Publications by authors named "Felice Festa"

68 Publications

Survival Rate of Zygomatic Implants for Fixed Oral Maxillary Rehabilitations: A Systematic Review and Meta-Analysis Comparing Outcomes between Zygomatic and Regular Implants.

Dent J (Basel) 2021 Apr 1;9(4). Epub 2021 Apr 1.

Department of Innovative Technologies in Medicine & Dentistry and CAST, University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.

Background: Zygomatic implants have been proposed alone or in combination with premaxillary conventional implants for severe resorbed maxillary atrophy rehabilitation. The aim of the present investigation was to evaluate through a qualitative systematic review and meta-analysis the survival rate of zygomatic implants in conjunction with regular fixtures for maxillary rehabilitation.

Methods: The article screening was conducted on the PubMed/Medline and EMBASE electronic databases according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) guidelines. The scientific papers were included for qualitative analysis and risk-of-bias evaluation. Only the papers that included rehabilitation with zygomatic implants in combination with regular implants were considered for the meta-analysis comparative evaluation of the implant survival rate.

Results: The paper search screened a total of 137 papers. After the initial screening, a total of 32 articles were considered for the qualitative analysis. There was a similar implant survival rate between zygomatic and premaxilla regular implants ( = 0.02; Z: 2.26).

Conclusions: Zygomatic and conventional implants showed a high long-term survival rate for fixed maxillary rehabilitations, but few included studies reported the marginal bone loss after loading. Further studies are necessary to evaluate the pattern of marginal bone loss between zygomatic and conventional implants after long-term functional loading.
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http://dx.doi.org/10.3390/dj9040038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8065623PMC
April 2021

Functional Magnetic Resonance Connectivity in Patients With Temporomadibular Joint Disorders.

Front Neurol 2021 12;12:629211. Epub 2021 Apr 12.

Department of Medical, Oral, and Biotechnological Sciences, University of G. d'Annunzio Chieti-Pescara, Chieti, Italy.

Myofascial pain in the masticatory region, generally referred to as headache, is a common temporomandibular disorder (TMD) characterized by the hypersensitive regions of the contracted skeletal muscle fibers. A correct clinical treatment of myofascial pain has the potential to modify the functional activation of cerebral networks associated with pain and unconscious teeth clenching, specifically the pain network (PN) and default mode network (DMN). In this study, research is presented as a case series of five patients with myofascial pain: three were diagnosed with intra- and extra-articular disorders, and two were diagnosed with only extra-articular disorders. All five patients received gnathological therapy consisting of passive splints and biofeedback exercises for tongue-palatal vault coordination. Before and after treatment, patients underwent pain assessments (through measures of visual analog scales and muscular palpation tests), nuclear magnetic resonance of the temporomandibular joint, and functional nuclear magnetic resonance of the brain. In each patient, temporomandibular joint nuclear magnetic resonance results were similar before and after the gnathological treatment. However, the treatment resulted in a considerable reduction in pain for all patients, according to the visual analog scales and the palpation test. Furthermore, functional nuclear magnetic resonance of the brain clearly showed a homogeneous modification in cerebral networks associated with pain (i.e., PN and DMN), in all patients. In conclusion, gnathological therapy consisting of passive aligners and biofeedback exercises improved myofascial pain in all five patients. Most importantly, this study showed that all five patients had a homogeneous functional modification of pain and default mode networks. Using passive splints in combination with jaw exercises may be an effective treatment option for patients with TMD. This research could be a starting point for future investigations and for clinicians who want to approach similar situations.
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http://dx.doi.org/10.3389/fneur.2021.629211DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072218PMC
April 2021

Protective Face Masks: Effect on the Oxygenation and Heart Rate Status of Oral Surgeons during Surgery.

Int J Environ Res Public Health 2021 02 28;18(5). Epub 2021 Feb 28.

Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy.

Background: Safety in medical work requires eye protection, such as glasses, and protective facial masks (PFM) during clinical practice to prevent viral respiratory infections. The use of facial masks and other full personal protective equipment increases air flow resistance, facial skin temperature and physical discomfort. The aim of the present study was to measure surgeons' oxygenation status and discomfort before and after their daily routine activities of oral interventions.

Methods: 10 male voluntary dentists, specializing in oral surgery, and 10 male voluntary doctors in dentistry, participating in master's courses in oral surgery in the Department of Oral Surgery of the University of Chieti, with mean age 29 ± 6 (27-35), were enrolled. This study was undertaken to investigate the effects of wearing a PFM on oxygenation status while the oral surgeons were actively working. Disposable sterile one-way surgical paper masks (Surgical Face Mask, Euronda, Italy) and FFP2 (Surgical Face Mask, Euronda, Italy) were used and the mask position covering the nose did not vary during the procedures. The FFP2 was covered by a surgical mask during surgical treatment. A pulse oximeter was used to measure the blood oximetry saturation during the study.

Results: In all surgeons wearing FFP2 covered by surgical masks, a reduction in arterial O saturation from around 97.5% before surgery to 94% after surgery was recorded with increase of heart rates. A shortness of breath and light-headedness/headaches were also noted.

Conclusions: In conclusion, wearing an FFP2 covered by a surgical mask induces a reduction in circulating O concentrations without clinical relevance, while an increase of heart frequency and a sensation of shortness of breath, light-headedness/headaches were recorded.
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http://dx.doi.org/10.3390/ijerph18052363DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967725PMC
February 2021

Clinical Management of Hypodontia of Two Mandibular Incisors.

Case Rep Dent 2021 3;2021:6625270. Epub 2021 Feb 3.

Department of Oral Medical Sciences and Biotechnology, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini, 32 66013 Chieti, Italy.

