The influence of speech-language-hearing therapy duration on the degree of improvement in post-stroke language impairment

浜松医科大学博士（医学）doctoral医学系研究科Background.The relevance of speech-language-hearing therapy (ST) duration to language impairment remains unclear. Objective.To determine the effect of ST duration on improvement in language impairment as a stroke sequela and to compare the findings with those for occupational therapy (OT) and physical therapy (PT). Methods. Data regarding patients with stroke sequelae who were registered in the Japanese Association of Rehabilitation Medicine database were analyzed. Propensity scores for ST, OT, and PT duration were calculated using logistic regression, followed by inverse probability weighting in generalized estimating equations to examine the odds ratio for improvement in the Functional Independence Measures scores for comprehension, expression, and memory. Analyses stratified by age and dementia severity were also conducted. Results. Compared with short-duration ST, longduration ST was significantly associated with improved scores for comprehension and expression in the overall study population and in some groups, with higher benefit especially for younger participants (<64 years) and those with more severe dementia. A significant but less pronounced effect was also observed for OT and PT. Conclusion. Long-duration ST is more effective than longduration OT or PT for improving language impairment occurring as stroke sequela. However, these effects are limited by age and severity of dementia.doctoral thesi

Chemopreventive and Biological Strategies in the Management of Oral Potentially Malignant and Malignant Disorders

Oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) represent a significant global health burden due to their potential for malignant transformation and the challenges associated with their diagnosis and treatment. Chemoprevention, an innovative approach aimed at halting or reversing the neoplastic process before full malignancy, has emerged as a promising avenue for mitigating the impact of OPMD and OSCC. The pivotal role of chemopreventive strategies is underscored by the need for effective interventions that go beyond traditional therapies. In this regard, chemopreventive agents offer a unique opportunity to intercept disease progression by targeting the molecular pathways implicated in carcinogenesis. Natural compounds, such as curcumin, green tea polyphenols, and resveratrol, exhibit anti-inflammatory, antioxidant, and anti-cancer properties that could make them potential candidates for curtailing the transformation of OPMD to OSCC. Moreover, targeted therapies directed at specific molecular alterations hold promise in disrupting the signaling cascades driving OSCC growth. Immunomodulatory agents, like immune checkpoint inhibitors, are gaining attention for their potential to harness the body’s immune response against early malignancies, thus impeding OSCC advancement. Additionally, nutritional interventions and topical formulations of chemopreventive agents offer localized strategies for preventing carcinogenesis in the oral cavity. The challenge lies in optimizing these strategies for efficacy, safety, and patient compliance. This review presents an up to date on the dynamic interplay between molecular insights, clinical interventions, and the broader goal of reducing the burden of oral malignancies. As research progresses, the synergy between early diagnosis, non-invasive biomarker identification, and chemopreventive therapy is poised to reshape the landscape of OPMD and OSCC management, offering a glimpse of a future where these diseases are no longer insurmountable challenges but rather preventable and manageable conditions

Orthodontic patients and the information found on the web: a cross-sectional study

Background In recent years, the Web has become a source of medical information for patients, even though the information available online may be incorrect or qualitatively inadequate. Younger generations, immersed in a digital environment since a very tender age, are more likely to get informed online. This study aims to understand the relevance of online information for prospective orthodontic patients and to investigate the effects of digital research on patients’ decision-making process, and it also aims to investigate potential generational differences between digital natives and digital immigrants. Materials and methods An anonymous questionnaire was developed to investigate patients’ orthodontic-themed Web searches as well as the effects digital material had on their decision-making process. Before submitting the newly designed survey to patients, it was validated in a pilot study. Univariate analysis was applied to analyze the relationship between the demographic characteristics of respondents and their answers on the use of digital research for the decision-making process. Results 64.6% of the study population searched the Web for orthodontic information prior to their visit. Google was the most used platform regardless of patients’ age. The perceived reliability of online sources varied significantly with age. Men displayed more trusting behavior towards their doctor than women. Prospective patients’ satisfaction with affected patients’ decision-making processes, and the perceived reliability of online sources of information had repercussions on the doctor-patient relationship. Conclusions Orthodontists should be aware that the majority of patients use the Internet as a source for orthodontic information, and that patients who are digital immigrants are more prone to trust the information found online. Patients who perceive the information found on the Web as either useful or reliable don’t easily discard it, even if it is inconsistent with the orthodontist’s opinion

