Anxiolytic and Analgesic Effects of Melatonin in Paediatric Dentistry

Aim: Fear and anxiety are the principal obstacles for dental treatment in children and can turn into dental phobia, leading to patients avoiding dental treatment. Melatonin, an endogenous indolamines produced and secreted by the pineal gland, is involved in many physiological functions such as regulation of circadian rhythm as well as possessing antioxidant, oncostatic, anti-inflammatory and anticonvulsant activity; it may be administered orally or sublingually, without any evidence of substantial side effects. After oral administration, melatonin undergoes first-pass effect, reaches the plasma peak after about 60 min and blood levels decrease in about 4 h. Study Design: This is a retrospective case-control age and sex matched study. We collected data about first visit and treatment of 50 patients admitted to the Dental Clinic and to the Private Center of the investigators. Methods: According to literature, 25 children received 0.5 mg/ kg Melatonin 60\u2019 before being subjected to first visit and pedodontic treatment. No preventive treatment was given to 25 children. We compared the success of treatment and the pain experienced by the child assessed by FLACC behavioural pain scale. Results: Both groups included 25 patients (15 male), mean age 7.6 yrs in Group A, 7.1 yrs in Group B. Melatonin treatment was well tolerated by 100% of children. According to FLACC scale categories, 42% of all children presented relaxed and comfortable or mild discomfort (FLACC scale 0-3), 42% moderate pain (FLACC scale 4-6), and 16% severe discomfort or pain or both (FLACC scale 7-10). Statistics: Operators found greater compliance by children receiving melatonin with 96 % successful treatment versus 68% (p 0.012). We found 60% of children receiving melatonin experienced relaxed and comfortable o mild discomfort versus 40% in Group B (p 0.001). Conclusions: Although a larger population study is needed, the anxiolytic and analgesic properties of melatonin seem to offer new therapeutic opportunity in the pedodontic field

Relapses of traumatic peroneal tendons subluxation already treated surgically: a new surgical approach

Aim To illustrate the surgical treatment of relapses of traumatic peroneal tendons subluxation. Methods We came across a young woman, who sustained a sprain in her dominant ankle after a trauma; we noticed subluxation of the peroneal tendons during eversion and extension of the foot. She referred to a previous accident some years before with peroneal tendon subluxation treated by superior peroneal retinaculum (SPR) sutures with a synthetic braided absorbable material. We prescribed conventional radiography, magnetic resonance imaging (MRI) and performed surgery: we removed scar tissue, reattached the retinaculum using suture anchors strengthening it with an acellular dermal matrix allograft patch. Results Periodic clinical follow-ups until 24 months were performed evaluating the stability of the ankle, checking the range of movement, and the Visual Analogic Scale (VAS) and American Orthopedic Foot and Ankle Society Score (AOFAS) was administered. At the first check the subluxation was resolved and the ankle was stable. The VAS scale had the value of 0 at the 3-month follow-up maintained until the final check. Conclusion Relapsing traumatic peroneal tendons subluxation is rare, as well as the possibility of a re-intervention years later. This technique seems to guarantee an excellent result even in the long term, allowing resolution of pain and joint stability. In fact, the use of acellular dermal patch is an already commonly described technique for the augmentation in rotator cuff and hip capsular repair; no reports are available in literature in relation to the use of graft for the repair of the superior peroneal retinaculum

High results and lower cost in four-bone arthrodesis with retrograde screws

Aim To describe the technique of the four-corner fusion with two retrograde crossed headless screws in cases of carpal collapse. Methods This technique is a consolidated procedure performed in cases of scaphoid non- union advanced collapse (SNAC) type II and III, scapholunate advanced collapse (SLAC) type II and III and in other cases of carpal collapse. Between 2017 and 2019 we treated six male patients (a mean age of 55.0 years) with radiocarpal osteoarthritis. Our technique involves the use of two retrograde crossed headless screws; the first screw was placed distally proximally from the uncinate to the lunate and the second screw from the pyramidal to the capitate, crossed at approximately 90 degrees. Clinical and radiographic two-year follow-up was performed. Before the treatment and during the follow-ups VAS, PRWE and DASH Quick score scales, measured wrist range of motion (WROM) were administered and evaluated. Results In all cases the X-ray consolidation of arthrodesis within five months was noticed; in 50% patients already under 3-month control. No observed signs of mobilization of screws and inflammatory or infectious processes were found. All patients were satisfied (reduction/disappearance of pain). All surgically treated patients resumed normal daily activities. These improvements were confirmed by the results of the evaluation scale and clinical examination. Conclusion This technique, in our opinion, represents a gold standard. Its low costs of the material used (especially comparing to other technique), a low prevalence of complications of materials and fusion in 100% of cases should be also considered

Graphene-Based Interconnects for Stable Dye-Sensitized Solar Modules

We present Z-Type Dye Sensitized Solar Modules (DSSMs) with screen printed graphene-based vertical interconnects. This prevents corrosion of interconnects in contact with electrolytic species, unlike conventional Ag interconnects. By enlarging the width of single cells, or by increasing the number of cells, we get an enhancement of the aperture power conversion efficiency ∼+12% with respect to Ag-based modules, with 1000 h stability under 85 °C stress test. This paves the way to original design layouts with decreased dead area and increased generated power per aperture area

Photocatalytic activity of exfoliated graphite-TiO2_2 nanocomposites

We investigate the photocatalytic performance of composites prepared in a one-step process by liquid-phase exfoliation of graphite in the presence of TiO2 nanoparticles (NPs) at atmospheric pressure and in water, without heating or adding any surfactant, and starting from low-cost commercial reagents. These show enhanced photocatalytic activity, degrading up to 40% more pollutants with respect to the starting TiO2-NPs, in the case of a model dye target, and up to 70% more pollutants in the case of nitrogen oxides. In order to understand the photo-physical mechanisms underlying this enhancement, we investigate the photo-generation of reactive species (trapped holes and electrons) by ultrafast transient absorption spectroscopy. We observe an electron transfer process from TiO2 to the graphite flakes within the first picoseconds of the relaxation dynamics, which causes the decrease of the charge recombination rate, and increases the efficiency of the reactive species photo-production.We acknowledge funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No. 785219 (GrapheneCore2), EU Neurofibres, ERC Minegrace and Hetero2D, EPSRC Grants EP/509K01711X/1, EP/K017144/1, EP/N010345/1, EP/M507799/5101, and EP/L016087/1