2,755 research outputs found
Redefine the Anterior Limit of the Dentition in Case of Functional Genioplasty: A Clinical Protocol
No full textObjectives: The purpose of this paper is to discuss the indications for “functional” genioplasty, as described by J. Delaire, and to analyze the implications of this surgical procedure on the choices the orthodontist must make regarding orthodontic treatment (extractions, anchorage, mechanics, etc.). In fact, this surgery modifies the position of the pogonion, the inferior reference point of the Apogonion line, which is fundamental for a correct calculation of spaces. Introduction: “Functional” genioplasty was first described by J. Delaire in 1983. This surgical procedure is indicated for individuals with Class II highangle malocclusion. The purpose of this procedure is not only to improve the aesthetics of patients with long, retruded chins, but also to promote labial competence by reducing the lower facial height. “Functional” genioplasty modifies both the labio-lingual neuromuscular balance and skeletal structure and, with it, some important cephalometric points and planes: Menton, Gnathion and pogonion, mandibular plane, facial axis, facial plane and A-Pogonion line. The orthodontist should carefully analyze these changes when evaluating treatment planning, especially when extractions are indicated and a new A-Pogonion line is to be drawn in the V.T.O (Visual Treatment Objectives). Materials and methods: The possibility of correcting a long, retruded chin by functional genioplasty and the reliability of cephalometric reevaluation with the described method are presented on a typical clinical case treated. The authors suggest specific timing for the orthodontic and surgical approach to high-angle Class II patients to achieve the best results. Results: The patient should undergo genioplasty as soon as the lower canines are erupted. Then it is important to wait 12–18 months to allow the improved labial competence to have an effect on the front dentition. Only at this point will it be possible to calculate orthodontic movements according to the new A-Pogonion line. Conclusions: “Functional” genioplasty is a low-impact, low-risk, and welltolerated surgical procedure. It corrects both neuromuscular and skeletal abnor- malities. However, the orthodontist must carefully consider these changes be- cause of the new orientation of the A-pogonion line
Orthodontic Correction of Traumatic Luxations, Disadvantages of Continuous Arch Techniques: A Clinical Protocol
No full textThe orthodontic management of traumatic vertical tooth dislocations requires to correct apply biomechanical principles. In fact, the choice between continuous or segmented arch technique is of great importance to avoid side effects on the dental elements adjacent to the traumatized ones. The purpose of the present work is to analyse the biomechanical advantages related to the correct application of mechanical classes according to Burstone. In the management of these situations, a fixed orthodontic appliance is usually used, with a continuous or segmented technique. Two types of techniques were compared: the continuous arch technique and the segmented arch technique, evaluating for each the vectors of single forces and the moments generated by pairs of forces acting on the bracket of the affected element and the anchorage unit. In Author’s opinion, the best choice is segmented mechanic because it allows to avoid a Burstone Class I interaction between the adjacent teeth. A class I mechanic may cause disadvantages: 1) opposite vertical movement of the unaffected tooth 2) less intrusion of the affected tooth 3) uprighting of both affected and unaffected tooth 4) the amount of the force may be inaccurate. These side effects do not exist in a segmented arch technique, because a single precise force passing through the center of resistance of the affected tooth is created, while the anchorage unit is only located on molars
TSCC - Trauma Symptom Checklist for Children.
No full textQuesta seconda edizione della versione italiana del TSCC nasce dall’esigenza di consentire agli operatori e ai ricercatori che lavorano nella clinica dello sviluppo e nel settore della tutela dei minori di continuare ad avvalersi di uno strumento particolarmente utile per cogliere elementi di criticità e fattori di rischio, che -sulla base della letteratura scientifica di riferimento- possono essere messi in relazione ad esperienze traumatiche. Siamo grate all’editore Hogrefe per aver accettato di rispondere a questa esigenza, affiancando al questionario rivolto ai genitori e caretakers per l’assessment della sintomatologia post-traumatica acuta e cronica in bambini di età compresa dai 3 ai 12 anni (TSCYC), anche il TSCC, che permette ai bambini e ai ragazzi di esprimere direttamente eventuali elementi di disagio e di malessere, anche in ambito sessuale, fornendo utili indicatori di possibili esperienze traumatiche.
La seconda edizione del manuale è stata arricchita dai contributi di due gruppi di studiosi che da anni operano in ambito clinico per affiancare i minori che hanno vissuto o stanno vivendo esperienze traumatiche, sostenendo il proprio lavoro con rigore metodologico e scientifico.
