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This study investigates the growth and calcification of the appendicular skeleton in Raja asterias (Delaroche, 1809), a member of the Batoidea, to explore the relationship between histomorphology and the mechanics of batoid locomotion within the water column. Although much prior research has focused on the "tessellated pattern" in these fishes, the variable structure of the appendicular skeleton provides fresh insights into the understudied interplay between skeletal histomorphology and the mechanical functions of Batoidea fins. The shape and initial growth of fin cartilage are influenced by the orientation of chondrocyte mitoses prior to mineral deposition, with subsequent calcification playing a pivotal role in shaping skeletal architecture. This study documents two distinct growth patterns: "crustal" and "catenated." The crustal pattern is predominantly observed in larger skeletal elements, such as the central body structures (skull, rostrum, and jaws), girdles, pterygia, and compound radials, whereas fin radials follow the catenated growth pattern. Notably, early-stage chondrichthyan cartilage shares similarities with mammalian metaphyseal growth plate cartilage, though in chondrichthyans, the calcified matrix is not resorbed or replaced by bone. Additionally, a previously unrecognized calcification pattern is identified in the pelvic-fin radials of R. asterias, indicating that the mechanical demands of locomotion in the water column may have driven the evolution of variable fin flexibility in Batoidea. This flexibility is achieved through joint mobility (diarthroses and amphiarthroses), specialized fin structures, and the distinct calcification patterns of the pectoral and pelvic fins., (© 2025 The Author(s). Journal of Fish Biology published by John Wiley & Sons Ltd on behalf of Fisheries Society of the British Isles.)

Objectives: The aim of this study was to systematically revise the state of art of the accuracy of digital and conventional impressions in clinical full-arch scenarios. Methods: Electronic and manual searches were conducted up to December 2024. Only trials comparing the accuracy of digital versus conventional impressions were selected by two independent reviewers. Accuracy was evaluated by analysing the fit of the prostheses obtained through conventional workflows and those obtained from digital workflows using intraoral scanners. Alternatively, accuracy was assessed by comparing the standard tessellation language data acquired from intraoral scanning with those obtained from scanning the physical model. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Meta-analysis was conducted to pool the mean differences from the included studies, with heterogeneity tested by Cochran's Q test and quantified by the I 2 index. Results: We included 9 relevant studies from a total of 2535 identified studies. The risk of bias was evaluated as low, and the main results of all the included articles reported similar accuracy between digital and conventional impressions. Random effects meta-analysis resulted in a pooled mean difference of 152.46 (95% C.I. = 76.46-228.46, p -value < 0.001, I 2 = 93.48%). Conclusions: In conclusion, the results of the present systematic review reveal contradictory findings regarding the accuracy of digital impressions. However, most studies analysing the clinical performance of prostheses obtained through digital impressions suggest that their accuracy falls within clinically acceptable thresholds. Future research should report comparable outcomes and focus attention on linear deviations, comparing differences between conventional and digital impressions not in absolute terms, but relative to the distance measured.

Background: Artificial Intelligence (AI) in dental diagnostics is evolving, offering innovative approaches for conducting cephalometric analysis with less manual input and overcoming the limitations of traditional imaging methods. To enhance the diagnostic processes in dentistry, an open-source software that utilises AI to improve the extraction of cephalometric values from limited field of view (FOV) images was created., Material and Methods: Reduced FOV images lack several vital cephalometric landmarks, prompting the creation of predictive models to estimate missing values. The GridSearchCV algorithm and other algorithms were used to construct predictive models using software and to select the best models. The software was validated by comparing the predicted values with the actual measurements and calculating the mean squared error using Excel. Further validation involved a randomly selected cohort of 25 untreated orthodontic cases., Results: Evaluation of the software showed that it was effective in accurately predicting key cephalometric measurements, suggesting that it could be a reliable tool for clinical use. However, some variations were noted in its predictive accuracy across different measurements, indicating areas that could benefit from further development. The software could align closely with the actual cephalometric measurements through detailed statistical analysis., Conclusions: The integration of AI into cephalometric analysis with the software could represent progress, potentially leading to more efficient dental diagnostics and a reduction in the need for additional X-rays. This study aimed to advance the integration and refinement of AI in healthcare, focusing on minimising bias and understanding its impact on clinical decisions. In future studies, the application of AI in dental practice should be expanded to address these challenges., Clinical Significance Statement: This software integrates AI into clinical practice to enhance the diagnostic and therapeutic phases for patient benefit. It enables precise and comprehensive cephalometric analyses using data previously considered insufficient, thereby reducing the need for X-rays and improving patient care., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Cell therapy has emerged as a revolutionary tool to repair damaged tissues by restoration of an adequate vasculature. Dental Pulp stem cells (DPSC), due to their easy biological access, ex vivo properties, and ability to support angiogenesis have been largely explored in regenerative medicine., Methods: Here, we tested the capability of Dental Pulp Stem Cell-Conditioned medium (DPSC-CM), produced in normoxic (DPSC-CM Normox) or hypoxic (DPSC-CM Hypox) conditions, to support angiogenesis via their soluble factors. CMs were characterized by a secretome protein array, then used for in vivo and in vitro experiments. In in vivo experiments, DPSC-CMs were associated to an Ultimatrix sponge and injected in nude mice. After excision, Ultimatrix were assayed by immunohistochemistry, electron microscopy and flow cytometry, to evaluate the presence of endothelial, stromal, and immune cells. For in vitro procedures, DPSC-CMs were used on human umbilical-vein endothelial cells (HUVECs), to test their effects on cell adhesion, migration, tube formation, and on their capability to recruit human CD14 + monocytes., Results: We found that DPSC-CM Hypox exert stronger pro-angiogenic activities, compared with DPSC-CM Normox, by increasing the frequency of CD31 + endothelial cells, the number of vessels and hemoglobin content in the Ultimatrix sponges. We observed that Utimatrix sponges associated with DPSC-CM Hypox or DPSC-CM Normox shared similar capability to recruit CD45 - stromal cells, CD45 + leukocytes, F4/80 + macrophages, CD80 + M1-macrophages and CD206 + M2-macropages. We also observed that DPSC-CM Hypox and DPSC-CM Normox have similar capabilities to support HUVEC adhesion, migration, induction of a pro-angiogenic gene signature and the generation of capillary-like structures, together with the ability to recruit human CD14 + monocytes., Conclusions: Our results provide evidence that DPSCs-CM, produced under hypoxic conditions, can be proposed as a tool able to support angiogenesis via macrophage polarization, suggesting its use to overcome the issues and restrictions associated with the use of staminal cells., (© 2024. The Author(s).)

The science of dental tissue grafting is evolving, with an increased understanding of factors influencing graft behavior. Despite the widespread clinical use of soft tissue grafts, the histological characteristics of different gingival harvesting sites are still underexplored. This study aimed to fill this gap by analyzing 50 tissue samples harvested from 25 patients across three sites: the hard palate, maxillary tuberosity, and palatal rugae. Each sample underwent thorough histological and histomorphometric analysis. Conventional statistical analysis was performed using SPSS, while predictive modeling was conducted with RapidMiner Studio. The study identified significant histological differences among the graft sites, with notable variations in total graft height, epithelial height, and interdigitation perimeter. These findings underscore the importance of donor site selection in influencing graft success. Pair plots and principal component analysis (PCA) further highlighted the distinct histological features of each tissue type. The random forest classifier identified total graft height, epithelial height, and perimeter as the most influential factors in predicting graft site behavior. This study offers valuable insights into the histological characteristics of soft tissue grafts, potentially leading to more predictable clinical outcomes.

