Torque changes of anchorage units in preadolescent patients treated with a digitally designed tooth-borne expander anchored to deciduous vs. permanent molars

AIM

To compare the effects on permanent or deciduous anchorage dental units in patients treated with a digitally designed palatal expander.

METHODS

Inclusion criteria were the following: presence of maxillary transverse deficiency, no previous orthodontic treatment, no extractions, absence of agenesis, congenital pathologies and cranio-maxillofacial malformations. Twenty patients (11 males, 9 females, 11 ± 1.8 years) received a digitally designed and metal printed palatal expander anchored on first permanent molars and 1 activation per day for 30 days (Group 1). Twenty-one patients (12 males, 9 females, 8.6 ± 1.4 years) received a digitally designed and metal printed palatal expander anchored on second deciduous molars and 2 activations per day for 14 days (Group 2). Digital intraoral scans were taken before expansion and after device removal, and torque and the palatal transverse diameter were digitally measured. The FDI notation was used to indicate each tooth CONCLUSION: Less dental torque augmentation was produced in Group 2.

RESULTS

Significant intragroup differences over time were found in Group 1 considering the torque of teeth 1.6, 1.4, 1.3, 2.1, 2.4, 2.5, 2.6. Significant differences between groups were found regarding the longitudinal change in torque of teeth 1.5, 2.4 and 2.5. Significant intragroup differences over time were found in both groups considering all transverse diameter parameters. No significant differences were found between groups in the transverse diameter modifications over time.

CONCLUSION

Less dental torque augmentation was produced in Group 2.

Perspectives in linear accelerator for FLASH VHEE: Study of a compact C-band system

PURPOSE

In order to translate the FLASH effect in clinical use and to treat deep tumors, Very High Electron Energy irradiations could represent a valid technique. Here, we address the main issues in the design of a VHEE FLASH machine. We present preliminary results for a compact C-band system aiming to reach a high accelerating gradient and high current necessary to deliver a Ultra High Dose Rate with a beam pulse duration of 3μs.

METHODS

The proposed system is composed by low energy high current injector linac followed by a high acceleration gradient structure able to reach 60-160 MeV energy range. To obtain the maximum energy, an energy pulse compressor options is considered. CST code was used to define the specifications RF parameters of the linac. To optimize the accelerated current and therefore the delivered dose, beam dynamics simulations was performed using TSTEP and ASTRA codes.

RESULTS

The VHEE parameters Linac suitable to satisfy FLASH criteria were simulated. Preliminary results allow to obtain a maximum energy of 160 MeV, with a peak current of 200 mA, which corresponds to a charge of 600 nC.

CONCLUSIONS

A promising preliminary design of VHEE linac for FLASH RT has been performed. Supplementary studies are on going to complete the characterization of the machine and to manufacture and test the RF prototypes.

Maxillary "en masse" high-pull traction in Class II division 1 subjects: Which kind of skeletal outcomes does it produce?

AIM

The aim of the present prospective study was to evaluate if the treatment performed using high-pull traction on a Stephenson plate had real orthopaedic outcomes in subjects with severe Class II Division 1 malocclusion due to maxillary protrusion.

MATERIALS AND METHODS

Twenty-three growing patients showing Class II Division 1 malocclusion (Stephenson plate group, SPG) were treated and compared with an untreated Class II control group (CG - 21 subjects selected from the database of Bolton-Brush Growth Study). Lateral cephalograms at T0 and T1 for both groups were analysed using cephalometric tracing by Jarabak, Pancherz and Ghosh-Nanda.

RESULTS

Orthopaedic forces were applied in SPG. SPG group showed significantly greater decrease than CG group of SNA° (-1.4° vs +0.7°), ANB° (-1.3° vs +0°), WITS (-1° vs 0.6°), overjet (-4.1 mm vs +0.3 mm), molar relationships (-6.1° mm vs -0.1 mm) and upper incisors proclination (1/SpP, -10.3° vs -1°). The maxilla substantially maintained its position (A/OLp +0.3 mm, SNA° -1.4°) while the mandible slightly grew (Pg/OLp +1.7 mm; SNB° + 0.7°). Facial pattern and AFA/AFP ratio did not change.

