Publications by authors named "Valentina Lanteri"

19 Publications

  • Page 1 of 1

Correlation between facial growth patterns and cortical bone thickness assessed with cone-beam computed tomography in young adult untreated patients.

Saudi Dent J 2021 Mar 6;33(3):161-167. Epub 2020 Feb 6.

Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, Milan, Italy.

Background: The vertical facial growth pattern is one of the most important issue in the orthodontic diagnosis and treatment. Previous studies investigated the association between interdental bone thickness and facial divergence using mainly bidimensional analysis. When two-dimensional dental radiographic views are not sufficient for diagnosis and measurements, cone-beam computed tomography (CBCT) images should be used to assess the alveolar bone structure three-dimensionally and with high accuracy and reliability.The aim of the present study was to evaluate the correlation between alveolar bone thickness and facial divergence in young adults untreated patients using a three-dimensional method analysis with CBCT images.

Methods: Records of 30 untreated patients (mean age 16 ± 2 years) with Angle Class I and mild to moderate crowding were analyzed. Subjects were classified as hypodivergent (<39˚), normodivergent (41 ± 2˚), and hyperdivergent (>43°). according to the inter-maxillary angle between the sagittal maxillary plane (ANS-PNS) and the mandibular plane (GN-ME). The alveolar bone thickness measurements were taken for the buccal and palatal/lingual surfaces of maxillary and mandibular anterior teeth. Axial-guided navigation (AGN) was used to locate all landmarks using a specific software (Horos 3.0).

Results: The statistical analysis showed a significant difference between the hypodivergent and hyperdivergent group regarding buccal bone height (P = 0.005), buccal apical bone thickness (P = 0.003) and palatal mid-root bone thickness (P = 0.006). Moreover, buccal bone height (P = 0.006) was found to be statistically significant different in normodivergent compared with hypodivergent individuals.

Conclusions: Facial types were found to be correlated with alveolar bone thickness. The hyperdivergent subjects presented thinner alveolus bone in the anterior maxilla and at almost all sites in the mandible. Clinicians should be aware of the possibility of thin cortical bone plates in hyperdivergent patients, reducing antero-posterior movements to avoid fenestration and dehiscence.
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http://dx.doi.org/10.1016/j.sdentj.2020.01.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7910683PMC
March 2021

Buccal Bone Changes Around First Permanent Molars and Second Primary Molars after Maxillary Expansion with a Low Compliance Ni-Ti Leaf Spring Expander.

Int J Environ Res Public Health 2020 12 6;17(23). Epub 2020 Dec 6.

Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy.

Vestibular bone thickness changes and dento-alveolar buccal tipping of second primary molars and of first molars after maxillary expansion performed with a slow maxillary expansion protocol was investigated. Twenty patients (mean age 7.3 ± 0.9 years old; 9 male and 11 female) were treated according to the Leaf Expander protocol. Buccal alveolar bone thickness (BT), buccal alveolar bone height (BH), inter-dental angle (TIP), and inter-molar width (IW) regarding first molars and second primary molars were calculated before and after expansion on cone beam computed tomography (CBCT) images. Descriptive statistics and paired t-tests were used to assess changes between the pre-treatment and post-treatment measurements. Bone thickness vestibular to second primary molars and intermolar width of both teeth were the only variables that showed statistically significant changes. It appears that buccal bone thickness vestibular to first molars was not significantly reduced after maxillary expansion with the Leaf Expander. The clinical use of a slow maxillary expander with Ni-Ti springs appears efficient and safe in in the correction of maxillary hypoplasia during mixed dentition.
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http://dx.doi.org/10.3390/ijerph17239104DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7730214PMC
December 2020

Correlation between Malocclusion and Allergic Rhinitis in Pediatric Patients: A Systematic Review.

Children (Basel) 2020 Nov 27;7(12). Epub 2020 Nov 27.

Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy.

Background: Oral breathing, nasal obstruction and airway space reduction are usually reported as associated to allergic rhinitis. They have been linked to altered facial patterns and dento-skeletal changes. However, no firm correlation based on the evidence has been established. This systematic review has been undertaken to evaluate the available evidence between malocclusion and allergic rhinitis in pediatric patients.