Before calcification begins, the early embryonic and fetal skeletal development of both mammalian Homo sapiens and the chondrichthyan fish Raja asterias consists exclusively of cartilage. This cartilage is formed and shaped through processes involving tissue segmentation and the frequency, distribution, and orientation of chondrocyte mitoses. In the subsequent developmental phase, mineral deposition in the cartilage matrix conditions the development further. The stiffness and structural layout of the mineralized cartilage have a significant impact on the shape of the anlagen (early formative structure of a tissue, a scaffold on which the new bone is formed) and the mechanical properties of the skeletal segments. The fundamental difference between the two studied species lies in how calcified cartilage serves as a scaffold for osteoblasts to deposit bone matrix, which is then remodeled. In contrast, chondrichthyans retain the calcified cartilage as the definitive skeletal structure. This study documents the distinct mineral deposition pattern in the cartilage of the chondrichthyan R. asterias , in which calcification progresses with the formation of focal calcification nuclei or "tesserae". These are arranged on the flat surface of the endo-skeleton (crustal pattern) or aligned in columns (catenated pattern) in the radials of the appendicular skeleton. This anatomical structure is well adapted to meet the mechanical requirements of locomotion in the water column. Conversely, in terrestrial mammals, endochondral ossification (associated with the remodeling of the calcified matrix) provides limb bones with the necessary stiffness to withstand the strong bending and twisting stresses of terrestrial locomotion. In this study, radiographs of marine mammals (reproduced from previously published studies) document how the endochondral ossification in dolphin flippers adapts to the mechanical demands of aquatic locomotion. This adaptation includes the reduction in the length of the stylopodium and zeugopodium and an increase in the number of elements in the autopodium's central rays.

This study presents a scanning electron microscopy analysis of a failed PEEK retainer in an orthodontic patient. After 15 months of use, the patient reported a gap opening between teeth 41 and 42. The PEEK retainer was removed and sent for electron microscope analysis. To investigate the failure, scanning electron microscopy was employed to assess the microstructure and composition of the retainer at various magnifications. These findings suggest that the failure of the PEEK retainer was multifaceted, implicating factors such as material defects, manufacturing flaws, inadequate design, environmental factors, and patient-related factors. In conclusion, this scanning electron microscopy analysis offers valuable insights into the failure mechanisms of PEEK retainers in orthodontic applications. Further research is necessary to explore preventive strategies and optimize the design and fabrication of PEEK retainers, minimizing the occurrence of failures in orthodontic practice.

Scanning electron microscopy (SEM) is a precious tool in materials science and morphology sciences, enabling detailed examination of materials at the nanoscale. However, precise and accurate sample repositioning during different observation sessions remains a significant challenge, impacting the quality and repeatability of SEM analyses. This study aimed to develop and evaluate a LEGO®-based sample positioning system for SEM analysis. The system was designed to consistently identify and align features across multiple repositioning cycles, maintain accurate positioning along the z-axis, minimize distortion, and provide repeatable and reliable results. The results indicated a high degree of precision and accuracy in the repositioning process, as evidenced by the minimal displacements, deviations in scaling and shearing, and the highly significant results (p < 0.001) obtained from the analysis of absolute translations and rotations. Moreover, the analyses were consistently replicated across six repetitions, underscoring the reliability of the observed results. While the findings suggest that the LEGO-based sample positioning system is promising for enhancing SEM analyses' quality and repeatability, further studies are needed to optimize the system's design and evaluate its performance in different SEM applications. Ultimately, this study contributes to the ongoing efforts to develop cost-effective, customizable, and accurate solutions for sample positioning in SEM, contributing to the advancement of materials science research and all SEM analysis requiring overtime observations of the same sample. RESEARCH HIGHLIGHTS: This study focused on the development and evaluation of a novel LEGO-based sample positioning system specifically designed for SEM analysis. One of the standout features of this system is its ability to consistently identify and align features across multiple repositioning cycles, showcasing its precision and reliability. To further understand the mechanical aspects of the SEM stage, we employed the Rambold Kontroll comparator, which provided a baseline understanding of its mechanical tolerance. The registration process results were particularly noteworthy, as they revealed high accuracy with minimal displacements. Furthermore, the consistent outcomes observed across multiple repetitions emphasize the reliability and robustness of the methods we employed in this research., (© 2023 The Authors. Microscopy Research and Technique published by Wiley Periodicals LLC.)

This study assessed the masticatory function of participants wearing clear aligners in order to determine whether these devices can be worn even when eating and therefore worn to extend treatment time and boost treatment effectiveness. An intercontrol test was conducted on 20 patients who received Invisalign ® treatment. Each participant was instructed to chew two pieces of Hue-Check Gum ® chewing gum (one pink and the other blue) in 5, 10, and 20 cycles both with and without aligners. After being removed from the oral cavity, the gum was dried and pressed using a 1 × 50 × 50 mm model that was 3D printed with a transparent layer in between. After being scanned on both sides with a flatbed scanner at 600 dpi, the samples were saved as jpg files and subjected to an optoelectronic examination using ViewGum software. To validate the procedure, a control group from a different institution (University of Bern) was used. A statistical analysis of the data was carried out. The Shapiro-Wilk test was used to confirm the normality of the samples. A one-way ANOVA test, a homogeneity of variance test, and a t-test did not reveal statistically significant differences between the two control groups, thus validating the methodology employed. In summary, clear aligners do not radically change the masticatory function while they are worn. As a result, clinicians can exploit the aligners for chewing to obtain a better fit of the plastic material to the dental surface and to attachments. Treatment times for patients could also be shorter.

This study compares the skeletal calcification pattern of batoid Raja asterias with the endochondral ossification model of mammalians Homo sapiens and teleost Xiphias gladius. Skeletal mineralization serves to stiffen the mobile elements for locomotion. Histology, histochemistry, heat deproteination, scanning electron microscopy (SEM)/EDAX analysis, thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), and Fourier transform infrared spectrometry (FTIR) have been applied in the study. H. sapiens and X. gladius bone specimens showed similar profiles, R. asterias calcified cartilage diverges for higher water release and more amorphous bioapatite. In endochondral ossification, fetal calcified cartilage is progressively replaced by bone matrix, while R. asterias calcified cartilage remains un-remodeled throughout the life span. Ca 2+ and PO 4 3- concentration in extracellular matrix is suggested to reach the critical salts precipitation point through H 2 O recall from extracellular matrix into both chondroblasts or osteoblasts. Cartilage organic phase layout and incomplete mineralization allow interstitial fluids diffusion, chondrocytes survival, and growth in a calcified tissue lacking of a vascular and canalicular system. HIGHLIGHTS: Comparative physico-chemical characterization (TGA, DTG and DSC) testifies the mass loss due to water release, collagen and carbonate decomposition of the three tested matrices. R. asterias calcified cartilage water content is higher than that of H. sapiens and X. gladius, as shown by the respectively highest dehydration enthalpy values. Lower crystallinity degree of R. asterias calcified cartilage can be related to the higher amount of collagen in amorphous form than in bone matrix. These data can be discussed in terms of the mechanostat theory (Frost, 1966) or by organic/inorganic phase transformation in the course evolution from fin to limbs. Mineral analysis documented different charactersof R. asterias vs H. sapiens and X. gladius calcified matrix., (© 2023 The Authors. Microscopy Research and Technique published by Wiley Periodicals LLC.)