This article presents the clinical management of a patient with bilateral congenitally missing mandibular incisors. This condition is relatively rare and always needs a careful diagnosis and treatment planning. The chosen treatment strategy for this patient included space closure by protraction of the mandibular posterior teeth and canine substitution of missing incisors. Furthermore, the problems arising from this treatment plan, such as premolar-protected occlusion and tooth size discrepancy, are discussed. From the case presented in this study, we can conclude that space closure may be considered an efficient treatment approach for achieving satisfactory functional and aesthetic results.
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http://dx.doi.org/10.1155/2021/6625270DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878071PMC
February 2021

Early Orthodontic Treatments of Unilateral Posterior Crossbite: A Systematic Review.

J Clin Med 2020 Dec 24;10(1). Epub 2020 Dec 24.

Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy.

We aimed to report an update of the systematic review by Petrén et al. (2003). The objective was to evaluate how orthodontic treatments can affect unilateral posterior crossbite (UPXB) in primary and early mixed dentition. Several databases were consulted, and articles published between January 2002 and March 2020 were selected. This review examines the following studies: randomized clinical trials, prospective and retrospective studies with concurrent untreated or normal control groups, and clinical trials comparing at least two treatment strategies. Among the 1581 articles retrieved from the searches, 11 studies were included. Quad-helix (QH) and expansion plate (EP) appliances were compared in three studies. One study compared rapid maxillary expansion (RME) treatment anchored on primary dentition otherwise on permanent molars. One study compared RME and a modified RME with arms extended until deciduous canine and EP. Four studies evaluated the effects of expansion appliances compared with a control group. Compared with the previous review, the quality of the included studies is higher. However, heterogeneity of treatments, different strategies in measurements, lack of a similar follow-up length, and absence of a cost-effectiveness analysis preclude the possibility of providing reliable scientific evidence on the most effective UPXB treatment in primary and early mixed dentition.
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http://dx.doi.org/10.3390/jcm10010033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795353PMC
December 2020

Evaluation of Knowledge among Dentists on Symptoms and Treatments of Temporomandibular Disorders in Italy.

Int J Environ Res Public Health 2020 11 25;17(23). Epub 2020 Nov 25.

Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy.

To determine the knowledge of general dentists and dental specialists on temporomandibular disorders (TMD) in Italy, a web-based questionnaire including 20 multiple- choice questions was sent to all general dental practitioners and specialists in Italy. Mean score of diagnosis and treatment knowledge of all participants was 23.8 ± 7.3 out of 40 achievable scores. There was a significant difference between the knowledge of dentists and the variables of sex, age, and years of experience (p < 0.05). However, overall, it is not possible to state a significant difference between the final score of dentists with different specializations (p = 0.89). The results of this study showed an acceptable knowledge of participants regarding TMD.
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http://dx.doi.org/10.3390/ijerph17238760DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7728326PMC
November 2020

Periauricular wrinkles removed with voltaic arc dermabrasion (Atmospheric Plasma technique).

J Cosmet Dermatol 2020 Jul 26;19(7):1709-1714. Epub 2019 Oct 26.

Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.

Background: In recent literature, different approaches have been proposed to improve the long-lasting treatment of age-related alterations on the human face with decreased invasiveness and side effects such as scar tissue. Voltaic arc dermabrasion is a minimally painful procedure that does not create discomfort to the patient and requires no anaesthesia.

Aims: The aim of this investigation was to evaluate the voltaic arc technique for the treatment of skin wrinkles in the periauricular area.

Methods: A total of 80 patients were treated in this study, 56 females and 24 males. The population was visited at 1 week, 1 month, and 2 months postoperative follow-ups to evaluate the healing of the treated regions.

Results: All subjects showed evidence of tissue contraction related to the skin of the periauricular region with a cosmetic reduction of wrinkles in the treated area. No scars, complications, or pigmentary alterations were reported. At 1 month, all treated areas showed complete healing.

Conclusions: The voltaic arc dermabrasion can be considered a useful tool for a noninvasive treatment of wrinkles related to the periauricular skin, with no discomfort for the patient or complications related to the procedure.
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http://dx.doi.org/10.1111/jocd.13204DOI Listing
July 2020

Ultrasonic vs Drill Implant Site Preparation: Post-Operative Pain Measurement Through VAS, Swelling and Crestal Bone Remodeling: A Randomized Clinical Study.

Materials (Basel) 2018 Dec 11;11(12). Epub 2018 Dec 11.

Department of Medical Sciences, University of Trieste, 34127, Trieste, Italy.

: Piezosurgery is a surgical procedure that is able to perform osteotomies by a micrometric and selective cut of the bone tissue. The objective of this investigation was to evaluate two different techniques; an ultrasonic device, and a drill approach for implant site preparation. : A total of fifty patients were recruited for the randomized clinical trial to receive dental implants for fixed prosthetic restoration in the posterior mandible and were allotted to two groups. In Group A the implant site was prepared following a drilling technique, while in Group B the implant site was prepared using an ultrasonic device; moreover, the operative duration was recorded. Postoperative pain and swelling were evaluated at 1, 2, 4, and 6 days. The crestal bone resorption was measured at 3 months from implant placement by a three-dimensional tomography evaluation. : The findings suggest that osteotomies performed by an ultrasonic device cause less pain and swelling. On the other hand, the piezoelectric preparation was characterized by a significative increase in the operative time. No statistical differences in crestal bone resorption were evident in the two different approaches. : According to the outcome of the study, ultrasonic implant bed preparation can be used with success in implantology and could be considered a suitable alternative to traditional drilling techniques for dental fixture placement.
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http://dx.doi.org/10.3390/ma11122516DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6316965PMC
December 2018

Cone beam computed tomography for dental and maxillofacial imaging: technique improvement and low-dose protocols.