Methods: The research refers to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines, databases (Medline, Cochrane Library, Pubmed, Embase and Google Scholar) were screened, the quality was evaluated through Quality Assessment of Diagnosfic Accuracy Studies (QUADAS-2).

Results: The articles selected (6 out of initial 1782) were divided on the basis of the study design: two observational randomized study, three case-control study, one descriptive cross-sectional study, and one longitudinal study. A total of 2188 patients were considered. Different results were reported as related to allergic rhinitis ranging from a higher incidence of dental malocclusion, to an increase of palatal depth, and in posterior cross-bite about anterior open-bite and to longer faces and shorter maxillas.

Conclusions: Most of the studies selected found a rise in the prevalence of both malocclusion and allergic rhinitis in children. However, the level of bias is high, impaired by a poor design and no conclusive evidence can be drawn.
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http://dx.doi.org/10.3390/children7120260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7760209PMC
November 2020

A Scoping Review of Respirator Literature and a Survey among Dental Professionals.

Int J Environ Res Public Health 2020 08 17;17(16). Epub 2020 Aug 17.

Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20122 Milan, Italy.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus was discovered in China in late 2019 and subsequently triggered a global pandemic. Dentists, like many other health professionals, are at an increased risk of contracting the virus as they work in close proximity to patients, especially when performing aerosol-generating procedures. Thus, in order for dentists to protect themselves and their patients, it is recommended that practitioners wear filtering facepiece 2 (FFP2) respirators. The prolonged use of these FFP2 respirators has been linked to several side effects. The aim of this paper is to assess the perceived experience associated with N95/FFP2 respirators based on the available literature and data collected through an online survey completed by Italian dental professionals. Articles were included up to May 2020 and literature searches were conducted through The National Library of Medicine, Cochrane Central Register of Controlled Trials, and Embase databases. The search terms included COVID-19, respirators, masks, and discomfort. An online survey was administered to 256 Italian dentists. The results from this survey were in agreement with the available literature. The findings concurred that the prolonged use of respirators was associated with headaches (47.5%), severe exertion and discomfort (50.8%), moderate concentration problems (54.3%), moderate breathing difficulties (63.5%), and consequently, an impaired work ability (85.5%). These findings were not influenced by the number of hours spent wearing the respirator. Despite several side effects, FFP2 respirators are fundamental in protecting dentists and their importance was acknowledged.
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http://dx.doi.org/10.3390/ijerph17165968DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460494PMC
August 2020

Comparative effectiveness of Invisalign and fixed appliances in first-premolar extraction cases.

J Clin Orthod 2020 05;52(5):294-301

Department of Biomedical, Surgical, and Dental Sciences, School of Dentistry, University of Milan, Milan, Italy.

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May 2020

Volumetric Changes in the Upper Airways after Rapid and Slow Maxillary Expansion in Growing Patients: A Case-Control Study.

Materials (Basel) 2020 May 13;13(10). Epub 2020 May 13.

Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy.

The aim is to evaluate changes in the volume of the upper airways before and after slow maxillary expansion (SME) obtained with the flexible properties of a nickel titanium leaf spring and rapid maxillary expansion (RME) with a conventional Hyrax appliance in growing patients. The records of 1200 orthodontic patients undergoing maxillary expansion from 2018 to 2019 were analyzed; among these pre and post treatment CBCT scans of 22 patients (mean age 8.2 ± 0.6 years old) treated by SME were compared with those obtained from 22 patients (mean age 8.1 ± 0.7 years old) treated by RME banded on the second primary molars. The following inclusion criteria were used: Maxillary transverse constriction, good general health, and no previous orthodontic treatment. Volumes of nasal cavity (NCavV), nasopharynx (NsPxV), and right and left maxillary sinuses (MSV) were calculated with ITK-SNAP. Shapiro-Wilk test revealed a normal distribution of data in each group. Paired -test was used for within-group comparisons and independent -test for between-group comparisons. Statistically significant increases occurred in NCavV, NsPxV, and MSVs after treatment with both appliances. No statistically significant difference between the appliances occurred in NCavV, NsPxV, and MSVs. Method error was considered negligible (mean intra-operator and inter-operator intraclass correlation coefficient were 0.928 and 0.911, respectively). It appears that both appliances produce similar effects on the different segments of the upper airway tract.
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http://dx.doi.org/10.3390/ma13102239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287613PMC
May 2020

Biomimetic Effect of Nano-Hydroxyapatite in Demineralized Enamel before Orthodontic Bonding of Brackets and Attachments: Visual, Adhesion Strength, and Hardness in In Vitro Tests.

