The correlation between soft and hard X-rays component in flares: from the Sun to the stars

In this work we study the correlation between the soft (1.6--12.4 keV, mostly thermal) and the hard (20--40 and 60--80 keV, mostly non-thermal) X-ray emission in solar flares up to the most energetic events, spanning about 4 orders of magnitude in peak flux, establishing a general scaling law and extending it to the most intense stellar flaring events observed to date. We used the data from the Reuven Ramaty High-Energy Solar Spectroscopic Imager (RHESSI) spacecraft, a NASA Small Explorer launched in February 2002. RHESSI has good spectral resolution (~1 keV in the X-ray range) and broad energy coverage (3 keV--20 MeV), which makes it well suited to distinguish the thermal from non-thermal emission in solar flares. Our study is based on the detailed analysis of 45 flares ranging from the GOES C-class, to the strongest X-class events, using the peak photon fluxes in the GOES 1.6--12.4 keV and in two bands selected from RHESSI data, i.e.20--40 keV and 60--80 keV. We find a significant correlation between the soft and hard peak X-ray fluxes spanning the complete sample studied. The resulting scaling law has been extrapolated to the case of the most intense stellar flares observed, comparing it with the stellar observations. Our results show that an extrapolation of the scaling law derived for solar flares to the most active stellar events is compatible with the available observations of intense stellar flares in hard X-rays.Comment: 9 pages, 10 figures. To be published in Astronomy and Astrophysic

New frontiers on adjuvants drug strategies and treatments in periodontitis

Causes of the progression of periodontitis such as an imbalance between the immune response by the host by the release of inflammatory mediators in the response of the oral pathogenic dysbiotic biofilm have been identified. New insights on specific cell signaling pathways that appear during periodontitis have attracted the attention of researchers in the study of new personalised approaches for the treatment of periodontitis. The gold standard of non‐surgical therapy of perio-dontitis involves the removal of supra and subgingival biofilm through professional scaling and root planing (SRP) and oral hygiene instructions. In order to improve periodontal clinical outcomes and overcome the limitations of traditional SRP, additional adjuvants have been developed in recent decades, including local or systemic antibiotics, antiseptics, probiotics, anti‐inflammatory and anti-resorptive drugs and host modulation therapies. This review is aimed to update the current and recent evolution of therapies of management of periodontitis based on the adjunctive and target therapies. Moreover, we discuss the advances in host modulation of periodontitis and the impact of targeting epigenetic mechanisms approaches for a personalised therapeutic success in the management of periodontitis. In conclusion, the future goal in periodontology will be to combine and personalise the periodontal treatments to the colonising microbial profile and to the specific response of the individual patient

Clinical Accuracy of Splintless Maxillary Positioning with Aid of CAD/CAM Fabricated Surgical Cutting Guides and Titanium Plates

New digital technologies are improving the accuracy of orthognathic surgery. One of the new approaches transfers the surgical plan into real surgery without using an occlusal splint. This pilot study aims to validate the splintless approach to orthognathic surgery on a series of cases. Five patients were enrolled. Surgeries were planned using a digital surgical simulation method thanks to three-dimensional images. The splintless surgical approach was planned for maxillary reposition. This consisted of cutting guides and three-dimensionally (3D) printed custom titanium plates. These two were created using the computer-aided design and computer-aided manufacturing (CAD-CAM) technique and were used intraoperatively to guide the osteotomy and repositioning of the bony segments without the use of the surgical splint. The difference between the planned surgery and the real final position was analyzed thanks to superimposition techniques and landmark analysis. Statistical tests were performed to detect significant differences. No difference was found in any of the landmarks. Midline landmarks differed from the planned position by 0.34 mm. Higher variability was found in the posterior landmark. These findings suggest that a splintless approach is useful in transferring the surgical plan without using an occlusal splint

Therapeutic and Metagenomic Potential of the Biomolecular Therapies against Periodontitis and the Oral Microbiome: Current Evidence and Future Perspectives

The principles of periodontal therapy are based on the control of microbial pathogens and host factors that contribute to biofilm dysbiosis, with the aim of modulating the progression of periodontitis and periodontal tissue destruction. It is currently known how differently each individual responds to periodontal treatment, depending on both the bacterial subtypes that make up the dysbiotic biofilm and interindividual variations in the host inflammatory response. This has allowed the current variety of approaches for the management of periodontitis to be updated by defining the goals of target strategies, which consist of reducing the periodontopathogenic microbial flora and/or modulating the host-mediated response. Therefore, this review aims to update the current variety of approaches for the management of periodontitis based on recent target therapies. Recently, encouraging results have been obtained from several studies exploring the effects of some targeted therapies in the medium- and long-term. Among the most promising target therapies analyzed and explored in this review include: cell-based periodontal regeneration, mediators against bone resorption, emdogain (EMD), platelet-rich plasma, and growth factors. The reviewed evidence supports the hypothesis that the therapeutic combination of epigenetic modifications of periodontal tissues, interacting with the dysbiotic biofilm, is a key step in significantly reducing the development and progression of disease in periodontal patients and improving the therapeutic response of periodontal patients. However, although studies indicate promising results, these need to be further expanded and studied to truly realize the benefits that targeted therapies could bring in the treatment of periodontitis

