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Although events such as tooth extraction and oral surgery were considered for a while the sole triggering factor for Medication-Related Osteonecrosis of the Jaw (MRONJ), it is still unclear if trigger events may be precipitating factors that accelerate the onset of the disease that would have possibly occurred anyway. Therefore, this research aimed to retrospectively analyze MRONJ cases diagnosed in our tertiary referral hospital during the last 14 years, focusing on the onset of the disease, potential trigger events, and countermeasures to update the knowledge on their pathogenesis. An audit of patients diagnosed with MRONJ attending our department from 2008 to 2021was performed. χ2 test and Fisher exact test were employed to assess the relationship between the medications used and trigger events; χ2 test was also used to assess any relationship between MRONJ localization and drug, drug class, trigger, or trigger type. Seventy-six patients' records were identified. Fifty-two records were selected for analysis. Trigger events for the onset of the disease were found in 35 cases (67.3%). χ2 test showed a correlation between the drug used and trigger event occurrence (P=0.045) confirmed by Fisher exact test (P=0.34). Visual histogram analysis showed positive correlation when Alendronate (12 cases, 85.7%), Zoledronate (12 cases, 75%), and Risedronate (2 cases, 100%) were administered. Subgroup analysis per underlying disease, showed a significant correlation between the drug used and trigger event occurrence in the osteoporosis group (χ2 test, P=0.021; Fisher exact test, P=0.009).

The aim of this study is to evaluate by means of the kinesiographic test, how the muscular alteration, linked with mouth breathing, modifies mandibular dynamics. From a sample of children aged.between 8-11 years, on the basis of increased nasal airways resistance measured with the forced oscillation technique, we selected a group of 14 subjects. These children underwent kinesiographic examination (K-System Biotronic) and they were compared to a control group. Certainly, the speeds reduction in the pathological group emerged as the most significant data. The mastication tracings on the frontal plane, in the group with increased nasal airways resistance, moreover appeared to be reduced in width, elongated in shape and sometimes irregularly square, compared to the bell shape typical of subjects without any dysfunctional pathologies. Considering that each subject responds in a personal manner to an increase of tbe nasélJ resistances, due to the extremely variable individual adaptability, the kinesiographic test, together with the electrorniographic one, in our opinion, can assist anarnnesis, clínica! examination and other instrumental investigations, in the identification of those subjects in which the increase of the nasal airways resistance interferes with muscular function, laying the basis for possible modifications in the craniofacial growth.

Objective: The aim of this research is to describe and to analyse the long-term results and the clinical steps of direct fragment reattachment technique with no additional tooth preparation, used to treat crown fracture. This technique achieves the clinical success, combining satisfactory aesthetic and functional results with a minimally invasive approach. Methods: The 3 years follow-up included 9 patients (5 males, 4 females) with coronal fracture. In all the cases the fragment was available and intact. The authors illustrate the adhesive procedure used. Under local anaesthesia and after positioning the rubber dam, both the tooth and the fragment surface were etched, rinsed and applied by the adhesive system in order to obtain the retention of the fractured part to the tooth without additional tooth preparation or resin cement. Results: The statistical analysis shows the good performances of direct fragment reattachment technique. After 36 months, in 22.2% of the cases, the detachment was observed of the bonded fragment and in 11.1% of patients, complications were recorded. Conclusion: Our clinical experience shows how the ultra-conservative procedure used is fast, easy and offers a long term predictability; it also allows good functional and aesthetic outcomes.

BACKGROUND: The purpose of the present study was to evaluate fresh socket implant outcome leaving granulomatous tissue into the bone defects. MATERIALS AND METHODS: Subjects requiring tooth extractions in periodontal infected sites were selected for this prospective study. Only patients with 4-wall defects and asymptomatic ones were included. The fresh sockets were randomly scheduled into two groups: In one group (Removal Group, RG) granulomatous tissue was removed and, in the other group (Left Group, LG) granulomatous tissue was left. Implants were positioned immediately after tooth extraction, and were loaded after 3 months in both groups. Intraoral digital radiographs were performed at temporary prosthesis placement; at 12, 24 and 36 months to evaluate marginal bone levels changes. Moreover, clinical parameters were acquired at the same time points. RESULTS: Sixty patients were included in this study. Three-hundred seventy-two implants were placed immediately after tooth extraction and, at 3-year follow-up, a survival rate of 98.66% was reported, 2 implants were lost in RG and 3 implants in LG. At 36-month follow-up, not statistically significant differences were found between RG and LG in marginal bone level changes and clinical parameters (p > 005). Moreover, not statistically significant differences were found in intragroup comparisons over time (p > 0.05). CONCLUSIONS: With the limits of this study it was concluded that granulomatous tissue left in infected fresh sockets doesn't injury dental implant outcome.

