G, Lo Giudice, G, Militi, A, Caccianiga, G, Cicciù, M, and Cordasco, G
- Abstract
Purpose: To investigate the resistance to sliding (RS) related to self-ligating and conventional ligation bracket systems at several first order rotational angulations using typical aligning arch wires in a 3-bracket experimental model. Materials and methods: Resistance to sliding (RS) was measured in self-ligating (SL: Interactive selfligating brackets with closed slide) and conventional ligation (CL: Interactive self-ligating brackets with open slide and elastomeric ligatures) groups in conjunction with 0.014-in heat-activated NiTi (Af temp: 36°). A custom-made machine was used to measure frictional resistance with tests repeated on 5 occasions at each simulated angulation. Results: The RS increased significantly as the angulation increased in both groups (P < 0.0001). However, RS measurements were significantly higher at each angulation (P < 0.0001) with the conventional ligation system than with self-ligation. Conclusion: During simulated tooth movement with low stiffness wires, RS is increased in conventional-ligating systems particularly at higher degrees of angulation.
- Published
- 2016
16. Load-deflection characteristics of superelastic and thermal nickel-titanium wires
- Author
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Gatto, E., primary, Matarese, G., additional, Di Bella, G., additional, Nucera, R., additional, Borsellino, C., additional, and Cordasco, G., additional
- Published
- 2011
- Full Text
- View/download PDF
17. In vitro evaluation of the frictional forces between brackets and archwire with three passive self-ligating brackets
- Author
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Cordasco, G., primary, Farronato, G., additional, Festa, F., additional, Nucera, R., additional, Parazzoli, E., additional, and Grossi, G. B., additional
- Published
- 2009
- Full Text
- View/download PDF
18. Standard and low-dose cone beam computer tomography protocol for orthognatodontic diagnosis: a comparative evaluation
- Author
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Portelli, M., Militi, A., Lo Giudice, A., Lo Giudice, R., Fastuca, R., Ielo, I., Mongelli, V., Lo Giudice, G., Martintoni, A., Manuelli, M., Lucchese, A., Nucera, R., Portelli, M, Militi, A, LO GIUDICE, A, LO GIUDICE, R, Fastuca, R, Ielo, I, Mongelli, V, LO GIUDICE, G, Martintoni, A, Manuelli, M, Lucchese, A, and Nucera, A
19. A Comparative Assessment of the Efficiency of Orthodontic Treatment With and Without Photobiomodulation During Mandibular Decrowding in Young Subjects: A Single-Center, Single-Blind Randomized Controlled Trial
- Author
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Antonino Lo Giudice, Riccardo Nucera, Gianluigi Caccianiga, Rosalia Leonardi, Alessio Paiusco, Marco Baldoni, Lo Giudice, A, Nucera, R, Leonardi, R, Paiusco, A, Baldoni, M, and Caccianiga, G
- Subjects
Adult ,Male ,Adolescent ,Tooth Movement Techniques ,Biomedical Engineering ,chemical and pharmacologic phenomena ,Single Center ,law.invention ,Photobiomodulation—Original Research ,accelerated dental movement ,Young Adult ,Orthodontic Appliances ,Randomized controlled trial ,law ,photobiomodulation ,Humans ,Medicine ,Single-Blind Method ,Radiology, Nuclear Medicine and imaging ,Low-Level Light Therapy ,Orthodontics ,orthodontic treatment ,business.industry ,fungi ,MED/28 - MALATTIE ODONTOSTOMATOLOGICHE ,Combined Modality Therapy ,Italy ,Female ,Single blind ,business ,Malocclusion - Abstract
Objective: To assess if photobiomodulation (PBM) improves the efficiency of orthodontic treatment with fixed appliance during the alignment stage. Methods: Eighty-nine subjects were included in this trial and randomly assigned for treatment with fixed appliance and PBM group or with fixed appliance only (control group). Inclusion criteria were as follows: (1) age between 13 and 30 years, (2) permanent dentition, (3) class I malocclusion, (4) lower 6-6 mild crowding measured on dental cast, (5) no spaces or diastema in the lower arch, (6) no ectopic teeth, (7) nonextractive treatment plan, and (8) no previous orthodontic treatment. PBM was administered in the PBM group every 14 days using the ATP38® (Biotech Dental, Allée de Craponne, Salon de Provence, France) (72 J/cm2 of fluency for each session). Dental alignment was assessed by visual inspection, and treatment time was defined in days as T2 (date of assessment of complete dental alignment)-T1 (date of brackets bonding). The number of monthly scheduled appointments was also recorded. All the data underwent statistical analysis for comparison between groups. Results: Treatment time was significantly shorter (p < 0.001) in the PBM group (203 days) compared with the control (260 days). Consequently, control visits (p < 0.001) were lower in the PBM group (7) compared with the control group (9). Conclusions: The present findings would confirm that PBM can be used to enhance the efficiency of orthodontic treatment during dental decrowding.
- Published
- 2020
- Full Text
- View/download PDF
20. Maxillary Orthodontic Expansion Assisted by Unilateral Alveolar Corticotomy and Low-Level Laser Therapy: A Novel Approach for Correction of a Posterior Unilateral Cross-Bite in Adults
- Author
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Alessio Paiusco, Marco Baldoni, Antonino Lo Giudice, Riccardo Nucera, Angela Militi, Gianluigi Caccianiga, Marco Portelli, Caccianiga, G, Lo Giudice, A, Paiusco, A, Portelli, M, Militi, A, Baldoni, M, and Nucera, R
- Subjects
Molar ,Urology ,medicine.medical_treatment ,Dermatology ,Maxillary expansion ,Functional occlusion ,03 medical and health sciences ,0302 clinical medicine ,Laser therapy ,medicine ,Dentistry (miscellaneous) ,Orthopedics and Sports Medicine ,Cross Bite ,Corticotomy ,Low level laser therapy ,Laser. LLLT, Corticotomy, Orthodontic ,Orthodontics ,LLLT ,Crossbite ,business.industry ,MED/28 - MALATTIE ODONTOSTOMATOLOGICHE ,Mean age ,Unilateral crossbite ,030206 dentistry ,medicine.disease ,Nephrology ,Original Article ,Surgery ,business ,030215 immunology - Abstract
Introduction: The treatment of a true unilateral posterior crossbite often requires asymmetric maxillary expansion; however, this is challenging to achieve with conventional expansion methods because of several biomechanical limitations. In this paper, we introduce a new protocol for the treatment of a unilateral posterior crossbite in adults based on maxillary orthodontic expansion assisted by corticotomy and low-level laser therapy (LLLT) performed on the crossbite side. Methods: The study sample included 15 adults (8 females, 7 males) affected by a true unilateral posterior crossbite, with a mean age of 21.6 ± 3.1 years at the at the beginning of treatment. After the application of orthodontic appliances (palatal expander and self-ligating brackets), corticomy was performed at the buccal aspect of the crossbite side while LLLT was monthly administered up to the correction of the crossbite. The efficacy of the technique was evaluated through measurements performed on maxillary digital models. Results: All subjects reported successful correction of the posterior unilateral crossbite, and functional occlusion was achieved as well. The average expansion was greater at the crossbite side compared to the unaffected side and such difference was significant at the levels of first premolars (P < 0.05), second premolars (P < 0.05) and first molars (P < 0.05). Conclusion: Orthodontic maxillary expansion assisted by unilateral corticotomy and LLLT was effective in the treatment of the true unilateral crossbite.
- Published
- 2019
- Full Text
- View/download PDF
21. Correlation between Mesio-Distal Angulation and Bucco.-Lingual Inclination of First and Second Maxillary Premolars Evaluated with Panoramic Radiography and Cone-Beam Computed Tomography
- Author
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Marta Fontana, Riccardo Nucera, Rosamaria Fastuca, Alberto Caprioglio, Alessandra Lucchese, Marco Portelli, Piero Antonio Zecca, Angela Militi, Fontana, M., Fastuca, R., Zecca, P. A., Nucera, R., Militi, A., Lucchese, A., Portelli, M., and Caprioglio, A.
