Evaluation of biomechanical effects of interocclusal surfaces on the mandible

ABSTRACT Introduction: Only few studies in the literature employ a mathematical model in the evaluation of the stress which follows the application of loads and constraints onto the mandible. Therefore, new approaches are needed so that the study of this phenomenon can rely less on the clinical hypothesis and experience of the operator, while taking advantage of the many benefits that virtual representations and mathematical calculations present. Aim of the study is to determine, by means of the finite element method (FEM), the stress produced onto the mandible as a result of the application of a force on itself, in association or not to the perioral musculature and according to the dental support given by the positioning of an interocclusal surface at three different levels: mesial, intermediate and distal. Aim: The aim is to allow a more objective evaluation of this phenomenon, its absolute repeatability, as well as to acquire important clinical informations concerning the role of orthodontic and gnathologic appliances. Materials and methods: Starting from a 1:1 scale model of the mandible (human adult male), a virtual three - dimensional (3D) representation was first obtained thanks to a dedicate software; it was then imported into a second software in order to permit the discretization into finite elements of the virtual model and the attribution of its mechanical properties. Finally, thanks to a specific software, it was possible to simulate the presence of load and constraints and to evaluate the stress status by using pseudo - colors. Results: The stress generated following the application of a force onto the mandible, undergoes significant variations in relation to the dental support and the presence or absence of the perioral musculature. Conclusions: Following the results of our research, we consider FEM as a valid and interesting method for this purpose, however additional FEM conducted studies are necessary in order to assess this phenomenon in more detail and determine the role of the perioral musculature as well as the possible clinical implications

Pilot Study of a New Mandibular Advancement Device

This study was conducted to determine the efficacy of a customized mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA). Eight patients (M = 3; F = 5; mean age = 56.3 ± 9.4) with a diagnosis of OSA confirmed by polysomnography (PSG) were re-cruited on the basis of the following inclusion criteria: apnea-hypopnea index (AHI) > 5, age between 18 and 75 years, body mass index (BMI) < 25, and PSG data available at baseline (T0). All were treated with the new NOA® MAD by OrthoApnea (NOA® ) for at least 3 months; PSG with NOA in situ was performed after 3 months of treatment (T1). The following parameters were calculated at T0 and T1: AHI, supine AHI, oxygen desaturation index (ODI), percentage of recording time spent with oxygen saturation <90% (SpO2 < 90%), and mean oxygen desaturation (MeanSpO2%). Data were submitted for statistical analysis. The baseline values were AHI = 21.33 ± 14.79, supine AHI = 35.64 ± 12.80, ODI = 17.51 ± 13.5, SpO2 < 90% = 7.82 ± 17.08, and MeanSpO2% = 93.45 ± 1.86. Four patients had mild OSA (5 > AHI < 15), one moderate OSA (15 > AHI < 30), and three severe OSA (AHI > 30). After treatment with NOA®, statistically significant improvements in AHI (8.6 ± 4.21) and supine AHI (11.21 ± 7.26) were recorded. OrthoApnea NOA® could be an effective alternative in the treatment of OSA: the device improved the PSG parameters assessed

Exploring the boundaries in an interdisciplinary context through the Family Resemblance Approach: The Dialogue Between Physics and Mathematics