Radiol Med 2017 Aug 1;122(8):581-588. Epub 2017 Apr 1.

Department of Radiology, University of Foggia, Viale Luigi Pinto 1, 71100, Foggia, Italy.

Objective: The aim of this study was to evaluate images quality and radiation doses of Cone Beam Computed Tomography (CBCT) for dental and maxillofacial imaging testing five different acquisition protocols.

Methods: Dose measurements of different acquisition protocols were calculated for Pax Zenith three-dimensional (3D) Cone Beam (Vatech, Korea) and for conventional orthopantomography (OPT) and cephalometric skull imaging Ortophos (Sirona Dental Systems, Bernsheim, Germany). The absorbed organ doses were measured using an anthropomorphic phantom loaded with thermoluminescent dosimeters at 58 sites related to sensitive organs. Five different CBCT protocols were evaluated for image quality and radiation doses. They differed in FOV, image resolution, kVp, mA, acquisition time in seconds and radiation dose. Measurements were then carried out with the orthopantomograph. Equivalent and effective doses were calculated.

Results: The reference protocol with large FOV, high resolution quality images, 95 kVp, 5 mA and acquisition time of 24 s resulted in a DAP value of 1556 mGy cm instead the protocol with reduced kVp from 95 to 80 kVp translated into a value of DAP inferior to 35% (from 1556 to 1013 mGy cm). Going from a high resolution to a normal resolution, there was a reduction of the acquisition time to 15 s which allowed further dose reduction of approximately 40% (628 mGy cm); this protocol resulted in a value of effective dose of 35 microSievert (μSv). Moreover, the effect of changing FOV has been evaluated, considering two scans with a reduced FOV (160 × 140  and 120 × 90 mm, respectively).

Conclusions: CBCT low-dose protocol with large FOV, normal resolution quality images, 80 kVp, 5 mA and acquisition time of 15 s resulted in a value of effective dose of 35 microSievert (μSv). This protocol allows the study of maxillofacial region with high quality of images and a very low radiation dose and, therefore, could be proposed in selected case where a complete assessment of dental and maxillofacial region is useful for treatment planning.
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http://dx.doi.org/10.1007/s11547-017-0758-2DOI Listing
August 2017

A Vestibular Rapid Palatal Expander.

J Clin Orthod 2016 Feb;50(2):110-7

Graduate School of Orthodontics, Gabriele d'Annunzio University of Chieti-Pescara, Italy; Private Practice of Orthodontics in Rome.

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February 2016

Effects of affective picture viewing on postural control in healthy male subjects.

Cranio 2013 Jul;31(3):202-10

University G. D'Annunzio, Chieti, Ithaly.

Emotion theory holds that unpleasant events prime withdrawal actions, whereas pleasant events prime approach actions. Recent studies have suggested that passive viewing of emotion-eliciting images results in postural adjustments. The main objective of this research was to investigate the effects of emotional inputs on the postural control. Ten healthy young adults looked at a series of emotion-eliciting images while standing on a force plate. The images were taken from the International Affective Picture System (IAPS). The posture-stabilometric parameters were statistically analyzed (RM ANOVA on Ranks). The results showed that the emotional inputs might influence body balance.
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http://dx.doi.org/10.1179/crn.2013.031DOI Listing
July 2013

Effects of viewing affective pictures on sEMG activity of masticatory and postural muscles.

Neurosci Lett 2013 Jun 6;544:10-4. Epub 2013 Apr 6.

Department of Medical, Oral and Biotechnological Sciences, University G. d'annunzio, Chieti-Pescara, Italy.

Recently there has been an upsurge of interest in the question to what extent the human motor control system is influenced by the emotional state of the actor. The aim of this study was to evaluate whether emotional inputs modify the activity of masticatory and postural muscles. Twenty healthy young adults viewed affective pictures, while surface electromyography (sEMG) of masticatory and postural muscles was recorded to investigate the coupling between emotional reactions and body muscular activity. One hundred and twenty pictures, chosen from the International Affective Picture System (IAPS), divided in two blocks of six sets, were presented to the subjects. sEMG data were statistically analyzed (RM ANOVA on Ranks). Root Mean Square (RMS) amplitudes, comparing the subsequent sets (Neutral, Unpleasant, Neutral, Pleasant) with the first and the last Baseline set, changed significantly only randomly. The results show that emotional inputs seems not influence the activity of masticatory and postural muscles, recorded by sEMG.
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http://dx.doi.org/10.1016/j.neulet.2013.02.053DOI Listing
June 2013

Condylar volume and condylar area in class I, class II and class III young adult subjects.

Head Face Med 2012 Dec 14;8:34. Epub 2012 Dec 14.

Department of Oral Science, Sapienza University of Rome, Rome, Italy.

Aim: Aim of this study was to compare the volume and the shape of mandibular condyles in a Caucasian young adult population, with different skeletal pattern.

Material And Methods: 200 Caucasian patients (15-30 years old, 95 male and 105 females) were classified in three groups on the base of ANB angle: skeletal class I (65 patients), skeletal class II (70 patients) and skeletal class III (65 patients). Left and right TMJs of each subject were evaluated independently with CBCT (Iluma). TMJ evaluation included: condylar volume; condylar area; morphological index (MI). Condylar volumes were calculated by using the Mimics software. The condylar volume, the area and the morphological index (MI) were compared among the three groups, by using non-parametric tests.