- Subjects
Cone beam computed tomography ,cone-beam computed tomography ,Radiography ,Computed tomography ,lcsh:Technology ,lcsh:Chemistry ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,orthodontic treatment ,panoramic radiography ,medicine ,General Materials Science ,Bucco ,Arch ,lcsh:QH301-705.5 ,Instrumentation ,Mathematics ,Fluid Flow and Transfer Processes ,Orthodontics ,medicine.diagnostic_test ,biology ,lcsh:T ,business.industry ,Process Chemistry and Technology ,General Engineering ,030206 dentistry ,biology.organism_classification ,lcsh:QC1-999 ,Computer Science Applications ,Dental arch ,medicine.anatomical_structure ,lcsh:Biology (General) ,lcsh:QD1-999 ,lcsh:TA1-2040 ,lcsh:Engineering (General). Civil engineering (General) ,business ,Clinical evaluation ,lcsh:Physics ,030215 immunology - Abstract
Background: Panoramic radiography creates distortion in teeth position and inclination especially in lateral areas of the arches due to acquisition and curved shape of dental arch. The aim of this study was to evaluate panoramic distortion compared to cone-beam computed tomography. Methods: Mesiodistal angulations were measured on panoramic radiography. Mesiodistal angulations and buccolingual inclinations of the teeth were determined on cone-beam computed tomography scans. The previous measurements were then compared through Pearson correlation coefficient. Results: The results showed higher correlation between mesiodistal 2D angulation and buccolingual 3D inclination, especially for first premolars, rather than between mesiodistal angulations measured in 2D and 3D. Conclusion: Especially for the lateral areas of the dental arches, root mesiodistal angulation measured on panoramic radiography is not reliable, in fact, it is greatly influenced by buccolingual inclination. Therefore, clinical evaluation is highly recommended with panoramic radiography to provide correct diagnosis and the most satisfactory results.
- Published
- 2021
22. Midpalatal Suture Density Evaluation after Rapid and Slow Maxillary Expansion with a Low-Dose CT Protocol: A Retrospective Study
- Author
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Ambra Michelotti, Alberto Caprioglio, Marco Portelli, Riccardo Nucera, Antonino Logiudice, Vincenzo D'Antò, Angela Militi, Rosamaria Fastuca, Fastuca, R., Michelotti, A., Nucera, R., D'Anto, Vincenzo, Militi, A., Logiudice, A., Caprioglio, A., and Portelli, M.
- Subjects
Male ,Palate, Hard ,Palatal Expansion Technique ,Bone density ,Computed tomography ,Article ,03 medical and health sciences ,0302 clinical medicine ,Suture (anatomy) ,Retrospective Studie ,Maxilla ,Medicine ,Low dose ct ,Humans ,In patient ,maxillary expansion ,Midpalatal suture ,Child ,Retrospective Studies ,Orthodontics ,lcsh:R5-920 ,medicine.diagnostic_test ,business.industry ,bone density ,Mean age ,Retrospective cohort study ,computed tomography ,030206 dentistry ,General Medicine ,Cranial Sutures ,Cranial Suture ,Female ,business ,lcsh:Medicine (General) ,Tomography, X-Ray Computed ,030217 neurology & neurosurgery ,Human - Abstract
Background and objectives: The aim of the present paper is to use low-dose computed tomography (CT) to evaluate the changes in the midpalatal suture density in patients treated with rapid maxillary expansion (RME) and slow maxillary expansion (SME). Materials and Methods: Thirty patients (mean age 10.2 ±, 1.2 years) were retrospectively selected from the existing sample of a previous study. For each patient, a low-dose computed tomography examination was performed before appliance placement (T0) and at the end of retention (T1), seven months later. Using the collected images, the midpalatal suture density was evaluated in six regions of interest. Results: No significant differences were found between the timepoints in the rapid maxillary expansion group. Three out of six regions of interest showed significant decreases between the timepoints in the slow maxillary expansion group. No significant differences were found in comparisons between the two groups. Conclusions: The midpalatal suture density showed no significant differences when rapid maxillary expansion groups were compared to slow maxillary expansion groups, suggesting that a similar rate of suture reorganization occurs despite different expansion protocols.
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- 2020
23. Low-dose protocol of the spiral CT in orthodontics: comparative evaluation of entrance skin dose with traditional X-ray techniques
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Alessandra Lucchese, Elda Gatto, Antonino Lo Giudice, Marco Portelli, Riccardo Nucera, Giancarlo Cordasco, Angela Militi, Cordasco, G, Portelli, M, Militi, A, Nucera, R, Lo Giudice, A, Gatto, E, and Lucchese, Alessandra
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thermoluminescence dosimetry ,medicine.medical_treatment ,Thyroid Gland ,Mandible ,Orthodontics, Corrective ,Phantoms ,Imaging ,Lens ,Thermoluminescent Dosimetry ,Maxilla ,Radiography, Dental ,image quality ,Parotid Gland ,Medicine ,Nasal Bone ,Tomography ,Skin ,Orthodontics ,radiation absorption ,Phantoms, Imaging ,Soft tissue ,phantom ,thermoluminescence dosimeter ,Spiral computed tomography ,X ray ,X-Ray Computed ,Radiographic Image Enhancement ,priority journal ,Absorbed dose ,Corrective ,Radiology ,Anatomic Landmarks ,Nasal Cavity ,radiation dose ,Chin ,medicine.medical_specialty ,spiral computer assisted tomography ,Tomography Scanners, X-Ray Computed ,Cephalometry ,EMTREE medical terms: article ,clinical protocol ,computed tomography scanner ,controlled study ,lens ,orthodontics ,parotid gland ,radiotherapy ,skin absorption ,thyroid gland ,Radiation Dosage ,Panoramic ,Imaging phantom ,Lens, Crystalline ,Radiography, Panoramic ,Humans ,Sella Turcica ,Tomography Scanners ,Zygoma ,Dosimeter ,Crystalline ,business.industry ,Research ,Mandibular Condyle ,Radiography ,Radiation therapy ,Dental ,Spiral Computed ,business ,Tomography, Spiral Computed - Abstract
Background The aim of this study was to evaluate the amount of radiation doses absorbed by soft tissues (entrance skin dose) with a low-dose spiral computed tomography (CT) protocol compared to conventional X-ray techniques commonly used in orthodontics. Methods The amount of skin dose has been evaluated using a tissue-equivalent head-neck radiotherapy humanoid phantom with thermoluminescent dosimeters placed at the level of eye lens, parotid glands, and thyroid glands. CT images have been taken using a Sensation 16 Siemens CT scan and a low-dose protocol (15 mAs, 1 pitch, 2.5 mGy (CTDIvol), 80 kV, 1-mm slice thickness). Results The difference in image quality between traditional X-ray techniques and low-dose spiral CT was statistically significant (P Conclusions Our protocol allows a more accurate orthodontic diagnosis without an increase of radiological risk for the patients in comparison to traditional X-ray techniques.
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- 2013
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24. Condylar volume and surface in Caucasian young adult subjects
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Simona Tecco, Mario Pagnoni, Giancarlo Cordasco, Giorgio Iannetti, Riccardo Nucera, Antonella Polimeni, Felice Festa, Matteo Saccucci, Tecco, Simona, Saccucci, M, Nucera, R, Polimeni, A, Pagnoni, M, Cordasco, G, Festa, F, and Iannetti, G.
