Corrado Paganelli

Endothelium and Its Alterations in Cardiovascular Diseases: Life Style Intervention

The endothelium, which forms the inner cellular lining of blood vessels and lymphatics, is a highly metabolically active organ that is involved in many physiopathological processes, including the control of vasomotor tone, barrier function, leukocyte adhesion, and trafficking and inflammation. In this review, we summarized and described the following: (i) endothelial cell function in physiological conditions and (ii) endothelial cell activation and dysfunction in the main cardiovascular diseases (such as atherosclerosis, and hypertension) and to diabetes, cigarette smoking, and aging physiological process. Finally, we presented the currently available evidence that supports the beneficial effects of physical activity and various dietary compounds on endothelial functions.

Evaluation of environmental bacterial contamination and procedures to control cross infection in a sample of Italian dental surgeries

OBJECTIVES To perform a pilot study on bacterial contamination in some dental surgeries (n=51) in a local health unit in Brescia (Lombardy Region, Italy) and to evaluate the procedures to control cross infection used by the personnel to reduce the risk of infection in dental practice. METHODS A survey was carried out by interviewing 133 dental personnel with a questionnaire on the procedures used to control infection. The autoclaves, chemical baths (chemiclaves), and ovens present in the surgeries were tested for sterilisation efficiency with a spore test, and already packed and sterilised instruments were randomly sampled and tested for sterility. Microbial contamination of air, surface, and dental unit water samples were also studied. RESULTS The dental personnel did not generally follow the principal procedures for infection control: 30% of personnel were not vaccinated against hepatitis B virus, infected instruments were often not decontaminated, periodic checks of autoclave efficiency were lacking, and the knowledge of disinfection mechanisms and procedures was incomplete. High bacteriological contamination of water at dental surgeries was often found and total bacteriological counts in air samples were high. Surface studies showed widespread bacterial contamination. CONCLUSIONS On the basis of these results, an educational programme for the prevention of infective hazards has been prepared and carried out. The results of this pilot study will be used for planning a national survey.

Determinants for success rates of temporary anchorage devices in orthodontics: a meta-analysis (n > 50)

INTRODUCTION The aim of this study was to review the literature and evaluate the failure rates and factors that affect the stability and success of temporary anchorage devices (TADs) used as orthodontic anchorage. METHODS Data were collected from electronic databases: MEDLINE database, Scopus, and Web of Knowledge. Four combinations of term were used as keywords: screw orthodontic failure, screw orthodontic success, implant orthodontic failure, and implant orthodontic success. The following selection criteria were used to select appropriate articles: articles on implants and screws used as orthodontic anchorage, data only from human subjects, studies published in English, studies with more than 50 implants/screws, and both prospective and retrospective clinical studies. RESULTS The search provided 209 abstracts about TADs used as anchorage. After reading and applying the selection criteria, 26 articles were included in the study. The data obtained were divided into two topics: which factors affected TAD success and to what degree and in how many articles they were quoted. Clinical factors were divided into three main groups: patient-related, implant-related, and management-related factors. CONCLUSIONS Although all articles included in this meta-analysis reported success rates of greater than 80 per cent, the factors determining success rates were inconsistent between the studies analysed and this made conclusions difficult.

Advantages of cone beam computed tomography (CBCT) in the orthodontic treatment planning of cleidocranial dysplasia patients: a case report

Our aim was to discuss, by presenting a case, the possibilities connected to the use of a CBCT exam in the dental evaluation of patients with Cleidocranial Dysplasia (CCD), an autosomal dominant skeletal dysplasia with delayed exfoliation of deciduous and eruption of permanent teeth and multiple supernumeraries, often impacted. We think that CBCT in this patient was adequate to accurately evaluate impacted teeth position and anatomy, resulting thus useful both in the diagnostic process and in the treatment planning, with an important reduction in the radiation dose absorbed by the patient.

Ex vivo measurement reliability using two different cbct scanners for orthodontic purposes

There are many cone beam computed tomography (CBCT) scanners available on the market: detector technology, algorithm precision, and scanner settings influence image quality. The aim of this study was to compare the accuracy of linear measurements made on images of the same sample obtained using two different CBCT scanners.

Dental status of three Egyptian mummies: radiological investigation by multislice computerized tomography

OBJECTIVE The aim of the study was to provide a paleopathologic and radiologic overview of the jaws and teeth of 3 Egyptian mummies preserved in the Civic Museum of History and Art in Trieste. Computerized tomography (CT) imaging and postprocessing techniques were used to examine the oral structures. STUDY DESIGN A 16-slice CT scanner was used (Aquilion 16; Toshiba Medical Systems Europe, Zoetermeer, The Netherlands). Scans were obtained at high resolution. Orthogonal-plane and 3-dimensional (3D) reconstructions were created along with curved reconstructions of the lower and upper jaws. Determination of decayed/missing teeth (DMT) and decayed/missing/tooth surfaces (DMTs) were made with 3D images. RESULTS Analyses revealed differences in the embalming techniques and state of preservation of the bodies. Marked wear of the occlusal surfaces was a characteristic finding in all of the mummies. The DMT and DMTs were low compared with values for contemporary populations. Two mummies had fully erupted third molars. All mummies exhibited bone changes consistent with periodontitis. CONCLUSION The CT evaluations of the oral structures of the mummies provided insight into the dental status and oral diseases of these ancient Egyptians. The low DMT and DMTs values and indications of periodontitis may be associated with the lifestyle of these Egyptians. The fully erupted and well aligned third molars may represent a morphologic adaptation of the arches to the muscular activity associated with grinding tough foods.

