New approaches in ortho-surgical treatments with stimulate & innovative technology

The aim of this study is to show the effectiveness of laser technology for the exposure of the palatally impacted canines, using a CO2 laser device (Smart US20D®, DEKA - Florence, Italy) and Diodi Laser device (Raffaello, DMT, Lissone, Italy, 980nm +645nm), which can stimulate the spontaneous eruption of the canine, without orthodontic traction application. Moreover, the purpose of this study is to monitor the movement of the impacted tooth after exposure with laser approach with digital technologies. Another aspect of this study is focused on the differences between digital monitoring through scanner and conventional monitoring which is based exclusively on the clinical evaluation of the photos and the study of the plaster casts. The final experimental sample was constituted of 18 patients, 9 females and 9 males; of these 8 patients showed a bilateral inclusion and 10 a mono-lateral inclusion of the canine, for a total of 26 canines. To demonstrate the validity of the technique applied to the study group, a CONTROL GROUP, which included 9 patients with unilateral and bilateral palatally impacted canines (in total 13 canines), treated by a traditional surgical-orthodontic approach, was observed. This experimental project was conducted in order to evaluate the effectiveness of laser surgery as an alternative approach to conventional surgical-orthodontic treatment. After laser exposure, no orthodontics treatment was initiated until the impacted tooth had erupted sufficiently into the palate and the autonomous eruption capacity was assessed. The spontaneous eruption was quantified by measuring the millimeter distance between the cusp of the canine one week after surgery (released from the overlying mucous and bone tissues) and the cusp of the same after 16 weeks from laser surgery. Of the 26 canines under study all of them performed a movement between 2,72 mm and 7,04 mm (mean value: 5,01 mm). Therefore, we can state that, at the end of the evaluation period of 16 weeks, a significant teeth movement was observed. Furthermore, the exposure of part of the dental crown, allowed, in all cases treated, to apply a bracket or a button to align the tooth in the dental arch. Our data suggests that the response of the dental element to the bio-stimulant action of the laser, applied to expose their crown, can be considered effective. Of the values obtained, the ones most distanced from the mean value were considered (the highest values 6,9 and 7,04 and the minimum values 2,72 and 3,12) and the type of inclusion of treated canines to which they refer was evaluated. The four values correspond to canines in bone inclusion; in particular, the millimetric value 7,04 corresponds to a deep inclusion canine. Therefore, from what emerges from our study, no significant correlation was found between the extent of spontaneous eruption (in mm) and the type of inclusion. A further purpose of this study was the evaluation of the possible different action between the CO2 laser (wavelength: 10600 nm; power: 4.5 Watts) used in super-pulsed emission mode (that no have bio-stimulation capacity) and the diode laser (wavelength: 980 nm + 645 nm; power: 4 Watts) used in continuous wave emission mode. Comparing the millimeters of eruption of the canines treated with the two different types of lasers and applying the Student’s T-Test, we found a super-imposable value. Moreover, the study groups (group A and group B) and the control group were compared in terms of mean eruption time, respectively spontaneous or forced by means of a Crozat orthodontic device, activated monthly to allow the displacement of the canines .I n the control group the duration of the orthodontic traction is, on average, 10 months. In the study groups the canine eruption was spontaneous and occurred in an average period of 4 months. It can be stated that, although a forced orthodontic traction was applied in the control group to allow tooth eruption, the eruption times in the study groups were significantly lower. The results obtained indicate the effectiveness of the new approach proposed by us, although performed on a small sample of patients. The results are significant from different points of view. The advantages found in this study are numerous. The main advantages of digital monitoring are the possibility of evaluating parameters that cannot be evaluated analogically and of making measurements of distances normally calculated on plaster casts with compass and rubber with the respective errors. Other advantages are represented by the reduction of work time, due to the abolishing of the need to request plaster casts to the dental technician. Which also means the reduction of the costs of the laboratory and it also means less costs for the patients. By eliminating the steps of the analogue impressions and of the plaster casts, the details are certainly represented with more precision and accuracy and there is a minimum error accumulated. This digital workflow that is created is also managed entirely by a single person, which represents a further saving of time. Moreover, we have clinical advantages, that are the less discomfort of the patient who does not tolerate the classic impressions in alginate and of the orthodontist, and the reduction of the chair time. The application of the digital technologies in the monitoring helps the orthodontist to make clinical decisions supported on measurable data and not just on clinical experience. The our ortho-surgical protocol with the use of different technologies set off to a new concept of work in dentistry, in particular, in the cases characterized by impacted teeth or cases that expect an orthodontic and surgical approach. Finally, a not indifferent aspect consists in the reduce of treatment time, which is an advantage for both the orthodontist and the patient. It is consequence of the reduction of the steps and work-time, and it is due to the real monitoring that can be performed on the patient