CONCLUSION

The high-pull traction on the Stephenson plate produced more dental than skeletal outcomes in growing subjects, despite of the application of orthopaedic forces.

Prevalence and Correlates of Anemia and Uncontrolled Anemia in Chronic Hemodialysis Patients – The Campania Dialysis Registry

Background

This study investigated prevalence and correlates of anemia and uncontrolled anemia in chronic hemodialysis patients.

Methods

A cross-sectional analysis was performed on registry data for 2,746 chronic (<6 months) hemodialysis patients aged 25–84. Data collection included years of dialysis, hours of dialysis/wk, disease causing hemodialysis, body mass index (BMI), erythropoietin (EPO) treatment, hemoglobin, markers of viral hepatitis, serum albumin, calcium, and phosphorus.

Results

Prevalence was 88.7% for anemia (hemoglobin <11 g/100 mL and EPO treatment at any Hb level), 39.4% for uncontrolled anemia (hemoglobin<11 g/100 mL). Gender, years of dialysis, hereditary cystic kidney disease (HCKD), and low BMI (<24 kg/m2) were independent correlates of anemia (P<0.001). Gender, HCKD, low BMI, serum albumin and calcium were independent correlates of uncontrolled anemia (P<0.05). An interaction was found between age (not correlated with anemia and uncontrolled anemia) and the association of gender with uncontrolled anemia (P<0.05). EPO doses were higher in patients with high prevalence of uncontrolled anemia than in patients with low prevalence (i.e., women vs men, other diseases vs HCKD, low vs not-low BMI, P<0.01). Gender, years of dialysis, HCKD, BMI, serum albumin, and calcium were independent correlates of the hemoglobin/EPO dose ratio in patients on EPO treatment (P<0.05).

Conclusion

Anemia and uncontrolled anemia are more frequent in hemodialysis patients with short-term dialysis, diseases other than HCKD, low BMI, and female gender. Gender effect was lower in elderly patients. Uncontrolled anemia was also associated with low serum albumin and calcium, suggesting that these parameters are indices of EPO resistance.

Suicide and drug and alcohol addiction: Self-destructive behaviours. An observational study on clinic hospital population

Introduction

Suicidal behaviour and drug and alcohol dependence represent two different aspects of self-destructive behavior.

Objectives

We evaluated the relationship between suicidal behavior and substance and alcohol addiction. It was investigated the role of childhood trauma in these self-destructive behaviors and in the development of the two mental constructions of hopelessness and mentalization.

Aims

We also assessed how a high level of hopelessness could affect suicidal ideation and how low or absent capacity of mentalization could influence the development of substance and/or alcohol addiction.

Methods

This naturalistic, observational study included 50 patients (mean age = 46.54; S.D = 14.57) recruited from the department of psychiatry (n = 18) and the centre for suicide prevention (n = 32) of Sant’Andrea Hospital (Rome). Different questionnaires were administered to each patient from February to May 2016.

Results

There was not a statistically significant relationship between suicidal behavior and addict behavior. Childhood trauma resulted a risk factor for alcohol abuse with a relationship that tended to significance (P = 0.07). Physical and sexual abuses were significantly associated with addiction (respectively P = 0.014; P = 0.033). It was showed a statistically significant interaction between high level of hopelessness and suicidal ideation (P = 0.037). The absence of mentalization was related to the absence of alcohol abuse (P = 0.061). Finally, trauma experienced during childhood was associated with high level of hopelessness (P = 0.005).

Conclusions

Suicidal behavior is influenced indirectly by a childhood traumatic experience that conditioning the level of hopelessness. Childhood trauma affected directly the development of drug abuse and alcoholism. The capacity of mentalization was not related with childhood trauma.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Assessment of Suicide-related Knowledge and Skills in a Sample of Health Professionals and Students

Objective

Assessment of suicide risk is of paramount importance for proper prevention.