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Male ,lcsh:Medical technology ,Population ,Dentistry ,Computed tomography ,Condyle ,White People ,Imaging ,Young Adult ,Imaging, Three-Dimensional ,stomatognathic system ,Reference Values ,Statistical significance ,Condylar volume ,Low dose ct ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Young adult ,Caucasian population ,education ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Significant difference ,Mandibular Condyle ,Organ Size ,Cone-Beam Computed Tomography ,stomatognathic diseases ,lcsh:R855-855.5 ,Italy ,Radiology Nuclear Medicine and imaging ,Reference values ,Female ,business ,Research Article - Abstract
Background There have been no quantitative standards for volumetric and surface measurements of the mandibular condyle in Caucasian population. However, the recently developed cone-beam computed tomography (CBCT) system allows measurement of these parameters with high accuracy. Methods CBCT was used to measure the condylar volume, surface and the volume to surface ratio, called the Morphometric Index (MI), of 300 temporo-mandibular joints (TMJ) in 150 Caucasian young adult subjects, with varied malocclusions, without pain or dysfunction of TMJs. Results The condylar volume was 691.26 ± 54.52 mm3 in males and 669.65 ± 58.80 mm3 in, and was significantly higher (p< 0.001) in the males. The same was observed for the condylar surface, although without statistical significance (406.02 ± 55.22 mm2 in males and 394.77 ± 60.73 mm2 in females). Furthermore, the condylar volume (693.61 ± 62.82 mm3 ) in the right TMJ was significantly higher than in the left (666.99 ± 48.67 mm3, p < 0.001) as was the condylar surface (411.24 ± 57.99 mm2 in the right TMJ and 389.41 ± 56.63 mm2 in the left TMJ; t = 3.29; p < 0.01). The MI is 1.72 ± 0.17 for the whole sample, with no significant difference between males and females or the right and left sides. Conclusion These data from temporomandibular joints of patients without pain or clinical dysfunction might serve as examples of normal TMJ's in the general population not seeking orthodontic care.
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- 2010
25. Analysis of resistance to sliding expressed during first order correction with conventional and self-ligating brackets: An in-vitro study
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Lo Giudice, Antonino, Nucera, Riccardo, Matarese, Giovanni, Portelli, Marco, Cervino, Gabriele, Lo Giudice, Giuseppe, Militi, Angela, Caccianiga, Gianluigi, marco cicciu, Cordasco, Giancarlo, Lo Giudice, A, Nucera, R, Matarese, G, Portelli, M, Cervino, G, Lo Giudice, G, Militi, A, Caccianiga, G, Cicciù, M, and Cordasco, G
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Genetics and Molecular Biology (all) ,Biochemistry, Genetics and Molecular Biology (all) ,Medicine (all) ,NiTi ,Self ligating ,Sliding ,Biochemistry - Abstract
Purpose: To investigate the resistance to sliding (RS) related to self-ligating and conventional ligation bracket systems at several first order rotational angulations using typical aligning arch wires in a 3-bracket experimental model. Materials and methods: Resistance to sliding (RS) was measured in self-ligating (SL: Interactive selfligating brackets with closed slide) and conventional ligation (CL: Interactive self-ligating brackets with open slide and elastomeric ligatures) groups in conjunction with 0.014-in heat-activated NiTi (Af temp: 36°). A custom-made machine was used to measure frictional resistance with tests repeated on 5 occasions at each simulated angulation. Results: The RS increased significantly as the angulation increased in both groups (P < 0.0001). However, RS measurements were significantly higher at each angulation (P < 0.0001) with the conventional ligation system than with self-ligation. Conclusion: During simulated tooth movement with low stiffness wires, RS is increased in conventional-ligating systems particularly at higher degrees of angulation.
26. Temporomandibular joint involvement in a cohort of patients with juvenile idiopatic arthritis and evaluation of the effect induced by functional orthodontic appliance: Clinical and radiographic investigation
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Portelli M, Matarese G, Militi A, Logiudice G, Riccardo Nucera, Lucchese A, Portelli, M, Matarese, G, Militi, A, Logiudice, G, Nucera, R, and Lucchese, Alessandra
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Male ,Adolescent ,CHILDREN ,Nuclear magnetic resonance ,Cohort Studies ,Humans ,Orthodontic Appliance Design ,Prospective Studies ,Range of Motion, Articular ,Child ,RHEUMATOID-ARTHRITIS ,MANDIBULAR GROWTH ,Juvenile Idiopathic Arthriti ,Mandibular Condyle ,Vertical Dimension ,Activator Appliances ,Myalgia ,Temporomandibular Joint Disorders ,Magnetic Resonance Imaging ,Arthritis, Juvenile ,Jaw Relation Record ,Child, Preschool ,Masticatory Muscles ,Temporomandibular Joint Arthritis ,Female ,Follow-Up Studies - Abstract
AIM: The aim of the study was to assess possible correlations between the clinical parameters of temporomandibular joint (TMJ) arthritis and pathologic MRI findings of the TMJ in patients affected by juvenile idiopathic arthritis (JIA), and the effect of a functional orthodontic therapy on the evolution of TMJ disorders. MATERIALS AND METHODS: A prospective clinical and nuclear magnetic resonance (NMR) investigation was conducted on a sample of 53 patients (41 female, 12 male) with JIA, treated for 24 months with an Andresen appliance. The involvement of TMJ was defined by clinical and radiological signs. NMR assessments were performed in closed and maximum opening mouth position before (T0) and at the end of functional orthodontic therapy (T1). RESULTS: Fifteen patients showed physical and radiologic TMJ abnormalities. Changes were not uniformly distributed among the different JIA subtypes. Patients with poliarticular JIA (≥5 peripheral joints affected) showed more destructive bony changes. No correlation existed between clinical symptoms and NMR alterations. Approximately one half of the patients experienced significant improvement of the TMJ and muscular pain using the Andresen appliance. CONCLUSION: The prevalence of TMJ involvement in patients suffering of JIA, and the improvement of TMJ and muscular pain associated with the use of functional appliance found in the present study, suggest an alert for TMJ dysfunction in patients with JIA and demonstrate the utility of functional orthodontic therapy in preventing the morbidities associated with TMJ arthritis in JIA.
27. Evaluation of the friction of self-ligating and conventional bracket systems
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Felice Festa, Simona Tecco, Giancarlo Cordasco, Beatrice Di Bisceglie, Donato Di Iorio, Riccardo Nucera, Tecco, Simona, Di Iorio, D, Nucera, R, Di Bisceglie, B, Cordasco, G, and Festa, F.
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Orthodontic brackets ,Friction ,business.industry ,Bracket ,Medicine ,In vitro study ,Dentistry ,Friction, Ligation, Orthodontic brackets ,Original Articles ,business ,General Dentistry ,Ligation - Abstract
Objectives: This in vitro study evaluated the friction (F) generated by aligned stainless steel (SS) conventional brackets, self-ligating Damon MX© brackets (SDS Ormco, Glendora, California, USA), Time3© brackets (American Orthodontics, Sheboygan, Wisconsin, USA), Vision LP© brackets (American Orthodontics), and low-friction Slide© ligatures (Leone, Firenze, Italy) coupled with various SS, nickel-titanium (NiTi), and beta-titanium (TMA) archwires. Methods: All brackets had a 0.022-inch slot, and the orthodontic archwires were 0.014-inch, 0.016-inch, 0.014×0.025-inch, 0.018×0.025-inch, and 0.019×0.025-inch NiTi; 0.017×0.025-inch TMA; and 0.019×0.025-inch SS. Each bracket-archwire combination was tested 10 times. In the test, 10 brackets of the same group were mounted in alignment on a metal bar. The archwires moved through all the 10 brackets at a crosshead speed of 0.5 mm/min (each run lasted approximately 5 min). The differences among 5 groups of brackets were analyzed through the Kruskal-Wallis test, and a Mann-Whitney test was calculated as post hoc analysis. The P value was set at 0.05. Results: Coupled with 0.014-inch NiTi and 0.016-inch NiTi, Victory Series© brackets generated the greatest F, while Damon MX© and Vision LP© brackets generated the lowest (P