Il primo, di Chiara Giovanelli e Chiara Bertonati, offre esempi di utilizzo del TSCC e del TSCYC nell’ambito della tutela dei minori, con una descrizione molto articolata di profili clinici che permettono di orientare gli operatori nell’interpretazione dei punteggi, inserendoli all’interno della complessità del processo di assessment, in situazioni di estrema vulnerabilità. Il secondo contributo, di Chiara Ionio, Giulia Ciuffo, Marco Zecca e Damiano Rizzi, descrive l’utilizzo del TSCC in ambito sanitario, per cogliere l’effetto destabilizzante e traumatico che una diagnosi di tumore può avere in bambini e ragazzi ricoverati nei reparti di oncologia pediatrica. Le due ricerche presentate in questo capitolo permettono di avere una rappresentazione articolata e complessa del possibile utilizzo del TSCC.
Grazie alle colleghe e ai colleghi che hanno accettato di dare il loro contributo a questa nuova edizione della validazione italiana del TSCC, speriamo di aver dato compimento a quel progetto che, più di dieci anni fa, Paola Di Blasio aveva elaborato, invitandoci a collaborare alla validazione italiana del TSCC. Purtroppo, non è riuscita a vedere la pubblicazione di questo lavoro, ma esso è certamente uno dei tanti prodotti della sua lungimiranza, sensibilità clinica, rigore scientifico, che continuano a vivere nelle attività di ricerca, di formazione, di intervento a tutela dei minori, portate avanti da tutti coloro che hanno avuto il privilegio di sentirsi suoi allievi
Pre- and Postsurgical Orthodontics in Patients with Moebius Syndrome
Get PDFThe authors report a combined orthodontic-surgical correction of an adult patient’s malocclusion affected by Moebius Syndrome (MS). The treatment was conducted at the Dentistry Unit and the Maxillofacial Surgery Unit of the University Hospital of Parma. Treatment of malocclusion was performed after the correction of facial mimic mobility with smile surgery. The postoperative stability and orthodontic results were good and the correction of the morphological problems related to the syndrome was very satisfactory
A narrative review on obstructive sleep apnoea syndrome in paediatric population
Get PDFObstructive sleep apnoea syndrome is a respiratory sleep disorder that affects 1–5% of children. It occurs equally in males and females, with higher incidence in school age and adolescence. OSAS may be caused by several factors, but in children, adenotonsillar hypertrophy, obesity, and maxillo-mandibular deficits are the most common. In general, there is a reduction in the diameter of the airway with reduced airflow. This condition worsens during sleep due to the muscular hypotonia, resulting in apnoeas or hypoventilation. While snoring is the primary symptom, OSAS-related manifestations have a wide spectrum. Some of these symptoms relate to the nocturnal phase, including disturbed sleep, frequent changes of position, apnoeas and oral respiration. Other symptoms concern the daytime hours, such as drowsiness, irritability, inattention, difficulties with learning and memorisation, and poor school performance, especially in patient suffering from overlapping syndromes (e.g., Down syndrome). In some cases, the child’s general growth may also be affected. Early diagnosis of this condition is crucial in limiting associated symptoms that can significantly impact a paediatric patient’s quality of life, with the potential for the condition to persist into adulthood. Diagnosis involves evaluating several aspects, beginning with a comprehensive anamnesis that includes specific questionnaires, followed by an objective examination. This is followed by instrumental diagnosis, for which polysomnography is considered the gold standard, assessing several parameters, including the apnoea-hypopnoea index (AHI) and oxygen saturation. However, it is not the sole tool for assessing the characteristics of this condition. Other possibilities, such as night-time video recording, nocturnal oximetry, can be chosen when polysomnography is not available and even tested at home, even though with a lower diagnostic accuracy. The treatment of OSAS varies depending on the cause. In children, the most frequent therapies are adenotonsillectomy or orthodontic therapies, specifically maxillary expansion
Analisi tridimensionale del volto in soggetti con Sindrome di Moebius mediante stereofotogrammetria
