Thermography as a method to detect dental anxiety in oral surgery

(1) Background: the aim of this study was to evaluate if dental anxiety can be measured objectively using thermal infrared imaging. (2) Methods: Patients referred to the Department of Oral Surgery of the University of Naples Federico II and requiring dental extractions were consecutively enrolled in the study. Face thermal distribution images of the patients were acquired before and during their first clinical examination using infrared thermal cameras. The data were analyzed in relation to five regions of interest (ROI) of the patient’s face (nose, ear, forehead, zygoma, chin). The differences in the temperatures assessed between the two measurements for each ROI were evaluated by using paired T‐test. The Pearson correlation and linear regression were performed to evaluate the association between differences in temperatures and Modified Dental Anxiety Scale (MDAS) questionnaire score, age, and gender; (3) results: sixty participants were enrolled in the study (28 males and 32 females; mean age 57.4 year‐old; age range 18–80 year‐old). Only for nose and ear zone there was a statistically significant difference between measurements at baseline and visit. Correlation between the thermal imaging measurements and the scores of the MDAS questionnaire was found for nose and ear, but not for all of the other regions. (4) Conclusions: the study demonstrated a potential use of thermal infrared imaging to measure dental anxiety

A multidisciplinary diagnostic approach preliminary to the restoration of the country church "San Maurizio" located in Ittiri (SS), Italy

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Short implants versus longer implants in vertically augmented atrophic mandibles: A systematic review of randomised controlled trials with a 5-year post-loading follow-up

Purpose: To compare the clinical outcome of fixed prostheses supported by 4 to 8 mmlong implants with prostheses supported by longer implants placed in vertically augmented atrophic mandibles after a follow-up of 5 years in function. Materials and methods: The Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE were searched up to 1 st September 2018 for randomised controlled trials (RCTs) with a follow up of at least 5 years in function comparing fixed prostheses supported by 4 to 8 mm-long implants with prostheses supported by longer implants placed in vertically augmented atrophic mandibles. Outcome measures were prosthesis failure, implant failures, augmentation procedure failures, complications, and peri-implant marginal bone level changes. Screening of eligible studies, assessment of the risk of bias and data extraction were conducted in duplicate and independently by two review authors. The statistical unit of the analysis was the prosthesis. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CIs). Results: Four eligible RCTs which included originally 135 patients were included. Two RCTs had a parallel group design and two a split-mouth design. Short implants were 5 to 6.6 mm long and were compared with longer implants placed in posterior mandibles augmented with interpositional blocks of bone substitutes. All trials were judged at unclear risk of bias. Twelve (14%) bone augmentation procedures failed to achieve the planned bone height to allow placement of implants with the planned length. Five years after loading 28 patients (21%) dropped from the four RCTs. There were no differences for patients having prosthesis (RR = 1.46; 95% CI 0.52 to 4.09; P = 0.47; Chi² = 1.35, df = 3 (P = 0.72); I² = 0%) or implant (RR = 1; 95% CI 0.31 to 3.21; P = 1.00; Chi² = 0, df = 3 (P = 1.00); I² = 0%) failures between the two interventions, but there were more patients experiencing complications (RR = 4.72; 95% CI 2.43 to 9.17; P < 0.00001; Chi² = 3.02, df = 3 (P = 0.39); I² = 0%) and peri-implant marginal bone loss (mean difference = 0.60 mm; 95% CI 0.36 to 0.83; P < 0.00001; Chi² = 5.47, df = 3 (P = 0.14); I² = 45%) at longer implants in augmented bone. Conclusions: Five years after loading, prosthetic and implants failures were similar between the two interventions, but complications and peri-implant marginal bone loss were higher and more severe at longer implants placed in vertically augmented mandibles. Larger trials and longer follow-ups up to 10 years after loading are needed to confirm or reject the present preliminary findings. However in the meantime short implants could be the preferable option

Platelet-rich plasma counteracts detrimental effect of high-glucose concentrations on mesenchymal stem cells from Bichat fat pad

Diabetic patients display increased risk of periodontitis and failure in bone augmentation procedures. Mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) represent a relevant advantage in tissue repair process and regenerative medicine. We isolated MSCs from Bichat's buccal fat pad (BFP) and measured the effects of glucose and PRP on cell number and osteogenic differentiation potential. Cells were cultured in the presence of 5.5-mM glucose (low glucose [LG]) or 25-mM glucose (high glucose [HG]). BFP–MSC number was significantly lower when cells were cultured in HG compared with those in LG. Following osteogenic differentiation procedures, calcium accumulation, alkaline phosphatase activity, and expression of osteogenic markers were significantly lower in HG compared with LG. Exposure of BFP–MSC to PRP significantly increased cell number and osteogenic differentiation potential, reaching comparable levels in LG and in HG. Thus, high-glucose concentrations impair BFP–MSC growth and osteogenic differentiation. However, these detrimental effects are largely counteracted by PRP

