Fatigue resistance of new and used nickel-titanium rotary instruments: a comparative study

Aim of the present study was twofold. First, to evaluate in vitro, the performance of two different NiTi rotary instruments in one molar case; then, to evaluate their resistance to cyclic fatigue, compared to new ones

Role of the flat-designed surface in improving the cyclic fatigue resistance of endodontic NiTi rotary instruments

The aim of this study was to investigate the role of the flat-designed surface in improving the resistance to cyclic fatigue by comparing heat-treated F-One (Fanta Dental, Shanghai, China) nickel-titanium (NiTi) rotary instruments and similar prototypes, differing only by the absence of the flat side. The null hypothesis was that there were no differences between the two tested instruments in terms of cyclic fatigue lifespan. A total of 40 new NiTi instruments (20 F-One and 20 prototypes) were tested in the present study. The instruments were rotated with the same speed (500 rpm) and torque (2 N) using an endodontic motor (Elements Motor, Kerr, Orange, CA, USA) in the same stainless steel, artificial canal (90° angle of curvature and 5 mm radius). A Wilcoxon-Mann-Whitney test was performed to assess the differences in terms of time to fracture and the length of the fractured segment between the flat- and non-flat-sided instruments. Significance was set at p = 0.05. The differences in terms of time to fracture between non-flat and flat were statistically significant (p < 0.001). In addition, the differences in terms of fractured segment length were statistically significant (p = 0.034). The results of this study highlight the importance of flat-sided design in increasing the cyclic fatigue lifespan of NiTi rotary instruments

Optimal therapy of type 2 diabetes: a controversial challenge

Type 2 diabetes mellitus (T2DM) is one of the most common chronic disorders in older adults and the number of elderly diabetic subjects is growing worldwide. Nonetheless, the diagnosis of T2DM in elderly population is often missed or delayed until an acute metabolic emergency occurs. Accumulating evidence suggests that both aging and environmental factors contribute to the high prevalence of diabetes in the elderly. Clinical management of T2DM in elderly subjects presents unique challenges because of the multifaceted geriatric scenario. Diabetes significantly lowers the chances of "successful" aging, notably it increases functional limitations and impairs quality of life. In this regard, older diabetic patients have a high burden of comorbidities, diabetes-related complications, physical disability, cognitive impairment and malnutrition, and they are more susceptible to the complications of dysglycemia and polypharmacy. Several national and international organizations have delivered guidelines to implement optimal therapy in older diabetic patients based on individualized treatment goals. This means appreciation of the heterogeneity of the disease as generated by life expectancy, functional reserve, social support, as well as personal preference. This paper will review current treatments for achieving glycemic targets in elderly diabetic patients, and discuss the potential role of emerging treatments in this patient population

The influence of a new clinical motion for endodontic instruments on the incidence of postoperative pain

Previous studies showed that motor motions play an important role in determining apical extrusion of debris. Therefore a new clinical motion (MIMERACI) has been proposed. The basic idea is to progress slowly (1mm advancement), and after each 1mm, to remove the instrument from the canal, clean flutes and irrigate. The aim of the study was to prove whether the clinical use of MIMERACI technique would influence or not postoperative pain.MATERIALS AND METHODS: 100 teeth requesting endodontic treatment were selected for the study and divided into two similar groups based on anatomy, pre-operative symptoms and vitality, presence or absence of periapical lesion. All teeth were shaped, cleaned and obturated by the same operator, using the same NiTi instruments. The only difference between the two groups was the instrumentation technique: tradional (group A) vs MIMERACI (group B). Assessment of postoperative pain was performed 3 days after treatment. Presence, absence and degree of pain were recorded with a visual analogue scale (VAS), validated in previous studies. Collected data statistically analyzed using one-way ANOVA post hoc Tukey test. RESULTS: For VAS pain scores MIMERACI technique showed significantly better results than group A (p=0,031). Overall, both incidence and intensity of symptoms were significantly lower. Flare ups occurred in 3 patients, but none treated with the MIMERACI Technique. CONCLUSIONS: Since extruded debris can elicit more postoperative pain, results obtained by using MIMERACI technique are probably due to many factors: better mechanical removal and less production of debris and more efficient irrigation during instrumentation

Oral lichen planus in children: an italian case series with literature review

Objectives. Oral lichen planus is a chronic mucous inflammatory disease. The prevalence in adults ranges between 0.5% and 2%, whereas children are involved just in 0.03% of cases. The purpose of this paper is to review the current literature and to present six Italian cases of Oral Lichen Planus in children (OLPc). Methods. We reported the data about a retrospective study on 6 cases of oral lichen planus in children. A detailed history was retrieved from clinical notes of each patient. Patients younger than 18 years old were enrolled in the study. All of them had the OLP diagnosis confirmed by clinical findings, history, and histopathology. Results. The family history for lichen planus was negative in all patients, the mean age was 11 years (range 6-14); there was no cutaneous involvement, whereas 2 patients had concomitant autoimmune diseases. Topical corticosteroids was the only treatment used in 66.67% of patients with good response in a mean time of 4.75 weeks. Conclusions. The rarity of OLPc may be due to the lack of symptoms that prevents the patient or his family from noticing the presence of the condition, but also to misdiagnosis of the dentist or the paediatrician. Thus, though LP in children is uncommon and oral mucosal involvement extremely rare, clinicians should be aware of its existence and management, and this diagnosis should be taken into account in children presenting oral white lesions

