Patrizio Bollero

Developing wearable bio-feedback systems: a general-purpose platform

Microprocessors, even those in PocketPCs, have adequate power for many real-time biofeedback applications for disabled people. This power allows design of portable or wearable devices that are smaller and lighter, and that have longer battery life compared to notebook-based systems. In this paper, we discuss a general-purpose hardware/software solution based on industrial or consumer devices and a C++ framework. Its flexibility and modularity make it adaptable to a wide range of situations. Moreover, its design minimizes system requirements and programming effort, thus allowing efficient systems to be built quickly and easily. Our design has been used to build two brain computer interface systems that were easily ported from the Win32 platform.

Prevalence of malocclusions, oral habits and orthodontic treatment need in a 7- to 15-year-old schoolchildren population in Tirana

BackgroundThe aim of present study was to determine the prevalence of malocclusions, oral habits and the need for orthodontic treatment in a sample of 7- to 15-year-old Albanese schoolchildren.MethodsThe final sample comprised 2,617 subjects (1,257 males and 1,360 females), all orthodontically untreated. Occlusal relationship and the functional analysis were recorded for all subjects. The prevalence rates for the dental health component of the index of orthodontic treatment need (IOTN) were calculated. Comparisons between genders were performed for the prevalence of malocclusions, oral habits and IOTN grades (chi-square tests).ResultsClass I, class II and class III malocclusions and asymmetries were observed in 40.4%, 29.2%, 3.2% and 27.1% of the sample, respectively. There were 2,108 subjects (80.6%) that showed oral habits, with females (82.1%) presenting with a greater prevalence rate than males (78.9%). The objective need for orthodontic treatment (grades 4 and 5 of IOTN) was registered in 1,077 subjects (41.2%). This prevalence rate is higher than those reported for other European countries. No significant differences between genders were found for the IOTN grades.ConclusionsThe findings of the present study revealed the need to improve public health plans for orthodontic prevention and screening and to organise the resources in this area in Albania.

Neurobehavioral phenotype observed in KBG syndrome caused by ANKRD11 mutations

KBG syndrome is a rare disease characterized by typical facial dysmorphism, macrodontia of upper central incisors, skeletal abnormalities, and developmental delay. Recently, mutations in ANKRD11 gene have been identified in a subset of patients with KBG syndrome, while a contiguous gene deletion syndrome involving 16q24.3 region (including ANKRD11) was delineated in patients with facial dysmorphism, autism, intellectual disability, and brain abnormalities. Although numerous evidences point to a central causative role of ANKRD11 in the neurologic features of these patients, their neurocognitive and behavior phenotypes are still poorly characterized. Herein, we report the complete neurological and psychiatric features observed in two patients with KBG syndrome due to ANKRD11 mutations. Both patients show intellectual disabilities, severe impairment in communication skills, deficits in several aspects of executive functions and working memory and anxious traits. Their features are compared with those of previously reported patients with KBG syndrome aiding in the delineation of neurocognitive phenotype associated to ANKRD11 mutations.

Kinematic and Diffusion Tensor Imaging Definition of Familial Marcus Gunn Jaw-Winking Synkinesis

Background Marcus Gunn jaw-winking synkinesis (MGJWS) is characterized by eyelid ptosis, which disappears during jaw movement. Familial MGJWS is an extremely rare condition. Some authors suggested that MGJWS is due to neural misdirection in the brainstem whereas others suggested that aberrant reinnervation or ephapse may be responsible for synkinetic activity. Pathogenesis of this condition is therefore still unclear. Methodology/Principal Findings To investigate pathogenetic mechanism in familial MGJWS we performed neurophysiological (EMG, Blink Reflex, Recovery cycle of the R2 component of the blink reflex, Masseter inhibitory reflex, BAEPS and kinematic analysis) and neuroradiological (MRI, Diffusion Tensor Imaging) investigations in a member of a multigenerational family with autosomal dominant Marcus Gunn jaw-winking synkinesis (MGJWS). Kinematic analysis of eyelid and jaw movements disclosed a similar onset and offset of the eyelid and jaw in both the opening and closing phases. The excitability of brainstem circuits, as assessed by the blink reflex recovery cycle and recovery index, was normal. Diffusion Tensor Imaging revealed reduced fractional anisotropy within the midbrain tegmentum. Conclusions/Significance Kinematic and MRI findings point to a brainstem structural abnormality in our familial MGJWS patient thus supporting the hypothesis of a neural misdirection of trigeminal motor axons to the elevator palpebralis muscle.