Aims

To examine the association between gatekeeper training and suicide-related knowledge among a diverse set of health care workers (psychiatrists, nurses, psychologists, and educators) and students enrolled in medical and psychological schools who took part in the world suicide prevention day 2015 conference.

Method

Among 223 participants who completed the assessment, 204 provided complete data for analyses. Participants were administered the applied suicide intervention skills training (ASIST), a 13-item survey questionnaire to assess participants’ knowledge about suicidal behavior and comfort dealing with suicidal clients. There were 62 psychiatrists; 23 nurses, 51 psychologists, 11 educators, and 57 university students.

Results

Among participants, 57.1% of the sample had experiences of suicide a patient (students were excluded from these analyses). Those who reported a suicide among patients (compared with others) less frequently answered that suicide risk is more alarming in older adults than youths. They also less frequently disagreed with questions asking if they had the training to deal with suicidal patients. Students more frequently answered correctly on the association between depression and suicide risk, and less frequently chose the correct answer on the seriousness of suicide intent in borderline personality disorder. Students also more frequently disagreed with questions asking on their suicide assessment skill.

Conclusions

Our study highlights that differences exist when it comes to knowledge and skills related to suicide risk assessment both among health professionals and students. Our results also indicate that suicide awareness among these groups should be promoted.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Denture-frame modifications in class III patients treated with rapid palatal expansion and facemask: a prospective controlled study

AIM

The aim of this prospective controlled investigation was to analyze the short-term cephalometric treatment outcomes, according to the denture frame analysis proposed by Sato, of rapid palatal expansion (RPE) and facial mask (FM) therapy.

METHODS

A group of 21 patients with Class III malocclusion treated with the RPE and FM (TG) was compared with untreated Class III controls (CG). The mean age of treatment group was 8.8 years; treatment consisted of 4 weeks of RPE activation (0.20 mm/die) followed by 14 hours wear of the FM for a mean of 333.1 days. As CG were used the data published by Tanaka and Sato. Pre- and post-treatment cephalometric values were compared and statistical analyzed with one-sample t-test. A P-value <0.05 was considered statistically significant.

RESULTS

For almost all parameters the differences pre and post treatment values resulted significantly different compared to those observed in CG. Regarding conventional occlusal plane (POC) values some differences compared to control group were found but they were not statistically significant (P=0.067) while for aterior occlusal plane (POA) no differences where noticed.

CONCLUSION

This study revealed an increase in inter-jaw angle during treatment with FM and RPE, an increase in the inclination of the posterior occlusal plane with respect to the Frankfurt plane and a posterior and lower adaptation of the mandible.

The efficacy of Italian guidelines in promoting oral health in children and adolescents

AIM

The purpose of the study was to evaluate the efficacy of the guidelines on oral health published by the Italian Health Ministry.

STUDY DESIGN

1239 patients (582 girls and 657 boys) with a mean age of 4.46 (SD 2.81) years were evaluated before application of the guidelines by paediatricians (T0) for the presence of caries, gingivitis, diseases of the oral mucosa, and malocclusion. Only patients aged 6 months, 3 years, 6 years, and 9 years at T0 were taken into consideration. All patients were reevaluated after application of the ministerial guidelines (T1).

METHODS

the study took place over a 3-year period. Enrolled patients referred to the outpatient clinics of three paediatricians of the Province of Genoa who strictly applied the ministerial guidelines.

STATISTICS

Chi square test analysis was performed to evaluate a statistically significant decrease in the incidence of caries, gingivitis and diseases of the oral mucosa.

RESULTS

After a 3-year follow-up collected data underlined a statistically significant decrease in the incidence of dental caries, gingivitis and oral mucosal diseases after implementation of the recommended ministerial guidelines. A statistically significant decrease of malocclusions was also evident in the elder patients (12 years old at T1).

