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Objective: Occlusal surfaces of dental restorations should reestablish the anatomy of cusps, pits and fissures that has been lost. Since this complex area of the restoration is difficult to polish properly with rigid and semi-rigid rotary instruments, the benefits of polishing pastes have been highlighted and their use advocated. The present study aims to individuate a polishing protocol for a microhybrid composite using abrasive pastes with decreasing grit. Methods: Sixty composite discs (Filtek Z250, 3M ESPE, USA) were assigned to six experimental groups (n=10), each one established to be the sequential step of a polishing protocol based on abrasive pastes (Diamond ACI, ACII and Excel, FGM, Brazil): G1, simulated finishing with 40 μm diamond bur; G2, as G1 + 75-80 μm paste; G3, as G2 + 30-35 μm; G4, as G3 + 2-4 μm; G5a, as G4 + felt wheel; G5b, as G4 + resin coating (Seal Coat Fast, DEI Italia, Italy) and felt wheel. The profilometric superficial parameter Sa was taken into account as measure of the roughness on the treated surfaces. Non-parametric statistical analysis was used to assess differences among groups (α=0.05). Results: The registered mean Sa values ±SD expressed in μm were: G1, 0.31±0.06; G2, 0.11±0.01; G3, 0.11±0.02; G4, 0.12±0.02; G5a, 0.17±0.07; G5b, 0.09±0.03. The decrease in surface roughness among groups representing subsequent steps was statistically significant between G1 and G2 (p

AIM: To determine the size of individual permanent teeth together with Bolton’s ratios in an Italian population, and to compare the distribution of clinically significant tooth size discrepancy (TSD) according to both Bolton’s rule method and a millimetric method. MATERIALS AND METHOD: Dental casts of 150 Italian subjects (90 females mean age 15.9 ± 6.4 years, 60 males 14.5 ± 4.2 years). TSD was calculated considering both Bolton’s index [mean ± standard (SD)] and millimetric discrepancy. RESULTS: Overall and anterior Bolton’s ratios (%) were 91.3 ± 2.0 and 77.9 ± 2.7, respectively. According to Bolton’s rule, the normal range set is within the mean ± 2 SD range, 5.3 and 20.0 per cent in the overall and anterior Bolton ratios, respectively, were out of such normality. However, greater frequencies of 52.6 and 21.4 per cent in the overall and anterior millimetric discrepancies, respectively, were above 1.5 mm. By merging the overall and the anterior millimetric discrepancies, up to 56.7 per cent of the sample presented a value of at least 1.5 mm. No differences between genders were seen. CONCLUSION: There were relevant differences in the interpretation of the degree of TSD between Bolton’s index rule and absolute millimetric discrepancies. The rule of the 2 SD range was not able to detect all clinically relevant TSDs. An underestimation of TSD using the current Bolton rule may not lead to optimal case finishing at the end of fixed orthodontic treatment.

la distalizzazione dei molari è una fase del trattamento che si prefigge lo scopo di ottenere un prima classe molare per recuperare lo spazio per posizionare i canini in una giusta posizione occluso-funzionale

L'applicazione del self-ligating non è la panacea per risolvere tutti i problemi ortodontici, ma è un mezzo di indubbia validità per il controllo delle forze frizionali nell'ambito della stretta interdipendenza tra forze meccaniche e reazioni a livello molecolare tissutale

The aim of this study was to assess the effect of water and saliva contamination on shear bond strength of APC Plus orthodontic brackets bonded with 3 different adhesives (Transbond XT, Transbond Moisture Insensitive Primer, and Transbond Plus Self Etching Primer) 24h after bonding and after thermocycling. A total of 270 bovine permanent mandibular incisor were randomly divided into 18 groups (n=15). Each adhesive material was tested in 3 different enamel surface conditions: dry, water and saliva application after etching. As a result 9 groups were defined and debonded after 24h 9 other similarly partitioned groups debonded after thermocycling (1500 thermocycles: 5±2/50±5°C, bath 30", transfer 5"). The samples have been subjected to a shear bond test and data were statistically analyzed (ANOVA, Scheffè). The adhesive surfaces of enamel have been observed (16x) before bonding brackets and after the detachment to assess the quantity of adhesive left on the surface (ARI score; Kruskal-Wallis, Mann-Whitney tests). Conventional adhesive had the highest bond strength on dry enamel surfaces and the lowest on moisture contemned surfaces (p