Results: The Kruskal-Wallis test and the Mann Whitney test revealed that: no significant difference was observed in the whole sample between the right and the left condylar volume; subjects in skeletal class III showed a significantly higher condylar volume, respect to class I and class II subjects (p < 0.05); significantly lower condylar volume was observed in class II subjects, respect to class I and class III (p < 0.05). In the whole sample condylar volume (699.8 ± 63.07 mm3 in males and 663.5 ± 81.3 mm3 in females; p < 0.01) as well as condylar surface (423.24 ± 63.03 mm2 in males and 389.76 ± 61.15 mm2 in females; p < 0.01) were significantly higher in males than in females.

Conclusion: Skeletal class appeared to be associated to the mandibular condylar volume and to the mandibular condylar area in the Caucasian orthodontic population.
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http://dx.doi.org/10.1186/1746-160X-8-34DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3558396PMC
December 2012

Upper canine extractions in adult cases with unusual malocclusions.

J Clin Orthod 2012 Feb;46(2):102-10; quiz 124

Department of Orthodontics, University G. D'Annunzio, Chieti, Italy.

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February 2012

Do skeletal cephalometric characteristics correlate with condylar volume, surface and shape? A 3D analysis.

Head Face Med 2012 May 15;8:15. Epub 2012 May 15.

Department of Oral Science, Sapienza University of Rome, Rome, Italy.

Objective: The purpose of this study was to determine the condylar volume in subjects with different mandibular divergence and skeletal class using cone-beam computed tomography (CBCT) and analysis software.

Materials And Methods: For 94 patients (46 females and 48 males; mean age 24.3 ± 6.5 years), resultant rendering reconstructions of the left and right temporal mandibular joints (TMJs) were obtained.Subjects were then classified on the base of ANB angle the GoGn-SN angle in three classes (I, II, III) . The data of the different classes were compared.

Results: No significant difference was observed in the whole sample between the right and the left sides in condylar volume.The analysis of mean volume among low, normal and high mandibular plane angles revealed a significantly higher volume and surface in low angle subjects (p < 0.01) compared to the other groups.Class III subjects also tended to show a higher condylar volume and surface than class I and class II subjects, although the difference was not significant.

Conclusions: Higher condylar volume was a common characteristic of low angle subjects compared to normal and high mandibular plane angle subjects. Skeletal class also appears to be associated to condylar volume and surface.
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http://dx.doi.org/10.1186/1746-160X-8-15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3484012PMC
May 2012

Orbital volume and surface after Le Fort III advancement in syndromic craniosynostosis.

J Craniofac Surg 2012 May;23(3):789-92

University G. d'Annunzio, Chieti/Pescara, Italy.

There are no quantitative standards for the volumetric measurements of the orbital cavity after Le Fort III advancement. Computed tomography (CT) scan images have given the opportunity to compare with accuracy the real anatomic changes and potentially the functional improvements that resulted after a surgical treatment.Three-dimensional CT scan images processed by DICOM files in Dolphin 3D Software were used to assess orbital volume and surface in 12 subjects affected by craniofacial syndromic malformations treated with Le Fort III advancement. The preoperative (T0) and postoperative (T1: 6 months after surgery) three-dimensional craniofacial CT scans of the subjects were collected and retrospectively analyzed. Image segmentation of the anatomic orbital cavity and the three-dimensional graphic rendering were done by using the Dolphin Imaging Plus 11.0 software.The orbital volume was increased after surgery, with statistical significance, from 22,267 to 22,706.3 mm(3) in the right eye and from 26,511 mm(3) to 26,256.4 mm(3) in the left eye. The surface of both bony orbits had an expansion, which is statistically significant. In conclusion, this study showed that the orbital advancement in white subjects after Le Fort III advancement was significant and produced a significant augmentation of the orbital volume and surface area with correction of the ocular bulb proptosis.
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http://dx.doi.org/10.1097/SCS.0b013e31824dbeecDOI Listing
May 2012

The prognosis of myofascial pain syndrome (MPS) during a fixed orthodontic treatment.

Cranio 2012 Jan;30(1):52-71

Unit of Orthodontics, Dept. of Oral Science, University G. D'Annunzio Chieti/Pescara, Via dei Vestini 31, Chieti 66013, Italy.

Among treatments in the literature for myofascial pain syndrome (MPS), the most reliable therapies in dentistry are spray and stretch, and, although less frequently used, anesthetic injection. Adult MPS subjects are often treated using fixed orthodontic therapy for resolution of malocclusion. There is no clarity in the literature on the prognosis of MPS during orthodontic therapy. The purpose of this study was to analyze the prognosis of MPS during orthodontic treatment of subjects with malocclusion, initially diagnosed as having MPS. The analysis covered the medical records of 91 young adult Caucasians scheduled for orthodontic treatment for various malocclusions. Thirty-seven of the patients were initially diagnosed as also having MPS (T0). Thirty patients began the orthodontic treatment and were recalled for a re-evaluation of MPS after dental alignment and dental class correction was achieved (T1). A wait-and-see strategy was applied in seven subjects who were included as the control subjects. They received no treatment for MPS. At T1, a statistically significant decrease was observed in the study group in the presence of any clicking or creaking noises from the jaw joint, a significant jaw joint and jaw muscle pain reduction, and a quality of life improvement. Among patients who were depressed at the beginning of treatment, the majority felt better at the follow-up evaluation. On muscular palpation, a statistically significant decrease was found on the visual analogic scale value of the middle fibers of the temporalis muscle, temporalis tendon, clavicular and sternal division of the sternocleidomastoid muscle, masseter muscles, and posterior cervical muscles. The temporalis and the masseter muscles showed a significant decrease in the number of subjects with trigger points (TrPs) in all areas in the study group, after treatment. The digastric and sternocleidomastoid muscles also showed a significant reduction in the number of subjects with TrPs. Subjects with MPS and malocclusion were treated using a fixed orthodontic treatment. They showed improvement, although no resolution, in the signs and symptoms of MPS, compared with the untreated control group.
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http://dx.doi.org/10.1179/crn.2012.007DOI Listing
January 2012

Does the design of self-ligating brackets show different behavior in terms of friction?