Biomed Res Int 2020 30;2020:6747498. Epub 2020 Jan 30.

Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.

Dietary habits with high consumption of acidic food can induce in orthodontic patients an increased risk of demineralization lesions around orthodontic brackets and bands. The purpose of the present laboratory study is to assess the visual efficacy of a biomimetic nano-hydroxyapatite remineralizing solution in a hypomineralized enamel surface and its effect on adhesion of fixed orthodontic appliances and on enamel microhardness. Intact teeth were demineralized, and subsequently the areas of demineralization were visually recorded using a 0-100 scale. Subsequently, a remineralizing solution (Biorepair® Repair Shock Treatment) was applied for ten minutes once a day/for one week per month for a total remineralizing treatment of 3 months. Visual effects were recorded. Moreover, bond strength was recorded and adhesive remnant index scores were measured for both orthodontic brackets and composite attachments both before demineralization and after demineralization and application of remineralizing solution. Also, Vickers microhardness was measured. All data were submitted to statistical analysis. The application of remineralizing solution induced a significant reduction of demineralized areas after the first week of application. No significant differences between untreated enamel surfaces and remineralized surfaces were detected after 2 months of remineralizing treatment. Bond strength values were significantly reduced for both brackets and attachments after remineralizing treatment. However, attachments showed higher adhesion values than brackets in both conditions tested. Remineralized enamel showed significantly higher microhardness values than demineralized enamel and lower values than intact enamel.
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http://dx.doi.org/10.1155/2020/6747498DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013302PMC
November 2020

Assessment of the Stability of the Palatal Rugae in a 3D-3D Superimposition Technique Following Slow Maxillary Expansion (SME).

Sci Rep 2020 02 14;10(1):2676. Epub 2020 Feb 14.

Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy.

The Palatal Rugae are considered a useful human identification marker for both orthodontists and forensic personnel. The principal aim of the present study was to evaluate the stability of palatal rugae with a 3D-3D superimposition procedure following Slow Maxillary Expansion (SME), in order to assess whether they kept their uniqueness and validity for human identification, even after a specific dental treatment. For this purpose, a sample of 27 digital dental models - belonging to growing patients (13 males and 14 females), aged between 8.5 and 15 years, who underwent SME therapy - was retrospectively studied and compared with a control group of 27 untreated subjects - (13 males and 14 females). Digital dental models were obtained pre-treatment and at device removal; both were processed by means of an intraoral scanner. A superimposition procedure was thus performed to reach the minimum point-to-point distance between two models of palatal rugae. Intra- and inter-observer differences were statistically analyzed by paired Wilcoxon test and Intra-class Correlation coefficient (ICC), showing values larger than 0.93. There was no difference in Root-Mean-Square (RMS) values between untreated control subjects and subjects treated with Leaf Expander (p = 0.062). A RMS value of 0.43 was the threshold to distinguish the pooled group ("Untreated" and "Leaf") from any mismatch. According to the obtained results, this study failed to reject the null hypothesis and presented no differences between the RMS values of the Test group and the RMS values of the untreated control group. This work highlighted the usefulness of 3D superimposition procedure for purposes of human identification, in subjects undergoing dental treatment. However, keeping in sight the forensic use of this technique as a helpful probation element in court, further studies should be performed to confirm these findings.
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http://dx.doi.org/10.1038/s41598-020-59637-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7021754PMC
February 2020

A multicenter, prospective, randomized trial of pain and discomfort during maxillary expansion: Leaf expander versus hyrax expander.

Int J Paediatr Dent 2020 Jul 20;30(4):421-428. Epub 2020 Jan 20.

Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy.

Background: Pain suffered by the young patient is the most frequent symptom during orthodontic treatment and is the one that most frightens children and causes worry in their families.

Aim: To investigate pain perception and function impairment during the first week of activation of two palatal expansion screws.

Design: A total of 101 subjects were randomly divided into two groups: RME group included patients treated with the standard hyrax expansion screw and LEAF group included patients treated with Leaf Expander appliance. Pain intensity was assessed via the Wong-Baker scale. A questionnaire on oral function impairments was also compiled by the patients.