We investigated the interfaces of the epiphyseal plate with over- and underlying bone segments using an integrated approach of histochemistry, microtomography and scanning electron microscopy (SEM) to overcome the inherent limitations of sections-based techniques. Microtomography was able to provide an unobstructed, frontal view of large expanses of the two bone surfaces facing the growth plate, while SEM observation after removal of the soft matrix granted an equally unhindered access with a higher resolution. The two interfaces appeared widely dissimilar. On the diaphyseal side the hypertrophic chondrocytes were arranged in tall columns packed in a sort of compact palisade; the interposed extracellular matrix was actively calcifying into a thick mineralized crust growing towards the epiphysis. Behind the mineralization front, histochemical data revealed a number of surviving cartilage islets which were being slowly remodelled into bone. In contrast, the epiphyseal side of the cartilage consisted of a relatively quiescent reserve zone whose mineralization was marginal in amount and discontinuous in extension; the epiphyseal bone consisted of a loose trabecular meshwork, with ample vascular spaces opening directly into the non-mineralized cartilage. On both sides the calcification process took place through the formation of spheroidal bodies 1-2 μm wide which gradually grew by apposition and coalesced into a solid mass, in a way distinctly different from that of bone and other calcified tissues., (© 2023 The Authors. Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.)

The macroscopic and microscopic morphology of the appendicular skeleton was studied in the two species Raja asterias (order Rajiformes) and Torpedo marmorata (Order Torpediniformes), comparing the organization and structural layout of pectoral, pelvic, and tail fin systems. The shape, surface area and portance of the T. marmorata pectoral fin system (hydrodynamic lift) were conditioned by the presence of the two electric organs in the disk central part, which reduced the pectoral fin surface area, suggesting a lower efficiency of the "flapping effectors" than those of R. asterias. Otherwise, radials' rays alignment, morphology and calcification pattern showed in both species the same structural layout characterized in the fin medial zone by stiffly paired columns of calcified tiles in the perpendicular plane to the flat batoid body, then revolving and in the horizontal plane to continue as separate mono-columnar rays in the fin lateral zone with a morphology suggesting fin stiffness variance between medial/lateral zone. Pelvic fins morphology was alike in the two species, however with different calcified tiles patterns of the 1st compound radial and pterygia in respect to the fin-rays articulating perpendicularly to the latter, whose tile rows lay-out was also different from that of the pectoral fins radials. The T. marmorata tail-caudal fin showed a muscular and connective scaffold capable of a significant oscillatory forward thrust. On the contrary, the R. asterias dorsal tail fins were stiffened by a scaffold of radials-like calcified segments. Histomorphology, heat-deproteination technique and morphometry provided new data on the wing-fins structural layout which can be correlated to the mechanics of the Batoid swimming behavior and suggested a cartilage-calcification process combining interstitial cartilage growth (as that of all vertebrates anlagen) and a mineral deposition with accretion of individual centers (the tiles). The resulting layout showed scattered zones of un-mineralized matrix within the calcified mass and a less compact texture of the matrix calcified fibers suggesting a possible way of fluid diffusion throughout the mineralized tissue. These observations could explain the survival of the embedded chondrocytes in absence of a canalicular system as that of the cortical bone., (© 2023 The Authors. Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.)

This article explores the potential risks associated with using artificial intelligence (AI)-generated images in the field of microscopy. It discusses the current state-of-the-art AI-based image-generation techniques and their limitations. It investigates the potential risks associated with the illegal use of AI-generated images, including their use in creating falsified scientific data and the consequences of such misuse. The article concludes by exploring possible solutions to mitigate these risks, such as implementing robust authentication methods and developing ethical guidelines for using and disseminating AI-generated images in the field of microscopy. Additionally, the article also presents the results of a survey involving 101 professionals, showing that the recognition of authentic and entirely AI-generated images is performed well. But, the detection of hybrid images could be improved., Competing Interests: Conflict of Interest The authors declare that they have no competing interest., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Microscopy Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Among all strategies directed at developing new tools to support re-vascularization of damaged tissues, the use of pro-angiogenic soluble factors, derived from mesenchymal stem cells (MSCs), appears a promising approach for regenerative medicine. Here, we compared the feasibility of two devices, generated by coupling soluble factors of human dental pulp mesenchymal stem cells (DPSCs), with a nanostructured scaffold, to support angiogenesis once transplanted in mice. DPSCs were obtained from impacted wisdom tooth removal, usually considered surgical waste material. After 28 days, we verified the presence of active blood vessels inside the scaffold through optical and scansion electron microscopy. The mRNA expression of surface antigens related to macrophage polarization (CD68, CD80, CD86, CD163, CD206), as well as pro-angiogenic markers (CD31, CD34, CD105, Angpt1, Angpt2, CDH5) was evaluated by real-time PCR. Our results demonstrate the capability of DPSC-scaffold and DPSC soluble factors-scaffold to support angiogenesis, similarly to adipose stem cells, whereas the absence of blood vessels was found in the scaffold grafted alone. Our results provide evidence that DPSC-conditioned medium can be proposed as a cell-free preparation able to support angiogenesis, thus, providing a relevant tool to overcome the issues and restrictions associated with the use of cells.

Background: The purpose of this study was to compare the three-dimensional dental changes for the maxillary first molars and the overall skeletal effects achieved after expansion between the rapid maxillary expansion (RME) appliance attached to two different anchor units, the maxillary deciduous molars and the maxillary permanent first molars., Methods: Patients were retrospectively selected according to the anchorage unit used for RME: deciduous upper second molars (RME-E group; 10 M, 10 F; mean age 8.4 ± 1.1 years) and first upper permanent molars (RME-6 group; 10 M, 10 F; mean age 12.6 ± 1.8 years). CBCT scans were obtained before treatment start (T1) and after retention and removal of the expander (T2). Images were analyzed using a new three-dimensional intra-hemi-maxillary reference system. 3D landmarks were marked to calculate all changes on maxillary first permanent molars; mesio-distal and buccal-lingual inclination and rotation, as well as intermolar and interforaminal distances were calculated. The Wilcoxon test was used to compare within-group changes, whereas the Mann-Whitney test was used to compare between-group differences, with the significance level set at 0.05., Results: In the RME-E group, significant distorotation and lingual inclination of the first permanent molars at T2 were observed (p < 0.01); in the RME-6 group, only the buccolingual inclination of the crossbite side after RME was resulted statistically significant (p < 0.01). In both groups, intermolar and interforaminal values increased significantly (p < 0.01). Intergroup analysis showed a significantly higher distorotation and reduced buccal inclination of maxillary first permanent molars in the RME-E group after RME (p < 0.01)., Conclusions: RME is effective in treating maxillary transverse hypoplasia; RME anchored too deciduous teeth spontaneously reduces buccal inclination and increases distorotation of maxillary first permanent molars, whereas anchorage to permanent molars is associated with increased buccal inclination, albeit with little clinical significance., (© 2023. The Author(s).)