Peri-implant marginal bone changes and soft tissue conditions around single implants with laser-microgrooved collar placed in regenerated extraction sockets and in native bone: 2-year results of RCT

The aim of present study was to compare peri-implant marginal bone changes and soft tissues conditions around single implants placed in alveolar sockets regenerated with porcine xenograft and collagen membrane or non-regenerated native bone. Forty patients who required single tooth extraction and single implant placement in premolar/molar area, were enrolled in this study. Subjects were randomly assigned to the control group (S; extraction sockets spontaneously healed) or to the test group (R; extraction sockets grafted with porcine-derived bone and covered with collagen membrane). Six months after extractions, single tapered implants with laser-microgrooved collars were inserted. For each implant, radiographic MBL and clinical parameters were evaluated during 2 years of function. At the 24-month follow-up, a survival rate of 100% was reported for all implants. For the S group, the mean marginal bone loss (MBL) was 0.118 ± 0.07 mm while for the R group the mean MBL was 0.131± 0.03 mm. No statistically significant differences were reported among groups (P >0.05). Between the two groups, no statistically significant differences were found also for plaque index, bleeding on probing, probing depth and gingival recession. At the 24-month follow-up, results showed that implants with laser-microgrooved collar surface placed in regenerated extraction sockets and in native bone did not performed differently with respect to implant survival, MBL and peri-implant soft tissue parameters

From shunt to recovery: A multidisciplinary approach to hydrocephalus treatment in severe acquired brain injury rehabilitation

Background: Hydrocephalus among Severe Acquired Brain Injury (SABI) patients remains overlooked during rehabilitation. Methods: A retrospective cohort study was carried out of traumatic and non-traumatic SABI patients with hydrocephalus, consecutively admitted over 9 years in a tertiary referral specialized rehabilitation hospital. Patients were treated with ventriculoperitoneal shunt before or during inpatient rehabilitation and assessed using the Level of Cognitive Functioning Scale and Disability Rating Scale. Logistic regression models were used to identify predictors of post-surgical complications. Linear regression models were used to investigate predictors of hospital length of stay (LOS), disability, and cognitive function. Results: Of the 82 patients, 15 had post-surgical complications and 16 underwent cranioplasty. Shunt placement complication risk was higher when fixed vs. when programmable pressure valves were used. A total of 56.3% achieved functional improvement at discharge and 88.7% improved in cognitive function; of the 82 patients, 56% were discharged home. In multiple regression analyses, higher disability at discharge was related to cranioplasty and longer LOS, while poorer cognitive function was associated with cranioplasty. Increase in LOS was associated with increasing time to shunt and decreasing age. Conclusions: A significant improvement in cognitive and functional outcomes can be achieved. Cranioplasty increased LOS, and fixed pressure valves were related to poorer outcomes

ATLAS RPC Cosmic Ray Teststand at INFN Lecce

We describe the design and functionality of the cosmic ray teststand built at INFN Lecce for ATLAS RPC quality control assurance.Comment: XXIV Physics in Collisions Conference (PIC04), Boston, USA, June 2004, 3 pages, LaTex, 2 eps figures. MONP0

New concepts for light mechanical structures of cylindrical drift chambers

A significant reduction in the amount of material at the end plates of a drift chamber can be obtained by the simple consideration of separating, in the mechanical structure, the gas containment function from the wire tension support function. According to this scheme, the wires are anchored to a self-sustaining light structure ("wire cage") surrounded by a very thin skin ("gas envelope") of suitable profile to compensate for the gas differential pressure with respect to the outside. The "wire cage" is schematically made of a set of radial spokes, constrained into a polygonal shape at the inner ends and extended to the outer endplate rim, thus subdividing the chamber in identical sectors. The drift chamber is, then, built by stacking up radially, in each of the sectors and between adjacent spokes, printed circuit boards, where the ends of the wires are soldered, alternated with proper spacers, to define the cell width. A system of adjustable tie-rods steers the wire tension to the outer endplate rim, where a rigid cylindrical carbon fibre support structure, bearing the total wire load, is attached. Two thin carbon fibre domes, free to deform under the gas pressure without affecting the wire tension and conveniently shaped to minimize the stress at the inner rim, contribute to the "gas envelope" and, together with an inner thin cylindrical foil and with the outer structural support, enclose the gas volume