Comparison of mandibular arch expansion by the schwartz appliance using two activation protocols: A preliminary retrospective clinical study

Background and objectives: Dental crowding is more pronounced in the mandible than in the maxilla. When exceeding a significant amount, the creation of new space is required. The mandibular expansion devices prove to be useful even if the increase in the lower arch perimeter seems to be just ascribed to the vestibular inclination of teeth. The aim of the study was to compare two activation protocols of the Schwartz appliance in terms of effectiveness, particularly with regard to how quickly crowding is solved and how smaller is the increasing of vestibular inclination of the mandibular molars. Materials and methods: We compared two groups of patients treated with different activation's protocols of the lower Schwartz appliance (Group 1 protocol consisted in turning the expansion screw half a turn twice every two weeks and replacing the device every four months; Group 2 was treated by using the classic activation protocol-1/4 turn every week, never replacing the device). The measurements of parameters such as intercanine distance (IC), interpremolar distance (IPM), intermolar distance (IM), arch perimeter(AP), curve of Wilson (COW), and crowding (CR) were made on dental casts at the beginning and at the end of the treatment. Results: A significant difference between protocol groups was observed in the variation of COWL between time 0 and time 1 with protocol 1 with protocol 1 subjects showing a smaller increase in the parameter than protocol 2 subjects. The same trend was observed also for COWR, but the difference between protocol groups was slightly smaller and the interaction protocol-by-time did not reach the statistical significance. Finally, treatment duration in protocol 1 was significantly lower than in protocol 2. Conclusion: The results of our study suggest that the new activation protocol would seem more effective as it allows to achieve the objective of the therapy more quickly, and likely leading to greater bodily expansion

Association between Anatomical Variations and maxillary canine impaction: A retrospective study in orthodontics

This study aims to evaluate whether or not there is a higher prevalence of skeletal abnormalities in subjects with maxillary canine impaction (MCI). This retrospective study was performed on 67 subjects with maxillary canine impaction (test group) and on 67 patients without dental displacement (control group). Sella turcica bridging (SB), ponticulus posticus (PP), atlas posterior arch deficiency (APAD) and the morphology of sella turcica and pterygopalatine fissure were evaluated on lateral cephalometric radiographs. Statistical analysis was performed using chi-square, Mann-Whitney test and multivariate logistic models; the level of significance was p < 0.05. Results showed that in the test and control groups 87% and 62.7% of patients had SB, respectively. PP was observed in 60% of patients in the test group and in 16.4% of patients in the control group. APAD was observed in 9% of test group and in 4.5% of the control group. Skeletal anomalies were significantly increased (p < 0.05) in subjects with MCI. A significant difference between the groups was observed in regards to the shape of the pterygopalatine fissure, found to be less wide and longer in the test group. SB, PP and APAD were higher in subjects with MCI; furthermore, an elongated pterygopalatine fissure was significantly associated with MCI

Weak proactive cognitive/motor brain control accounts for poor children's behavioral performance in speeded discrimination tasks

Background: Motor and inhibitory control rely on frontal cortex activity, which is known to reach full maturation only in late adolescence. The development of inhibitory control has been studied using event-related potentials (ERP), focusing on reactive processing (i.e. the N2 and the P3 components). Scarce information exists concerning pre-stimulus activity as that represented by the Bereinshafstpotential (BP) and by the prefrontal negativity (pN). Further, no literature exists concerning the post-stimulus components originating within the anterior insula (pN1, pP1, pP2). This study aims at associating children performance with these motor-cognitive processing in frontal brain areas. Methods: High-resolution EEG recordings were employed to measure ERPs from 18 children (12 years old) and 18 adults (28 years old) during a visuo-motor discriminative response task. Response time (RT), commission (CE) and omission errors, and RT variability were compared between groups. At brain level, two pre-stimulus (BP and pN) and seven post-stimulus (P1; pN1; N1; pP1; N2; pP2; P3) ERP components were compared between groups. Results: Children showed slower and more variable RTs and poorer inhibition (higher CEs) than adults. At electrophysiological level, children presented smaller BP and pN. After stimulus onset, children showed lower amplitude of N1, pP1, P3, and pP2 components. The P1, pP1, N2 and P3 were delayed compared to adults. Conclusions: Our results demonstrate that children are characterized by less intense task-related proactive activities in frontal cortex, which may account for subsequent poor and delayed reactive processing and, thus, for inaccurate and slow performance

Oral and craniofacial manifestations of Ellis-Van Creveld syndrome: A systematic review

Aim A systematic literature review on oral and craniofacial manifestations of Ellis-Van Creveld syndrome was performed. Methods From 2 databases were selected 74 articles using as key words "Ellis-Van Creveld" AND "Oral" OR "Craniofacial" OR "Dental" OR "Malocclusion". Prisma protocol was used to create an eligible list for the screening. Data were collected in a table to compare the clinical aspects found. Results From the first research emerged 350 articles, and only 72 of them were selected. Conclusion Through this analysis oral and cranio-facial manifestations of Ellis-Van Creveld syndrome were pointed out. Management of Ellis-Van Creveld syndrome requires a multidisciplinary approach involving different clinicians; dentists play an important role in early diagnosis and treatment of the patients

3D pelvimetry and biometric measurements: a surgical perspective for colorectal resections