Photobiomodulation therapy on orthodontic movement: analysis of preliminary studies with a new protocol

This study aimed to investigate the effectiveness of photobiomodulation therapy (PBMT) on the acceleration of orthodontic movements, deriving from its biostimulating and regenerative capacity on soft tissues, consequent to the increase in differentiation, proliferation, and activity of cells that are involved with alveolar bone remodeling. The present randomized controlled trial was conducted on six patients who required extractive orthodontic therapy because their ectopic canines had erupted. A total of eight canines were analyzed, four of which received laser irradiation (i.e., experimental group). Two weeks after the extractions, all canines of the experimental and placebo groups were distalized simultaneously and symmetrically with the laceback retraction technique. The PBMT protocol consisted of four cycles of laser applications, one each on days 0, 3, 7, and 14 of the study, with session treatment durations of 2-4 min. The results of the descriptive analysis on the distal displacement speed of the canines after 1 month of follow-up indicate an average displacement of 1.35 mm for the non-irradiated group and 1.98 mm for the irradiated group. Through inferential analysis, a statistically significant difference (p < 0.05) was found between the average speed of the irradiated canines and the control canines. The low energy density laser used in this study, with the parameters set, was found to be a tool capable of statistically significantly accelerating the distal displacement of canines

Psychometric properties of the Fatigue Severity Scale in obese patients

BACKGROUND: The aim of this study was to examine the psychometric properties of the Fatigue Severity Scale (FSS) to verify whether this instrument is a valid tool to measure fatigue in obese patients, and to examine the prevalence of fatigue in obese patients. METHODS: Before and after a three-week residential multidisciplinary integrated weight reduction program, 220 patients were asked to fill in the questionnaires: FSS, Profile of Mood States (Fatigue-Inertia subscale, POMS-Fatigue, and Vigor-Activity subscale, POMS-Vigor), and the Obesity-Related Well-Being (ORWELL-97). A subsample of 50 patients completed the questionnaire within two days. RESULTS: The prevalence of fatigue using a cut-off value of 4 for the FSS score was 59%. Correlations were found between FSS and POMS-Fatigue and -Vigor scores (r = 0.58 and 0.53, respectively). A relation was also found between FSS and ORWELL97 (r = 0.52, 0.42 to 0.61). From the factorial analysis only 1 factor was extracted explaining 63% of variance, with factor loading values ranging from 0.71 (item 7) to 0.87 (item 6). Intraclass Correlation Coefficient was 0.89 (0.82 to 0.94), while the agreement as measured using the Standard Error of Measurement was 0.43 (0.36 to 0.54) corresponding to 13% (11 to 17%). Cronbach’s alpha values ranged from 0.94 to 0.93. The internal responsiveness of FSS was comparable to the ORWELL97 (Standardized Response Mean = 0.50 and 0.44, respectively). CONCLUSIONS: Fatigue is an important and frequent symptom in obese patients and therefore should be routinely assessed in both research and clinical practice. This can be achieved using the FSS, which is a short, simple, valid and reliable tool for assessing and quantifying fatigue in obese patients

CO2 and diode lasers vs. conventional surgery in the disinclusion of palatally impacted canines: a randomized controlled trial

Abstract: Background: The aim of this RCT is to show the effectiveness of laser technology for the exposure of palatally impacted canines, using a CO2 or diode laser, and to evaluate the possible bio-stimulation effect of the laser on the spontaneous eruption of the canine. Methods: This study was carried out on a sample of 27 patients, divided randomly into three groups: treated with a CO2 laser (Group A), treated with a diode laser (Group B), and treated with a cold blade (Group C). Monitoring was performed at 1, 8, and 16 weeks after surgery, through photo and digital scans performed with a CS3500 intraoral scanner. Results: It was found that the average total eruptions are 4.55 mm for Group A, 5.36 mm for Group B, and 3.01 mm for Group C. The difference in eruption between groups A and B is not significant. Comparing the laser groups with the control group, it has emerged that the difference in eruption is statistically significant. Conclusion: A significant tooth movement was observed in both Groups A and B. The response of the canine to the bio-stimulation of the laser can be considered effective, resulting in a statistically significant difference between the study groups and the control group. Both lasers have the same bio-stimulatory action on the eruption of canines