Orthodontics (Chic.) 2011 ;12(4):330-9

Department of Oral Science, Nano, and Biotechnology, University G.D'Annunzio, Chieti, Pescara, Italy.

Aim: This in vitro study evaluated the friction generated by aligned stainless steel conventional brackets, self-ligating Damon MX brackets, Time3 brackets, Vision LP brackets, and low-friction Slide ligatures coupled with various stainless steel, nickel-titanium (Ni-Ti), and beta-titanium (TMA) archwires.

Methods: All brackets had a 0.022-inch slot; the orthodontic archwires were 0.014-inch Ni-Ti, 0.016-inch Ni-Ti, 0.014 x 0.025-inch Ni-Ti, 0.018 x 0.025-inch Ni-Ti, 0.017 x 0.025-inch TMA, 0.019 x 0.025-inch stainless steel, and 0.019 x 0.025-inch Ni-Ti. Each bracket-archwire combination was tested 10 times.

Results: Coupled with 0.014-inch Ni-Ti and 0.016-inch Ni-Ti archwire, conventional brackets generated the greatest friction, while Damon MX and Vision LP brackets generated the lowest (P < .05). No significant difference was observed between Time3 brackets and Slide ligatures. Coupled with all the rectangular archwires, Victory Series brackets, Slide ligatures, and Vision LP self-ligating brackets generated significantly lower friction than Time3 and Damon MX self-ligating brackets (P < .05).

Conclusion: These findings suggest that self-ligating brackets are a great family of brackets that, in vitro, can generate different levels of friction when coupled with thin, thick, rectangular, or round archwires. Clinical conclusions based on our results are not possible, due to the limitations of the experimental conditions.
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July 2012

Scoliosis and dental occlusion: a review of the literature.

Scoliosis 2011 Jul 29;6:15. Epub 2011 Jul 29.

Department of Health Science, University of L'Aquila, Edificio Delta 6 L'Aquila Fraz, Coppito, 67010, L'Aquila, Italy.

Background: Idiopathic scoliosis is a deformity without clear etiology. It is unclear wether there is an association between malocclusion and scoliosis. Several types of occlusion were described in subjects with scoliosis, mostly case-reports.

Objectives: The aim of this review was to evaluate the type of occluslins more prevalent in subjects with scoliosis

Search Strategy: All randomised and controlled clinical trials identified from the Cochrane Oral Health Group Trials Register, a MEDLINE search using the Mesh term scoliosis, malocclusion, and relevant free text words, and the bibliographies of papers and review articles which reported the outcome of orthodontic treatment in subjects with scoliosis that were published as abstracts or papers between 1970 and 2010.

Selection Criteria: All randomised and controlled clinical trials published as full papers or abstracts which reported quantitative data on the outcomes malocclusion in subjects with scoliosis.

Data Collection And Analysis: Data were extracted without blinding to the authors, age of patients or type of occlusion.

Main Results: Using the search strategy eleven observational longitudinal studies were identified. No randomized clinical trials were recorded. Twenty-three cross-sectional studies were recorderd, and the others studies were reviews, editorials, case-reports, or opinions. The clinical trials were often not controlled and were about the cephalometric evaluation after treatment with the modified Milwuakee brace, followed by the orthodontic treatment of the class II relationship with a functional appliance. Clinical trials also included the study of the associations between scoliosis and unilateral crossbite, in children with asymmetry of the upper cervical spine. This association was also investigated in rats, pigs and rabbits in clinical trials. The other associations between scoliosis and occlusion seems to be based only on cross-sectional studies, case-reports, opinions.

Authors' Conclusions: Based on selected studies, this review concludes that there is plausible evidence for an increased prevalence of unilateral Angle Class II malocclusions associated with scoliosis, and an increased risk of lateral crossbite, midline deviation in children affected by scoliosis. Also, documentation of associations between reduced range of lateral movements and scoliosis seem convincing. Data are also mentioned about the association between plagiocephaly and scoliosis.
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http://dx.doi.org/10.1186/1748-7161-6-15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162939PMC
July 2011

Evaluation of the friction of self-ligating and conventional bracket systems.

Eur J Dent 2011 Jul;5(3):310-7

Post-graduate student, Department of Oral Science, University G.D'Annunzio, Chieti, Italy.

Objectives: This in vitro study evaluated the friction (F) generated by aligned stainless steel (SS) conventional brackets, self-ligating Damon MX(©) brackets (SDS Ormco, Glendora, California, USA), Time3(©) brackets (American Orthodontics, Sheboygan, Wisconsin, USA), Vision LP(©) brackets (American Orthodontics), and low-friction Slide(©) ligatures (Leone, Firenze, Italy) coupled with various SS, nickel-titanium (NiTi), and beta-titanium (TMA) archwires.

Methods: All brackets had a 0.022-inch slot, and the orthodontic archwires were 0.014-inch, 0.016-inch, 0.014×0.025-inch, 0.018×0.025-inch, and 0.019×0.025-inch NiTi; 0.017×0.025-inch TMA; and 0.019×0.025-inch SS. Each bracket-archwire combination was tested 10 times. In the test, 10 brackets of the same group were mounted in alignment on a metal bar. The archwires moved through all the 10 brackets at a crosshead speed of 0.5 mm/min (each run lasted approximately 5 min). The differences among 5 groups of brackets were analyzed through the Kruskal-Wallis test, and a Mann-Whitney test was calculated as post hoc analysis. The P value was set at 0.05.

