A New 3D Tool for Planning Plastic Surgery

Face plastic surgery (PS) plays a major role in today medicine. Both for reconstructive and cosmetic surgery, achieving harmony of facial features is an important, if not the major goal. Several systems have been proposed for presenting to patient and surgeon possible outcomes of the surgical procedure. In this paper, we present a new 3D system able to automatically suggest, for selected facial features as nose, chin, etc, shapes that aesthetically match the patient's face. The basic idea is suggesting shape changes aimed to approach similar but more harmonious faces. To this goal, our system compares the 3D scan of the patient with a database of scans of harmonious faces, excluding the feature to be corrected. Then, the corresponding features of the k most similar harmonious faces, as well as their average, are suitably pasted onto the patient's face, producing k+1 aesthetically effective surgery simulations. The system has been fully implemented and tested. To demonstrate the system, a 3D database of harmonious faces has been collected and a number of PS treatments have been simulated. The ratings of the outcomes of the simulations, provided by panels of human judges, show that the system and the underlying idea are effectiv

Seven-year prospective clinical study on zirconia-based single crowns and fixed dental prostheses

OBJECTIVES: Zirconia-based prostheses are used for esthetic crown and fixed restorations, but follow-ups are still limited. The authors evaluated the 7-year clinical results of 303 zirconia core restorations, performed in a general dental private practice. MATERIALS AND METHODS: Clinical events (fracture and loss of retention, gingivitis, tenderness, excess cement, and temporary pain) were recorded in 303 zirconia core restorations positioned in 88 patients. Kaplan-Meier survival probability estimates were computed for failures (needed the replacement or removal of the prosthesis) and complications (resolved without replacing the prosthesis). RESULTS: One hundred and fifty single crowns (130 tooth-supported, 20 implant-supported) and 153 multiple units up to 6 elements (49 tooth-supported, 104 implant-supported) were followed-up for 7 years in 88 patients (40 men, 48 women), aged 35-89 years (mean 57). During the follow-up period, there were no complications for 287 (95 %) of the restorations. Sixteen restorations/abutment teeth (5 %) had some complication: extraction of abutment tooth (7, 2 %); caries (2, 1 %), porcelain veneer fracture (3, 1 %), loss of retention (4, 1 %). Nine (3 %) restorations were recorded as failures. The overall 7-year survival probability estimate for failures was 0.966 (95 % confidence limits, 0.932 and 0.983), for complications was 0.976 (95 % confidence limits 0.947 and 0.989), with a cumulative survival rate of 94.7 %. CONCLUSIONS: Within the analyzed follow-up, zirconia core restorations appear a good clinical solution, with favorable functional properties. CLINICAL RELEVANCE: All ceramic restorations can be successfully used for both single-and multiple-unit prostheses, either teeth or implants supported

3D surface acquisition systems and their applications to facial anatomy : let’s make a point

In the last decades 3D optical devices have gained a primary role in facial anthropometry, where they find several applications from the anatomical research to clinics and surgery. With time the number of articles focusing on 3D surface analysis has raised, as well as validation studies which aim at verifying the reliability of different devices and methods of acquisition in comparison with other methods or direct anthropometry. This review aims at making a point in the field of 3D surface acquisition systems, describing the most used types of available devices and comparing the relevant outcomes in acquiring 3D facial models. Results show that currently stereophotogrammetric devices represent the gold standard, further improved by the diffusion of portable models. Caution should be given to the use of low-cost devices, more and more frequently described by literature, as often they do not meet the basic criteria for being applied to the anatomical study of face

Influence of energy cost and physical fitness on the preferred walking speed and gait variability in elderly women