Results: The Pain Scale analysis showed that patients in the RME group suffered from a significantly higher level of pain than those in the LEAF group (88.6% vs 25%, P < .01). RME group showed highest pain indexes from day 1 to day 4 (51.4% RME vs 9.7% LEAF suffered at least once from strong pain in the first 4 days, P < .01). Furthermore, oral functions were similarly affected in both groups.

Conclusions: Pain reported during maxillary arch expansion is influenced by clinical activation protocol and by the screw type. Patients treated with Leaf Expander reported significantly lower pain level in the first 7 days of treatment.
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http://dx.doi.org/10.1111/ipd.12612DOI Listing
July 2020

Correlation between Dental Vestibular-Palatal Inclination and Alveolar Bone Remodeling after Orthodontic Treatment: A CBCT Analysis.

Materials (Basel) 2019 Dec 16;12(24). Epub 2019 Dec 16.

Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy.

The aim of this study was to evaluate the correlation between dental vestibular-palatal inclination changes and the cortical bone remodeling after fixed orthodontic treatment using cone beam computed tomography (CBCT). Twenty-two patients with Angle Class I malocclusion, permanent dentition, and mild to moderate dental crowding were included in the present three-dimensional (3D) analysis. Bone dimensions were evaluated by CBCT scans obtained before and after orthodontic treatment, whereas the torque values were calculated by means of digital models using the 3D VistaDent software. A paired t-test was used to compare the changes between the pretreatment and post-treatment measurements. The correlations between variables were analyzed with linear regression analysis. A significant correlation between torque variations and bone thickness changes was observed for the apical buccal level of the anterior side ( < 0.05). Limited and not significant alveolar bone resorption for the apical thickness of anterior teeth occurred at ± 5 degrees of torque variation, while for tooth inclination exceeding +5 or -5 degrees, the bone remodeling was more evident. The present study demonstrated that anterior region was the most affected area by bone remodeling and that torque variation was highly related to apical bone thickness adaptation for maxillary and mandibular incisors and maxillary canines.
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http://dx.doi.org/10.3390/ma12244225DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947223PMC
December 2019

Comparison of a tridimensional cephalometric analysis performed on 3T-MRI compared with CBCT: a pilot study in adults.

Prog Orthod 2019 Oct 21;20(1):40. Epub 2019 Oct 21.

Department of Orthodontics, UOC Maxillofacial and Dental Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20142, Milan, Italy.

Objective: Since the introduction of cone-beam computed tomography (CBCT) in dentistry, this technology has enabled distortion-free three-dimensional cephalometric analysis for orthodontic and orthognathic surgery diagnosis. However, CBCT is associated with significantly higher radiation exposure than traditional routine bidimensional examinations for orthodontic diagnosis, although low-dose protocols have markedly reduced radiation exposure over time. The objective of this preliminary feasibility study is to compare the accuracy and diagnostic capabilities of an already-validated three-dimensional cephalometric analysis on CBCT to those of an analysis on 3-T magnetic resonance imaging (3T-MRI) to assess whether the latter can deliver a comparable quality of information while avoiding radiation exposure.

Materials And Methods: In order to test the feasibility of three-dimensional cephalometry on 3T-MRI, 18 subjects (4 male; 14 female) with mean age 37.8 ± SD 10.2, who had undergone both maxillofacial CBCT and maxillofacial 3T-MRI for various purposes within 1 month, were selected from the archive of the Department of Dentistry and Maxillofacial Surgery of Fondazione Ospedale Policlinico Maggiore, IRCCS, Milano, Italy. A three-dimensional cephalometric analysis composed of ten midsagittal and four bilateral landmarks and 24 measurements (11 angular, 13 linear) was performed on both scans using Mimics Research® v. 17.0 (NV, Technologielaan 15, 3001 Leuven, Belgium). Cephalometric analysis was performed twice by two independent orthodontists for each scan, and each orthodontist repeated the measurements 3 weeks later. Statistical analysis was performed with SPSS® 20.00 for Windows (IBM® Corporation, Sommers, NY, USA). A Bland-Altman test for each cephalometric value was performed to assess the agreement between the procedures. The intraclass correlation coefficient (ICC) was used to assess interobserver and intraobserver reliability. The coefficient of variation was used to evaluate precision.