Results: Coupled with 0.014-inch NiTi and 0.016-inch NiTi, Victory Series(©) brackets generated the greatest F, while Damon MX(©) and Vision LP(©) brackets generated the lowest (P<.05); no significant differences were observed between Time3(©) brackets and Slide(©) ligatures. Coupled with all the rectangular archwires, Victory Series(©) brackets, Slide(©) ligatures, and Vision LP(©) self-ligating brackets generated significantly lower F than did Time3(©) and Damon MX(©) self-ligating brackets (P<.05).

Conclusions: These findings suggest that self-ligating brackets are a family of brackets that, in vitro, can generate different levels of F when coupled with thin or thick, rectangular, or round archwires. Clinical conclusions based on our results are not possible due to the limitations of the experimental conditions.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137445PMC
July 2011

Signs and symptoms of temporomandibular joint disorders in Caucasian children and adolescents.

Cranio 2011 Jan;29(1):71-9

University G. D'Annunzio of Chieti.

This study investigated the prevalence of the signs and symptoms of temporomandibular disorders (TMD) in a population of children and adolescents. TMD signs and symptoms were recorded in 1134 subjects (593 males and 541 females; age range 5-15 years), divided into various groups according to the: (i) Angle dental class; (ii) presence and type of crossbite; (iii) gender; and (iv) age (ages 5-11 and 12-15 years). The percentages of signs and symptoms were compared using the chi2-test to determine the differences among the groups for the rates of TMD symptoms, bruxism, joint sounds, deviation during opening, reduced opening/lateral/protrusive movements, and myofascial pain. Subjects who were 12-15 years old showed a significantly higher prevalence of myofascial pain than those who were 5-11 years old (chi2 = 4.263; p < 0.05). Females showed a significantly higher prevalence of myofascial pain than males (chi2 = 3.882; p < 0.05). Subjects with posterior, unilateral crossbite showed a significantly higher prevalence of TMD symptoms (chi2 = 33.877; p < 0.001) and reduction of functional movements (chi2 = 10.800; p < 0.05) than those with no crossbite, or with anterior or posterior bilateral crossbite. TMD's signs and symptoms seem to be associated to some definite characteristics of the patient, such as female gender, young age, and presence of posterior unilateral crossbite.
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http://dx.doi.org/10.1179/crn.2011.010DOI Listing
January 2011

Upper airway volume after Le Fort III advancement in subjects with craniofacial malformation.

J Craniofac Surg 2011 Jan;22(1):351-5

University La Sapienza, Rome, Italy.

Aim: There are no quantitative standards for the volumetric measurements of the airway space after Le Fort III advancement. Computed tomographic (CT) scans have provided the opportunity to compare with the accuracy of real anatomic changes, thus the functional improvements, resulting after a surgical treatment.

Materials And Methods: Three-dimensional CT scans processed by Digital Imaging and Communications in Medicine files in Dolphin 3D software were used to assess the airway space volume in 4 subjects affected by craniofacial syndromic malformations treated with Le Fort III advancement. The preoperative (T0) and postoperative (T1: 6 mo after surgery) three-dimensional craniofacial CT scans of the subjects were collected and retrospectively analyzed. Image segmentation of the anatomic structures of interest and the three-dimensional graphic rendering were done by using the Dolphin Imaging Plus 11.0 software.

Results: The airway space volume was significantly increased after surgery (mean [SD]: from 9166.57 [1861.48] mm to 15,300.45 [5114.09] mm; P < 0.01). The sagittal surfaces had an expansion from 798.92 (74.88) to 1151.45 (218.47) mm. The coronal surfaces grew from 226.75 (62.85) to 390.42 (102.21) mm, and axial surfaces increased 473.32 (62.34) to 676.00 (151.07) mm from T0 to T1.

Conclusions: In conclusion, this study showed an increase in the upper airway space volume in white subjects after Le Fort III advancement.
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http://dx.doi.org/10.1097/SCS.0b013e3181f7e11bDOI Listing
January 2011

Condylar volume and surface in Caucasian young adult subjects.

BMC Med Imaging 2010 Dec 31;10:28. Epub 2010 Dec 31.

Department of Oral Science, Nano and Biotechnology, University G,D'Annunzio, Via dei Vestini 31, Chieti, 66013, Italy.

Background: There have been no quantitative standards for volumetric and surface measurements of the mandibular condyle in Caucasian population. However, the recently developed cone-beam computed tomography (CBCT) system allows measurement of these parameters with high accuracy.

Methods: CBCT was used to measure the condylar volume, surface and the volume to surface ratio, called the Morphometric Index (MI), of 300 temporo-mandibular joints (TMJ) in 150 Caucasian young adult subjects, with varied malocclusions, without pain or dysfunction of TMJs.

Results: The condylar volume was 691.26 ± 54.52 mm3 in males and 669.65 ± 58.80 mm3 in, and was significantly higher (p< 0.001) in the males. The same was observed for the condylar surface, although without statistical significance (406.02 ± 55.22 mm2 in males and 394.77 ± 60.73 mm2 in females).Furthermore, the condylar volume (693.61 ± 62.82 mm3 ) in the right TMJ was significantly higher than in the left (666.99 ± 48.67 mm3, p < 0.001) as was the condylar surface (411.24 ± 57.99 mm2 in the right TMJ and 389.41 ± 56.63 mm2 in the left TMJ; t = 3.29; p < 0.01). The MI is 1.72 ± 0.17 for the whole sample, with no significant difference between males and females or the right and left sides.

