Multidisciplinary Approach in a 12-Year-Old Patient Affected by Severe Obstructive Sleep Apnea: a Case-Report

A 12-year-old boy shows a restless sleep and snoring episodes declaring himself tired during the day and the school lessons. On clinical examination the patient presents a second-class profile, a retrusive jaw with a small chin and an open nasolabial angle. From the intraoral examination a tonsillar hypertrophy is denoted. The patient is sent by the ear, nose, and throat specialist (ENT) and subsequently subjected to a polysomnography (PSG). The ENT decides to subject him to a tonsillectomy and the subsequent PSG shows an improvement in the obstructive sleep apnea syndrome (OSAS) pathology with an apnea-hypopnea index (AHI) improved from 25.5 episodes/hr to 3.4 episodes/hr. Subsequently a orthodontic treatment with twin-block was start to further reduce the apnea episodes. The last PSG highlights the success of the treatment further lowering the AHI to 0.7 episodes/hr. This case report shows how a multidisciplinary approach to OSAS is fundamental also in the young patient and that the orthodontist carried out in this area a fundamental task both in diagnosis and treatment

Elongated styloid process : an epidemiological study on digital panoramic radiographs

The styloid process is a projecton of the temporal bone, its lenght is between 20 to 30 mm, when it is longer than 30 mm it is defined elongated styloid process. The aim of this study is an epidemiological evaluation of 1003 digital panoramic radiographs in an Italian population between 5 and 90 years old. This is a retrospective analysis and the radiographs were selected from the Complex Operating Unit of Dentistry of Padua University Hospital database. The radiographs were performed using a Sirona Ortophos XG and the styloid process length was measured using the measuring tool of Sidexis Software. It was measured from the point where it left the temporal bone plate to its tip. Styloid processes measuring more than 30 mm were considered elongated. Chi-squared test, Fligner-Killeen test, Shapiro-Wilk test and t-test with Welch correction were performed. In the study 33.40% of the patients showed an elongated styloid process. The number of patients with elongated styloid process and the mean length of the process increase with the age confirming the chronic development of the calcification described in literature. No statistically significant correlation is found between the presence of elongated styloid process and the gender and affected side (bilateral or unilateral)

Resolution of a Severe Grade of Obstructive Sleep Apnea Syndrome with Mandibular Advancement Device: A Case Report

Obstructive sleep apnea syndrome (OSAS) is a disorder of the sleep with episodes of the obstruction at the upper airway that can be recurrent, partial or complete. The continuous positive airway pressure (CPAP) is the gold treatment for OSAS, but many patients do not tolerate this kind of treatment, and for this reason mandibular advancement device are used. A 55-year-old Caucasian man affected by severe OSAS [apnea-hypopnea index (AHI): 51, lowest saturation value (NADIR): 77%] came at Padua University Hospital Dental Clinic after ENT evaluation to consider an alternative treatment to CPAP. After a surgery treatment and the use of oral appliance (Somnodent, Somnomed Limited) associated with vertical elastics AHI improve to 2.4 and NADIR to 88%

Elongated styloid process evaluation on digital panoramic radiograph in a North Italian population

The aim of this study is to evaluate the prevalence of elongated styloid process in digital panoramic radiographs in a North Italian population in relation to age, gender and side. This study was performed as a retrospective analysis on digital panoramic radiographs of 600 (271 males and 329 females) Italian patients between 6 and 87 years old. The styloid process length were measured using the measuring tool of Sidexis Software. It was measured from the point where it left the temporal bone plate to its tip. Styloid processes measuring more than 30 mm were considered elongated. Chi-squared and Fisher tests were used and the test is considered significant if the p-value is lower or equal to 0.05. Thirty-three per cent of the patients showed an elongated styloid process. Seventeen per cent were elongated on both right and left side, fifteen point nine per cent were elongated only in one side. The prevalence of elongated styloid process was high and a progressive increase of the elongation prevalence was found in older groups

Dental water jet efficacy in the plaque control of orthodontic patients wearing fixed appliance : a randomized controlled trial

Different studies assess the role of fixed orthodontic appliances in supragingival plaque accumulation. In patients wearing fixed orthodontic appliances a good management of oral hygiene is required in order to prevent complication like as decay, enamel demineralization, gingivitis, gingival hyperplasia and periodontitis. The aim of this Randomized Controlled Trial (RCT) is to evaluate the efficacy of the use of a DWJ in patients under orthodontic treatment with fixed multibracket appliance. The study design was single-blinded RCT with a split mouth protocol. Each patient followed a personal cleaning protocol using a DWJ in addition to traditional brushing only on one side while just brushing on the control side. The side on which was decided to use the DWJ was chosen randomly and the dental hygienist who took the measurements was blind. Plaque and gingival indexes were evaluated at baseline and at one, three and six-months follow-up. It did not emerge any difference in the plaque and gingival indexes trend between the two groups. Patients initially reported an worsening of the indexes at one month evaluation, then they set at baseline levels at three and six months. The dental water jet does not improve significantly the efficacy of home oral hygiene in orthodontic patients wearing a multi-bracket fixed appliance. Patients did not show the traditional worsening during the whole orthodontic therapy

Periodontitis in the Developmental Age: Pathogenesis, Epidemiology, Differential Diagnosis and Treatment. A Narrative Review

Periodontal disease is one of the most widespread diseases in the world and is, as a prevalence, immediately after diseases..

Fatal Spotted Fever Rickettsiosis, Minas Gerais, Brazil

The emergence and reemergence of a serious infectious disease are often associated with a high case-fatality rate because of misdiagnosis and inappropriate or delayed treatment. The current reemergence of spotted fever rickettsiosis caused by Rickettsia rickettsii in Brazil has resulted in a high proportion of fatal cases. We describe two familial clusters of Brazilian spotted fever in the state of Minas Gerais, involving six children 9 months to 15 years of age; five died. Immunohistochemical investigation of tissues obtained at necropsy of a child in each location, Novo Cruzeiro and Coronel Fabriciano municipalities, established the diagnosis by demonstration of disseminated endothelial infection with spotted fever group rickettsiae. The diagnosis in the two fatal cases from Coronel Fabriciano and the surviving patient from Novo Cruzeiro was further supported by immunofluorescence serologic tests

Measurements of the leptonic branching fractions of the τ\tau

Data collected with the DELPHI detector from 1993 to 1995 combined with previous DELPHI results for data from 1991 and 1992 yield the branching fractions B({\tau \rightarrow \mbox{\rm e} \nu \bar{\nu}}) = (17.877 \pm 0.109_{stat} \pm 0.110_{sys} )\% and $B({\tau \rightarrow \mu \nu \bar{\nu}}) = (17.325 \pm 0.095_{stat} \pm 0.077_{sys} )\%$