28. Correlations between Obstructive Sleep Apnea Syndrome and Periodontitis: A Systematic Review and Meta-Analysis.
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Portelli M, Russo I, Bellocchio AM, Militi A, and Nucera R
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The focus of this article was to evaluate the link between obstructive sleep apnea syndrome (OSAS) and periodontitis, considering various hypotheses supporting the relationship between respiratory disorders and periodontitis. The literature review for this study was performed using the PubMed, Google Scholar, Cochrane library, and Proquest databases. The review process was guided by the PRISMA guidelines. The PECOS protocol (Population, Exposure, Control, Outcome, Study) was followed in developing the search strategy to ensure consistent and accurate selection of articles. To evaluate quality, cross-sectional studies were reviewed using the Joanna Briggs Institute (JBI) critical appraisal tool. Case-control studies were assessed with the Newcastle-Ottawa Scale (NOS). The research included a total of 10 studies, encompassing 88,040 participants. The meta-analysis observed a statistically significant association between OSAS and periodontitis, with an odds ratio OR = 2.4620 (95%-CI: 1.7345-3.4946 p ≤ 0.0001). The results suggest a potential association between OSA and periodontitis. Further investigations are warranted to confirm this association and elucidate its underlying mechanism.
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- 2024
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29. Indirect orthodontic bonding using an original 3D method compared with conventional technique: A narrative review.
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Nucera R, Militi A, Caputo A, Bellocchio AM, Minervini G, Cervino G, and Portelli M
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As well known success in orthodontics is related to a correct diagnosis and to a carefull treatment planning. Our study aims to provide clinician with a reproducible and precise method, for orthodontic indirect bonding, thanks to CBCT images and due to a CAD-CAM process., Methods: A case of an orthodontic treatment plan, of a female patient, 37 years old, was selected. Plaster models were digitally acquired using the Extra-Oral scanner Maestro 3D and processed within the Studio Maestro 3D software. CBCT images in DICOM format were imported into the MIMICS software, in order to perform the segmentation of the dental elements, and to obtain a three-dimensional coronal-root dental arches model. The DICOM file thus processed was exported in an STL file, reworked with Meshmixer software to improve image quality, and imported into the 3D Maestro software to be superimposed on the digital model. In this way a three-dimensional real model of the dental arches was developed. After an accurate orthodontic virtual set-up, we proceeded to brackets positioning on the 3D model of the dental arches. Subsequently, a virtual transfer template was created, in order to carry out the digital printing of a thermo-printed mask necessary to perform an indirect bonding of the orthodontic appliance., Results: The original digital workflow proposed in this study allows the development of a real and non-ideal three-dimensional coronal-root model of the dental arches; this model can be used for indirect orthodontic bonding eliminating any errors in the expression of 1st, 2nd and 3rd order information of the pre-informed orthodontic appliance., Conclusions: Technological advancements in oral scanning and 3D printing will allow the achievement of an easy and reproducible ideal positioning of the orthodontic brackets., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 THE AUTHORS.)
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- 2024
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30. Evaluation of the Clinical Variables Affecting Attachment Reproduction Accuracy during Clear Aligner Therapy.
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Bellocchio AM, Portelli M, Ciraolo L, Ciancio E, Militi A, Peditto M, Barbera S, and Nucera R
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Background: The purpose of this study was to evaluate some of the clinical variables that influence the accuracy of reproducing the planned attachment shape. The following clinical variables were considered: the template material, type of composite, and pressure application on the template during attachment curing., Methods: In this study, the evaluated materials for the thermoplastic transfer template construction are Erkolen 0.8 (polyethylene: PE) and Erkodur 0.8 (polyethylene terephthalate glycol-PET-G), and two types of composite resins: Enaflow (light-curing low-viscosity composite resin) and Enamel plus dentina HRI (light-curing high-viscosity composite resin). Two different light-curing lamps were used: Valo cordless color with no pressure and push light pressure (SCS). The 26 models included in the study were imported into the 3 Shape Ortho System 2022 (ver. 85.0.20 3 Shape, Denmark), and attachments were virtually placed on the dental elements of the first premolar and on both sides of the first upper molars. The accuracy of the attachment reproduction was evaluated through linear and angular evaluations against the reference model (MCAD). Three physical models were obtained: model A (MA), which was printed with attachments; model B (MB) with attachments made with a PE template; and model C (MC) with attachments made with a PET-G template., Results: The results showed statistically significant differences ( p < 0.05) between the PE and PET-G templates with greater precision using the PET-G template. Statistically significant differences ( p < 0.05) were found among the high-viscosity composite and low-viscosity composite with pressure curing., Conclusions: In light of the obtained data, using a PET-G template is recommended. The pressure application during composite curing reduces the reproduction accuracy with a low-viscosity composite.
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- 2023
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31. Body Image and Psychological Impact of Dental Appearance in Adolescents with Malocclusion: A Preliminary Exploratory Study.
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Sicari F, Merlo EM, Gentile G, Nucera R, Portelli M, Settineri S, Myles LAM, and Militi A
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Background: Body image and psychosocial functioning represent central challenges during adolescence and early adulthood. Malocclusion, defined as an irregularity in the alignment of the teeth, is known to negatively influence psychological outcomes. The current study aimed to elucidate the role of malocclusion, together with age, gender, and dental class, in body image and psychological functioning., Methods: A total of 126 participants aged from 12 to 19 years old (mean: 15.87, SD: 2.35, female participants: 52.4%, male participants: 47.6%) were recruited. Participants were visited at the University Hospital of Messina, Italy, and completed a sociodemographic questionnaire, the Body Image Concern Inventory (I-BICI), and the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ)., Results: Significant correlations were found between age, dental class, the BICI, and the PIDAQ. In particular, age showed a positive and significant correlation with PIDAQ-total score. The correlations between occlusal status and the BICI variables were all significant and positive. All correlations between occlusal status and the PIDAQ variables were all significant and positive, except for dental self-confidence. The correlations between the variables of the PIDAQ and BICI instruments were all significant and positive, except for dental self-confidence, where the directions were significant and negative. Moreover, age, gender, and occlusal status predicted BICI and PIDAQ scores. Age was a positive predictor for PIDAQ self-confidence, gender for BICI and PIDAQ total scores, along with dysmorphic symptoms, social impact, psychological impact, and aesthetic concerns. Several significant gender differences were highlighted by the analyses, with higher scores in the female group on all the BICI variables, except symptom interference, and all the PIDAQ variables, except dental self-confidence., Conclusions: Malocclusion appeared to play a central role in the psychological, representational, and psychosocial life of the participants. This research suggests that malocclusion and dental issues influence the psychological, representational, and psychosocial life of adolescents. Further research is required to examine the psychological impact of dental problems.
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- 2023
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32. Implant Site Changes in Three Different Clinical Approaches: Orthodontic Extrusion, Regenerative Surgery and Spontaneous Healing after Extraction: A Systematic Review.