Tissue regeneration or healing both require efficient vascularization within a tissue-damaged area. Based on this concept, a remarkable number of strategies, aimed at developing new tools to support re-vascularization of damaged tissue have emerged. Among the strategies proposed, the use of pro-angiogenic soluble factors, as a cell-free tool, appears as a promising approach, able to overcome the issues concerning the direct use of cells for regenerative medicine therapy. Here, we compared the effectiveness of adipose mesenchymal stem cells (ASCs), use as cell suspension, ASC protein extract or ASC-conditioned-medium (i.e., soluble factors), combined with collagenic scaffold, in supporting in vivo angiogenesis. We also tested the capability of hypoxia in increasing the efficiency of ASC to promote angiogenesis, via soluble factors, both in vivo and in vitro. In vivo studies were performed using the Integra® Flowable Wound Matrix, and the Ultimatrix in sponge assay. Flow cytometry was used to characterize the scaffold- and sponge-infiltrating cells. Real-time PCR was used to evaluate the expression of pro-angiogenic factors by stimulating Human Umbilical-Vein Endothelial Cells with ASC-conditioned media, obtained in hypoxic and normoxic conditions. We found that, in vivo, ACS-conditioned media can support angiogenesis similar to ASCs and ASC protein extract. Also, we observed that hypoxia increases the pro-angiogenic activities of ASC-conditioned media, compared to normoxia, by generating a secretome enriched in pro-angiogenic soluble factors, with bFGF, Adiponectine, ENA78, GRO, GRO-a, and ICAM1-3, as most regulated factors. Finally, ASC-conditioned media, produced in hypoxic condition, induce the expression of pro-angiogenic molecules in HUVECs. Our results provide evidence that ASC-conditioned-medium can be proposed as a cell-free preparation able to support angiogenesis, thus providing a relevant tool to overcome the issues and restrictions associated with the use of cells., (© 2023. The Author(s).)

The aim of this study was to evaluate the masticatory function of subjects with clear aligners and to propose a simple and repeatable method for the clinical and experimental evaluation of masticatory function. For the testing we used almonds, a natural substance that can be easily found and stored, has intermediate consistency and hardness, is insoluble in saliva, and has the ability easily lose the moisture absorbed in the mouth. Thirty-four subjects using the Invisalign ® (Align Technology, Santa Clara, CA, USA) protocol were randomly selected. This was an "intercontrol test", i.e., all subjects under the same conditions acted as controls but also as cases whilst wearing the clear aligners. Patients were asked to chew an almond for 20 s, once with aligners and once without aligners. The material was then dried, sieved, and weighted. Statistical analysis was performed to investigate any significative differences. In all our subjects, the efficiency of chewing with clear aligners was found to be comparable to the efficiency of chewing without clear aligners. In detail, the average weight after drying was 0.62 g without aligners and 0.69 g with aligners, while after sieving at 1 mm, the average weight was 0.08 g without aligners and 0.06 g with aligners. The average variation after drying was of 12%, and after sieving at 1 mm, it was 25%. In summary, there was no substantial difference between chewing with or without clear aligners. Despite some discomfort in chewing, the clear aligners were well tolerated by most subjects, who wore them without difficulty even during meals.

In the synovial joints the transition between the soft articular cartilage and the subchondral bone is mediated by a layer of calcified cartilage of structural and mechanical characteristics closer to those of bone. This layer, buried in the depth of articular cartilage, is not directly accessible and is mostly visualized in histological sections of decalcified tissue, where it appears as a darker strip in contact with the subchondral bone. In this study conventional histology and scanning electron microscopy (SEM) with secondary electron imaging (SE) or backscattered electron imaging (BSE) were used to discriminate the calcified and the uncalcified cartilage in high resolution on native, untreated tissue as well as in deproteinated or demineralized tissue. This approach evidenced a high heterogeneity of the calcified layer of articular cartilage. High resolution pictures revealed that the mineralization process originates by progressive accretion and confluence of individual, small mineral clusters, in a very different way from other hard tissues such as bone, dentin and mineralized tendons. Finally, selective removal of the soft matrix by thermal treatment allowed for the first time a face-on, unrestricted 3D view of the mineralization front., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

This preliminary retrospective study evaluates how effective the OrthoPulse ® (Biolux Technology, Austria) is in increasing the predictability of orthodontic treatment in patients treated with Invisalign ® clear aligners (Align Technology Inc., Tempe, AZ, USA). A group of 376 patients were treated with Invisalign ® orthodontic clear aligners in association with an OrthoPulse ® . The OrthoPulse ® was prescribed for 10 min a day for the entire duration of the orthodontic treatment. The OrthoPulse ® App remotely tracked the percentage compliance of each patient. The number of aligners planned with the ClinCheck software at the beginning of the treatment and the number of total aligners (including the adjunctive aligners) used to finish the treatment were then considered. After applying inclusion/exclusion criteria, a total of 40 patients remained in the study and were compared with a control group of 40 patients with the same characteristics as the study group. A statistical analysis was carried out to investigate whether using OrthoPulse ® led to a statistical reduction in the number of adjunctive aligners, thus leading to a more accurate prediction of the treatment. The statistical analysis showed that patients who used OrthoPulse ® needed fewer finishing aligners and a greater predictability of the treatment was obtained. In fact, in the treated group the average number of additional aligners represented 66.5% of the initial aligners, whereas in the control group 103.4% of the initially planned aligners were needed. In conclusion, in patients treated with clear aligners, OrthoPulse ® would appear to increase the predictability of orthodontic treatment with clear aligners, thus reducing the number of finishing phase requirements.

The relationship between cartilage growth - mineralization patterns were studied in adult Rajidae with X-ray morphology/morphometry, undecalcified resin-embedded, heat-deproteinated histology and scanning electron microscopy. Morphometry of the wing-fins, nine central rays of the youngest and oldest specimens documented a significant decrement of radials mean length between inner, middle and outer zones, but without a regular progression along the ray. This suggests that single radial length growth is regulated in such a way to align inter-radial joints parallel to the wing metapterygia curvature. Trans-illumination and heat-deproteination techniques showed polygonal and cylindrical morphotypes of tesserae, whose aligned pattern ranged from mono-columnar, bi-columnar, and multi-columnar up to the crustal-like layout. Histology of tessellated cartilage allowed to identify of zones of the incoming mineral deposition characterized by enhanced duplication rate of chondrocytes with the formation of isogenic groups, whose morphology and topography suggested a relationship with the impending formation of the radials calcified column. The morphotype and layout of radial tesserae were related to mechanical demands (stiffening) and the size/mass of the radial cartilage body. The cartilage calcification pattern of the batoids model shares several morphological features with tetrapods' endochondral ossification, that is, (chondrocytes' high duplication rate, alignment in rows, increased volume of chondrocyte lacunae), but without the typical geometry of the metaphyseal growth plates. RESEARCH HIGHLIGHTS: 1. The wing-fins system consists of stiff radials, mobile inter-radial joints and a flat inter-radial membrane adapted to the mechanical demand of wing wave movement. 2. Growth occurs by forming a mixed calcified-uncalcified cartilage texture, developing intrinsic tensional stresses documented by morphoanatomical data., (© 2022 The Authors. Microscopy Research and Technique published by Wiley Periodicals LLC.)