Among the relevant aspects of the family resemblance approach (FRA), our study focuses on the potential of the approach to elaborate on disciplinary identities in an interdisciplinary context, specifically regarding the interplay between physics and mathematics. We present and discuss how the FRA wheel can be used and intertwined with the framework of boundary objects and boundary crossing mechanisms (Akkerman & Bakker, Review of Educational Research, 81, 132–169, 2011), which is well-known in STEM education for dealing with interdisciplinarity. The role of the FRA discussed in the article is dual: both practical and theoretical. It is practical in that we show how its use, in combination with the Akkerman and Bakker framework, appears effective in fostering productive discussions among prospective teachers on disciplinary identities and interdisciplinarity in historical cases. It is theoretical in that the combination of the two frameworks provides the vocabulary to characterise the ‘ambiguous nature’ of interdisciplinarity: like boundaries, interdisciplinarity both separates disciplines, making their identities emerge, and connects them, fostering mechanisms of crossing and transgressing the boundaries. This empirical study reveals how the theoretical elaboration took advantage of the prospective teachers’ contributions. We initially presented the FRA to characterise disciplinary identities, but the prospective teachers highlighted its potential to characterise also the boundary zone and the dialogue between physics and mathematics. The data analysis showed that the combination of the two frameworks shaped a complex learning space where there was room for very different epistemic demands of the prospective teachers: from those who feel better within the identity cores of the disciplines, to those who like to inhabit the boundary zone and others who like to re-shape boundary spaces and move dynamically across them

Making sense of youth futures narratives: Recognition of emerging tensions in students' imagination of the future

In this era of great uncertainty, imagining the future may be challenging, especially for young people. In science education, the interest in future-oriented education is now emerging, research needs, however, to keep eyes on youngsters' future perceptions and on the development of a future literacy. In this article, starting from a sample of individual students' narratives about their future daily life in 2040, we aim to delineate which ways of grappling with the future can be observed in the essays and which methodological tools are suited to operationalize their identification and characterization. The analysis led to the definition of "polarization" and "complexification" attitudes that represent the ways in which the students' narratives are positioned with respect to a bunch of dichotomies: personal-societal, functional-aesthetics oriented, good-bad, natural-artificial, and certain-uncertain. Moreover, with this study, we provide a contribution to the methodological reflection that deals with the collection and analysis of data, when students' future perceptions need to be investigated. Discussing the limits of the current data collection tool, we introduce the design of a SenseMaker (R) questionnaire which contributed to feeding a collaboration with #OurFutures project, recently launched by the European Commission to collect future narratives all around Europe

Oral Signs and HLA-DQB1 1702 Haplotypes in the Celiac Paediatric Patient: A Preliminary Study.

Celiac disease (CD) diagnosis can be extremely challenging in the case of atypical patterns. In this context, oral signs seem to play a decisive role in arousing suspicion of these forms of the disease. At the same time, the different expressions of the HLA-DQB1 1702 allele apparently seem to facilitate the interpretation of signs and highlighted symptoms. The aim of this work was to verify whether it is possible to identify a correlation between the development of oral signs and different DQ2 haplotypes in celiac pediatric patients. 44 celiac patients with a medium age of 9.9 were studied. Oral examinations were performed in order to identify recurrent aphthous stomatitis (RAS) and dental enamel defects (DED). The diagnosis of DED resulted as being related to allele expression (P value = 0.042) while it was impossible to find a similar correlation with RAS. When both oral signs were considered, there was an increase in correlation with HLA-DQB1 1702 expression (P value = 0.018). The obtained results identified both the fundamental role that dentists can play in early diagnosis of CD, as well as the possible role of HLA haplotype analysis in arousing suspicion of atypical forms of the disease

Physiotherapists and Osteopaths’ Attitudes: Training in Management of Temporomandibular Disorders

Temporomandibular disorders (TMDs) are a condition which has multifactorial etiology. The most acknowledged method to classify TMDs is the diagnostic criteria (DC) introduced firstly by Dworkin. This protocol considers different aspects that are not only biological, but even psychosocial. Diagnosis is often based on anamnesis, physical examination and instrumental diagnosis. TMDs are classified as intra-articular and/or extra-articular disorders. Common signs and symptoms include jaw pain and dysfunction, earache, headache, facial pain, limitation to opening the mouth, ear pain and temporomandibular joint (TMJ) noises. This study regards two kind of clinicians that started in the last years to be more involved in the treatment of TMDs: osteopaths (OOs) and physiotherapists (PTs). The purpose is to analyze their attitude and clinical approach on patients affected by TMDs. Four hundred therapists answered an anonymous questionnaire regarding TMJ and TMDs. OOs showed greater knowledges on TMDs and TMJ and, the therapists with both qualifications seemed to be most confident in treating patients with TMDs. In conclusion this study highlights OOs and all the clinicians with this qualification, have a higher confidence in treating patients with TMD than the others. Dentists and orthodontists, according to this study, should co-work with OOs and PTs, because they are the specialists more requested by them than other kinds of specialists