No full textOBJECTIVES Moebius Syndrome (MS) is a rare disorder defined by bilateral con genital paralysis of the abducens and facial nerves in combination with various odontological, cra nio-facial, ophthalmological and orthopaedic conditions. Despite the broad spectrum of clinical manifestations, the main feature of patients with MS is due to the involvement of the VII cranial nerve and consists in the absence of movement of the facial mimic muscles with important aesthetic and functional consequences. The aim of this study is to quantify the surface facial asymmetry in two subjects affected by MS, us ing a novel stereophotogrammet ric method. MATERIALS AND METHODS A male patient (case 1, age 17.3 years) and a female patient (case 2, age 7.7 years), both affected by MS, were imaged with a ste reophotogrammetric facial scan ner. A three-dimensional (3D) elaboration was performed throughout the software View box (dHAL Software, Kiflissia, Greece) and each original image was du plicated in a mirror version. The root mean square error (RMSE) of the distances between the corre sponding points of each original photograph and its mirror copy was calculated for the whole face and for each trigeminal third, as defined by the innervation of tri geminal branches. Deviations between the original and mirror facial images were al so presented graphically as color maps and quantitatively on histo grams. RESULTS Case 1 presented incomplete bi lateral denervation of the facial nerve and had a RMSE value of 4.028, which quantified the global asymmetry; such a value progres sively increased from the upper third (RMSE = 2.277), through the middle third (RMSE = 3.675) and to the lower third of face (RMSE = 5.031). By contrast, case 2 had bilateral agenesis of facial nerve (missing facial nerves) and showed a minor global asymme try of the face (RMSE = 2.427) with a similar distribution of asym metry in all trigeminal thirds, whose RMSE values were respec tively 2.244 in the upper third, 2.023 in the middle third and 2.674 in the lower third. The evaluation of color maps confirms the data regarding the different degree and localization of the asymmetry in the two sub jects examined: in case 1 the asymmetry involves the region of the lateral and alar cartilages of the nose and the nasolabial fold, extending to the cheeks, man dibular angles and lateral areas of the chin; case 2 shows asym metrical areas mainly in corre spondence with the lateral sides of the nose, from the root to wards the apex, with a reduced involvement of the peri-labial and para-symphyseal surfaces. CONCLUSIONS The reported 3D technique provid ed an accurate topographic analy sis of the facial asymmetry and it is recommended for the quantitative and qualitative evaluation of rare cranio-facial conditions such as MS, showing a wide range of phe notypic presentations. CLINICAL SIGNIFICANCE The study of the facial morphology using methods based on stereo photogrammetry may improve both cranio-facial research and clinical practice, providing addi tional information for diagnosis, treatment planning and follow-up
Prima segnalazione di Lactococcus garvieae in salmerino di fonte (Salvelinus fontinalis) selvatico in ambiente alpino
No full textPlanning the Aesthetics of the Mandibular Angles in Orthognathic Surgery: Traditional vs. Virtual 3D Articulators
Get PDFThe surgical correction of dento-maxillofacial deformities for aesthetic reasons is increasingly required. In order to obtain the results that our patients expect, it is necessary to very thoroughly evaluate every aesthetic detail of the face, because an optimal result comes from the correction of all parameters. The region of the mandibular angles is very important in determining the final aesthetics but is at the same time difficult to predict. Traditional programming based on model surgery is inadequate in this regard compared to that based on CT (Computed Tomography) reconstruction. The authors explain the reasons for this and demonstrate the problems by reporting a typical clinical case
Sardine: fenomenologia di un movimento di piazza
No full textCelebrate, criticate, sopravvalutate da taluni, sottovalutate da altri. Da due mesi le Sardine sono al centro dell’attenzione collettiva. A torto o a ragione. A loro sono state dedicate pagine intere di quotidiani e di settimanali, ore di dirette televisive e radiofoniche. Di loro si parla sui social network, sovente più sull’onda di simpatie o di antipatie che di conoscenza approfondita e argomentata. Un fenomeno nuovo e vecchio al tempo stesso quello della partecipazione popolare attraverso la piazza che ha conquistato spazi rilevanti anche nella discussione tra leader politici, accedendo con prepotenza alla costruzione dei processi di agenda setting di questo inizio degli anni Venti. Sospese a metà tra la ricerca di un’identità e la definizione di un ruolo funzionale da espletare nella definizione degli equilibri futuri della politica italiana a partire dall’esito delle elezioni regionali del 2020, le Sardine meritano di essere studiate oltre che raccontate. Questo libro è scritto da studiosi provenienti da diverse aree di competenza che indagano il fenomeno con gli strumenti della comunicazione politica, della storia, della politologia e del marketin
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