Efficacy and accuracy of maxillary arch expansion with clear aligner treatment

The aim of this work was to evaluate the efficacy and accuracy of maxillary arch transverse expansion using the Invisalign® clear aligner system without auxiliaries other than Invisalign attachments. Knowing the accuracy of a movement through a clear aligner system allows the clinician to plan the treatment with greater precision and to achieve the expected result faster. The study group included 28 patients with a mean age of 17 ± 3.2 years. The treatment protocol for all the selected patients included the application of the Invisalign® clear aligner system without auxiliaries, except for the Invisalign® attachments; in no case were tooth extraction or interproximal enamel reduction (IPR) performed. Linear measurements of the expansion were assessed before treatment (T0), at the end of treatment (T1), and on final virtual models by ClinCheck® (TC). A paired t-test was used to compare T0-T1 and T1-TC differences. A paired t-test was applied, and one normality was validated with the Shapiro-Wilks test. If normality was not met, the nonparametric test (Mann-Whitney U test) was applied. The level of significance was set at 5%. Statistically significant differences were found for all measurements at T0-T1. The results showed an average accuracy of efficacy of 70.88%. The differences in predictability between the various vestibular measurements (intercanine, inter-premolar, and intermolar) were not statistically significant, while they were for gingival measurements. The overall accuracy of the expansion treatment was 70%, regardless of tooth type

Evaluation of photodynamic therapy using a diode laser 635 nm as an adjunct to conventional chemo-mechanical edodontic procedures against enterococcus faecalis biofilm: ex-vivo study

The study aimed to evaluate the antimicrobial effect of photodynamic therapy (PDT) with the use of Toluidine Blue (TB) on extracted teeth infected with biofilms of Enterococcus faecalis. Fifty-four extracted teeth with single-roots and single canals were mechanically shaped, autoclaved, and contaminated with E. faecalis. They were randomly divided into six groups: two groups were negative and positive control groups, two groups were subjected to mechanical instrumentation and PDT with different pre-irradiation times and irradiation times, and two groups were subjected to chemo-mechanical endodontic treatment and PDT with different pre-irradiation times and irradiation times. In PDT groups, after the application of TB, the canals were irradiated with a diode laser of wavelength 635 nm, with a fiber diameter of 200 μm and 100 mW of power in continuous mode. The bacterial load was evaluated using a BioTimer Assay protocol. The greatest reduction of bacterial load was observed in groups of combined PDT with chemo-mechanical treatment. The reductions of bacterial load in groups of combined PDT with chemo-mechanical treatment, and in the positive control group, were significant (p < 0.01) when compared to that of the negative control group. Photodynamic therapy as an adjunctive modality may improve the disinfection capacity of conventional endodontic treatment against E. faecalis

CO 2

Laparoscopy (LS) has been shown to decrease the inflammatory sequelae of endotoxemia. β-arrestin 2 plays an important function in signal transduction pathway of TLR4. High mobility group box-1 (HMGB-1) is involved in the delayed systemic inflammatory response. We investigated the effects of CO2 insufflation on liver, lung, and kidney expression of both β-arrestin 2 and HMGB-1 during sepsis. Cecal ligation and puncture (CLP) was performed in male rats and 6 h later the animals were randomly assigned to receive a CO2 pneumoperitoneum or laparotomy. Animals were euthanized; liver, lung, and kidney were removed for the evaluation of β-arrestin 2 and HMGB-1 expression. Immunohistochemical detection of myeloperoxidase (MPO) was investigated in lung and liver and bacterial load was determined in the peritoneal fluid. CO2 pneumoperitoneum reduced peritoneal bacterial load, increased the expression of β-arrestin 2, and blunted the expression of the potent proinflammatory HMGB-1 in liver, lung, and kidney compared with laparotomy. Liver and lung MPO was markedly reduced in rats subjected to LS compared with laparotomy. We believe that CO2 exerts an early protective effect by reducing bacterial load and likely toll-like receptor activation which in turn leads to a preserved β-arrestin 2 expression and a reduced HMGB-1 expression