BACKGROUND: The purpose of the present study was to evaluate if the presence of granulation tissue in asymptomatic apical periodontitis compromised immediate implant placement. METHODS: Patients requiring extraction of one tooth (maxillary and mandibular incisive, canine or premolar) with asymptomatic apical periodontitis, were recruited for this prospective study. They were randomly scheduled into two groups: in first group (A) including 30 teeth, reactive soft tissue was debrided before implant placement, and in second group (B) including 30 teeth, reactive soft tissue was left in the apical lesion. Implants were positioned immediately after tooth extraction, and were loaded after 3 months in both groups. Cone beam computed tomography was performed before tooth extraction and at 1-year follow-up to evaluate the radiolucency around the root apex and the implant, bucco-lingual bone levels were also checked. RESULTS: Sixty patients were included in this study. Sixty implants were placed immediately after tooth extraction and, at 1-year follow-up, a survival rate of 100% was reported. After one year both groups showed absence of radiolucent zone at the apical region of implants. All fresh sockets presented a buccal-palatal bone reduction in both groups after one year, even if not statistically significant differences were found between baseline bone levels and within groups. CONCLUSIONS: Within the limitations of the present study, the immediate placement of implants into the extraction sockets with asymptomatic apical periodontitis, in presence of primary stability, did not lead to an increased rate of complications and rendered an equally favorable type of tissue integration.

This paper takes up the ecobalance topic giving prominence to a calculation procedure of necessary energy consumptions for the production of a product in the different phases of a whole life cycle. Are used to identify all stages of the life cycle are determined and simplified formulas for the calculation of specific energy consumption. Is also examined a case where the components of the final product are up to 8. The model is valid for any type of product and through operations research (ie, placing constraints on the variables) you could get to optimal solutions minimizing the objective function.

Purpose: To investigate the effect of intravitreal ranibizumab on extrafoveal choroidal neovascularization secondary to age-related macular degeneration. Methods: Eighteen eyes affected by extrafoveal choroidal neovascularization secondary to age-related macular degeneration were prospectively enrolled in this study. After an initial intravitreal ranibizumab, all patients were reevaluated monthly over 12 months of follow-up. Further retreatments were performed on a pro re nata basis, depending on detection of any type of fluid on optical coherence tomography and/or the presence of leakage on fluorescein angiography. Primary outcome measures were mean changes in best-corrected visual acuity and the proportion of eyes gaining at least 15 letters (3 Early Treatment Diabetic Retinopathy Study [ETDRS] lines) at the end of the follow-up. Secondary outcome measures were central macular thickness variations and changes in choroidal neovascularization size. Results: Mean best-corrected visual acuity presented a significant improvement during the follow-up period, being 0.3 +/- 0.2 logMAR at baseline and 0.2 +/- 0.2 logMAR at the 12-month examination (P < 0.001). An improvement of at least 3 EDTRS lines was achieved by 6 eyes (33.3%), whereas 6 patients (33.3%) gained 1 to 2 lines. The mean central macular thickness at baseline was 314 +/- 87 mu m, changing to 268 +/- 65 mu m at the 12-month examination (P = 0.003). The mean lesion size was 1.4 +/- 1.4 mm(2) and remained stable throughout the follow-up, being 1.8 +/- 2.9 mm(2) at 12 months (P = 0.64). Conclusion: Intravitreal ranibizumab administered after a pro re nata regimen with monthly evaluation is a beneficial approach for the management of extrafoveal choroidal neovascularization secondary to age-related macular degeneration over 12 months of follow-up. Further studies are warranted to confirm our preliminary results.

Pseudoaneurysm of the internal maxillary artery due to a traumatic event is a rare condition. Pseudoaneurysms are usually directly produced by arteries break with extravasation of blood. The compressed perivascular tissue forms the wall of aneurysmal sac. Then, this sac gradually expands and can be damaged. It is rare to see pseudoaneurysms of IMA. They are usually associated with fracture of the neck of the mandible. To the best of our knowledge the pseudoaneurysm of the internal maxillary artery related to maxillofacial trauma is an event extremely rare in the literature and if not quickly managed can lead to the patient’s death. This case underlines how the close cooperation between surgeons and radiologists results in a quick diagnosis and management of such pathological events.