Results: Both procedures showed good reliability, with mean intraobserver ICCs of 0.977/0.971 for CBCT and 0.881/0.912 for MRI. The average interobserver ICCs were 0.965 for CBCT and 0.833 for MRI. A Bland-Altman analysis for the cephalometric tracing revealed a similar range of agreement between the two modalities; the bias range (mean ± SD) was - 0.25-0.66 mm (0.174 ± 0.31) for distances and - 0.41-0.54° (0.12 ± 0.33) for angles.

Conclusions: Within the main limitation of this pilot study, that is, the small sample, it is possible to state that cephalometric measurements on 3T-MRI seem to possess adequate reliability and repeatability and that they show satisfying agreement with values measured on CBCTs. An MRI examination does not expose patients to ionizing radiation and could provide an alternative to CBCT for three-dimensional cephalometrics in the future.
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http://dx.doi.org/10.1186/s40510-019-0293-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801285PMC
October 2019

Evolution of the Leaf Expander: A Maxillary Self Expander.

J Clin Orthod 2019;53(5):260-266

Private practice of orthodontics, Bra, Italy.

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December 2019

Current state of the art in the use of augmented reality in dentistry: a systematic review of the literature.

BMC Oral Health 2019 07 8;19(1):135. Epub 2019 Jul 8.

School of Medicine and Surgery, University of Insubria, Via G. Piatti 10, 21100, Varese, Italy.

Background: The aim of the present systematic review was to screen the literature and to describe current applications of augmented reality.

Materials And Methods: The protocol design was structured according to PRISMA-P guidelines and registered in PROSPERO. A review of the following databases was carried out: Medline, Ovid, Embase, Cochrane Library, Google Scholar and the Gray literature. Data was extracted, summarized and collected for qualitative analysis and evaluated for individual risk of bias (R.O.B.) assessment, by two independent examiners. Collected data included: year of publishing, journal with reviewing system and impact factor, study design, sample size, target of the study, hardware(s) and software(s) used or custom developed, primary outcomes, field of interest and quantification of the displacement error and timing measurements, when available. Qualitative evidence synthesis refers to SPIDER.

Results: From a primary research of 17,652 articles, 33 were considered in the review for qualitative synthesis. 16 among selected articles were eligible for quantitative synthesis of heterogenous data, 12 out of 13 judged the precision at least as acceptable, while 3 out of 6 described an increase in operation timing of about 1 h. 60% (n = 20) of selected studies refers to a camera-display augmented reality system while 21% (n = 7) refers to a head-mounted system. The software proposed in the articles were self-developed by 7 authors while the majority proposed commercially available ones. The applications proposed for augmented reality are: Oral and maxillo-facial surgery (OMS) in 21 studies, restorative dentistry in 5 studies, educational purposes in 4 studies and orthodontics in 1 study. The majority of the studies were carried on phantoms (51%) and those on patients were 11 (33%).

Conclusions: On the base of literature the current development is still insufficient for full validation process, however independent sources of customized software for augmented reality seems promising to help routinely procedures, complicate or specific interventions, education and learning. Oral and maxillofacial area is predominant, the results in precision are promising, while timing is still very controversial since some authors describe longer preparation time when using augmented reality up to 60 min while others describe a reduced operating time of 50/100%.

Trial Registration: The following systematic review was registered in PROSPERO with RN: CRD42019120058.
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http://dx.doi.org/10.1186/s12903-019-0808-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613250PMC
July 2019

Efficacy of ketoprofen lysine salt and paracetamol/acetaminophen to reduce pain during rapid maxillary expansion: A randomized controlled clinical trial.

Int J Paediatr Dent 2019 Jan 9;29(1):58-65. Epub 2018 Oct 9.

Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy.

Background: Rapid maxillary expansion (RME) is an orthopaedic procedure indicated for a wide variety of clinical conditions.

Aim: The aim of the study was to compare the effects of ketoprofen lysine salt (KLS) vs paracetamol/acetaminophen (P) on pain perception during RME.