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Isola G, Nucera R, Damonte S, Ugolini A, De Mari A, and Migliorati M
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Both surgical and non-surgical techniques are employed for implant site development. However, the efficacy of these methods has not been thoroughly evaluated and compared. This systematic review aims to compare the biologic, functional and esthetic outcomes of three different approaches before implant placement in both the maxillary and mandibular arches: orthodontic extrusion, regenerative surgery and spontaneous healing after extraction. The systematic research of articles was conducted up to January 2020 in Medline, Scopus and the Cochrane Library databases. Studies were selected in a three-stage process according to the title, the abstract and the inclusion criteria. The methodological quality and the risk of bias of the included studies were evaluated using ROBINS-I tools for non-randomized studies, Rob 2.0 for RCT. Quality evaluation of case reports was performed using CARE guidelines. Through the digital search, 1607 articles were identified, and 25 of them were included in the systematic review. The qualitative evaluation showed a good methodological quality for RCT, sufficient for non-randomized studies and poor for case reports. Based on the available results, both orthodontic extrusion and regenerative surgery allowed the development of the implant site with satisfying esthetic and functional outcomes. Studies about the spontaneous healing of the extraction socket showed resorption of the edentulous ridge, which complicated the implant insertion. No study referred to failures or severe complications. Most of the studies reported only qualitative results. The present systematic review demonstrated that there is a substantial lack of data and evidence to determine which of the presented methods is better for developing a future implant site. Both surgical and non-surgical procedures appear effective in the regeneration of hard tissue, whereas not all the techniques can improve soft tissue volume, too. The orthodontic technique simultaneously enhances both hard and soft tissue.
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- 2022
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33. Evaluation of palatal bone depth, cortical bone, and mucosa thickness for optimal orthodontic miniscrew placement performed according to the third palatal ruga clinical reference.
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Nucera R, Costa S, Bellocchio AM, Barbera S, Drago S, Silvestrini A, and Migliorati M
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- Adolescent, Cone-Beam Computed Tomography, Cortical Bone diagnostic imaging, Humans, Maxilla diagnostic imaging, Mouth Mucosa diagnostic imaging, Palate diagnostic imaging, Retrospective Studies, Young Adult, Orthodontic Anchorage Procedures
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Objectives: This retrospective CBCT study aimed to evaluate the palatal anatomical characteristics using the third palatal ruga as a reliable clinical reference for miniscrew placement., Methods: Thirty-six subjects (mean age17.1 y.o. ± 4.1) were randomly selected and their records (CBCT volume and maxillary digital models) were included.BlueSkyPlan CBCT software viewer (BluSkyBio, V4.7) was used to measure the following outcomes at the level of third palatal ruga, 2 mm anteriorly and 2 mm posteriorly: total bone depth, cortical bone thickness, and mucosa thickness. The outcomes were evaluated on lines perpendicular to the palatal mucosa laying on different sagittal planes: the mid-palatal plane, 2 and 4 mm paramedian planes., Results: The maximum mean amount of bone depth was registered 2 mm posteriorly to the third ruga and 4 mm paramedian (9.7 mm). No significant difference was observed between the third ruga insertion site and its corresponding 2 mm posterior site. Cortical bone of palatal vault did not change significantly in anteroposterior direction for all the considered sites. Significant differences were found comparing cortical bone at the suture level with cortical bone 2-mm and 4-mm paramedian at all anteroposterior levels. Palatal mucosa increases its thickness in paramedian insertion sites, and it decreases in posterior insertion sites., Conclusions: Both third palatal ruga and 2 mm posteriorly to third ruga (4 mm paramedian) could be the optimal insertion site for palatal miniscrew placement, depending on individual anatomic conditions. The thickness of the cortical palatal bone showed, at 4 mm paramedian, optimal characteristics for miniscrew primary stability. Palatal mucosa thickness values suggest miniscrew neck extension of 2.0-2.5 mm for optimal mucosa adaptation., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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- 2022
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34. Evaluation of bone depth, cortical bone, and mucosa thickness of palatal posterior supra-alveolar insertion site for miniscrew placement.
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Nucera R, Ciancio E, Maino G, Barbera S, Imbesi E, and Bellocchio AM
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- Bone Screws, Cone-Beam Computed Tomography methods, Cortical Bone diagnostic imaging, Humans, Maxilla surgery, Mucous Membrane, Palatal Expansion Technique, Young Adult, Orthodontic Anchorage Procedures
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Background: The use of palatal miniscrew offers the possibility to improve the effectiveness of orthodontic expansion devices. Palatal expanders supported by miniscrew can be applied with different clinical protocols. Some authors proposed the use of four palatal miniscrews during miniscrew-supported palatal expansion to maximize skeletal effects in young adults' treatment. However, bone availability decreases in the posterior paramedian palatal regions, making the positioning of the two-posterior paramedian palatal miniscrews challenging, when it is performed avoiding nasal cavities invasion. Some authors proposed miniscrews insertion in a specific region located laterally to the palatal process of the maxillary bone, and apically relatively to the dento-alveolar process. The aim of this study was to evaluate the bone thickness, cortical bone thickness, and mucosae depth of this anatomical site that, in this study, was defined as palatal posterior supra-alveolar insertion site., Results: The evaluation of bone availability of palatal posterior supra-alveolar insertion site at different antero-posterior levels showed that the maximum amount of total bone thickness was found between the second premolar and the first molar. At this level total bone, thickness is significantly (p < .05) greater compared to the other sagittal sites and it offers on average around 2 mm of extra bone depth for miniscrew placement. Cortical bone thickness is adequate for primary miniscrew stability. Overall, cortical bone thickness considered at different insertion sites showed significant statistically (p < .05) differences. The findings of this study showed that palatal mucosa is particularly thick with average values ranging from 4 to 7 mm, and its extension ultimately affects miniscrew length selection. Palatal mucosa thickness showed no clinically significant differences comparing different sagittal and vertical insertion sites. Data also showed that palatal mucosal thickness slightly significantly increases (p < .05) with the inclination of the insertion axis relative to the occlusal plane. Finally, study findings showed that vertical growth pattern can significantly affect considered outcomes (p < .05)., Conclusions: Palatal posterior supra-alveolar insertion site is an appropriate site for posterior insertion of palatal miniscrews. Considering high anatomical variation preliminary CBCT evaluation is important to achieve optimal miniscrew placement., (© 2022. The Author(s).)
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- 2022
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35. Effects of Composite Attachments on Orthodontic Clear Aligners Therapy: A Systematic Review.
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Nucera R, Dolci C, Bellocchio AM, Costa S, Barbera S, Rustico L, Farronato M, Militi A, and Portelli M
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This systematic review aims to highlight the differences between different clear aligner therapies that differ in the presence of attachments or in attachment configuration. Eight electronic databases were searched up to March 2020. Two authors independently proceeded to study selection, data extraction, and risk of bias assessment. The analysis of the results was carried out examining six groups of movements (mesio-distal tipping/bodily movement; anterior bucco-lingual tipping/root torque; posterior bucco-lingual tipping/expansion; intrusion; extrusion; rotation). Five clinical trials were selected and all of them showed a medium risk of bias. Literature showed that attachments mostly increase the effectiveness of orthodontic treatment with clear aligners, improving anterior root torque, rotation, and mesio-distal (M-D) movement; they are also important to increase posterior anchorage. However, some articles showed contradictory or not statistically significant results. Attachments also seem to improve intrusion, but the evidence about this movement, as well as extrusion, is lacking. No studies evaluated posterior bucco-lingual tipping/expansion. Further clinical trials are strongly suggested to clarify the influence of attachments and their number, size, shape, and position on each orthodontic movement.
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- 2022
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36. Can Orthodontic Treatment Be Stable 20 Years after the End of the Treatment Scheme? Treatment of a Class 2, Division 1 Malocclusion with Severe Skeletal Discrepancy and Its 20-Year Follow-Up.