Transition from regular to complex behaviour in a discrete deterministic asymmetric neural network model

We study the long time behaviour of the transient before the collapse on the periodic attractors of a discrete deterministic asymmetric neural networks model. The system has a finite number of possible states so it is not possible to use the term chaos in the usual sense of sensitive dependence on the initial condition. Nevertheless, at varying the asymmetry parameter, $k$, one observes a transition from ordered motion (i.e. short transients and short periods on the attractors) to a ``complex'' temporal behaviour. This transition takes place for the same value $k_{\rm c}$ at which one has a change for the mean transient length from a power law in the size of the system ($N$) to an exponential law in $N$. The ``complex'' behaviour during the transient shows strong analogies with the chaotic behaviour: decay of temporal correlations, positive Shannon entropy, non-constant Renyi entropies of different orders. Moreover the transition is very similar to that one for the intermittent transition in chaotic systems: scaling law for the Shannon entropy and strong fluctuations of the ``effective Shannon entropy'' along the transient, for $k > k_{\rm c}$.Comment: 18 pages + 6 figures, TeX dialect: Plain TeX + IOP macros (included

Facial Asymmetry Detected with 3D Methods in Orthodontics: A Systematic Review

Background: Historically, the development of two-dimensional (2D) imaging techniques forerun that of three-dimensional (3D) ones. Some 2D methods are still considered valid and effective to diagnose facial asymmetry but 3D techniques may provide more precise and accurate measurements. Objective: The aim of this work is to analyze the accuracy and reliability of the imaging techniques available for the diagnosis of facial asymmetry in orthodontics and find the most reliable. Methods: A search strategy was implemented using PubMed (National Library of Medicine, NCBI). Results: A total of 3201 papers were identified in electronic searches. 90 articles, available in full text, were included in the qualitative synthesis consisting of 8 reviews on the diagnosis of facial asymmetry, 22 in vivo and in vitro studies on 2D methods and 60 in vivo and in vitro studies on 3D methods to quantify the asymmetry. Conclusion: 2D techniques include X-ray techniques such as posterior-anterior cephalogram, which still represents the first level exam in the diagnosis of facial asymmetry. 3D techniques represent the second level exam in the diagnosis of facial asymmetry. The most current used techniques are CBCT, stereophotogrammetry, laser scanning, 3D optical sensors and contact digitization. The comparison between bilateral parameters (linear distances, angles, areas, volumes and contours) and the calculation of an asymmetry index represent the best choices for clinicians who use CBCT. The creation of a color-coded distance map seems to represent the most accurate, reliable and validated methods for clinicians who use stereophotogrammetry, laser scanning and 3D optical sensors

Periodontitis and tooth loss have negative systemic impact on circulating progenitor cell levels: A clinical study

The aim of the present study was to investigate the association and impact of periodontitis and tooth loss on a subtype of endothelial progenitor cell (EPC) levels (CD133+/KDR+). Furthermore, the objective was to determine if the periodontal status influenced CD133+/KDR+ levels. In all, 88 patients with periodontitis and 79 healthy controls (HCs) were enrolled in the study. Enrolled patients were examined and characterized by clinical and blood sample analysis. Spearman\u2019s correlation test was applied in order to assess the interdependence between CD133+/KDR+ levels and all periodontal parameters. In order to estimate a statistically significant trend (p-trend) for ordered CD133++/KDR+ quartiles, the Jonckheere\u2013Terpstra test was applied for all variables. Patients in the periodontitis group presented significantly lower CD133+/KDR+ levels (66.4 (45.5\u2013269.6 cells/\ub5L)) compared to the HC group (76.7 (24.3\u2013313.2 cells/\ub5L), p < 0.001). Lower CD133+/KDR+ levels negatively correlated with C-reactive protein (CRP), with the number of teeth, and with all periodontal parameters (p < 0.001). Moreover, there was a proportional increase in CD133+/KDR+ levels with a progressive increase in number of teeth (p-trend < 0.001), while there was a proportional decrease in CD133+/KDR+ levels with a proportional increase in clinical attachment level (CAL, p-trend = 0.003), probing depth (PD, p-trend = 0.007), and bleeding sites (bleeding on probing (BOP), p-trend < 0.001) as an extent measure of periodontitis. This study demonstrated that patients with periodontitis presented significantly lower CD133+/KDR+ levels compared to HCs. Moreover, all patients presented an increase in the CD133+/KDR+ EPC levels with an extended level of periodontitis and tooth loss