Aim To evaluate the two-year success rate of primary root canal treatment performed with two integrated shaping and filling systems on upper central incisors with chronic periapical pathosis. Methodology The trial enrolled 60 patients with an untreated maxillary central incisor presenting a chronic periapical lesion smaller than 5 mm in diameter, who were randomly assigned to two treatment groups: G1 ( n = 30), Revo-S/One Step Obturator; G2 ( n = 30) GTX/GTX Obturator. The patients underwent single-session root canal treatments by an experienced endodontist and were followed up for two years. The clinical evaluation entailed percussion and palpation tests. Two independent examiners rated the radiographic healing on the basis of a previously described scale. Comparability between groups in terms of baseline clinical parameters was tested with a Mann-Whitney test (age, apical gauging) and χ 2 test (tenderness to percussion and palpation). The comparison of clinical data and radiographic healing scores between the groups and among time points was carried out with non-parametric statistical methods ( p Results The two groups were comparable in terms of baseline clinical parameters. All patients were available for the re-evaluation after two years. Only one patient per group was positive to the clinical tests at the final recall. An improvement of radiographic healing scores along the follow-up period was observed. After two years, the lesions were scored as totally healed, partially healed and not healed in 93.3%, 3.3% and 3.3% of cases in G1 and in 93.3%, 0% and 6.7% of cases in G2, without pointing out statistically significant differences between groups. Conclusions Both the two tested integrated shaping and filling systems proved to be effective for the treatment of upper central incisors with periapical pathosis. When monitoring the healing of periapical lesions, follow-up times longer than one year may be required to observe complete healing.

Aim To assess the 18-month success rate of root canal treatment with two integrated shaping and filling systems on upper central incisors with chronic periapical pathosis. Methodology Sixty patients with an upper central incisors with a chronic periapical lesion smaller than 5 mm in diameter were randomly allocated to two treatment groups, which only differed in terms of canal shaping and filling protocol: G1 (n = 30), Revo-S/One Step Obturator; G2 (n = 30) GTX/GTX Obturator. The patients underwent clinical assessment at baseline and after 6, 12 and 18 months. Radiographic healing was scored according to a previously described scale by two independent examiners, who analysed the periapical radiographs taken at the recall visits. Intra- and inter-observer reliability was tested with Kappa statistics. The significance of the differences between the two groups and among time points with regard to clinical and radiographic data was evaluated with non-parametric tests (p Results All enrolled patients were available for re-evaluation. At the final recall, the cases were scored as total healing, partial healing and failure with the following frequencies: 93.3%, 3.3% and 3.3% of cases in G1 and in 93.3%, 0% and 6.7% of cases in G2. Radiographic healing scores were similar in the two groups irrespective of the experimental time point. The prevalence of symptoms was scarce (0–10%), stable over time and similar in the two groups. Conclusions The clinical performance of two considered integrated systems for the endodontic treatment of upper central incisors with periapical lesion was comparable and allowed for high success rates after 18 months.

Aim To assess preliminarily the success rate of the root canal treatment with two integrated shaping and filling systems of upper central incisors with chronic periapical pathosis. Methodology Sixty adult subjects with an untreated maxillary central incisor presenting a chronic periapical lesion smaller than 5 mm in diameter were recruited for the present study. The patients were randomly divided into two treatment groups: G1 ( n = 30), Revo-S/One Step Obturator; G2 ( n = 30) GTX/GTX Obturator. All root canal treatments were performed in a single session by the same operator. Sensitivity to palpation and percussion was registered at baseline and at the six-month recall. Radiographic healing was scored by two blind examiners according to a previously described scale. The absence of statistically significant differences in terms of baseline clinical parameters between the two groups was assessed by means of a Mann–Whitney test (age, apical gauging) and χ 2 test (sensitivity to percussion and palpation). The radiographic scores attributed to the two groups were compared with a Mann–Whitney test, while a χ 2 test served to compare the clinical data gathered after six months ( p Results Baseline clinical parameters registered in the two groups were found to be comparable. All patients attended the six-month recall and all the teeth were referred to be negative to sensitivity, with the exemption of two subjects per group. The periapical lesions were scored as totally healed, partially healed and not healed in 43.4%, 53.3% and 3.3% of cases in G1 and in 43.3%, 50.0% and 6.7% of cases in G2. The differences between the groups were not significant. Conclusions Tough cases scored as incomplete healing should be further followed up, the present study attests that the two tested integrated shaping and filling systems are capable of high and comparable six-month success rate in upper central incisors with periapical pathosis.