Predictability of Invisalign® Clear Aligners Using OrthoPulse®: A Retrospective Study

This preliminary retrospective study evaluates how effective the OrthoPulse (Biolux Technology, Austria) is in increasing the predictability of orthodontic treatment in patients treated with Invisalign (R) clear aligners (Align Technology Inc., Tempe, AZ, USA). A group of 376 patients were treated with Invisalign (R) orthodontic clear aligners in association with an OrthoPulse (R) . The OrthoPulse (R) was prescribed for 10 min a day for the entire duration of the orthodontic treatment. The OrthoPulse (R) App remotely tracked the percentage compliance of each patient. The number of aligners planned with the ClinCheck software at the beginning of the treatment and the number of total aligners (including the adjunctive aligners) used to finish the treatment were then considered. After applying inclusion/exclusion criteria, a total of 40 patients remained in the study and were compared with a control group of 40 patients with the same characteristics as the study group. A statistical analysis was carried out to investigate whether using OrthoPulse (R) led to a statistical reduction in the number of adjunctive aligners, thus leading to a more accurate prediction of the treatment. The statistical analysis showed that patients who used OrthoPulse (R) needed fewer finishing aligners and a greater predictability of the treatment was obtained. In fact, in the treated group the average number of additional aligners represented 66.5% of the initial aligners, whereas in the control group 103.4% of the initially planned aligners were needed. In conclusion, in patients treated with clear aligners, OrthoPulse (R) would appear to increase the predictability of orthodontic treatment with clear aligners, thus reducing the number of finishing phase requirements

Defects-related early childhood caries as hints of possible maternal–fetal health issues: Evidence from medieval northern Italy

Developmental defects of enamel (DDE) are important markers of stress as they arise from the disruption of ameloblastic activity during enamel matrix secretion and mineralization. Defects on the crowns of the deciduous dentition provide insights into maternal–fetal health because they can emerge during intrauterine development as a result of gestational issues. The presence of previous defective enamel represents one of the most predisposing causes of caries development. Thus, circular caries on the deciduous dentition are considered an indicator of stress because of their ascertained relation with dental enamel defects. In bioarchaeological analysis, these lesions allow us to deepen the question of maternal–fetal health issues in the ancient period. Here, we present evidence of defects-related early childhood caries in three infants from a medieval cemetery in northern Italy. The findings in the dentitions of the three subjects were investigated with a multi-analytical approach, including macroscopic examination, microscopic observation, cone-beam computed tomography (CBCT), scanning electron microscopy (SEM), and histological sections. In the specimens analyzed, the lesions observed in the dentitions appeared to have arisen during the fetal period and then protracted in the postnatal life, suggesting the implication of in utero environment and maternal health in the etiology of defects

Understanding first-year students’ curiosity and interest about physics : Lessons learned from the HOPE project

This paper focuses on results of an interview based survey of first-year university physics students, carried out within the EU Horizons in Physics Education (HOPE) project (http://hopenetwork.eu/). 94 interviews conducted in 13 universities have been analyzed to investigate the factors that inspire young people to study physics. In particular, the main motivational factor, which was proven to consist of personal interest and curiosity, was unfolded into different categories and detailed interest profiles were produced. The results are arguably useful to help academic curriculum developers and teaching personnel in physics departments to provide guidance to students in developing and focusing their interest towards specific sub-fields and/or to design targeted recruitment and outreach initiatives.Peer reviewe