Comparision of profile macro-estethic perception among orthodontists, dentistry students, orthodontic patients and surgical orthodontic patients

Background: The patient's needs should guide the orthodontist in choosing the most appropriate therapy. The purpose of the present survey was to compare the esthetic perception of the facial profile by orthodontists (O), dentistry students (DS), orthodontic patients (OP) and surgical-orthodontic patients (SOP) and to evaluate the influence of gender, age and level of study. Material and Methods: A facial profile photograph of a young female was taken and twelve modified images were made, altering the position of the jaws in protrusion and in retrusion. Two hundred caucasian examiners, divided into four groups (O, DS, OP, SOP), were selected. Each examiner was asked to complete the questionnaire with an approval rating from 1 to 10. An ordinary least square OLS model was applied. Significant levels were set at P ≤ 0.05. Results: All examiners considered a straight profile or a slight retrusion of the maxilla as the most attractive profile. Slight discrepancies (up to 2 mm) in jaw protrusion were barely perceived by patients. Mandibular retrusion (2 and 4 mm) was one of the least appreciated condition by all examiners. Surgical-orthodontic patients assigned lower ratings compared to orthodontic patients. Female subjects assigned lower ratings than males. Patients with secondary school education assigned higher statistically significant values compared to other levels of study. The lowest values were attributed by the sample of age > = 17 years. Conclusions: The choice of the most appropriate therapy is based not only on a correct diagnosis, but on the evaluation of esthetic and psychological aspects

Is a two-month healing period long enough to achieve osseointegration? A prospective clinical cohort study

The aim of this study was to evaluate the effectiveness of loading at 2 months after the surgical placement of implants. A tapered implant was used. Implant stability was determined using resonance frequency analysis at implant insertion (T0; primary stability), after 2 months (T1), and at the 6-month follow-up (T2). Descriptive statistics and the t-test were used. Significance was at P ≤ 0.05. A total of 268 implants were inserted in 142 patients. No patient dropped out and no implant had failed at the 6-month follow-up. The mean implant stability quotient value (ISQ) increased over time, with a statistically non-significant difference for T0 vs. T1 (P = 0.08) and a statistically significant difference for T1 vs. T2 (P = 0.0018) and T0 vs. T2 (P = 0.000). Only 99 implants, characterized by an extremely high mean primary stability value (80.34), did not have a recorded increase in ISQ at T1. A 2-month healing period allowed the implant to achieve secondary stability, confirming the effectiveness of the loading protocol at 2 months

Peri-implant bone loss around platform-switched Morse taper connection implants: a prospective 60-month follow-up study

The aim of this study was to measure the crestal bone level changes at 60 months of follow-up and to evaluate the influence of biologically relevant, anatomical, and implant-related variables. A prospective study design was used. STROBE guidelines were followed. A total of 576 implants were inserted in 270 patients needing an implant-supported, partial, fixed dental prosthesis or a single crown. Standardized peri-apical radiographs were obtained at 2 months (time of implant-abutment connection and prosthetic loading) and 60 months of follow-up. Descriptive statistics were used and inter- and intra-examiner reliability determined. A mixed model was used to evaluate the predictor variables. The correlation among multiple implants inserted in a single patient was considered. Significance was assessed using the type 3 test. Sensitivity analyses, least-squares means analyses, t-tests, and χ(2) tests were also conducted. The statistical analysis was performed at the implant level; P<0.05 indicated statistical significance. At the 60-month follow-up, the mean marginal bone remodelling was -0.59±1.34mm (range -5.70 to 3.65mm). Marginal bone loss was significantly influenced by implant depth, implant location, and the interactions implant depth×jaw, implant location×timing of implant placement, and jaw×implant diameter. At the 60-month follow-up, a low mean marginal bone loss was found, which was significantly higher with subcrestal implants and anterior implants

Is there a learning curve in static computer-assisted implant surgery? A prospective clinical study