Conclusion: These data from temporomandibular joints of patients without pain or clinical dysfunction might serve as examples of normal TMJ's in the general population not seeking orthodontic care.
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http://dx.doi.org/10.1186/1471-2342-10-28DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3019198PMC
December 2010

Relation between facial morphology on lateral skull radiographs and sEMG activity of head, neck, and trunk muscles in Caucasian adult females.

J Electromyogr Kinesiol 2011 Apr 8;21(2):298-310. Epub 2010 Dec 8.

University G. D'Annunzio, Department of Oral Science, Chieti/Pescara, Italy.

This study aimed to evaluate whether there is an association between facial morphology on cephalometrics and surface electromyographic (sEMG) recordings of the head, neck, and trunk muscles. Forty-seven Caucasian adult females, 18-29years of age (average: 24), underwent lateral skull radiographs in "natural head position", obtained by having the subject look at a small mirror at eye level, and sEMG recordings for the following muscles: masseter, anterior temporal, digastric, posterior cervicals, sternocleidomastoid, and upper and lower trapezius. All muscles were monitored bilaterally at mandibular rest position and during maximal voluntary clenching (MVC). The maximal bite force was also measured to check MVC. Pearson's correlation coefficient revealed significant correlations (p<0.01): (i) between the variables concerning mandibular position and size and the sEMG activity of upper trapezius at mandibular rest position; (ii) between the topographic correlation between the maxillary and mandibular bases (called skeletal class) and the sEMG activity of upper trapezius at MVC; (iii) between the sEMG activity of sternocleidomastoid and the Frankfort to mandibular plane angle; and (iv) between the sEMG activity of masseter and the anterior cranial base to mandibular plane angle. Some associations between the cephalometric variables and the sEMG activity of the head, neck, and trunk muscles were observed. No certain conclusion, however, was possible on the mechanism concerning these results. Future longitudinal studies are required.
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http://dx.doi.org/10.1016/j.jelekin.2010.10.014DOI Listing
April 2011

Electromyographic evaluation of masticatory, neck, and trunk muscle activity in patients with posterior crossbites.

Eur J Orthod 2010 Dec 26;32(6):747-52. Epub 2010 Aug 26.

Department of Oral Science, University G. d'Annunzio, Chieti, Pescara, Italy.

This study investigated the pattern of masticatory, neck, and trunk muscle activity in patients with posterior crossbites and associated mandibular displacement. The test group consisted of 75 patients [45 males mean age 19.5 years, SD 5.6 years, and 30 females mean age 20.4 (SD 3.2) years]. Of this group, 25 patients presented a left posterior crossbite, 25 a right posterior crossbite, and the remaining 25 patients a bilateral posterior crossbite. A control group of 25 subjects (19 males and 6 females aged 22.5 ± 5.8 years) without any crossbite were included. Surface electromyographic (sEMG) activity was recorded bilaterally, in the mandibular rest position and during maximum voluntary clenching (MVC), at the following sites: anterior and posterior temporal, masseter, sternocleidomastoid (SCM), upper and lower trapezius, and cervical muscles. In the mandibular rest position, patients with unilateral crossbites showed a significant difference (P < 0.05) in sEMG activity of the anterior temporal muscle, with the greatest activity being detected on the side to which the mandible displaced. Control subjects demonstrated significantly lower (P < 0.05) sEMG activity but only in the SCM muscle when compared with patients with bilateral posterior crossbites; no such differences were detected in relation to unilateral crossbites. During MVC, control subjects showed significantly lower (P < 0.01) sEMG activity in both the SCM and the posterior cervical muscles compared with patients demonstrating both unilateral and bilateral crossbites. The findings of the present study indicate that the presence of a crossbite can affect electromyography activity of masticatory, neck, and trunk muscles.
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http://dx.doi.org/10.1093/ejo/cjq024DOI Listing
December 2010

Oral lichen planus: update on etiopathogenesis, diagnosis and treatment.

Immunopharmacol Immunotoxicol 2011 Mar 6;33(1):11-20. Epub 2010 Jul 6.

Department of Dentistry and Surgery, University of Bari, Bari, Italy.

Lichen planus is an inflammatory mucocutaneous disorder. Skin, oral and genital mucosal surfaces, scalp, and nails can be affected. Its development is chronic, with a possible malignant degeneration. Spontaneous remission is rare. Although the etiology of oral lichen planus is still unclear, there is evidence that it is a complex immunologic disease mediated by cytotoxic cells directed against basilar keratinocytes and resulting in vacuolar degeneration and lysis of basal cells. In long-standing, atrophic and erosive forms, the treatment is usually aimed at relieving pain and may include immunosuppressive agents, especially corticosteroid, topical cyclosporin, or tacrolimus, topical and systemic retinoids. However, the use of these drugs may be accompanied by several side effects. For this reason clinicians, currently, have focused their attention to new biological agents which provide selective immunological results with less side effects than generic immunosupressants.
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http://dx.doi.org/10.3109/08923973.2010.498014DOI Listing
March 2011

Relationship between facial morphology on lateral skull radiographs and sEMG activity of neck and trunk muscles in Caucasian adult females. A cross-sectional study.

Prog Orthod 2010 11;11(1):27-36. Epub 2010 May 11.

Department of Oral Science, University G. D'Annunzio, Chieti/Pescara, Italy.

Objective: To evaluate whether there is an association between facial morphology on cephalometrics and surface electromyographic (sEMG) recordings of head, neck and trunk muscles.

Materials And Methods: 31 Caucasian adult females, average age 26 years (range 21-29) underwent lateral skull radiographs in natural head position (mirror position) and the sEMG recordings for the following muscles: masseter, anterior temporal, digastric, posterior cervicals, sternocleidomastoid, and upper and lower trapezius. All muscles were monitored in the mandibular rest position, and during maximal voluntary clenching (MVC).