CONCLUSION

The accurate implementation of the Guidelines is supported. Only collaboration and increased synergy between paedodontists and paediatricians can fulfill the objectives which were the reason for publishing the "National guidelines for the promotion of oral health and the prevention of oral diseases in developmental age".

Evaluation of the cephalometrics modification of growing Class II Division I patients after treatment with the PUL appliance: a pilot study

AIM

The aim of this preliminary study was to evaluate short-term dentoskeletal changes obtained with a functional appliance for Class II Division I malocclusions called propulsor universal light (PUL).

METHODS

Fifteen Class II Division 1 patients (10.6±1.2 years) were consecutively treated by one expert operator with PUL appliance and they were compared with a longitudinal group of Class II Division I untreated patients (9.9±1.9 years) matched for pubertal growth spurt stage and sex. Lateral cephalograms were taken before PUL therapy and at the end of treatment. The mean duration of treatment was 11.2±0.3 months; t-test or Mann-Whitney U-test was used (P <0.05).

RESULTS

Statistically significant reduction of the overjet, WITS and ANB was noticed in treated group as well as a significant improvement of CoGo and Ramus.

CONCLUSION

Class II Division I malocclusion in the short term was efficiently treated by PUL appliance with both skeletal and dentoalveolar changes.

Signal transduction on enzymes: the effect of electromagnetic field stimuli on superoxide dismutase (SOD)

Protein functions and characteristics can highly differ from physiological conditions in presence of chemical, mechanical or electromagnetic stimuli. In this work we provide a rigorous picture of electric field effects on proteins behavior investigating, at atomistic details, the possible ways in which an external signal can be transduced into biochemical effects. Results from molecular dynamics (MD) simulations of a single superoxidismutase (SOD) enzyme in presence of high exogenous alternate electric fields will be discussed.

Early functional treatment in Class II division 1 subjects with mandibular retrognathia using Fränkel II appliance. A prospective controlled study

AIM

This was to clarify dentoalveolar, skeletal and facial profile modifications induced by Fränkel II functional treatment in Class II division 1 subjects in prepubertal stages CS1-2.

MATERIALS AND METHODS

Evaluation of 25 caucasian subjects (15 males, 10 females), mean age 8y 11m, in vertebral stages CS1-2. The mean duration of functional treatment was 1y 11m.

STUDY DESIGN

Prospective controlled study. The sample was evaluated at T0, start of treatment, and T1, end of Fränkel II therapy. Untreated subjects in Class II division 1 were the control group.

STATISTICS

T-test for paired data was calculated before and after treatment (P< 0.05).

RESULTS

A statistically significant increase between T0 and T1 was obtained for SNB (p = 0.022), ANB (p <0.001), Mx/Mn differential (p = 0.001), Co-Go-Me (p = 0.014), OJ (p < 0.001), OB (p = 0.042), IMPA (p = 0.021) . OJ (p < 0.001) and OB (p = 0.003) showed a higher significant change in the Fränkel group compared to control group.

CONCLUSION

The Fränkel II appliance produced, in CS1-2 subiects, significant effects in teeth position, skeletal modifications and soft tissue changes, although the pubertal growth spurt would occur at least two years later.

Incidence and distribution of deciduous molar ankylosis, a longitudinal study

AIM

To study incidence and distribution of deciduous molar ankylosis.

MATERIALS AND METHODS

study design: longitudinal retrospective study. A total of 512 consecutive subjects (aged 5 to 15 years) were examined at the Orthodontics and Paediatric Dentistry Department of the Genoa University School of Dentistry; for each subject an ortopantomography x-ray was taken.

RESULTS

Thirty-four children were affected by deciduous molars ankylosis (6.6%). A statistically significant difference was revealed between the distributions: the lower deciduous molars were ankylosed more frequently than the upper ones (P < 0.001); the second deciduous molars were ankylosed more frequently than the first molars (P < 0.001). No statistical significance was found between sex and number of infraoccluded teeth (P = 0.74).