情報発信型コミュニケーション能力の育成（資料）

Articledepartmental bulletin pape

兵庫県自然学校における指導補助員の実態と指導に与える影響 ： 教員・指導補助員双方の立場から見た自然学校

兵庫教育大学修士thesi

Actinomyces infection after permanent fillers lip augmentation: Diagnosis and treatment

Background: Although dermal filler injections are a widespread and secure practice, early or late complications may nonetheless occur. Objective: In this paper, the authors report an unusual asymptomatic late filler infection caused by Actinomycetes in a patient having received liquid silicone and acrylate filler injections for lip enhancement, seeking treatment for upper lip macrocheilia. Methods: The case report is about a patient who complained of recurrent lip region edema and denied any infective episodes. Preoperative analysis was in the normal range. Sonographic exam showed two fillers in the upper lip, suggestive of silicone and polyacrylamide gel. A conservative macrocheilia reduction was performed; healing was uneventful. Results: Histology report confirmed the preoperative sonographic diagnosis, together with an actinomycetes infection, clinically unsuspected. Many microorganisms have been reported to cause abscesses or granuloma after dermal filler treatments, sterile abscesses were reported as well, suggesting a biofilm infection as causative granuloma origin. Conclusion: This study differs from previous filler complication reports because of the occasional finding of a silent actinomyces infection, a commensal of the oral cavity but responsible for suppurative diseases in the soft tissues. This occasional finding seems to support the biofilm origin of dermal filler granuloma

3D Diagnosis in Dentistry

INTRODUCTION 3D imaging is rapidly changing diagnostic procedures in all fields of dentistry. Intraoral scanners and three-dimensional radiographs, Tc and ConeBeam, have entered the routine of everyday clinical practice. Patient photography has also evolved into stereophotogrammetry, which obtains threedimensional images of the face. The advancements in 3D technologies have stimulated the production of software that allows the anatomy of the dental patient to be reconstructed in three dimensions. Technological development has stimulated research in finding ways to improve diagnostic programming and therapeutic programming. In recent years, many articles have been published that compare 2D technologies to 3D technologies in dental diagnosis. At the same time, new 3D image analysis systems were studied, enhanced by the development of artificial intelligence systems based on machine learning. Research in the field of dentomaxillofacial radiology concerns automated diagnosis of dental and maxillofacial diseases, localization of anatomical landmarks for orthodontic and orthognathic treatment planning, and general improvement of image quality. Other recent research evaluates the quality and use of intraoral scanners and 3D software and printers for the design and implementation of therapeutic means. CAD / CAM technology is used in many fields of dentistry, especially in implantology, prosthetics, orthodontics, and maxillofacial surgery. Surgical guides for implantology and orthodontic miniscrews placement, provisional and definitive prosthetic restorations, and many orthodontic appliances are designed and built. In this field, research and technology are revolutionizing clinical procedures, which in many cases can follow a digital workflow. Finally, many studies propose the evaluation of stereophotogrammetry as a means of integrating 3D diagnosis. In this field, scientific research has produced works on the evaluation of the means of image acquisition and on the positioning of landmarks that allow measuring the proportions * Address correspondence to this author at the Dental Institute, Catholic University of the Sacred Heart, Fondazione Policlinico Gemelli IRCCS. L.go A. Gemelli, 8 – 00168 Rome, Italy; E-mail: [email protected] of the facial volumes and accurately observing the effects of therapies on soft tissues. As a demonstration of the novelty and scientific interest in this topic, the production of scientific works is constantly increasing. The researchers are trying to overcome the gap in the difficulty of using the technology through the proposal of automatic 3D image processing systems, which make clinical application easier. This Guest Editor issue is particularly dedicated to updating the knowledge regarding the use of digital devices in the diagnostic process. One of the results in publishing articles on 3D diagnosis is to show the community of dentists how to use the new technologies in daily practice. I am grateful to the Editorial Board of The Open Dentistry Journal at Bentham OPEN for this special issue. The articles collected in this issue report the novelties brought by digital technologies in orthodontics. One of the most peculiar effects of using new technologies is that dentists are allowed to study the face of the patient and measure it precisely. This aspect is very important for orthodontic diagnosis, but its importance is growing in all the fields of dentistry due to the increase of attention on the facial aspect. Facial esthetic today has the same importance as dental occlusion and function, thus has contributed to increasing the multidisciplinarity of dental interventio