Results: Spearman's correlation coefficient revealed significant correlations (P<0.01): (i) between the variables controlling mandibular position, and the inclination of the lower incisors, and the sEMG activity of the trapezius; (ii) between the sEMG activity of sternocleidomastoid and the variables indicating the height of the mandibular ramus; (iii) between the sEMG activity of anterior temporal and the incisive angle, the inclination of the upper incisors and the maxillary base length, and (iv) between the sEMG activity of cervical muscles and the anterior cranial base length.

Conclusions: Some associations between cephalometric variables and sEMG of the neck and trunk muscles were observed. However, in view of the cross-sectional nature of the study and the limited sample, no conclusion was possible about the mechanism concerning these results. Future longitudinal studies are required to investigate the "mechanism at work".
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http://dx.doi.org/10.1016/j.pio.2010.04.005DOI Listing
February 2012

Postural loads during walking after an imbalance of occlusion created with unilateral cotton rolls.

BMC Res Notes 2010 May 25;3:141. Epub 2010 May 25.

Department of Oral Sciences, University G,D'Annunzio, Chieti/Pescara, Italy.

Background: It was showed that stomatognathic functions correlate with alterations in locomotion, that are detectable through the analysis of loading during walking. For example, subjects with symptoms of Temporomandibular disorders (TMDs) showed a significant higher load pressure on the two feet, respect to health subjects, when cotton rolls were inserted. This previous study appeared to suggest that the alteration of postural loads associated to a particular alteration of stomatognathic condition (in this case, the cotton rolls inserted between the two dental arches) is detectable only in TMD's subjects, while it resulted not detectable in health subjects, because in that study, health subjects did not show any significant alteration of postural loads related to the different stomatognathic tested conditions. In other words, in that previous study, in the group of health subjects, no significant difference in postural loads was observed among the different test conditions; while TMD subjects showed a significant higher load pressure on the two feet when cotton rolls were inserted, respect to all the other tested conditions. Thus, the aim of this study was to better investigate these correlations in health subjects without TMD's symptoms, testing other different intra-oral conditions, and to verifywhether an experimentally induced imbalance of occlusion, obtained putting an unilateral cotton roll, could cause an alteration of postural loading on feet during walking.

Findings: In a sample of thirty Caucasian adult females (mean age 28.5 +/- 4.5), asymptomatic for TMDs, when a cotton roll was positioned on the left or the right sides of dental arches, so causing a lateral shift of the mandible, the percentage of loading and the loading surface of the ipsi-lateral foot, left or right, were found to be significantly lower than in habitual occlusion (p < 0.05). Males were not included because of their different postural attitude respect to females. Further studies in a sample of males will be presented.

Conclusions: This study showed that in health subjects without TMD's symptoms, an experimentally induced imbalance of the occlusion, obtained through an unilateral cotton roll, is associated to detectable alterations in the distribution of loading on feet surface, during walking.
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http://dx.doi.org/10.1186/1756-0500-3-141DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887904PMC
May 2010

Prevalence of signs and symptoms of temporomandibular disorders in children and adolescents with and without crossbites.

World J Orthod 2010 ;11(1):37-42

Department of Oral Science, University G.D'Annunzio, Chieti/Pescara, Italy.

This study investigated the prevalence of signs and symptoms of temporomandibular disorders (TMD) in 1,134 orthodontically untreated children and adolescents (593 boys, 541 girls; age range 5 to 15 years) with and without crossbites. The sample with crossbites was further grouped according to the type (anterior, posterior, unilateral, or bilateral). The TMD symptoms bruxism (obvious active attrition/myalgia), joint sounds (clicking/crepitation), deviation during opening, reduced functional movements (maximum opening <40 mm), and myopain (originating in the masticatory muscles/related to masticatory functions) were evaluated based on the standardized RDC/TMD protocol (Research Diagnostic Criteria for Temporomandibular Disorders) and compared among the various groups. Girls had a significantly higher prevalence of myopain than boys (x(2)=3.882, P<.05). Furthermore, individuals with posterior unilateral crossbites showed a significantly higher prevalence of TMD symptoms (x(2)=33.877, P<.001) and reduced functional movements (x2 = 10.800, P<.05) than any other group. In conclusion, sex and type of crossbite play a role in the prevalence of TMD signs and symptoms.
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August 2013

Maxillary and mandibular base size in ancient skulls and of modern humans from Opi, Abruzzi, Italy: a cross-sectional study.

World J Orthod 2010 ;11(1):e1-4

Department of Oral Science, University G.D'Annunzio, Chieti/Pescara, Italy.

Aim: The size and shape of the jaws are related to occlusion and masticatory muscle function. Consequently, teeth and muscles are considered the functional matrix for the two jaws. Existing studies did not focus on the relationship between maxillary and mandibular base but on just their absolute dimensions. As the relationship between the two is of interest to orthodontists, the aim of this study was to calculate the maxillary-mandibular ratio (m-m ratio) in individuals from Central Italy and to compare it to that of ancient skulls from the same geographic area.

Methods: Forty individuals from Opi, a small, isolated mountain village in Central Italy, and 40 ancient skulls from the same region were the sample of this study. The lengths of the maxillary and mandibular base were assessed on lateral cephalograms, the m-m ratio was calculated, and the measurements between the groups were compared.

Results: Due to a significantly shorter maxillary base in the modern human sample, the m-m ratio was significantly lower in these subjects.

Conclusion: This finding supports the hypothesis that growth of the skull is strongly modulated by the functional matrix, within which a morphologic unit develops.
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August 2013