Wavefront invasion for a chemotaxis model of Multiple Sclerosis

In this work we study wavefront propagation for a chemotaxis reaction-diffusion system describing the demyelination in Multiple Sclerosis. Through a weakly non linear analysis, we obtain the Ginzburg–Landau equation governing the evolution of the amplitude of the pattern. We validate the analytical findings through numerical simulations. We show the existence of traveling wavefronts connecting two different steady solutions of the equations. The proposed model reproduces the progression of the disease as a wave: for values of the chemotactic parameter below threshold, the wave leaves behind a homogeneous plaque of apoptotic oligodendrocytes. For values of the chemotactic coefficient above threshold, the model reproduces the formation of propagating concentric rings of demyelinated zones, typical of Baló’s sclerosis

A proposed protocol for ordinary and extraordinary hygienic maintenance in different implant prosthetic scenarios

Prevention of peri-implantitis involves the early diagnosis of peri-implant mucositis. This article presents a protocol of hygienic maintenance in different implant prosthetic scenarios: single crown, fixed partial prosthesis, fixed full-arch, and overdentures. Others clinical conditions have to be taken into consideration: patient compliance; history of periodontitis; implants placed in augmented bone; short, zygomatic, pterygoid, and tilted implants; and complex prosthesis with false gingiva. Two levels of implant maintenance are described: ordinary, performed by dental hygienist, and extraordinary, carried out by both dentist and hygienist. Extraordinary maintenance also involves the removal and decontamination of the prosthetic structure. To obtain an effective prevention of peri-implantitis, one must plan ordinary and extraordinary hygiene in relation to the type of rehabilitation and clinical parameters

Effectiveness of surgical procedures in the acceleration of orthodontic tooth movement: Findings from systematic reviews and meta-analyses

The current overview aimed to summarise the findings provided by systematic reviews (SRs) on the effect of surgical procedures in the acceleration of tooth movement and to assess the methodological quality of the included SRs. Three electronic databases have been explored. SRs addressing the effects of surgical procedures on the acceleration of tooth movement were included. The methodological quality of the included SRs was assessed using the updated version of “A Measurement Tool to Assess Systematic Review” (AMSTAR-2). Twenty-eight (28) SRs were included. The methodological quality of the included reviews ranged between critically low (6 studies) and high (12 studies). The most common critical weakness in the included reviews was the absence of clearly a-prior established review methods and any significant deviations from the protocol. The most studied surgical procedure was corticotomy, followed by micro-osteoperforation, piezocision and periodontally accelerated osteogenic orthodontics. The majority of the included SRs supported short-term favourable effects of corticotomy on treatment time and tooth movement rate, in the short-term. However, the authors of the included SRs reported that results were based on weak quality evidence. Conflicting results arise from the existent SRs with regards to the effectiveness of piezocision and micro-osteoperforation. Few SRs summarised complications and side effects of surgical techniques, supporting absence of loss of tooth vitality, periodontal problems, or severe root resorption. The current overview of SRs highlighted the need of high quality SRs comparing different surgical approaches for tooth movement acceleration though network meta-analysis, in order to determine the most efficient instrument for orthodontic movement acceleration

Vanishing Viscous Limits for 3D Navier-Stokes Equations with A Navier-Slip Boundary Condition

In this paper, we investigate the vanishing viscosity limit for solutions to the Navier-Stokes equations with a Navier slip boundary condition on general compact and smooth domains in $\mathbf{R}^3$. We first obtain the higher order regularity estimates for the solutions to Prandtl's equation boundary layers. Furthermore, we prove that the strong solution to Navier-Stokes equations converges to the Eulerian one in $C([0,T];H^1(\Omega))$ and L^\infty((0,T)\times\o), where $T$ is independent of the viscosity, provided that initial velocity is regular enough. Furthermore, rates of convergence are obtained also.Comment: 45page

Fracture and migration in right atrium of a permanent venous central access system in a elderly patient: case report and literature review

Catheter dislocation and fracture with migration of central venous lines have been reported in the International literature. Catheter fracture with consequent migration has been observed in 0.5-3.0% and may either be consequent to catheter removal or it can occur spontane-ously. Our case report concerns the migration of a Hickman catheter connected to a venous port to the right atrium in a 61-year old patient. A literature up-to-date has been performed to assess the risk of port-a-cath positioning. The position of catheter tip is considered critical for the risk of migration, that is greater as higher the tip localization respect to the carina. The aim of our study is to underline the critical role of X-ray to visualize the exact location of the catheter tip, regard-less of the approach used for catheter positioning

Viscous-Inviscid Interactions in a Boundary-Layer Flow Induced by a Vortex Array

In this paper we investigate the asymptotic validity of boundary layer theory. For a flow induced by a periodic row of point-vortices, we compare Prandtl's solution to Navier-Stokes solutions at different $Re$ numbers. We show how Prandtl's solution develops a finite time separation singularity. On the other hand Navier-Stokes solution is characterized by the presence of two kinds of viscous-inviscid interactions between the boundary layer and the outer flow. These interactions can be detected by the analysis of the enstrophy and of the pressure gradient on the wall. Moreover we apply the complex singularity tracking method to Prandtl and Navier-Stokes solutions and analyze the previous interactions from a different perspective