First Sagittarius A* Event Horizon Telescope results. II. EHT and multiwavelength observations, data processing, and calibration

We present Event Horizon Telescope (EHT) 1.3 mm measurements of the radio source located at the position of the supermassive black hole Sagittarius A* (Sgr A*), collected during the 2017 April 5–11 campaign. The observations were carried out with eight facilities at six locations across the globe. Novel calibration methods are employed to account for Sgr A*'s flux variability. The majority of the 1.3 mm emission arises from horizon scales, where intrinsic structural source variability is detected on timescales of minutes to hours. The effects of interstellar scattering on the image and its variability are found to be subdominant to intrinsic source structure. The calibrated visibility amplitudes, particularly the locations of the visibility minima, are broadly consistent with a blurred ring with a diameter of ∼50 μas, as determined in later works in this series. Contemporaneous multiwavelength monitoring of Sgr A* was performed at 22, 43, and 86 GHz and at near-infrared and X-ray wavelengths. Several X-ray flares from Sgr A* are detected by Chandra, one at low significance jointly with Swift on 2017 April 7 and the other at higher significance jointly with NuSTAR on 2017 April 11. The brighter April 11 flare is not observed simultaneously by the EHT but is followed by a significant increase in millimeter flux variability immediately after the X-ray outburst, indicating a likely connection in the emission physics near the event horizon. We compare Sgr A*'s broadband flux during the EHT campaign to its historical spectral energy distribution and find that both the quiescent emission and flare emission are consistent with its long-term behavior.http://iopscience.iop.org/2041-8205Physic

First Sagittarius A* Event Horizon Telescope Results. II. EHT and Multiwavelength Observations, Data Processing, and Calibration

We present Event Horizon Telescope (EHT) 1.3 mm measurements of the radio source located at the position of the supermassive black hole Sagittarius A* (Sgr A*), collected during the 2017 April 5–11 campaign. The observations were carried out with eight facilities at six locations across the globe. Novel calibration methods are employed to account for Sgr A*'s flux variability. The majority of the 1.3 mm emission arises from horizon scales, where intrinsic structural source variability is detected on timescales of minutes to hours. The effects of interstellar scattering on the image and its variability are found to be subdominant to intrinsic source structure. The calibrated visibility amplitudes, particularly the locations of the visibility minima, are broadly consistent with a blurred ring with a diameter of ∼50 μas, as determined in later works in this series. Contemporaneous multiwavelength monitoring of Sgr A* was performed at 22, 43, and 86 GHz and at near-infrared and X-ray wavelengths. Several X-ray flares from Sgr A* are detected by Chandra, one at low significance jointly with Swift on 2017 April 7 and the other at higher significance jointly with NuSTAR on 2017 April 11. The brighter April 11 flare is not observed simultaneously by the EHT but is followed by a significant increase in millimeter flux variability immediately after the X-ray outburst, indicating a likely connection in the emission physics near the event horizon. We compare Sgr A*’s broadband flux during the EHT campaign to its historical spectral energy distribution and find that both the quiescent emission and flare emission are consistent with its long-term behavior

Treatment efficiency of conventional vs. self-ligating braces: systematic review and meta-analysis

Objective: The aim of this study was to conduct a systematic search for eligible publications within the past 17 years and to conduct a meta-analysis on differences between conventional and self-ligating brackets regarding overall treatment time and number of appointments. Material & Methods: This review’s pre-de ned protocol was based on the Cochrane guidelines, and it is reported according to the PRISMA statement and its extension for abstracts. We included randomized controlled trials (RCTs) and quasi-RCTs, published in English between 1998 and 2015; we included human patients of any age or gender that received xed-appliance orthodontic treatment as well as comparable patients for age, gender, and malocclusion receiving therapy with conventional as well as self-ligating brackets. Results: After we performed the research, we analyzed the useful full-text publications. The total duration of the treatment was higher in the self-ligating brackets group than those of the conventional brackets in all the studies reviewed. The number of appointments were greater in the self-ligating group than in the conventional brackets group, while in other studies, the conventional brackets group shows a greater number of appointments. Conclusion: Results from our meta-analysis revealed weak and statistically not signi cant overall effects that failed to substantiate major advantages of self-ligating brackets over conventional brackets. Treatment time does not depend exclusively on the type of bracket. The number of appointments is of interest when considering treatment duration