The skeleton of the batoid fish consists of a mixture of calcified and uncalcified cartilage with a typical layout of mineral deposition toward the outer border, leaving an uncalcified central core in most of the skeleton segments. An exception is observed in the radials, where mineral deposition is central. Joints and endoskeleton segments were studied in two adult samples of Raja cf. polystigma. Histomorphology, mineral deposition pattern, and zonal chondrocyte duplication activity were compared among several endoskeleton segments, but with particular attention to the fin rays; in the first, the uncalcified cartilage is central with an outer layer ranging from mineralized tesserae to a continuous calcified coating, whereas in the second, the uncalcified cartilage surrounds one or more central calcified columns. The diarthroses have a joint cavity closed by a fibrous capsule and the sliding surfaces rest on the base of mineralized tesserae, whereas the interradial amphiarthroses show a layer of densely packed chondrocytes between the flat, calcified discs forming the base of neighboring radials. In the endoskeleton segments, three types of tesserae are distinguished, characterizing the phases of skeletal growth and mineralization which present differences in each endoskeleton segment. The chondrocyte density between central core, subtesseral layer, and radial external cartilage did not show significant differences, while there was a significant difference in chondrocyte density between the latter zones and the type c tesserae of the pelvic girdle. The histomorphology and morphometry observed in Raja cf. polystigma suggest a model of cartilage growth associated with structural stiffening without remodeling. A key point of this model is suggested to be the incomplete mineralization of the tesseral layer and the continuous growth of cartilage, both enabling fluid diffusion through the matrix fibril network of scattered, uncalcified cartilage zones inside and between the tesserae., (© 2022 Anatomical Society.)

Purpose: The aim of the present study was to investigate the influence of different facial components (face length, lip volume, nose size, and cheekbone contour) on the perception of facial attractiveness of patients with Angle class III malocclusion in different categories of responders (orthodontists, laypersons, patients) with two-dimensional (2D) and three-dimensional (3D) simulations., Methods: An ideal standard 3D face was manipulated to create a class III facial malocclusion. Four facial components were modified (face length, lip volume, nose size and cheekbone contour) and the resulting simulations were used to obtain 2D figures and 3D videos, which were evaluated in a survey by orthodontists, patients, and laypersons., Results: No significant differences were detected between the 2D figures and 3D video simulations. Good correspondence was shown between the three categories of responders for the most and the least attractive faces. Smaller lips and bigger nose, regardless to the vertical dimension (short or long face), were found to be the least attractive features with agreement of all respondents., Conclusion: Regarding class III facial attractiveness perception, the sum of all facial features and not the alteration of a single component alone seems to play a key role in the perception of facial attractiveness. The 2D or 3D perspective did not play a significant role in perception and the analyzed categories of responders did not show significant differences when perceiving facial attractiveness of the utilized simulations., (© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

The free surface of the articular cartilage must withstand compressive and shearing forces, maintain a low friction coefficient and allow oxygen and metabolites to reach the underlying matrix. In many ways it is critical to the physiology of the whole tissue and its disruption always involves deep pathological alterations and loss of the joint integrity. Being very difficult to image with section-based conventional techniques, it was often described by previous research in conflicting terms or entirely overlooked. High-magnification face-on observations with high resolution scanning electron microscopy and with scanning probe microscopy revealed a very thin, delicate superficial layer rich in glycoconjugates, which may explain the very low friction coefficient of the tissue but which was very easily altered and/or dissolved in the preparation. Beneath this superficial sheet lies a thicker coat of thin, highly uniform, slightly wavy collagen fibrils lying parallel to the surface and mutually interconnected by a huge number of interfibrillar glycosaminoglycan bridges. These bridges and the collagen fibrils form an extended reticular structure able to redistribute tensile and compressive stress across a larger area of the surface and hence a greater volume of tissue., (© 2020 Wiley Periodicals LLC.)

(1) Background: To investigate condylar position in subjects with functional posterior crossbite comparing findings before and after rapid maxillary expansion (RME) treatment through 3D analysis; (2) Methods: Thirty-two Caucasian patients (14 males, mean age 8 y 8 m ± 1 y 2 m; 18 females mean age 8 y 2 m ± 1 y 4 m) with functional posterior crossbite (FPXB) diagnosis underwent rapid palatal expansion with a Haas appliance banded on second deciduous upper molars. Patients' underwent CBCT scans before rapid palatal expansion (T0) and after 12 months (T1). The images were processed through 3D slicer software; (3) Results: The condylar position changes between T1 and T0 among the crossbite and non-crossbite sides were not statistically significant, except for the transversal axis. At T1, the condyles moved forward (y axis) and laterally (x axis), they also moved downward (z axis) but not significantly; (4) Conclusions: Condilar position in growing patients with functional posterior crossbite did not change significantly after rapid maxillary expansion.

Direct Laser Metal Sintering (DLMS) is an additive manufacturing (AM) technique that is capable of manufacturing metal parts according to a three-dimensional (3D) design made using computer-assisted-design (CAD) software, thanks to a powerful laser beam that melts selectively micro-powder layers, one on top of the other, until the desired object is generated. With DMLS, it is now possible to fabricate custom-made titanium implants for oral and maxillofacial applications. We present the case of a 67-year-old woman diagnosed with a squamous cell carcinoma of the mandible. The patient underwent subtotal mandibular resection; conventional reconstruction procedures failed to rehabilitate the function of the mandible. A prosthesis replacing the resected mandible was designed and fabricated using a digital workflow. The extensive bone defect was rehabilitated with a prosthesis replacing the mandibular bone and supporting a morse-taper dental prosthesis. The masticatory function was reestablished.

Introduction: Growth retardation was frequently observed in obstructive sleep apnea (OSA) patients but the complex mechanisms causing this condition are still unclear. Several findings suggested growth catch-up after surgical treatment but other studies did not confirm the results, showing no improvement in OSA patients after tonsillectomy and adenoidectomy (T&A). The aim of the present study was to systematically review scientific literature of the relationships between OSA and metabolic changes involving growth hormone (GH) axis before and after treatment in patients., Evidence Acquisition: Different databases were searched without limitations up to August 2017. Additionally, the bibliographies of the finally selected articles were hand searched to identify any relevant publications that were not previously identified., Evidence Synthesis: From the 37 studies collected from all the databases based on their title and abstract, only 12 studies actually fulfilled the selection criteria. From the twelve finally selected articles, eight focused on growth mediators, two evaluated endothelial mediators, one focused on neurocognitive function and mediators and one focused on local inflammation., Conclusions: OSA children present lower levels of growth mediators (IGF-I and IGFBP-3) thus indicating growth retardation, significantly higher cardiovascular disease risk and decreased cognitive functions when compared to controls. T&A seems to improve all the above mentioned functions with great impact on general health.