Design: One hundred and fifty-one subjects (mean age 8.6 year) were enrolled in this prospective controlled clinical trial according to inclusion criteria: prepuberal stage of development, negative posterior transverse interarch discrepancy, non-concurrent use of other drugs. First phase: n.40 allocated to Group 1 used 40 mg of KLS, n.40 to Group 2 used 250 mg of P, n.36 to Group 3 as control group. Second phase: n.35 allocated to Group 4 used 40 mg ketoprofen lysine salt once a day for the first 3 days of activation. Pain experience was reported on a numeric rating scale (0-4) and a 100-mm visual analogue scale. Pain perception was tested with the Mann-Whitney test (P < 0.05).

Results: Pain perception was higher during the first 3 days of activation and it was described as mild to moderate. Group 1 experienced significantly less pain during the fourth, fifth, and sixth day (P < 0.05) compared with Group 2. Patients of the Group 4 reported significantly lower pain during the whole period of RME activation (P < 0.05).

Conclusions: The perceived higher pain was reported during the second and third day of expansion. The analgesic effect of KLS is more effective than P during the fourth, fifth, and sixth day. The use of KLS during the first 3 days of activation seems to be able reducing pain during the whole active phase.
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http://dx.doi.org/10.1111/ipd.12428DOI Listing
January 2019

The efficacy of orthodontic treatments for anterior crowding with Invisalign compared with fixed appliances using the Peer Assessment Rating Index.

Quintessence Int 2018 ;49(7):581-587

Objective: The purpose of this retrospective study was to determine the efficacy of Invisalign in a large sample of patients compared to fixed appliances.

Method And Materials: The test group consisted of 100 patients treated with Invisalign compared with a control group treated with conventional fixed appliances matched for sex, age, and initial severity of malocclusion based on the amount of anterior dental crowding (Little Index) and the Peer Assessment Rating (PAR Index) scores. The retainer used was a 0.0175-inch multistranded stainless-steel wire bonded from canine-to-canine in the mandibular arch and from lateral inisor-to-lateral incisor in the maxillary arch. A paired t test was used to compare both initial and final PAR scores.

Results: There was an overall 80.9% improvement, and 63 subjects did not need any refinement. The mean number of aligners used was 14 (+ 15 for the refinements) in the maxillary arch and 29 (+ 14 for the refinements) in the mandibular arch. The mean duration of treatment was 14 months (+ 7 months for the refinements). Significant statistical differences were found in the posttreatment scores, within both the Invisalign group and the control group. No differences were found in the follow-up scores. Additionally, the duration of treatment was 4 months longer in the control group.

Conclusion: More than 90% of the subjects treated with Invisalign achieved a significant improvement, as shown by the PAR scores. A need for additional aligners was reported for 37% of the patients. Fixed bonded retainers seem to be a good option in preventing tooth relapse after Invisalign and fixed conventional treatments.
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http://dx.doi.org/10.3290/j.qi.a40511DOI Listing
March 2019

Timing considerations on the shear bond strength of orthodontic brackets after topical fluoride varnish applications.

J Orthod Sci 2017 Jan-Mar;6(1):11-15

Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, Milan, Italy.

Objectives: To assess the best temporal association between the application of a fluoride varnish on enamel and bonding procedures.

Materials And Methods: Eighty mandibular bovine incisors were used. Teeth were divided into 4 groups (20 per group); Groups 1-3 were treated with fluoride varnish (Fluor Protector, Ivoclar Vivadent, Schaan, Liechtenstein), and Group 4 served as control with no pretreatment. Tooth were stored in deionized water (37°C) and subjected to thermal cycling for 400 (Group 1), 800 (Group 2), and 2500 (Group 3) cycles corresponding, respectively, to 15, 30, and 90 days in order to simulate the three different timing of bracket bonding. Shear bond strength (SBS) was measured using an Instron Universal Testing machine. Tooth surfaces were examined under a stereomicroscope at 10× magnification to assess the amount of adhesive remnant index (ARI). One-way analysis of variance (ANOVA) and Tukey's honestly significant difference post-hoc test were used for the comparison of SBS values between groups ( < 0.05). The Chi-square test was used to examine differences among ARI scores. ( < 0.05).

Results: One-way ANOVA and Tukey post-hoc test showed that the SBS of different groups were significantly different and was impacted by different timing of bonding ( < 0.05). The main differences were between the control group (17.02 ± 6.38 MPa) and Group 1 (6.93 ± 4.3 MPa). The ARI scores showed that there were no significant differences between the four tested groups.