Typically gait speed decreases and gait variability increases in elderly. The aim of this study was to define the influence of energy cost of walking on gait speed and of health-related physical fitness on gait variability. Thirty healthy young and older women were recruited in the study. Energy cost of walking (NetCW) was analyzed with indirect calorimetry while a kinematic analysis was performed with an optoelectronic system to calculate gait variability (GV) during treadmill walking at different speeds. Gait speed was defined as the preferred walking speed (PWS) of the subject and health related physical fitness (HRPF) comprised body fat, strength, flexibility, and cardiorespiratory fitness. In healthy elderly women, the coefficient of variation of step width was found to be a better indicator of GV than stride time, stride length and double support coefficients of variation. GV was not affected by age allowing a high PWS. Furthermore, significant associations, adjusted for age, body mass index and number of falls, were identified neither between NetCW and the PWS, nor between HRPF and GV; only a significant association was found between hand-grip strength and gait stability. Findings highlighted the importance to evaluate hand-grip strength as an indicator of gait efficiency

Standardised surface electromyography allows effective submental muscles assessment

The aims of this pilot study were to evaluate: (i) the reproducibility and variability of an electromyographical protocol developed for the assessment of submental muscles (SM) (ii) to apply the new protocol to maximal teeth clenching, a simple and largely studied static task in order to quantify the relative contribution of submental muscles. In 20 healthy subjects, aged 19-35years, surface electromyography of SM, masseter (MM) and anterior temporalis (TA) muscles was performed during maximal voluntary clenching (MVC) with and without cotton rolls and the pushing of the tongue against the palate. Clenching on cotton rolls and pushing the tongue against the palate were used to standardise respectively MM and TA, and SM muscular potentials. The exercises were repeated in two appointments (T1-T2); submental muscles standardisation was also repeated twice (A-B) in each session to assess repeatability. Symmetry and activity were calculated for each couple of muscles. A two-way analysis of variance was computed for SM: no Factor 1 (T1 vs T2) or Factor 2 (A vs B) or F1 7F2 significant effects were found. SM recruitment was 31% of the maximal activity, with symmetry values larger than 80%. In conclusion, standardised electromyography allows a reliable assessment of Submental muscles activity

Adverse events associated with home use of mouthrinses: a systematic review

Background: Poor oral hygiene is strongly associated with oral and systemic diseases. Alongside mechanical tooth cleaning, the adjunctive use of mouthrinses has been widely advocated. Although research on the efficacy of various mouthrinse formulations is very active, there are a lack of conclusive data regarding their adverse effects. Methods: We undertook a systematic review in accordance wih PRISMA guidelines of electronic databases of clinical trials of any duration with daily home use of mouthwashes, presenting clinical and subjective side effects (PROSPERO registration: CRD42016054037). Results: After evaluating 614 titles and abstracts, 154 studies were selected for full-text analysis; 85 final papers were included. Based on the active ingredient in the test product, nine categories were created: cetyl pyridinium chloride, essential oils, chlorhexidine, triclosan, natural products, diclofenac, fluorides, delmopinol, and miscellaneous active substances. Most of the studies were of short duration (less than 6 months) with a defective 'methods' description; the reporting of adverse events often being overlooked. Both local morphological (oral mucosa and dental-crown staining, mucosal lesions) and functional (taste modifications, abnormal oral sensation) alterations were reported. Tooth staining was the most commonly listed adverse event, but it was quantitatively assessed only in a very small number of papers; most studies relied on patient reports. Staining was time associated; the longer the study, the higher its reported incidence and severity. Conclusions: The reduced report of side effects may partly be due to a lack of an objective measure and lack of general guidelines that demand studies report their adverse events. The most frequently reported adverse effect was teeth staining. As in most studies, the effect was associated with trial duration; clinical trials should be of sufficient duration. New investigations meeting the suggested criteria of a minimal duration of 6 months should be planned