Introduction: Rapid maxillary expansion (RME) might cause buccal displacement of anchor teeth. Dislocation of teeth outside their alveolar process can damage the periodontium; for this reason, maxillary expansion using deciduous teeth as anchorage in the mixed dentition might be suggested. The aim of this study was to compare changes of buccal bone plate thickness on the maxillary permanent first molars after RME in the mixed and permanent dentitions with different types of anchorage., Methods: Two groups of patients were evaluated with cone-beam computed tomography before and after RME. Group E (21 patients) underwent RME using deciduous teeth as anchorage; group 6 (16 patients) underwent RME using permanent teeth as anchorage. The Wilcoxon test was used to compare changes between the time points in the same groups, and the Mann-Whitney U test was used to compare differences between the groups., Results: In group E, generally, no statistically significant reduction was found in buccal bone plate thickness between the time points. In group 6, most measurements showed significant reductions in buccal bone plate thickness (P <0.05) between the time points, with a maximum decrease of 1.25 mm., Conclusions: RME in the mixed dentition with the appliance anchored to deciduous teeth did not reduce the buccal bone plate thickness of the maxillary permanent first molars, except for the mesial roots on both sides. RME in the permanent dentition caused a reduction of the buccal bone plate thickness of the maxillary permanent first molars when they were used as anchorage in the permanent dentition., (Copyright © 2018 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Background: Moebius syndrome is a rare condition characterized by bilateral facial and abducens nerve paralysis. The aim of this study is to evaluate the main orthodontic features and the frequency of associated clinical characteristics in patients with Moebius syndrome (MS)., Methods: According to Terzis classifications, 58 patients with MS aged 8 months to 46 years old underwent orthodontics and clinical examination., Results: Strabismus, upper and lower limb malformations, lip and palatal cleft were frequently associated with MS. Reduced TM movements were noted (48%). Cephalometric analysis did not allow identifying a typical facies and a characteristic cephalometric pattern; we have noticed a higher prevalence of Class II (56%) with micrognathia and excessive maxillary development probably due to the lack of lip seal. Early treatment is recommended, with a multidisciplinary approach to reduce the impact of sequelae on the lives of MS patients or their families., Conclusions: Early treatment is recommended, with a multidisciplinary approach to diminish the impact of sequelae on the lives of MS patients or their families.

Background: Personalized maxillary expansion procedure has been proposed to correct maxillary transversal deficiency; different protocols of stem cell activation have been suggested and rapid maxillary expansion (RME) is the most commonly used among clinicians. The present study aimed to quantify in three-dimensions (3D) the osteo-regeneration of the midpalatal suture in children submitted to RME., Methods: Three patients (mean age 8.3 ± 0.9 years) were enrolled in the study to preform biopsy of midpalatal suture. Two patients (subjects 1 and 2) were subjected to RME before biopsy. The third patient did not need maxillary expansion treatment and was enrolled as control (subject 3). Midpalatal suture samples were harvested 7 days after RME in subject 1, and 30 days after RME in subject 2. The samples were harvested with the clinical aim to remove bone for the supernumerary tooth extraction. When possible, maxillary suture and bone margins were both included in the sample. All the biopsies were evaluated by complementary imaging techniques, namely Synchrotron Radiation-based X-ray microtomography (microCT) and comparative light and electron microscopy., Results: In agreement with microscopy, it was detected by microCT a relevant amount of newly formed bone both 7 days and 30 days after RME, with bone growth and a progressive mineralization, even if still immature respect to the control, also 30 days after RME. Interestingly, the microCT showed that the new bone was strongly connected and cross-linked, without a preferential orientation perpendicular to the suture's long axis (previously hypothesized by histology), but with well-organized and rather isotropic 3D trabeculae., Conclusions: The microCT imaging revealed, for the first time to the authors' knowledge, the 3D bone regeneration in children submitted to RME.

Objectives: The aim of the present randomized controlled trial (RCT) was therefore the tridimensional evaluation of soft tissue changes after rapid maxillary expansion in growing patients., Setting and Sample Population: Treated group comprised 17 patients (10 males and 7 females) with a mean age of 9.8 ± 1.2 years, and control group comprised 17 patients (13 males and 4 females) with a mean age of 9.1 ± 2.1 years., Material & Methods: All patients of the treated group underwent maxillary expansion with Haas-type expander while patients of the control group underwent no treatment. 3D facial scans were acquired at T1, at the beginning of treatment or observation period, and at T2, 18 months apart. The mean interval between the timepoints was 18.2 ± 0.4 months., Results: The main differences between groups were reported in the nasal area. Nasal width (Alr-All) significantly increased in the treated group compared with the control. The increase in intereye and mouth width in the study group did not show differences with the control group. No significant differences were reported for lips' protrusion, angular measurements and facial heights between groups. The total nose volume difference was significantly higher in the treated group compared with control, and this result was related mainly to the significant increase in the nasal dorsum volume., Conclusion: Maxillary expansion produced significant increase in the nasal base and nasal volumes, but its clinical relevance is still questionable., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: The aim of the present study is to propose a 3-dimensional evaluation of lower intrusion obtained with lingual orthodontics considering not only the crowns but also dental roots., Methods: 9 adult patients underwent fixed lingual orthodontic treatment with i-TTя lingual brackets system for the correction of crowding in the lower arch associated with a deep overbite. Initial records, consisting of photos, CBCTs and intraoral scans were collected. Threshold segmentation of the CBCT was performed to generate a three-dimensional virtual model of each the teeth of the lower arch, superimposed with the crown of the same teeth obtained by intraoral scan models to generate a complete set of digital composite lower arch The same procedure was performed to monitor one key step of the i-TT Я technique consisting in lower incisors intrusion (T2). T1-T2 three-dimensional superimposition and color displacement maps were generated to measure and evaluate the movements obtained at the lower arch., Results: The root displacement of the incisors during their intrusion in the early stage was totally "bone-safe" in the 88.9% (8 of 9) of the cases observed. No significant extrusion of the premolars used as anchorage unit was measured., Conclusion: This method has proved to be an accurate and reliable approach to dynamically visualize the 3-dimensional positions of the teeth, including their roots, with no additional radiation for in-progress treatment monitoring. The 3-dimensional evaluation showed that the employed lingual appliance allowed to obtain significant lower incisors intrusion with negligible undesired extrusion of premolars employed as anchorage teeth.