Conclusions: The SBS of the brackets bonded 15 days after the application of the fluoride was set back to an optimal value.
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http://dx.doi.org/10.4103/2278-0203.197392DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278579PMC
February 2017

The Leaf Expander for Non-Compliance Treatment in the Mixed Dentition.

J Clin Orthod 2016 Sep;50(9):552-560

Department of Surgery and Translational Medicine, Orthodontics, University of Florence, Florence, Italy.

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September 2016

Effects of six different preventive treatments on the shear bond strength of orthodontic brackets: study.

Acta Biomater Odontol Scand 2015 Jan 14;1(1):13-17. Epub 2015 Apr 14.

Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Department of Biomedical, Surgical and Dental Sciences, Unit of Orthodontics and Pediatric Dentistry, School of Dentistry, University of MilanMilanItaly.

: The aim of this study is to evaluate the effect of six different prophylactic agents on shear bond strength (SBS) of orthodontic brackets. : One hundred twenty-six freshly extracted mandibular bovine incisors were used. Teeth were randomly divided into 7 equal groups (18 per group) as follows: group-1 served as control with no pre-treatment; group-2 enamel treated with fluoride varnish (Fluor Protector, Ivoclar Vivadent); group-3 containing casein-phosphopeptide-amorphous calcium-phosphate (CPP-ACP) paste (GC Tooth Mousse, RECALDENT™); group-4 with ozone (HealOzone, Kavo; group-5 with glycine powder (Perio Flow, EMS); group-6 with hydroxyapatite powder 99.5% (Coswell S.p.A.); group-7 with a toothpaste made of hydroxyapatite nanocrystals (BioRepair® Plus, Coswell S.p.A). Brackets were all bonded using the same technique with transbond XT (3 M Unitek, Monrovia, CA). All the bonded specimens were stored for 24 h in deionized water (37 °C) and subjected to thermal cycling for 1000 cycles. The SBS was measured with an Instron Universal Testing machine and the adhesive remnant was assessed with the adhesive remnant index (ARI) using a stereomicroscope at 10× magnification. : Statistical differences (ANOVA) were found among the seven investigated groups ( = 12.226, 0.001). SBS of groups 2, 5 and 6 were significantly lower than the control group ( < 0.05). ARI scores (chi-square test) were correlated with the differences of SBS values. CPP-ACP paste, ozone or BioRepair® did not compromise on bracket bond strength. Fluoride, glycine or hydroxyapatite significantly decreased the SBS; only the fluoride group showed significant clinically low (<6 MPa) SBS values.
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http://dx.doi.org/10.3109/23337931.2015.1021351DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433176PMC
January 2015

Third molars and dental crowding: different opinions of orthodontists and oral surgeons among Italian practitioners.

Prog Orthod 2014 Nov 22;15:60. Epub 2014 Nov 22.

Background: The role of third molars as a cause of incisor crowding, especially in the lower arch, continues to be controversial. The aim of this work is to compare opinions of Italian oral surgeons and orthodontists on this topic.

Methods: One hundred ninety-three Italian practitioners of the Society of Orthodontics (SIDO) and the Italian Society of Oral Surgery (SICOI) were asked to fill out an online questionnaire made up of six questions. Practitioners were asked to express their opinion on the relation between upper and lower third molar eruption and anterior crowding.

Results: One hundred sixty-six members of both societies completed the online research survey; response rate (RR) was 86%. There were no statistically significant differences between the two groups (P > 0.005). Both agree not to believe that third molars create a force responsible for anterior crowding in the upper (82.5% orthodontists, 83.8% surgeons) and in the lower arch (52.6% orthodontists, 63.8% surgeons). Both agree also not to consider the upper (89.7% orthodontists, 82.1% surgeons) and lower (58.8% orthodontists, 63.2% surgeons) third molar extraction useful to prevent crowding.

Conclusions: Italian orthodontists and oral surgeons have the same opinion on the role of the third molar in causing anterior crowding. The majority of both groups of clinicians do not consider their preventive extraction useful in order to prevent anterior crowding.
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http://dx.doi.org/10.1186/s40510-014-0060-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4240869PMC
November 2014