In un momento storico da molti denominato di “rinascimento nucleare”, caratterizzato da un ritorno di interesse a livello internazionale verso l’energia nucleare, il volume si propone di fare il punto su questa importante fonte energetica, in maniera chiara e concisa ma documentata. Attorno all’energia nucleare sono stati costruiti molti falsi miti e create paure ingiustificate, che il libro cerca di discutere con spirito critico. Dopo una breve storia dell’energia nucleare, del disastro di Chernobyl e delle sue conseguenze, il libro presenta lo scenario energetico mondiale e il ruolo che il nucleare potrà rivestire nel futuro, anche in relazione alla riduzione delle emissioni di gas climalteranti; è quindi illustrata la recente svolta italiana in materia di energia nucleare. La seconda parte del libro, più tecnica, anche se comunque caratterizzata da un linguaggio semplice e divulgativo, spiega i principi fisici che sono alla base della reazione nucleare di fissione, tratta il problema dei combustibili nucleari, descrive il principio di funzionamento dei reattori e presenta le innovazioni tecnologiche più recenti, quali i reattori di ultima generazione e le modalità di smaltimento delle scorie radioattive. Un vero ambientalista, anche in vista dell’esaurimento dei combustibili fossili, deve considerare tutte le fonti a disposizione per la difesa dello sviluppo, nel rispetto dell’ambiente. In questo senso, il libro auspica un’alleanza tra “ambientalisti” e “nuclearisti”, per esaminare insieme programmi alternativi per la salvezza del pianeta.

The paper focuses on the key drivers of World’s energy demand and on the current energy market (oil, gas, coal, nuclear and renewables). In the first part, the paper analyses the key factors of the present and future energy market, with particular regard to economy, population, fuel prices and CO2 pricing. World GDP (Gross Domestic Product) and population drive the energy profile. The global economy entered a downturn since 2007, therefore primary energy consumption decreased of 1,1% in 2009. World population will reach 9 billion of person by 2040. Despite the economy recover is uneven, global energy demand will be 30 percent higher in 2040 than 2010, driven by non–OECD countries. Energy prices (especially, oil and gas) and CO2 pricing (e.g. EU ETS, Carbon Tax, cape-and-trade schemes) affect fuel consumption and the investments in energy sector. In the second part, the current energy situation is presented (estimated resources, production and consumption). At the moment, fossil fuels are still the dominant source of energy (81% of world primary supply in 2009). The role of nuclear in the power generation is affected by Fukushima accident in March 2011. All presented data are taken from the most important energy reports, such as the ones issued by IEA (World Energy Outlook 2011), EIA (International Energy Outlook 2011), REN21 (Renewables Global Status Report 2011), Exxon Mobile (The Outlook for Energy, 2012); historical energy data are based on BP Statistical Review of World Energy 2012.

Objective: Purpose of this study is to point out the effectiveness of a bleaching technique consisting of hydrogen peroxide 38% applied with and without photo-activation with a LED lamp. Study design: Nine groups, each consisting of two adjacent teeth extracted from the same patient for periodontal disease, have been involved in the study. Similar features in color characterized all teeth considered. The first tooth of each couple was treated by the use of the LED lamp (KromaOgna WS25 T) and the second one without photoactivation. The bleaching agent consist of a gel made of hydrogen peroxide 38%, oxalic acid and ortho-phosphoric acid and a gel activator composed of strontium chloride and calcium hydroxide. Results: The analysis of colorimetric values underlines how bleached teeth treated with photo activation showed a 67% of positive changes in color while the remaining 33% did not go through any variation. Conclusion: The data of the study clearly evidence that the use of the LED lamp for the whitening procedure increases the effectiveness of the bleaching material if compared to the technique with no photo-activation.

The aim of this study was to evaluate the role of TLR4 and NOD2/CARD15 genes in gastric carcinogenesis.We investigated the allelic frequencies of TLR4 (D299G and T399I) and NOD2/CARD15 (R702W, G908R, and L1007finsC) SNPs in 87 asymptomatic serologically H. pylori-positive individuals (Group I), in 63 patients with antrum-predominant gastritis (Group II) and in 60 patients with corpus-predominant gastritis or pangastritis (Group III).There was significant difference in allelic frequencies of TLR4 D299G SNP in Group II (p=0.02; OR 2.97) as well as in Group III (p=0.001; OR 4.80). Significant difference of T399I SNP allele frequency was only found in Group III (p=0.009; OR 3.73). The allele frequencies of NOD2/CARD15 G908R and of L1007insC SNP were higher in Group III (p=0.003, OR 5.18; p=0.03; OR 3.66, respectively).TLR4 and NOD2/CARD15 genes are associated with high risk Group III patients and, therefore, they appear to play a role in gastric carcinogenesis.