Background: The aim of this study is to identify cephalometric pretreatment parameters for prediction of Class II improvement induced by rapid maxillary expansion., Methods: Lateral cephalograms of 30 patients (mean age 8.3 ± 1.6 years old) showing Class II molar relationship and undergone to rapid maxillary expansion on the upper deciduous molars were traced before treatment, and molar relation changes were evaluated on dental casts before and after treatment. Overall treatment time lasted 10.2 ± 2 months. Good responders (18 subjects, 10 females and 8 males) showed improvement of at least 2.50 mm, and bad responders (12 subjects, 7 females and 5 males) showed no improvement, improvement less than 2.50 mm, or worsening of molar relationship after treatment. Student's t test was used to assess significance of differences between groups, and discriminant analysis allowed identification of predictive pretreatment variables., Results: Articular angle, superior gonial angle, and mandibular dimensions (Co-Gn, S-Ar, Ar-Go, Go-Me) showed significant differences in the comparison between groups. Mandibular length Co-Gn and superior gonial angle were selected as significant predictive variable for discrimination., Conclusions: Patients with smaller mandibular length and more acute superior gonial angle are expected to have more chances to improve molar Class II after rapid maxillary expansion.

Background: Scientific evidence showed that rapid maxillary expansion (RME) affects naso-maxillary complex, increasing nasal width and volume. This study aimed to evaluate nasal changes induced by rapid maxillary expansion with different anchorage and appliance design by using low dose and cone beam computed tomography., Methods: A total of 44 patients (20 males, mean age 8y 8 m ± 1y 2 m; 24 females mean age 8y 2 m ± 1y 4 m) were included in the investigation and divided into three groups according to the appliance: Hyrax-type expander anchored to permanent teeth, modified Hyrax-type expander anchored to deciduous teeth, modified Haas-type expander anchored to deciduous teeth. Maxillary expansion was performed until overcorrection and the expander was passively kept in situ for 7 months at least. All patients had three-dimensional imaging before expansion (T0) and after the retention period (T1). Nasal floor width, nasal wall width, maxillary inter-molar width were measured by means of Mimics software. The paired sample t-test was employed to assess the significance of the differences between the time points; the analysis of variance test (ANOVA) was used to compare differences between groups., Results: The statistical analysis revealed significant differences between T0 and T1 for each recorded measurement in each group; no significant differences were found by comparing groups., Conclusions: Rapid maxillary expansion produces a significant skeletal transverse expansion of nasal region in growing patients. No significant differences in nasal effects are expected when the appliance is anchored onto deciduous teeth, with or without the palatal acrylic coverage.

The present case report aimed to investigate immediate histologic changes in midpalatal suture in humans following rapid maxillary expansion compared to control. Three patients (mean age 8.3 +/- 0.9 years) were enrolled in the case report and underwent midpalatal suture biopsy. Two patients underwent treatment before biopsy. The third patient did not show transversal maxillary deficiency and was enrolled as a control. Biopsy samples of midpalatal suture at 7 (subject 1) and 30 days (subject 2) after maxillary expansion as well as of one control (subject 3) were collected and processed for histology. In the control (subject 3) inter-digitations at the palatal suture gap were observed. At 7 days (subject 1) mature bone with small marrow spaces and trabecular bone with the peculiar storiform appearance inside the soft tissue and collagen fibers running parallel only in the central part were present. At 30 days (subject 2), a greater number of newly-formed bone trabeculae with a perpendicular orientation to the long axis of the suture could be seen. At 30 days the fibrous component of bone tissue was less represented compared to the sample at 7 days. Data from the preliminary histological results showed that bone formation was observed in the gap after rapid maxillary expansion, although the healing process was still ongoing.

Aim: The present study aimed to evaluate the relationship between masseter size, maxillary intermolar width and craniofacial vertical skeletal pattern., Study Design: The study followed a prospective longitudinal design and enrolled 61 subjects (30 males and 31 females), 9-14 years of age (mean age 11.5) at 2-3 CVM stage. The participants were divided into three groups based on their vertical skeletal pattern which was estimated using the Frankfurt-mandibular plane angle: low-angle group (L-A), normal-angle group (N-A), high-angle group (H-A). An additional gender-based distinction was made. Maxillary intermolar width was measured on the maxillary cast of each patient by means of an electronic caliper; masseter volume was estimated by using magnetic resonance (MR) and masseter thickness was measured by means of ultrasonography (US). The US registrations were performed during the relaxation state (RS) and the maximum voluntary contraction (MVC) of the muscle. The indipendent samples T- test was used for sex comparisons; the analysis of variance test (ANOVA) was used to evaluate the differences between the three groups in males and females, and the Pearson r correlation coefficient was employed to assess the correlation between maxillary intermolar width and masseter volume., Results and Conclusion: Maxillary intermolar width, masseter volume and thickness showed significant gender differences; all the tested variables decreased significantly according to the facial vertical pattern, with greater values in females, especially in low- and normal-angle subjects; maxillary intermolar width and masseter volume showed significant correlations, higher in females.

Purpose. The aim of the present prospective study was to investigate correlations between 3D facial soft tissue scan and lateral cephalometric radiography measurements. Materials and Methods. The study sample comprised 312 subjects of Caucasian ethnic origin. Exclusion criteria were all the craniofacial anomalies, noticeable asymmetries, and previous or current orthodontic treatment. A cephalometric analysis was developed employing 11 soft tissue landmarks and 14 sagittal and 14 vertical angular measurements corresponding to skeletal cephalometric variables. Cephalometric analyses on lateral cephalometric radiographies were performed for all subjects. The measurements were analysed in terms of their reliability and gender-age specific differences. Then, the soft tissue values were analysed for any correlations with lateral cephalometric radiography variables using Pearson correlation coefficient analysis. Results. Low, medium, and high correlations were found for sagittal and vertical measurements. Sagittal measurements seemed to be more reliable in providing a soft tissue diagnosis than vertical measurements. Conclusions. Sagittal parameters seemed to be more reliable in providing a soft tissue diagnosis similar to lateral cephalometric radiography. Vertical soft tissue measurements meanwhile showed a little less correlation with the corresponding cephalometric values perhaps due to the low reproducibility of cranial base and mandibular landmarks.

Objective: To evaluate changes in airway volumes and respiratory performance in patients undergoing rapid maxillary expansion and determine whether any correlations exist between the morphological and respiratory functional modifications induced by rapid maxillary expansion and pretreatment airway stenosis., Materials and Methods: Fifteen patients (11 females and 4 males; mean age, 7.5 ± 0.3 years) were enrolled in the study. Each patient underwent cone beam computed tomography and polysomnography examination before rapid maxillary expansion and after the removal of the maxillary expander 12 months later. The airway regions were segmented and the volumes were computed., Results: The upper, middle, and lower airway volumes were significantly increased 2305 mm(3), 1144 mm(3), and 1915 mm(3), respectively. Similarly, oxygen saturation was increased (+5.3%) and the apnea/hypopnea index was improved (-4.2 events). All the observed modifications were statistically significant (P < .05). Baseline middle and lower airway volume showed a significant negative correlation with the oxygen saturation modification., Conclusions: The results of this study showed that when rapid maxillary expansion is performed in subjects having posterior crossbite, oxygen saturation is improved. The improvement is greater in subjects having more reduced middle and lower airway volumes.

