Long term therapeutic efficacy of a soft monobloc mandibular advancement device in adults with obstructive sleep apnea

To evaluate the long term (48 months) therapeutic efficacy of a soft monobloc mandibular advancement device in adult patients with mild or moderate obstructive sleep apnea

Low-dose CT protocol for orthodontic diagnosis.

AIM: This was to correlate the dosimetric evaluation with high diagnostic accuracy by suggesting a protocol that significantly reduces the dose administered by a Dentascan exam without affecting diagnostic accuracy. MATERIALS AND METHODS: 17 patients were selected consecutively (7 males and 10 females) of a mean age of 11.2 (8-14 years) who sought orthodontic treatment. They needed CT control before and after treatment with RME to evaluate impacted canines. The study was performed using a multidetector 16-rows CT with two protocols that provided 2 different KV acquisition parameters: 80 KV or 120 KV. Radiation dose was evaluated in two ways: CTDI and DLP. Image quality was rated and the results were compared to identify significant differences in terms of image quality, radiation exposure and presence of artefacts. RESULTS: The 80 KV scanning has a significantly lower effective radiation dose compared to the 120 KV scanning (p <0.05). The images of all patients were used for comparing the protocols in terms of image quality. The mean scores for the 80 KV scanning images were 4.18 +/-0.81 and 4.41 +/-0.80 for dose obtained by 120 KV scanning. The median image quality was 4 (good) for both protocols. The 80 KV protocol allowed, as well as the 120 KV, a careful analysis by the orthodontist and the dental surgeon that together, based on this images, can choose the best line of treatment between several available options. CONCLUSION: 80 KV protocols compared with 120 KV protocols resulted in reduced total radiation dose without relevant loss of diagnostic image information and quality. The images were good enough to obtain information about the exact position of impacted teeth and to plan the best line of surgical treatment and mechanotherapy strategy

Treatment and posttreatment skeletal effects of rapid maxillary expansion studied with low-dose computed tomography in growing subjects

Introduction: The aim of this study was to apply low-dose computed tomography (CT) to evaluate treatment and posttreatment effects produced by rapid maxillary expansion (RME) at the levels of the midpalatal suture and the pterygoid processes. Methods: A sample of 17 subjects (7 boys, 10 girls; mean age, 11.2 years) was analyzed. Multi-slice CT scans were taken before RME, at the end of the active expansion phase, and after a retention period of 6 months. Statistical analysis was performed with ANOVA for repeated measures with post-hoc tests. Results: The amounts of opening of the midpalatal suture during the active phase of expansion were 3.01, 2.17, and 1.15 mm for the anterior, middle, and posterior suture widths, respectively. Pterygoid width also showed a statistically significant increase (1.49 mm). In the postretention period, all transverse measurements had significant decreases except for pterygoid width. Conclusions: At the end of the retention phase after RME therapy, the transverse width of the midpalatal suture was similar to the pretreatment width, whereas the width between the pterygoid processes was significantly increased

Intersession reliability of a posturo-stabilometric test, using a force platform

To evaluate the intersession reliability of a posturo-stabilometric examination. METHODS: Single blind clinical trial conducted in two sessions over two weeks. 44 healthy volunteers free from postural and temporomandibular disorders. All the subjects complied with the criteria for completing the study. All the subjects underwent two sessions of posturo-stabilometric examinations in different visual and mandibular conditions. Sway area, sway length and the coordinates of the center of pressure were evaluated and statistically analyzed using the Intraclass correlation coefficient (ICC). RESULTS: All the posturo-stabilometric parameters seemed to have an excellent reproducibility with overall ICCs higher than 70% and good confidence intervals except for the sway area (ICC 0.422 with CI 0.283-0.560 with open eyes and ICC 0.554 with CI 0.424-0.683 with closed eyes). CONCLUSIONS: The posturo-stabilometric examination carried out using a force platform has a good intrasession and intersession reliability, especially considering sway velocity, COP X and COP Y parameters. The force platform usefulness in analyzing static posture is confirmed in any medical field

Influence of activation protocol on perceived pain during rapid maxillary expansion

To investigate the influence of two different activation protocols on the timing and intensity of pain during rapid maxillary expansion (RME)

Immediate and post-retention effects of rapid maxillary expansion investigated by computed tomography in growing patients

Objective: To determine by low-dose computed tomography (CT) protocol the dental and periodontal effects of rapid maxillary expansion (RME). Materials and Methods: The sample comprised 17 subjects (7 males and 10 females), with a mean age at first observation of 11.2 years. Each patient underwent expansion of 7 mm. Multislice CT scans were taken before rapid palatal expansion (TO), at the end of the active expansion phase (T1), and after a retention period of 6 months (T2). On scanned images, measurements were performed at the dental and periodontal levels. Mean differences between measurements at TO, T1, and T2 were examined through analysis of variance (ANOVA) for repeated measures with post-hoc tests. Results: All interdental transverse measurements were significantly increased at both T1 and T2 with respect to TO. In the evaluation of T0-T1 changes, periodontal measurements were significant on the buccal aspect of banded teeth with a reduction in alveolar bone thickness corresponding to the mesial (-0.5 mm; P < .05) and distal (-0.4 mm; P < .05) roots of the right first molar and to the mesial root of the left first molar (-0.3 mm; P < .05). In the evaluation of overall T0-T2 changes, the lingual bone plate thickness of both first molars was found to be significantly increased (+0.6 mm; P < .05). Conclusions: RME therapy induces a significant increase in the transverse dimension of the maxillary arch in growing subjects without causing permanent injury to the periodontal bony support of anchoring teeth discernible on CT imaging. (Angle Orthod. 2009;79:24-29.

Gnathological features in growing subjects

Aim of this study was to evaluate the prevalence of temporomandibular disorders (TMD) in a sample of consecutive subjects

Long-Term Safety of Anti-TNF Adalimumab in HBc Antibody-Positive Psoriatic Arthritis Patients: A Retrospective Case Series of 8 Patients

Immunosuppressive drugs commonly used in the treatment of psoriatic arthritis make patients more susceptible to viral, bacterial, and fungal infections because of their mechanism of action. They not only increase the risk of new infections but also act altering the natural course of preexisting infections. While numerous data regarding the reactivation of tuberculosis infection are available in the literature, poor information about the risk of reactivation or exacerbation of hepatitis viruses B and C infections during treatment with biologics has been reported. Furthermore, reported series with biological therapy included short periods of followup, and therefore, they are not adequate to verify the risk of reactivation in the long-term treatment. Our study evaluated patients with a history of hepatitis B and psoriatic arthritis treated with adalimumab and monitored up to six years. During the observation period, treatment was effective and well tolerated in all patients, and liver function tests and viral load levels remained unchanged