Aim To assess by micro-computed tomography (μCT) the quality of fillings in canals shaped with Reciproc considering the effects of filling technique and post insertion. Methodology The canals of 60 single-rooted teeth were instrumented with Reciproc R40 and randomly assigned to four groups (n = 15): G1, single point; G2, as G1 + DT Light Post; G3, continuous wave of condensation; G4, as G3 + DT Light Post. The filling voids were quantified by μCT. Data were statistically analysed by non-parametric test (p Results Filling greater than 96% of the entire canal volume was observed in all groups. The volume of internal voids was greater in G3 than in G4 (p Conclusions Our findings support the use of simplified techniques of canal shaping, filling with matching taper points and post cementation.

Objective: To evaluate the capability of both cervical vertebral maturation (CVM) stages 3 and 4 (CS3-4 interval) and the peak in standing height to identify the mandibular growth spurt throughout diagnostic reliability analysis. Materials and Methods: A previous longitudinal data set derived from 24 untreated growing subjects (15 females and nine males,) detailed elsewhere were reanalyzed. Mandibular growth was defined as annual increments in Condylion (Co)–Gnathion (Gn) (total mandibular length) and Co–Gonion Intersection (Goi) (ramus height) and their arithmetic mean (mean mandibular growth [mMG]). Subsequently, individual annual increments in standing height, Co-Gn, Co-Goi, and mMG were arranged according to annual age intervals, with the first and last intervals defined as 7–8 years and 15–16 years, respectively. An analysis was performed to establish the diagnostic reliability of the CS3-4 interval or the peak in standing height in the identification of the maximum individual increments of each Co-Gn, Co-Goi, and mMG measurement at each annual age interval. Results: CS3-4 and standing height peak show similar but variable accuracy across annual age intervals, registering values between 0.61 (standing height peak, Co-Gn) and 0.95 (standing height peak and CS3-4, mMG). Generally, satisfactory diagnostic reliability was seen when the mandibular growth spurt was identified on the basis of the Co-Goi and mMG increments. Conclusions: Both CVM interval CS3-4 and peak in standing height may be used in routine clinical practice to enhance efficiency of treatments requiring identification of the mandibular growth spurt.

OBJECTIVES: Controversial results have been reported on potential correlations between the stomatognathic system and body posture. We investigated whether malocclusal traits correlate with body posture alterations in young subjects to determine possible clinical applications. METHODS: A total of 122 subjects, including 86 males and 36 females (age range of 10.8–16.3 years), were enrolled. All subjects tested negative for temporomandibular disorders or other conditions affecting the stomatognathic systems, except malocclusion. A dental occlusion assessment included phase of dentition, molar class, overjet, overbite, anterior and posterior crossbite, scissorbite, mandibular crowding and dental midline deviation. In addition, body posture was recorded through static posturography using a vertical force platform. Recordings were performed under two conditions, namely, i) mandibular rest position (RP) and ii) dental intercuspidal position (ICP). Posturographic parameters included the projected sway area and velocity and the antero-posterior and right-left load differences. Multiple regression models were run for both recording conditions to evaluate associations between each malocclusal trait and posturographic parameters. RESULTS: All of the posturographic parameters had large variability and were very similar between the two recording conditions. Moreover, a limited number of weakly significant correlations were observed, mainly for overbite and dentition phase, when using multivariate models. CONCLUSION: Our current findings, particularly with regard to the use of posturography as a diagnostic aid for subjects affected by dental malocclusion, do not support existence of clinically relevant correlations between malocclusal traits and body posture.

AIM: External apical root resorption (EARR) is a common complication that may occur during and after orthodontic treatment. In case of need of endodontic therapy for a tooth with EARR, it has not been clarified yet which benefits can be derived by the use of electronic apex locators (EALs). The present study aimed to assess the accuracy of EALs on extracted teeth before and after simulation of EARR subsequent to orthodontic treatment. MATERIALS AND METHODS: Standard access cavities were prepared on 64 single-rooted teeth. After working length (CWL) determination, specimens were embedded in an alginate mass, connected to two EALs (Apit, Osada, Tokyo, Japan; Root ZX, Morita Corp., Tokyo, Japan) and the electronic working length (EWL) was measured. The apical portion of the specimens was then modified to simulate EARR, and the EWL was determined again. The discrepancy between CWL and EWL was regarded as statistical unit. Collected data underwent statistical analysis by means of non-parametric tests (p < 0.05). RESULTS: Within a range of ± 0.5 and ± 1.0 mm from CWL, the accuracies were 79.7% and 98.4% (Apit/intact tooth); 82.8% and 96.9% (Apit/simulated EARR); 81.3% and 98.4% (Root ZX/intact tooth); 76.6% and 96.9% (Root ZX/simulated EARR). No statistically significant differences in relation to device or apical condition emerged (p > 0.05). CONCLUSION: The two considered EALs showed similar accuracy, which was not affected by the EARR simulation. The use of EALs in the treatment of teeth with EARR following orthodontic treatment may be useful.