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Aiello D, Nucera R, Costa S, Figliuzzi MM, and Paduano S
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Class II malocclusions, after class I malocclusions, are the most frequent in the juvenile Italian population. They are most often skeletal in origin and due to mandibular retrusion. Functional devices seem to have a beneficial effect on the growth of the jaw. Long-term maintenance of the achieved results is essential for therapeutic success in any orthodontic treatment; moreover, the retention phase should last as long as possible, especially in the lower anterior sector. A female patient aged 10 years and 3 months presented a visibly convex profile and a severe mandibular retrusion. The anamnesis brought to light the habit of oral breathing and lower-lip sucking. The cephalometric analysis showed a normodivergent skeletal class II. The first treatment phase involved the use of a Bass type for 12 months at the end of the functional treatment; the second phase of fixed therapy was carried out following the principles of bioprogressive techniques. The photos at the end of treatment show an important improvement in the profile; a full class I ratio of molar and canine teeth was achieved with an excellent interarch relationship and a correction of the V-shaped upper arch. The result is occlusally and profilometrically stable after 2, 4, 5, 10, 14, and 20 years. The maintenance of a stable orthodontic result over time is the result not only of a correct and physiological occlusion but also and above all of a correct diagnosis and correct identification of problems that can cause the malocclusion itself. Flawed habits such as interposition of the lower lip and oral breathing must be intercepted and corrected early in order to correct them and not affect the long-term result of orthodontic treatment. In this case, a functional device associated with an orthodontic fixed finishing and a correct retention phase were necessary to correctly treat a second-class mandibular retrusion whose result remained stable 20 years after the end of therapy., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2021 Domenico Aiello et al.)
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- 2021
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37. A Simplified Digital Approach to the Treatment of a Postpuberty Patient with a Class III Malocclusion and Bilateral Crossbite.
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Aiello D, Nucera R, Costa S, Figliuzzi MM, and Paduano S
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Monolateral and bilateral crossbites are amongst the most frequent forms of malocclusion in the world population. The lack of early correction of this type of malocclusion leads to the partial or total ossification of the sutures which then require surgical treatment in adult patients. In recent years, devices on minipalatal screws have noticeably increased the time window in which it is possible to correct these types of alterations. In this case report, we show how it is possible to correct a third-class skeletal malocclusion associated with a posterior bilateral crossbite in a young woman using a rapid expander on miniscrews and fixed orthodontic device to finalise the process. The procedure for the insertion of the palatal screws was aided by the use of a digitally printed surgical guide, and the appliance was applied in the same sitting thanks to the use of a digital flow software and a systematic easy driver. The CBCT scans show how the orthopaedic expansion of the upper maxilla was obtained without any important alterations that damaged the permanent teeth. This case report wishes to demonstrate how easy and predictable it can be to resolve cases of this type with optimal aesthetic and functional results even when body growth has ended., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2021 Domenico Aiello et al.)
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- 2021
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38. Psychological and Social Effects of Oral Health and Dental Aesthetic in Adolescence and Early Adulthood: An Observational Study.
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Militi A, Sicari F, Portelli M, Merlo EM, Terranova A, Frisone F, Nucera R, Alibrandi A, and Settineri S
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- Adolescent, Adult, Esthetics, Dental, Female, Humans, Quality of Life, Self Concept, Surveys and Questionnaires, Young Adult, Malocclusion, Oral Health
- Abstract
Background: Is well known that oral health and dental aesthetic have significant effects on the sociality of human beings. The aim of the present study was to assess some aspects of oral health with possible repercussions in adolescent and youth, with particular reference to gender differences., Methods: A total of 190 subjects with female prevalence (F = 62.6%, M = 37%) and ages between 14 and 29 years old (Mean = 23.8; SD = 3.27) participated. Evaluation was carried using standardized instruments to assess quality of oral life (PIDAQ), negative impact of oral conditions (OHIP-14), and self-esteem (Rosenberg Self Esteem Scale). Correlational and difference analyses and linear regressions were performed., Results: Significant gender differences were found in terms of gender, in reference to variables such as self-confidence and convictions. Positive correlations emerged between psychological impact and social impact, aesthetic concern and social impact, convictions and self-confidence, oral health with psycho-social impact, and aesthetic concern, self-esteem with oral health. Inverse correlations emerged between psycho-social impact and self-confidence, aesthetic concern and self-confidence, oral health, and self-confidence. Multivariate linear regression indicated relations between age and psychological impact, sex and self-confidence, crooked teeth and conviction., Conclusions: The impact of oral health on the psychological well-being of young people is relevant. These factors, if considered within clinical practice, can improve the quality of life of the subject.
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- 2021
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39. Complications reported with the use of orthodontic miniscrews: A systematic review.
- Author
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Giudice AL, Rustico L, Longo M, Oteri G, Papadopoulos MA, and Nucera R
- Abstract
Objective: The aim of this systematic review was to evaluate the complications and side effects associated with the clinical use of orthodontic miniscrews by systematically reviewing the best available evidence., Methods: A survey of articles published up to March 2020 investigating the complications associated with miniscrew insertion, in both the maxilla and mandible, was performed using 7 electronic databases. Clinical studies, case reports, and case series reporting complications associated with the use of orthodontic miniscrew implants were included. Two authors independently performed study selection, data extraction, and risk-of-bias assessment., Results: The database survey yielded 24 articles. The risk-of-bias assessment revealed low methodological quality for the included studies. The most frequent adverse event reported was root injury with an associated periradicular lesion, vitality loss, pink discoloration of the tooth, and transitory loss of pulp sensitivity. Chronic inflammation of the soft tissue surrounding the miniscrew with mucosal overgrowth was also reported. The other adverse events reported were lesion of the buccal mucosa at the insertion site, soft-tissue necrosis, and perforation of the floor of the nasal cavity and maxillary sinus. Adverse events were also reported after miniscrew removal and included secondary bleeding, miniscrew fracture, scars, and exostosis., Conclusions: These findings highlight the need for clinicians to preliminarily assess generic and specific insertion site complications and side effects.
- Published
- 2021
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40. Short-term treatment effects produced by rapid maxillary expansion evaluated with computed tomography: A systematic review with meta-analysis.
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Giudice AL, Spinuzza P, Rustico L, Messina G, and Nucera R
- Abstract
Objective: To identify the available evidence on the effects of rapid maxillary expansion (RME) with three-dimensional imaging and provide meta-analytic data from studies assessing the outcomes using computed tomography., Methods: Eleven electronic databases were searched, and prospective case series were selected. Two authors screened all titles and abstracts and assessed full texts of the remaining articles. Seventeen case series were included in the quantitative synthesis. Seven outcomes were investigated: nasal cavity width, maxillary basal bone width, alveolar buccal crest width, alveolar palatal crest width, inter-molar crown width, inter-molar root apex width, and buccopalatal molar inclination. The outcomes were investigated at two-time points: postexpansion (2-6 weeks) and post-retention (4-8 months). Mean differences and 95% confidence intervals were used to summarize and combine the data., Results: All the investigated outcomes showed significant differences postexpansion (maxillary basal bone width, +2.46 mm; nasal cavity width, +1.95 mm; alveolar buccal crest width, +3.90 mm; alveolar palatal crest width, +3.09 mm; intermolar crown width, +5.69 mm; inter-molar root apex width, +2.85 mm; and dental tipping, +3.75°) and post-retention (maxillary basal bone width, +2.21 mm; nasal cavity width, +1.55 mm; alveolar buccal crest width, +3.57 mm; alveolar palatal crest width, +3.32 mm; inter-molar crown width, +5.43 mm; inter-molar root apex width, +4.75 mm; and dental tipping, 2.22°) compared to pre-expansion., Conclusions: After RME, skeletal expansion of the nasomaxillary complex was greater in most caudal structures. Maxillary basal bone showed 10% post-retention relapse. During retention period, uprighting of maxillary molars occurred.
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- 2020
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41. Enhancing the diagnosis of maxillary transverse discrepancy through 3-D technology and surface-to-surface superimposition. Description of the digital workflow with a documented case report.