CONCLUSION

This study found an incidence of deciduous molar ankylosis of about 6.6%; the lower deciduous molars and second deciduous molars were ankylosed more frequently (P < 0.001).

Three-dimensional tomographic mapping related to primary stability and structural miniscrew characteristics

OBJECTIVES

To evaluate the maxilla, mandible, and cortical plates on computerized tomographic (CT) scans to achieve accurate three-dimensional bone thickness measurements.

SETTING AND SAMPLE POPULATION

We selected the CT scans of 25 subjects (among 102), aged 18-58 years (10 men, 15 women), with nearly complete dentition.

MATERIAL AND METHODS

We performed interradicular and bucco-lingual (including cortical plate thickness) measurements in dental areas distal to the canines in both alveolar arches, at three levels (5, 8, and 11 mm) from the alveolar ridge.

RESULTS

The mean thicknesses of the cortical plates in the maxilla were 1.10 mm buccally and 1.27 mm on the palatal side (p < 0.05). In the mandible, cortical plates were 2.23 mm buccally and 2.02 mm lingually. Mandibular buccal and lingual cortical plates became thicker distally in the second and third molar areas. There was considerable variation in cortical thickness (from 0.25 to 5.50 mm). Based on interradicular distances, only 13% of measured sites in the maxilla were suitable for miniscrew insertion (≥3.3 mm), but 63% of sites were suitable in the mandible.

CONCLUSION

This study showed considerable individual variation in bone thickness. Our data suggested that the palatal/lingual side may provide greater primary stability for miniscrews. The palatal area, between the second upper bicuspid and the first molar, appeared to be the most suitable area for tapered 7- to 9-mm miniscrews, starting at 1.5-2 mm from the alveolar crest.

Temporary anchorage device stability: an evaluation of thread shape factor

The resistance to extraction of temporary anchorage devices (TADs) depends on various factors, including miniscrew design, shear strength, and bone density. This research introduces the thread shape factor (TSF) as a new factor for the evaluation of TAD mechanical properties. The authors evaluated three TADs for a total of 27 tests: Mini-impianto autoforante (Leone, 1.75 mm diameter and 8 mm length), Orthoscrew (Leader Ortodonzia, 1.65 mm diameter and 9 mm length), and MAS (Miniscrew Anchorage System, 1.3 mm diameter and 11 mm length). For each TAD, the images were acquired via a 20.00 kV scanning electron microscopy to measure their respective mean depth of thread (D), pitch (P), and the relationship between the two (TSF). Subsequently, pullout tests on organic bone analogue were carried out using a testing machine; a crosshead speed of 2 mm/minutes was applied. A two-way analysis of variance was performed to evaluate the interaction between the type of miniscrew and the cortical thickness. A post hoc analysis for single comparisons was subsequently employed. In addition, if homogeneity of variances was not rejected, Scheffè's test was performed, while Tamhane's test was carried out if the homogeneity of variance assumption was not met. Univariate linear regression models were fitted to evaluate the relationship between the outcomes and TSF, D, and P separately. A P value of 0.05 was considered statistically significant. From univariate linear regression, TSF, D, and P were statistically significant predictors of 'peak load'. The tests showed that TSF has a statistical significance for describing the mechanical competency of TADs.

Manual orthodontic vs. oscillating-rotating electric toothbrush in orthodontic patients: a randomised clinical trial

AIM

To compare the efficacy of manual and oscillating-rotating electric toothbrushes in removing plaque and reducing gingivitis in patients with fixed orthodontic appliances.

STUDY DESIGN

Randomised clinical trial.

MATERIALS AND METHODS

20 subjects aged 10 to 14 years (8 males; 12 females) scheduled for fixed orthodontic treatment were enrolled, randomly divided into two groups, A and B, and later assigned electric or manual toothbrushes, respectively. Three months after orthodontic appliance bonding (T1), and again after a further 4 (T2) and 8 (T3) weeks, plaque levels (PI), gingival bleeding (GBI) and hypertrophy were assessed.