Aim: The objective of this study was to evaluate the airway volume of growing patients combining a morphological approach using cone beam computed tomography associated with functional data obtained by polysomnography examination after rapid maxillary expansion treatment., Study Design: 22 Caucasian patients (mean age 8.3±0.9 years) undergoing rapid maxillary expansion with Haas type expander banded on second deciduous upper molars were enrolled for this prospective study. Cone beam computed tomography scans and polysomnography exams were collected before placing the appliance (T0) and after 12 months (T1)., Methods: Image processing with airway volume computing and analyses of oxygen saturation and apnoea/hypopnoea index were performed., Results: Airway volume, oxygen saturation and apnea/hypopnea index underwent significant increase over time. However, no significant correlation was seen between their increases., Conclusion: The rapid maxillary expansion treatment induced significant increases in the total airway volume and respiratory performance. Functional respiratory parameters should be included in studies evaluating the RME treatment effects on the respiratory performance.

Background: Only a few studies have dealt with immediately loaded, unsplinted mini-implants supporting ball attachment-retained mandibular overdentures (ODs). The aim of this study is to evaluate treatment outcomes of ball attachment-retained mandibular ODs supported by one-piece, unsplinted, immediately loaded, direct metal laser sintering (DMLS) mini-implants., Methods: Over a 4-year period (2009 to 2012), all patients referred to the Dental Clinic, University of Varese, and to a private practice for treatment with mandibular ODs were considered for inclusion in this study. Each patient received three or four DMLS mini-implants. Immediately after implant placement, a mandibular OD was connected to the implants. At each annual follow-up session, clinical and radiographic parameters were assessed, including the following outcome measures: 1) implant failures; 2) peri-implant marginal bone loss; and 3) complications. Statistical analysis was conducted using a life-table analysis., Results: A total of 231 one-piece DMLS mini-implants were inserted in 62 patients. After 4 years of loading, six implants failed, giving an overall cumulative survival rate of 96.9%. The mean distance between the implant shoulder and the first visible bone-to-implant contact was 0.38 ± 0.25 and 0.62 ± 0.20 mm at the 1- and 4-year follow-up examinations, respectively. An incidence of 6.0% of biologic complications was reported; prosthetic complications were more frequent (12.9%)., Conclusions: Within the limits of this study, it can be concluded that the immediate loading of one-piece, unsplinted, DMLS titanium mini-implants by means of ball attachment-supported mandibular ODs is a successful treatment procedure. Long-term follow-up studies are needed to confirm these results.

This report documents the clinical, radiographic, and histologic outcome of a custom-made computer-aided-design/computer-aided-manufactured (CAD/CAM) scaffold used for the alveolar ridge augmentation of a severely atrophic anterior mandible. Computed tomographic (CT) images of an atrophic anterior mandible were acquired and modified into a 3-dimensional (3D) reconstruction model; this was transferred to a CAD program, where a custom-made scaffold was designed. CAM software generated a set of tool-paths for the manufacture of the scaffold on a computer-numerical-control milling machine into the exact shape of the 3D design. A custom-made scaffold was milled from a synthetic micromacroporous biphasic calcium phosphate (BCP) block. The scaffold closely matched the shape of the defect: this helped to reduce the time for the surgery and contributed to good healing. One year later, newly formed and well-integrated bone was clinically available, and two implants (AnyRidge, MegaGen, Gyeongbuk, South Korea) were placed. The histologic samples retrieved from the implant sites revealed compact mature bone undergoing remodelling, marrow spaces, and newly formed trabecular bone surrounded by residual BCP particles. This study demonstrates that custom-made scaffolds can be fabricated by combining CT scans and CAD/CAM techniques. Further studies on a larger sample of patients are needed to confirm these results.

Background: Oral breathing and maxillary deficiency are often associated with steep mandibular plane angle, and retrognathic mandible compared with the faces of healthy controls. Some studies suggested that after rapid maxillary expansion, improvement in nasal breathing and repositioning of mandible with transitory increasing of facial height and, in some cases, spontaneous forward repositioning might occur. The above-mentioned mandibular effects could contribute to enlarge oropharynx volume with repositioning of tongue and soft palate with an improvement of upper airway volume after treatment. The aim of this study was to investigate by cone beam computed tomography the role of oropharyngeal volume and mandibular position changes after rapid maxillary expansion in patients showing improved breathing pattern confirmed by polysomnography exam., Methods: The final sample of this retrospective study comprised 14 Caucasian patients (mean age 7.6 years) who undergone rapid maxillary expansion with Haas-type expander banded on second deciduous upper molars. Cone beam computed tomography scans and polysomnography exams were collected before placing the appliance (T0) and after 12 months (T1). Mandibular landmarks localization and airway semiautomatic segmentation on cone beam computed tomography scans allowed airway volume computing and measurements., Results: No significant differences were found between oropharyngeal airway changes and mandibular displacement after rapid maxillary expansion in growing patients., Conclusions: The suggested improvement in upper airway and breathing after rapid maxillary expansion should be further related to different compartments of airway such as rhinopharynx and nasal cavity.

Objectives: The aim of the present prospective study was to investigate the effects of rapid maxillary expansion on the airway correlating airway volumes computed on cone beam computed tomography and polysomnography evaluation of oxygen saturation and apnea/hypopnea index., Methods: The study group comprised 14 caucasian patients (mean age 7.1 ± 0.6 years) undergone to rapid maxillary expansion with Haas type expander banded on second deciduous upper molars. Cone beam computed tomography scans and polysomnography exams were collected before placing the appliance (T0) and after 12 months (T1). Landmarks localization and airway semiautomatic segmentation on cone beam computed tomography scans allowed airway volume computing and measurements., Results: Increases of total airway volume, oxygen saturation and apnea/hypopnea index were statistically significant. No correlation was found among total airway volume, oxygen saturation and apnea/hypopnea index changes between the examined timepoints., Conclusions: Computing airway volume on cone beam computed tomography allow to measure the amount of air that flows through nasal cavity, nasopharynx and oropharynx while oxygen saturation and apnea/hypopnea index could give information about functional parameters. In the present study all three variables investigated showed statistically significant differences between T0 and T1 but no correlation was found between increases of the different variables tested., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Purpose: Selective laser sintering (SLS) is a new technique that allows implants to be produced by annealing titanium powder microparticles in a focused laser beam, according to a computer-generated model. The aim of this study was to evaluate the survival and success rate of immediately restored 1-piece narrow-diameter SLS implants, placed in the posterior jaws, after 2 years of functional loading., Materials and Methods: At the 2-year follow-up examination, several parameters were assessed. Success criteria included absence of pain, suppuration, exudation, implant mobility; distance between the implant shoulder and the first visible bone-to-implant contact <2.0 mm; and absence of prosthetic complications., Results: Thirty-seven implants were placed in the posterior jaws (14 maxilla, 23 mandible) of 16 patients (9 males, 7 females). The prosthetic restorations comprised 16 immediately restored fixed partial prostheses. No implant failure occurred, resulting in a 100% survival rate. The implant success was 94.6%, and the mean distance between the implant shoulder and the first visible bone-to-implant contact (DIB) was 0.4 ± 0.3 mm., Conclusions: This study supports the hypothesis that 1-piece narrow-diameter SLS implants can be used in fixed prosthetic rehabilitations in the posterior regions of both jaws with a predictable positive outcome.