Bite and Sight: Is There a Correlation? Clinical Association between Dental Malocclusion and Visual Disturbances in Pediatric Patients

Aim: The aim of this study was to evaluate the correlation between malocclusions and visualdefects. Thisisacase-controlstudyevaluatingtheprevalenceofvisualdefectsinpatientswith di\ufb00erent types of malocclusions. Methods: One-hundred and sixty patients aged from 5 to 14 were evaluatedusingtheROMAindextodetectmalocclusion;theoneswiththelowestscoreswereusedas the control group. They were also submitted to visual-capacity inspection for motility and refractive disorders. Results: Our work showed an enhanced prevalence of refractive defects or fusional vergence defects and alteration of eye movements (especially the saccades) in almost all dental malocclusions. Statistics: TheKappatestvaluesforROMAindexwerebetween0.643and1.00forthe intraoperator agreement (0.00 &lt; p &lt; 0.002) and between 0.773 and 1.00 for the agreement between operators (p = 0 &lt; 0.001). The statistically signi\ufb01cance level for the correlation malocclusion/visual defectswassetatp &lt; 0.05. StatisticalanalyseswereperformedwiththeSTATAsoftware(version15.0, Stata Corp LP, College Station, TX, USA). Conclusion: Considering the high level of the statistical analysis and the accuracy of the methodology used, these data allows the establishment of a huge correlation between sagittal, transversal and vertical malocclusions with ocular disorders (myopia, hyperopia, astigmatism and ocular motility defects)

Three-dimensional analysis of dental arch forms in Italian population

Abstract Background: The aim of this study was the comparison of male and female upper and lower dental arch form in untreated Italian patients by 3D analysis, to find differences in shape, in transversal and longitudinal diameters between sexes, and to give a representative set of population \u2019s dental arch to clinicians in order to provide suitable orthodontic treatment. Methods: The sample consisted of 3D scans of dental casts deriving from 104 Italian untreated patients (Male = 35, Female = 69) in permanent dentition. An evaluation of the arch form was performed by angular and linear values on every patient using a 3D software (SolidWorks\uae). A Student \u2019s two-tailed t test was used to determine if the differences in measurements between the male and female groups were significant and the level of significance was set at P<0.05. Results: Statistically significant differences in upper and lower transversal and longitudinal diameters were found. Male arch widths were significantly larger than those of females. Male intercanine, intermolar, and interpremolar diameters were significantly greater than females. Dental arch depth was significantly smaller in the female group. Anterior upper dental arch form was flatter, wider, and less sharp in the female group. Conclusions: Basing on the anatomical arches differences found between sexes concerning Italian patients, it is suggested to have regard to each patient pre-treatment arch form, width, and depth during orthodontic treatment according to gender

3D Facial Analysis in Class II Subdivision Malocclusion

Background: Class II subdivision is an asymmetric condition presenting a Class I dental occlusion on one side and a Class II on the contralateral one. It presents a midline deviation that may be caused by a monolateral distalization of the mandible (type 1) or a mesialization of one side of the maxilla (type 2). The evaluation of asymmetry based on 2D radiographic records has been demonstrated to be less accurate than the one made using 3D radiographs. Objective: The aim of this work is to evaluate the facial asymmetry in a group of patients with Class II subdivision, compared to patients in Class I without evident asymmetry, by using 3D photographs of the face. Methods: 32 young adults with Class II subdivision were compared to a group of 32 subjects with bilateral Class I molar relationship. 3D photograph of their face was acquired using a stereophotogrammetric camera (3dMDtrio System-3dMD Atlanta, GA, USA). 3D photographs were imported into the Geomagic Software to create mirror 3D photography. Independent T-tests were made to compare facial asymmetries measured on Class II subdivision group with the Class I group. Results: The results show that there is a statistically significant difference in landmarks location between the control group and the experimental group regarding the values measured at the level of the lips and the perioral area. The asymmetry was more marked in patients with mandibular midline deviation. This is in line with previous observations with radiographic investigations. Conclusion: For a correct assessment of the asymmetry, a study of 3D photographs cannot replace an evaluation by cone beam, but it can be an important aid to estimate possible asymmetries in the perioral area and in the lip area