RESULTS

Between the two toothbrush types, statistically significant differences in PI were detected from T2 to T3 (P value 0.010), but not from T1 to T2. In contrast, the GBI was significantly different from T1 to T2 (P value 0.025), but not from T2 to T3.

CONCLUSION

With respect to the manual orthodontic toothbrush, the electric oscillating-rotating toothbrush was found to better improve both PI and GBI.

Experimental demonstration of emittance compensation with velocity bunching

In this Letter we report the first experiments aimed at the simultaneous demonstration of the emittance compensation process and velocity bunching in a high brightness electron source, the SPARC photoinjector in INFN-LNF. While a maximum compression ratio up to a factor 14 has been observed, in a particular case of interest a compression factor of 3, yielding a slice current of 120 A with less than 2 microm slice emittance, has been measured. This technique may be crucial in achieving high brightness beams in photoinjectors aiming at optimized performance of short wavelength single-pass free electron lasers or other advanced applications in laser-plasma accelerators.

Complete recovery of olfactory associative learning by activation of 5-HT4 receptors after dentate granule cell damage in rats

Bilateral intradentate injections of 3.0microg of colchicine induced a substantial loss of granule cells and damage to the overlying pyramidal cell layer in region CA1 in adult male Long-Evans rats. All rats with such lesions showed a significant associative learning deficit in an olfactory discrimination task, while being unimpaired in the procedural component of this task. Injection of a partial selective 5-HT(4) agonist (SL65.0155; 0.01mg/kg, i.p., vs. saline) before the third of six training sessions enabled complete recovery of associative learning performance in the lesioned rats. Activation of 5-HT(4) receptors by a selective agonist such as SL65.0155 might therefore provide an opportunity to reduce learning and memory deficits associated with temporal lobe damage, and could be useful for the symptomatic treatment of memory dysfunctions related to pathological aging such as Alzheimer's disease.

Analysis methodology of movable emittance-meter measurements for low energy electron beams

The design of photoinjectors for modern free electron laser linac relies heavily on particular beam behavior in the few meters after the gun. To experimentally characterize it a movable emittance meter was proposed and built [L. Catani et al., Rev. Sci. Instrum. 77, 093301 (2006)] based on the beam slicing technique. This paper addresses all the aspects of analysis of the data acquired with the emittance meter and common to any slit based emittance measurement for low energy beams.

Direct measurement of the double emittance minimum in the beam dynamics of the sparc high-brightness photoinjector

In this Letter we report the first experimental observation of the double emittance minimum effect in the beam dynamics of high-brightness electron beam generation by photoinjectors; this effect, as predicted by the theory, is crucial in achieving minimum emittance in photoinjectors aiming at producing electron beams for short wavelength single-pass free electron lasers. The experiment described in this Letter was performed at the SPARC photoinjector site, during the first stage of commissioning of the SPARC project. The experiment was made possible by a newly conceived device, called an emittance meter, which allows a detailed and unprecedented study of the emittance compensation process as the beam propagates along the beam pipe.

Saturation and electron-beam lifetime in a storage ring free-electron laser

We present a phenomenological treatment of free-electron laser storage ring saturation dynamics. The model includes longitudinal instabilities, Touschek intrabeam scattering, and nonzero off-energy-function contributions. The model predictions are compared with Super ACO experimental results and the agreement is shown to be satisfactory.

Suppression of the sawtooth instability in a storage ring by free-electron laser: an example of nonlinear stabilization by noise

The stabilization of nonlinear excitations by noise is a topic of fundamental importance in many physical problems. We discuss a genuine example within the context of storage ring-free electron laser physics, by presenting a model which allows the characterization of the system evolution and the determination of the conditions leading to the suppression of instabilities of sawtooth type. The conclusions of the model are confirmed by a comparison with experimental results on the Super Aco Storage Ring-Free Electron Laser.