Aim To evaluate the 6-month outcome of endodontic treatment of periapical lesions with integrated systems by clinical examination and digital subtraction radiography (DSR). Methodology Eighty-four patients with chronic periapical pathosis were randomly allocated to two groups and received endodontic treatment with Revo-S/One Step Obturator (G1, n = 41) or GTX/GTX Obturator (G2, n = 43). Six months later, clinical examination and DSR analysis were performed. Non-parametric statistical methods were used (p Results Total healing, partial healing and failure occurred in 48.4%, 48.4% and 3.2% of cases in G1, in 50.0%, 43.8% and 6.2% of cases in G2, respectively. No significant difference was detected. Conclusions The integrated endodontic techniques allowed for a high 6-month success rate in both groups in accordance with literature data.

To assess the scientific evidence for detectable volume changes of gingival crevicular fluid (GCF) incident to orthodontic tooth movement (OTM). A literature survey of longitudinal split-mouth studies was performed searching PubMed, SCOPUS and the Cochrane Library, with the last access in 15 April 2012. After selection, 13 articles qualified for the final analysis. One study was judged to be of medium/high quality, six were of medium quality and the rest of low quality. Across all studies, there was very little or no statistically significant change in GCF volume incident to OTM. The changes seen were generally ascribed to the clinical or subclinical inflammation consequent to placement of the fixed orthodontic appliance. A reappraisal of the data provided in these studies was performed by comparing the GCF volume from the test (moved) and control (non-moved) teeth, in terms of effects-size (ES) coefficients and variations, as percentages. Generally, the ES coefficients and the variations were below 1.0 and 20%, respectively. Therefore, when using current methods to collect and measure GCF volume, there was no meaningful diagnostic potential for the GCF volume as an index of tissue remodelling incident to OTM. The GCF volume is not a reliable index for tissue remodelling incident to OTM.

RiassuntoObiettiviValutare la guarigione di lesioni periapicali dopo sei mesi dal trattamento con sistemi integrati di strumentazione e otturazione canalare.Materiali e metodiSessanta pazienti con lesione periapicale sono stati assegnati a gruppi di trattamento (n=30) con sistema RevoS+One Step Obturator (G1) o con GTX+GTX Obturator (G2). La guarigione è stata valutata a sei mesi clinicamente e con Digital Subtraction Radiography (test non parametrici, p0,05).ConclusioniIl successo a sei mesi è alto e in linea coi dati della letteratura. Le tecniche semplificate considerate sono efficaci nel trattamento di lesioni periapicali.SummaryAimTo assess the healing of periapical lesions six months after the treatment with integrated systems for root canal shaping and filling.MethodologySixty patients with periapical lesion were randomly assigned to two treatment groups (n=30) with RevoS+One Step Obturator (G1) or GTX+GTX Obturator (G2). Healing was assessed by clinical examination and Digital Subtraction Radiography after six months (non-parametric tests, p0.05).ConclusionsThe six-month success was high and consistent with previously reported findings. The considered simplified techniques are effective for the treatment of periapical lesions.

Objectives. To build a 3D parametric model to detect shape and volume of dental roots, from a panoramic radiograph (PAN) of the patient.Materials and Methods. A PAN and a cone beam computed tomography (CBCT) of a patient were acquired. For each tooth, various parameters were considered (coronal and root lengths and widths): these were measured from the CBCT and from the PAN. Measures were compared to evaluate the accuracy level of PAN measurements. By using a CAD software, parametric models of an incisor and of a molar were constructed employing B-spline curves and free-form surfaces. PAN measures of teeth 2.1 and 3.6 were assigned to the parametric models; the same two teeth were segmented from CBCT. The two models were superimposed to assess the accuracy of the parametric model.Results. PAN measures resulted to be accurate and comparable with all other measurements. From model superimposition the maximum error resulted was 1.1 mm on the incisor crown and 2 mm on the molar furcation.Conclusion. This study shows that it is possible to build a 3D parametric model starting from 2D information with a clinically valid accuracy level. This can ultimately lead to a crown-root movement simulation.