Mechanical response of bone under short-term loading of a dental implant with an internal layer simulating the nonlinear behaviour of the periodontal ligament.

We consider a non-standard design for a fixed dental implant, incorporating a soft layer which simulates the presence of the periodontal ligament (PDL). Instead of being aimed at causing an a priori defined stress/strain field within the surrounding bone, upon loading, such a design simply tries to better reproduce the natural tooth–PDL configuration. To do this, the mechanical properties of the internal layer match those of the PDL, determined experimentally to be strongly nonlinear. Three-dimensional finite element analyses show that the presence of such a layer produces (i) a prosthesis mobility very similar to that of a healthy tooth, for several loading conditions, and (ii) a stress/strain distribution substantially different from that arising, upon loading, around a conventional implant. The lack of knowledge of the real mechanical fields existing, under loading, in the bone around a healthy tooth makes it very difficult to state that the stress distribution produced by the modified implant is “better” than that produced by the standard one. Nevertheless, the comparison of the results obtained here, with those of previous refined analyses of the tooth–PDL–bone system, indicates that the modified implant tends to produce a stress distribution in the bone, upon loading, closer to “natural” than that given by the standard one, within the limits imposed by the presence of threads coupling the implant with the bone.

Leadership, governance and management in dental education - new societal challenges.

Dental schools around the world face new challenges that raise issues with regard to how they are governed, led and managed. With rapid societal changes, including globalization and consumerism, the roles of universities and their funding have become intensely debated topics. When financial burdens on universities increase, so does the pressure on dental schools. This is exacerbated by the relative expense of running dental schools and also by the limited understanding of both university managers and the public of the nature and scope of dentistry as a profession. In these circumstances, it is essential for dental schools to have good systems of leadership and management in place so that they can not only survive in difficult times, but flourish in the longer term. This paper discusses the concept of governance and how it relates to leadership, management and administration in dental schools and hospitals. Various approaches to governance and management in dental schools on different continents and regions are summarized and contrasted. A number of general governance and leadership issues are addressed. For example, a basic principle supported by the Working Group is that an effective governance structure must link authority and responsibility to performance and review, i.e. accountability, and that the mechanism for achieving this should be transparent. The paper also addresses issues specific to governing, leading and managing dental schools. Being a dean of a modern dental school is a very demanding role and some issues relating to this role are raised, including: dilemmas facing deans, preparing to be dean and succession planning. The importance of establishing a shared vision and mission, and creating the right culture and climate within a dental school, are emphasized. The Working Group advocates establishing a culture of scholarship in dental schools for both teaching and research. The paper addresses the need for effective staff management, motivation and development, and highlights the salience of good communication. The Working Group suggests establishing an advisory board to the dean and school, including lay persons and other external stakeholders, as one way of separating governance and management to some extent and providing some checks and balances within a dental school. Several other suggestions and recommendations are made about governance, management and leadership issues, including the need for schools to promote an awareness of their roles by good communication and thereby influence perceptions of others about their roles and values.

Attenuation of ultraviolet A‐induced alterations in NIH3T3 dermal fibroblasts by melatonin

Sun exposure is responsible for long‐term clinical skin changes such as photoageing, photodamage and photocancers. Ultraviolet (UV)A wavelengths stimulate the production of reactive oxygen species (ROS) that may contribute to photoageing. To protect against oxidative stress, skin cells have developed several defence systems, including ROS and metal ion scavengers and a battery of detoxifying, haem‐degrading and repair enzymes. Melatonins antioxidant activity is the result of three different but complementary actions: (i) a direct action due to its ability to act as a free radical scavenger; (ii) an indirect action that is a consequence of melatonins ability to reduce free radical generation (radical avoidance); and (iii) its ability to upregulate antioxidant enzymes.

Effectiveness of an indirect bonding technique in reducing plaque accumulation around braces

OBJECTIVE To evaluate if the use of an indirect braces bonding protocol for localized enamel etching and adhesive application could help reduce plaque accumulation and demineralization around the brackets compared with a conventional direct-bonding technique. MATERIALS AND METHODS Thirty patients were bonded with a split-mouth approach: two randomly selected opposite quadrants were used as the test sides and the other two as control sides. During the first 6 months, the plaque presence around the braces was recorded monthly according to a plaque accumulation index (PAI), as was the presence of demineralization. PAI values were measured at each of the four bracket sides for every bonded tooth. Analysis of variance was used to identify significant differences between different bracket margins and between test and control sides. RESULTS Test and control sides differed significantly for PAI measurements from t(1) (1 month after bonding) to t(4) (4 months after bonding), with the highest value of significance (P < .001) at t(1) but with no significant differences from t(5) to t(7) (treatment end). Considering whole-mouth results, different bracket margin PAI scores did not differ significantly. PAI scores were higher at t(1) and progressively decreased during the treatment. At debonding, the onset of 21 new white spots was recorded overall for the control sides and eight new white spots for the test sides. CONCLUSION Especially during the first 4 months after brackets placement, this indirect bonding protocol allowed for significant reduction in plaque accumulation around the braces and reduced onset of white spots during the orthodontic treatment.