Purpose: Male sex, high BMI, narrow pelvis, and bulky mesorectum were acknowledged as clinical variables correlated with a difficult pelvic dissection in colorectal surgery. This paper aimed at comparing pelvic biometric measurements in female and male patients and at providing a perspective on how pelvimetry segmentation may help in visualizing mesorectal distribution. Methods: A 3D software was used for segmentation of DICOM data of consecutive patients aged 60 years, who underwent elective abdominal CT scan. The following measurements were estimated: pelvic inlet, outlet, and depth; pubic tubercle height; distances from the promontory to the coccyx and to S3/S4; distance from S3/S4 to coccyx\u2019s tip; ischial spines distance; pelvic tilt; offset angle; pelvic inlet angle; angle between the inlet/sacral promontory/coccyx; angle between the promontory/coccyx/pelvic outlet; S3 angle; and pelvic inlet to pelvic depth ratio. The measurements were compared in males and females using statistical analyses. Results: Two-hundred patients (M/F 1:1) were analyzed. Out of 21 pelvimetry measurements, 19 of them documented a significant mean difference between groups. Specifically, female patients had a significantly wider pelvic inlet and outlet but a shorter pelvic depth, and promontory/sacral/coccyx distances, resulting in an augmented inlet/depth ratio when comparing with males (p < 0.0001). The sole exceptions were the straight conjugate (p = 0.06) and S3 angle (p = 0.17). 3D segmentation provided a perspective of the mesorectum distribution according to the pelvic shape. Conclusion: Significant differences in the structure of pelvis exist in males and females. Surgeons must be aware of the pelvic shape when approaching the rectum

Periodontology Part 4: Periodontal disease in children and adolescents

The aim of this manuscript was to investigate the epidemiology and the factors related to the periodontal disease in children and adolescents. Several systemic and immunological disorders have shown a relationship with periodontal disease in this population and early diagnosis and treatment of gingivitis is important to prevent it from evolving into periodontitis. Two cases are reported showing the presencce of periodontal disease at a young age

New technologies in orthodontics: A digital workflow to enhance treatment plan and photobiomodulation to expedite clinical outcomes

Background: The transversal maxillary deficiency represents one of the most frequent skeletal discrepancies of the craniofacial region. The analysis of morphological characteristics of the maxilla can be detrimental for a correct diagnosis and treatment plan. Methods: This paper shows a user-friendly digital workflow involving mirroring, superimposition, and the deviation analysis of 3D models of the maxilla in order to identify the presence of symmetry/asymmetry of the palatal vault. Such information can be helpful to clinicians in order to design an appropriate orthodontic appliance for the treatment of transversal maxillary deficiency. We also describe a case report of a seven-year-old female aected by mild transversal maxillary deficiency associated with anterior openbite. The appliance is designed after a comprehensive evaluation of the morphology of the maxilla performed by using the presented diagnostic digital workflow. Additionally, the orthodontic treatment is assisted by photobiomodulation sessions that expedite the achievement of clinical outcomes

Elastodontic Devices in Orthodontics: An In-Vitro Study on Mechanical Deformation under Loading

The purpose of the present study was to evaluate the mechanical resistance of elastodontic devices (ED): their maximum compression loads and plastic deformation under loading (percentage). An Instron universal machine (Model 3365, Instron, Industrial Product Group, Grove City, PA, USA) was employed with a 100 N load cell and with Bluehill software for loading analyses. Each device was submitted to a five-cycles test. The following ED were evaluated: A.M.C.O.P. (Micerium, Genova, Italy) in red color, in orange color, and in blue color; HealthyStart (Ortho-Tain, Winnetka, IL, USA), and T4KTM phase 1 (Myofunctional Research Co., Helensvale, Australia). During the five-cycles test, the Ortho-Tain device delivered the greatest compression load (7.56 N), with the lowest percentage of deformation (0.95%). For all devices, a slight plastic deformation of the material was registered, ranging from 0.95% to 1.75%. For the T4K device it was not possible to complete the five-cycles test. For all the analyzed ED, a slight plastic deformation under loading was registered, that in all cases can be considered clinically acceptable. Further studies are needed to test the appliances after clinical usage

Impact of School Nurse on Managing Pediatric Type 1 Diabetes with Technological Devices Support: A Systematic Review

Introduction: Type 1 diabetes (T1D) is a disease that primarily occurs in pediatric populations. A school nurse (SN) can provide valuable support in the school setting for minors affected by this condition. Methods: The main objective of this study was to evaluate the impact of nursing care provided to adolescents and children with T1D using technological devices in school. Qualitative and quantitative outcomes considered in the included studies were collected and discussed. A systematic review was conducted in the PubMed, CINAHL, and Scopus databases and reported thought the PRISMA guidelines. Results: Eleven studies were included. The results showed that SNs need to enhance both their skills and organization to effectively manage young patients with T1D using technology. The response of both the pediatric population and their caregivers to the disease management by a SN has been positive. Conclusions: The management of chronic diseases is one of the most urgent public health issues, especially for Western healthcare systems. Proper management of patients with T1D at the school level is definitely an aspect that policymakers and healthcare managers should consider to improve the quality of life of this extremely vulnerable population, particularly those using technological management T1D