This was to clarify dentoalveolar, skeletal and facial profile modifications induced by Fränkel II functional treatment in Class II division 1 subjects in prepubertal stages CS1-2. MATERIALS AND METHODS: Evaluation of 25 caucasian subjects (15 males, 10 females), mean age 8y 11m, in vertebral stages CS1-2. The mean duration of functional treatment was 1y 11m. STUDY DESIGN: Prospective controlled study. The sample was evaluated at T0, start of treatment, and T1, end of Fränkel II therapy. Untreated subjects in Class II division 1 were the control group. STATISTICS: T-test for paired data was calculated before and after treatment (P< 0.05). RESULTS: A statistically significant increase between T0 and T1 was obtained for SNB (p = 0.022), ANB (p

Aim To evaluate the repeatability of different static posturographic parameters with regard to the analysis of correlations between the masticatory system and body posture. Materials and methods In 15 healthy subjects (26.4 ± 3.7 years, 9 females and 6 males) with no malocclusion, posturographic recordings were carried out by vertical force platform under mandibular rest position (RP) and dental intercuspidal position (ICP). Six different posturographic parameters were recorded at baseline, 30 min, 1 day and 7 days. Repeatability analysis was based on the method of the moment estimator (as percentage over the baseline scores, i.e. method error) and interclass correlation coefficients (ICC). Moreover, a meta-analysis of the variations in posturographic recordings between different occlusal conditions, i.e. RP vs. ICP, from previous studies was also performed. Results Only the sway area and velocity yielded acceptable errors and ICCs up to 14.8% and 0.94, respectively. The spatial parameters, i.e. displacement of the centre of pressure from the theoretical point, performed poorly with lowest errors and greatest ICCs of 149.0% and 0.64, respectively. At the meta-analysis, ten studies were included and a total of 281 variation scores were calculated, with most of the greater and significant variations seen for the spatial parameters. Conclusions The sway area and velocity show acceptable reliability, but a threshold of 25% should be used as a true variation between two different recording conditions, i.e. RP vs. ICP. Considering that most of the previous results on the relevant correlations between the masticatory system and body posture are based on spatial parameters, with the poorest repeatability, corresponding conclusions should be interpreted with caution.

There are no reports on the aging effects of thermocycling of nickel-titanium (NiTi) based coil springs, and few studies have investigated their superelasticity phases in full. In this study, we compared the mechanical properties of NiTi-based closed-coil springs after the combined aging effects of prolonged strain and thermocycling, as a reflection of the clinical situation.Ninety NiTi-based closed-coil springs were used, 30 each of the following types: (1) Nitinol (3M Unitek, Monrovia, Calif), (2) Ni-Ti (Ormco, Glendora, Calif), and (3) RMO (Rocky Mountain Orthodontics, Denver, Colo); all had similar dimensions (length, 12 mm). In each sample group, 2 equal subgroups of 15 coil springs were extended by either 50% (to 18 mm) or 150% (to 30 mm), immersed in artificial saliva, and kept at 37°C for 45 days. All springs underwent sessions of 1000 thermocycles (1 minute long) from 5°C to 55°C on days 22 and 45. Unload deflection curves from both the 50% and 150% extensions (according to their strain subgroups) were recorded by using a universal testing machine before the strain (baseline) and at both 22 and 45 days, immediately after thermocycling.At baseline, the loads exerted by the NiTi-based coil springs varied from 99.8 to 245.1 gf for the RMO (50% strain) and Ni-Ti (150% strain) groups. Statistically significant, although small, differences were seen at each time point in both the 50% and 150% strain subgroups; generally, the highest and lowest values were recorded in the Ni-Ti and Nitinol groups (all, P0.001). Only the Nitinol coil-spring group showed an acceptable superelasticity phase. The strain and thermocycling did not dramatically change the deactivation forces of any coil springs.NiTi-based closed-coil springs might not have a superelasticity phase, and prolonged strain and thermocycling do not produce clinically relevant alterations in their deactivation forces.

Obiettivi: Valutare preliminarmente i potenziali benefici dell’uso del platelet-rich fibrin (PRF) nella moderna endodonzia chirurgica in termini di accelerazione della guarigione radiografica e riduzione del discomfort postoperatorio. Materiali e metodi: Undici pazienti con paradentite periapicale cronica sono stati assegnati casualmente al gruppo PRF (n=7) o al gruppo controllo (n=4). Gonfiore e dolore postoperatori sono stati valutati con un questionario. Nell’arco di un anno di osservazione e stato assegnato un punteggio alla guarigione radiografica secondo la scala di Molven. I dati sono stati analizzati statisticamente con test non parametrici. Risultati: I pazienti del gruppo PRF hanno provato meno dolore nelle 2-6 ore postoperatorie e sviluppato minor edema, che era sempre limitato e intraorale. Nel gruppo PRF la guarigione radiografica era individuabile precocemente, con la maggioranza dei casi classificata come guarigione completa dopo 2-3 mesi. Conclusioni: L’uso aggiuntivo del PRF sembra promuovere l’accelerazione della guarigione radiografica e ridurre il discomfort postoperatorio.