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Lo Giudice A, Nucera R, Ronsivalle V, Di Grazia C, Rugeri M, and Quinzi V
- Subjects
- Child, Female, Humans, Palatal Expansion Technique, Workflow, Malocclusion, Maxilla
- Abstract
Background: Maxillary transverse discrepancy is often diagnosed in childhood. The evaluation of morphological characteristics of the maxilla is crucial for appropriate treatment of this condition, however conventional diagnostic method is based on visual inspection and transversal linear parameters. In this paper, we described a user-friendly diagnostic digital workflow based on the surface-to-surface analysis. We also described a case report., Case Report: A 6-year-old female patient presenting mild transversal maxillary deficiency associated with functional posterior crossbite was treated by using maxillary removable appliance. In this respect, the appliance was designed in accordance to the morphological characteristics of the maxilla obtained by using the diagnostic digital work-flow and the maxillary surface-to-surface analysis., Conclusion: The present user-friendly diagnostic digital workflow based on surface-to-surface analysis helps clinicians to detect specific morphological characteristics of the maxilla, such as shape and area of asymmetry, in order to reach a comprehensive diagnosis and choose the correct biomechanics for treating the condition.
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- 2020
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42. 3D Assessment of Endodontic Lesions with a Low-Dose CBCT Protocol.
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Portelli M, Militi A, Lo Giudice A, Lo Giudice R, Rustico L, Fastuca R, and Nucera R
- Abstract
Background: Cone beam computed tomography (CBCT) is often used in different fields of dental science, especially in complex anatomical districts like the endodontic one. The aim of this study is to propose a low-dose CBCT protocol useful in cases of endodontic lesions. Methods: The device used was a MyRay Hyperion X9-11x5; the low dose setting of the machine was 90 Kv, 27 mAs, CTDI/Vol 2.89 mGy. The absorbed organ doses have been evaluated with an anthropomorphic phantom loaded with thermoluminescent dosimeters positioned at the level of sensitive organs like brain, bone marrow, salivary glands, thyroid, esophagus, oral mucosa, extrathoracic airways, and lymph nodes. Equivalent and effective doses have been calculated; the last one has been calculated using the recommendations approved by the Main Commission of ICRP (International Commission Radiological Protection) in March 2007. For the assessment of image quality, five senior clinicians, independent and experienced clinicians, were asked to state if CBCT scans were accurate enough to assess endodontic lesions. Results: The use of a low-dose CBCT acquisition produced the lowest organ dose (5.01 microSv) at the level of the esophagus. Image quality has been considered accurate enough for endodontic diagnostic needs. Conclusions: CBCT low-dose protocol can be used over the standard one in endodontic special cases because it provides a significantly lower radiation dose to the patients while ensuring good image quality. However, further studies are necessary to evaluate the opportunity of low-dose CBCT exams in endodontic clinical practice., Competing Interests: The authors declare no conflict of interest.
- Published
- 2020
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43. A Full Diagnostic Process for the Orthodontic Treatment Strategy: A Documented Case Report.
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Lo Giudice A, Rustico L, Ronsivalle V, Spinuzza P, Polizzi A, Bellocchio AM, Scapellato S, Portelli M, and Nucera R
- Abstract
The need for extractions in orthodontic treatment has always been a controversial topic. However, to date there is not a specific clinical guideline that can help the clinicians deciding to plan an extractive or a non-extractive orthodontic treatment. In this respect, clinicians must deal with patients' occlusal, functional, periodontal and aesthetics characteristics before planning an orthodontic treatment including extraction. Considering the absence of specific guidelines, the choice to extract teeth or not is complicated, particularly in borderline cases. In this case report, we present a borderline case of a patient with the skeletal Class III pattern and significant crowding in both arches that could be treated with or without extraction, illustrating the diagnostic and decision-making processes that were conducted for the orthodontic treatment strategy.
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- 2020
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44. Correlation between Caries, Body Mass Index and Occlusion in an Italian Pediatric Patients Sample: A Transverse Observational Study.
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Militi A, Nucera R, Ciraolo L, Alibrandi A, Fastuca R, Lo Giudice R, and Portelli M
- Subjects
- Adolescent, Child, Cross-Sectional Studies, DMF Index, Female, Humans, Italy epidemiology, Male, Body Mass Index, Dental Caries epidemiology, Overweight
- Abstract
Background: The aim of this study was to evaluate the correlation between caries, body mass index (BMI) and occlusion in a sample of pediatric patients., Methods: The study group included 127 patients (72 female, 55 male) aged between 6 and 16 years (mean age 10.2) and selected between January and June 2019 at the Department of Pediatric Dentistry, University of Messina. Caries incidence was evaluated using the decayed, missing and filled teeth (DMFT) index. On the basis of BMI values, using a table adjusted for age and gender, patients were grouped into four categories (underweight, normal weight, risk of overweight, overweight)., Results: There was no significant correlation between BMI and DMFT in the whole sample. The study of the correlation between BMI and DMFT in patients with different types of malocclusion showed a significant inverse correlation for patients affected by II class and deepbite malocclusion., Conclusions: The incidence of caries does not seem to be significantly related to BMI and occlusal patterns, but it decreases with increasing age.
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- 2020
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45. Midpalatal Suture Density Evaluation after Rapid and Slow Maxillary Expansion with a Low-Dose CT Protocol: A Retrospective Study.
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Fastuca R, Michelotti A, Nucera R, D'Antò V, Militi A, Logiudice A, Caprioglio A, and Portelli M
- Subjects
- Bone Density, Child, Female, Humans, Male, Retrospective Studies, Tomography, X-Ray Computed, Cranial Sutures diagnostic imaging, Maxilla diagnostic imaging, Palatal Expansion Technique, Palate, Hard diagnostic imaging
- Abstract
Background and objectives: The aim of the present paper is to use low-dose computed tomography (CT) to evaluate the changes in the midpalatal suture density in patients treated with rapid maxillary expansion (RME) and slow maxillary expansion (SME). Materials and Methods: Thirty patients (mean age 10.2 ± 1.2 years) were retrospectively selected from the existing sample of a previous study. For each patient, a low-dose computed tomography examination was performed before appliance placement (T0) and at the end of retention (T1), seven months later. Using the collected images, the midpalatal suture density was evaluated in six regions of interest. Results: No significant differences were found between the timepoints in the rapid maxillary expansion group. Three out of six regions of interest showed significant decreases between the timepoints in the slow maxillary expansion group. No significant differences were found in comparisons between the two groups. Conclusions: The midpalatal suture density showed no significant differences when rapid maxillary expansion groups were compared to slow maxillary expansion groups, suggesting that a similar rate of suture reorganization occurs despite different expansion protocols.
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- 2020
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46. Maxillary Orthodontic Expansion Assisted by Unilateral Alveolar Corticotomy and Low-Level Laser Therapy: A Novel Approach for Correction of a Posterior Unilateral Cross-Bite in Adults.
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Caccianiga G, Lo Giudice A, Paiusco A, Portelli M, Militi A, Baldoni M, and Nucera R
- Abstract
Introduction: The treatment of a true unilateral posterior crossbite often requires asymmetric maxillary expansion; however, this is challenging to achieve with conventional expansion methods because of several biomechanical limitations. In this paper, we introduce a new protocol for the treatment of a unilateral posterior crossbite in adults based on maxillary orthodontic expansion assisted by corticotomy and low-level laser therapy (LLLT) performed on the crossbite side. Methods: The study sample included 15 adults (8 females, 7 males) affected by a true unilateral posterior crossbite, with a mean age of 21.6 ± 3.1 years at the at the beginning of treatment. After the application of orthodontic appliances (palatal expander and self-ligating brackets), corticomy was performed at the buccal aspect of the crossbite side while LLLT was monthly administered up to the correction of the crossbite. The efficacy of the technique was evaluated through measurements performed on maxillary digital models. Results: All subjects reported successful correction of the posterior unilateral crossbite, and functional occlusion was achieved as well. The average expansion was greater at the crossbite side compared to the unaffected side and such difference was significant at the levels of first premolars ( P < 0.05), second premolars ( P < 0.05) and first molars ( P < 0.05). Conclusion: Orthodontic maxillary expansion assisted by unilateral corticotomy and LLLT was effective in the treatment of the true unilateral crossbite., (Copyright © 2019 J Lasers Med Sci.)