Autonomic pain responses during sleep: a study of heart rate variability

The autonomic nervous system (ANS) reacts to nociceptive stimulation during sleep, but whether this reaction is contingent to cortical arousal, and whether one of the autonomic arms (sympathetic/parasympathetic) predominates over the other remains unknown. We assessed ANS reactivity to nociceptive stimulation during all sleep stages through heart rate variability, and correlated the results with the presence of cortical arousal measured in concomitant 32-channel EEG. Fourteen healthy volunteers underwent whole-night polysomnography during which nociceptive laser stimuli were applied over the hand. RR intervals (RR) and spectral analysis by wavelet transform were performed to assess parasympathetic (HF(WV)) and sympathetic (LF(WV) and LF(WV)/HF(WV) ratio) reactivity. During all sleep stages, RR significantly decreased in reaction to nociceptive stimulations, reaching a level similar to that of wakefulness, at the 3rd beat post-stimulus and returning to baseline after seven beats. This RR decrease was associated with an increase in sympathetic LF(WV) and LF(WV)/HF(WV) ratio without any parasympathetic HF(WV) change. Albeit RR decrease existed even in the absence of arousals, it was significantly higher when an arousal followed the noxious stimulus. These results suggest that the sympathetic-dependent cardiac activation induced by nociceptive stimuli is modulated by a sleep dependent phenomenon related to cortical activation and not by sleep itself, since it reaches a same intensity whatever the state of vigilance

Enhanced Grazing Management Assessment Using Drone-Based Lidar Measurements

Globally, there is an urgent need of research-based technologies for small ruminant producers to benefit from rapidly growing market demands for ruminant meat and related food products from forage-based operations. However, effective forage-based animal production requires a rapid assessment, and monitoring of grazing management needs to adjust stocking rates and/or spatial animal distribution in a timely manner. Applicability of unmanned aerial vehicles (drones) for grazing management offers opportunities to rapidly estimate biomass build-ups, ground coverage, and monitor animal behaviour. The reliability of drone-based laser scanning (DLS) for monitoring warm-season grass responses to simulated grazing intensities was assessed at Virginia State University. Aerial DLS point-cloud data were collected from pure and mixed native warm-season grass stands at early- and mid-season post-harvest regrowth in early May and June, respectively, along with ground-based estimates of yield and ground cover. Animal behavioural responses to drone activity at different heights were also recorded. The aerial estimates from DLS point cloud characteristics were compared with matching ground-based measurements of forage biomass, sward heights, and ground cover. Discernible correlations between the point cloud-based estimates and actual measurements for forage biomass, ground cover and sward heights were observed. Goats showed no changes in activity due to drone flights at ≥15 m above ground but demonstrated curiosity to drone presence between 10 & 15 m. These preliminary results suggest reliable applicability of DLS for expedited assessment of plant and animal responses to grazing management

Long-term effects of functional appliances in treated versus untreated patients with Class II malocclusion: A systematic review and meta-analysis

Objective To assess the cephalometric skeletal and soft-tissue of functional appliances in treated versus untreated Class II subjects in the long-term (primarily at the end of growth, secondarily at least 3 years after retention). Search methods Unrestricted electronic search of 24 databases and additional manual searches up to March 2018. Selection criteria Randomised and non-randomised controlled trials reporting on cephalometric skeletal and soft-tissue measurements of Class II patients (aged 16 years or under) treated with functional appliances, worn alone or in combination with multi-bracket therapy, compared to untreated Class II subjects. Data collection and analysis Mean differences (MDs) and 95% confidence intervals (95% CIs) were calculated with the random-effects model. Data were analysed at 2 primary time points (above 18 years of age, at the end of growth according to the Cervical Vertebral Maturation method) and a secondary time point (at least 3 years after retention). The risk of bias and quality of evidence were assessed according to the ROBINS tool and GRADE system, respectively. Results Eight non-randomised studies published in 12 papers were included. Functional appliances produced a significant improvement of the maxillo-mandibular relationship, at almost all time points (Wits appraisal at the end of growth, MD -3.52 mm, 95% CI -5.11 to -1.93, P < 0.0001). The greatest increase in mandibular length was recorded in patients aged 18 years and above (Co-Gn, MD 3.20 mm, 95% CI 1.32 to 5.08, P = 0.0009), although the improvement of the mandibular projection was negligible or not significant. The quality of evidence was \u2018very low\u2019 for most of the outcomes at both primary time points. Conclusions Functional appliances may be effective in correcting skeletal Class II malocclusion in the long-term, however the quality of the evidence was very low and the clinical significance was limited