Static computer-assisted surgery (s-CAS) has been introduced to improve the results of implantology. A prospective cohort study was conducted following the STROBE guidelines to determine the presence of a learning curve in s-CAS. Six partially and six totally edentulous patients were treated by two surgeons experienced in implantology but completely inexperienced in s-CAS. Preoperative and postoperative computed tomography scans were matched to assess coronal, apical, and angular deviation and the positioning error. The accuracy data were used to evaluate the learning curve. Fifty-six implants were inserted. In partially and totally edentulous patients, the mean (range; standard deviation) coronal deviation was 0.87 (0.34–1.27; 0.35) and 1.24 (0.72–2.67; 0.79); the mean apical deviation was 1.13 (0.48–1.63; 0.39) and 1.52 (0.88–3.84; 1.15); the mean angular deviation was 2.63 (1.89–4.50; 0.98) and 3.59 (1.69–6.30; 1.65); and the mean positioning error was 0.80 (0.32–1.25; 0.35) and 1.14 (0.35–2.56; 0.77), respectively. A typical ‘learning curve’ effect was not identified for s-CAS

Relationship between upper lateral incisors anomalies and palatal displaced canine: a case-control retrospective study

Background: An observational case-control study was designed to retrospectively assess the association among sex, skeletal and dental variables and the and the palatal maxillary canine impaction. Methods: The STROBE guidelines were followed. The records of 2195 subjects were analyzed. The data records of subjects with palatally displaced canine (PDC) were compared with the data of randomly selected subjects without PDC. Descriptive statistics, logistic regression model and χ2 test were used. Resultlts: One hundred and one subjects presented at least one PDC; 106 subjects without PDC were randomly selected. From the logistic model, it was found that only gender and persistence of the deciduous canine were significantly associated with PDC. The Chi-square test showed a correlation between the presence of upper lateral incisor anomalies and PDC, otherwise, considering the unilateral impaction, there was no statistically significant difference in the relationship between canine impaction and the presence of the lateral incisor anomalies, on the same or opposite side of the impaction. Conclusions: The female sex and the persistence of maxillary deciduous canines are associated with PDC. The anomalies of the lateral incisor do not seem to play a mechanistic role, but could rather represent a genetic variable of the canine eruption disorder

Reduction of risk factors for cardiovascular diseases in morbid-obese patients following biliary-intestinal bypass: 3 years' follow-up

BACKGROUND: Obese patients are often affected by hypertension, dyslipidaemia, impaired glucose metabolism, and suffer from cardiovascular disease (CVD), related to the characteristic metabolic alterations. AIM OF THE STUDY: To evaluate reduction of risk factors for CVDs in morbid-obese patients ( body mass index (BMI) 440 kg/m(2)) after weight loss upon bariatric surgery intervention of biliary-intestinal bypass. SUBJECTS: 45 (17 men, 28 women) morbid-obese patients (age: 19-49 y, BMI>40 kg/m(2)). All patients were selected on the basis of medical history, physical and biochemical evaluation and of psychiatric tests, which were performed on all individuals admitted to our Day Hospital to verify the safety of surgical intervention. MEASUREMENTS: Body weight, body composition (by dual X-ray absorptiometry, DXA), blood pressure, lipid profile, fibrinogen and glucose metabolism were monitored at baseline and 1, 3, 6, 9, 12, 24 and 36 months after surgery. RESULTS: A significant and persistent weight loss was present in all patients at the end of the 3 y follow-up period (P<0.001), with a progressive reduction of total and trunk fat mass as evaluated by means of DXA. Additionally, a parallel significant reduction in systolic (P<0.001) and diastolic (P<0.001) blood pressure was observed. Total and LDL cholesterol were significantly reduced (P<0.001), while HDL showed no modifications; triglycerides declined progressively during the 3 y follow-up (P<0.001). Fibrinogen decreased from 364.5&PLUSMN;82.4 to 266.4&PLUSMN;45.7 mg/dl at the end of the period (P<0.001). Fasting glucose levels and glucose levels 120 min after an oral glucose tolerance test were reduced from 95.1720.3 to 78.679.1 mg/dl (P<0.001) and from 116.9&PLUSMN;34.7 to 77.6&PLUSMN;15.5 mg/dl (P<0.001), respectively, at baseline and at the end of the study. Moreover, fasting insulin decreased from 30.0720.4 to 8.672.9 muUI/ml (P<0.001) after 3 y, while insulin levels after ( 120 min) oral glucose load decreased from 105.5761.5 to 12.076.0 &mu;UI/ml (P<0.001). CONCLUSION: Our results show that biliary-intestinal bypass may represent a valid and alternative therapeutic approach in patients with morbid obesity since it induces a significant and stable reduction of body weight and obesity-related risk factors for CVD