- Published
- 2019
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47. Could the Combined Administration of Bone Antiresorptive Drug, Taxanes, and Corticosteroids Worsen Medication Related Osteonecrosis of the Jaws in Cancer Patients?
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Oteri G, Campisi G, Panzarella V, Morreale I, Nucera R, Di Fede O, Picone A, and Marcianò A
- Subjects
- Diphosphonates, Drug Interactions, Female, Humans, Italy, Male, Neoplasms drug therapy, Osteonecrosis, Retrospective Studies, Adrenal Cortex Hormones adverse effects, Bisphosphonate-Associated Osteonecrosis of the Jaw etiology, Bone Density Conservation Agents adverse effects, Taxoids adverse effects
- Abstract
The study presents a report of 58 metastatic cancer patients who developed osteonecrosis of the jaws after being treated with zoledronic acid and taxanes, plus corticosteroids. A retrospective analysis of data registered in the archives of two Italian osteonecrosis of the jaws treatment centers, who are based at the University of Messina and at the University of Palermo, was performed in order to study, in these patients, demographic data and characteristics such as frequency of cancer location, lines of therapy, frequency of cancer drugs, presence/absence of oral trigger, number, location, and stage of jaw osteonecrosis. It was found that the majority of patients developed advanced stages of osteonecrosis, frequently complicated with infection. It was hypothesized that the concurrent administration of chemotherapeutic agents could be eventually considered as a factor able to allow a faster worsening of the clinical manifestation through the exacerbation of soft tissue defects, due to chemotherapy drugs.
- Published
- 2018
- Full Text
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48. Standard and low-dose cone beam computer tomography protocol for orthognatodontic diagnosis: a comparative evaluation.
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Portelli M, Militi A, Lo Giudice A, Lo Giudice R, Fastuca R, Ielo I, Mongelli V, Lo Giudice G, Martintoni A, Manuelli M, Lucchese A, and Nucera R
- Subjects
- Humans, Phantoms, Imaging, Cone-Beam Computed Tomography methods, Orthodontics
- Abstract
Considering the diagnostic capability offered by cone-beam computed tomography (CBCT), nowadays orthodontists often use this exam for treatment planning, especially in cases of impacted teeth, maxillary ipoplasia, orthognathic surgery etc. The aim of this study was to compare the radiation doses related to a conventional CBCT setting and that of a low dose protocol, usable in orthodontic practice. The absorbed organ doses were measured using an anthropomorphic phantom loaded with thermo-luminescent dosimeters related to sensitive organs (brain, bone marrow, salivary glands, thyroid, esophagus, oral mucosa, extrathoracic airways, lymph nodes). The device used was a MyRay Hyperion X9-11x5. The standard setting of the apparatus was 90 Kv, 36 mAs, CTDI/Vol 4.09 mGy, instead the low dose one was 90 Kv, 27 mAs, CTDI/Vol 2.89 mGy. Equivalent and effective doses have been calculated; the measurement of the effective doses was based on the ICRP recommendations. For the assessment of image quality, five readers, independent and experienced orthodontists, were asked to state if the images were sufficient enough to perform an orthodontic diagnosis. The lowest organ dose (5.01 microSv) was received by the esophagus during low dose CBCT acquisition. The highest mean organ dose instead (1227.67 microSv) was received by the salivary glands during conventional setting CBCT acquisition. Image quality has been considered sufficient for orthodontic diagnostic needs for both CBCT protocols. CBCT low dose setting should be preferred over the standard one in orthodontic practice, because it provides a significant lower radiation dose to the patients ensuring a good image quality. However, further studies are necessary to evaluate the opportunity of CBCT exams in orthodontic treatment planning.
- Published
- 2018
49. Is static friction affected by aging and amount of elastomeric ligatures in orthodontic sliding mechanics? An in-vitro investigation.
- Author
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Lo Giudice A, Portelli M, Militi A, Spinuzza P, Bellocchio AM, Nucera R, Marcolina M, Ghilardi G, Manuelli M, and Lucchese A
- Subjects
- Orthodontic Brackets, Saliva, Artificial chemistry, Elastomers, Friction, Materials Testing, Orthodontic Wires
- Abstract
In straight-wire mechanics, friction can significantly influence the forces expressed by wires. The aim of this study is to assess whether the aging and the sum of elastomeric ligatures affect the static friction during orthodontic space closure. A 0.017x 0.025-in SS was drawn throughout a 3-bracket experimental model and engaged with elastomeric ligatures. Before performing the test, the ligatures were soaked in artificial saliva for 48 hours (Group 1), 2 weeks (Group 2) and 4 weeks (Group 3); brand-new ligatures were also tested as control group (Group 4). The resistance to sliding (RS) was recorded at 3 different numerical configurations of ligatures using a customized testing machine and tests were repeated for ten times. Data of RS were statistically analysed by using two way analysis of variance (ANOVA) and Tukey’s multiple comparison tests. RS was found to increase systematically when more elastomeric ligatures were included in the wire engaging system. At two weeks of immersion in artificial saliva elastomeric ligatures showed the lowest values of RS while they became significantly more frictional after immersion for 4 weeks. The results of this study showed that in multi-bracket orthodontic therapy, the RS increases with the number of elastomeric ligatures involved for arch-wire engagement. Differently from the frictional behavior of elastomeric modules, the aging of these ligatures does not influence their incremental effect of frictional forces.
- Published
- 2018
50. Evidence for Dietary Fibre Modification in the Recovery and Prevention of Reoccurrence of Acute, Uncomplicated Diverticulitis: A Systematic Literature Review.
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Dahl C, Crichton M, Jenkins J, Nucera R, Mahoney S, Marx W, and Marshall S
- Subjects
- Acute Disease, Anti-Bacterial Agents therapeutic use, Diet, Diverticulitis drug therapy, Diverticulitis prevention & control, Evidence-Based Medicine, Humans, Meta-Analysis as Topic, Observational Studies as Topic, Probiotics administration & dosage, Randomized Controlled Trials as Topic, Recurrence, Risk Factors, Dietary Fiber administration & dosage, Diverticulitis diet therapy
- Abstract
In practice, nutrition recommendations vary widely for inpatient and discharge management of acute, uncomplicated diverticulitis. This systematic review aims to review the evidence and develop recommendations for dietary fibre modifications, either alone or alongside probiotics or antibiotics, versus any comparator in adults in any setting with or recently recovered from acute, uncomplicated diverticulitis. Intervention and observational studies in any language were located using four databases until March 2017. The Cochrane Risk of Bias tool and GRADE were used to evaluate the overall quality of the evidence and to develop recommendations. Eight studies were included. There was "very low" quality evidence for comparing a liberalised and restricted fibre diet for inpatient management to improve hospital length of stay, recovery, gastrointestinal symptoms and reoccurrence. There was "very low" quality of evidence for using a high dietary fibre diet as opposed to a standard or low dietary fibre diet following resolution of an acute episode, to improve reoccurrence and gastrointestinal symptoms. The results of this systematic review and GRADE assessment conditionally recommend the use of liberalised diets as opposed to dietary restrictions for adults with acute, uncomplicated diverticulitis. It also strongly recommends a high dietary fibre diet aligning with dietary guidelines, with or without dietary fibre supplementation, after the acute episode has resolved., Competing Interests: The authors declare no conflict of interest.
- Published
- 2018
- Full Text
- View/download PDF
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