Three-Dimensional Evaluation of Masseter Muscle in Different Vertical Facial Patterns A Cross-Sectional Study in Growing Children

The aim of the present study was to analyze the anatomical three-dimensional (3D) characteristics of masseter muscle in growing subjects with different vertical patterns by using an ultrasound (US) method. The sample comprised 60 prepuberal subjects (33 males, 27 females) with a mean age of 11.5 ± 1.6 years with late mixed or permanent dentition and Class I molar and skeletal relationship. For each subject, a lateral cephalogram was required, and according to the mandibular plane angle (Frankfort horizontal plane/mandibular plane angle [FMA]), the subjects were divided into three groups of different underlying vertical facial patterns: brachyfacial: FMA < 22°, mesofacial: 22° ≤ FMA ≤ 28°, and dolichofacial: FMA > 28°. For each subject, an US scan was carried out to analyze the width, the thickness, the cross-sectional area, and the volume of the masseter muscle. Mean differences in measurements between vertical facial subgroups were contrasted by means of analysis of variance (ANOVA) with Tukey’s post hoc tests (p < 0.05). Measurements of the whole masseter in dolichofacial patients were significantly smaller when compared with brachyfacial and mesofacial individuals during relaxation and contraction. The volume of the masseter decreased significantly by 10% going from the brachyfacial group to the mesofacial group and from the mesofacial group to the dolichofacial group with no difference between the left and the right sides. A significant negative correlation was found between the US measurements and the divergency (FMA°). Ultrasound is a technique indicated in children for evaluating muscles of mastication in vivo. Growing patients with a dolichofacial vertical pattern present with a reduced dimension of the masseter when compared with brachyfacial and mesofacial subjects.

Statistical analysis of the frequency distribution of signs and symptoms of patients with temporomandibular disorders.

The purpose of this text is to evaluate the distribution by sex and age of TMD patients and the frequency of pain on palpation of the lateral pterygoid muscle, pterygoid internal, sternocleidomastoid, masseter, temporal. The purpose is also to assess the existence of direct correlations between the articulating click and lateral deviation, the headache and tenderness of the temporal, the back pain and tenderness of the sternocleidomastoid, the postural disorders and difficulty finding the exact mating closing, the disorders related to previous dental procedures (large conservative reconstructions, rehabilitations fixed dentures and dental extractions) and tenderness to the temporal and masseter. 623 medical records, including 451 males and 175 females were randomly selected. It was statistically calculated the F/M ratio, age distribution and frequency of muscle tenderness to palpation through the relationship of positive feedback on the total sample multiplied by one hundred. The correlation between various disorders was calculated by estimating the Mantel-Haenszel common odds ratio. For each result it has been finally calculated the asymptotic level of significance.

A Retrospective 2-Year Clinical Study of Immediate Prosthetic Rehabilitation of Edentulous Jaws with Four Implants and Prefabricated Bars.

PURPOSE The purpose of this retrospective investigation was to evaluate the use of a prefabricated bar system for immediately loaded implants placed and restored according to the All-on-Four concept with up to 24-month follow-up. MATERIALS AND METHODS A total of 51 patients (31 males and 20 females; mean age 63.4 years) presented with edentulous or partially edentulous jaws with severe atrophy of the posterior regions. All patients were treated with full-arch fixed prostheses (28 maxillary, 34 mandibular) each supported by four implants (two vertical, two distally tilted). The implants were immediately loaded with screw-retained full-arch restorations. Each prosthesis was supported by a prefabricated metal bar combined with high-density acrylic resin. Follow-up visits were scheduled at 6, 12, and 24 months after initial prosthetic loading. Intraoral radiographs were obtained immediately after surgery and at each follow-up visit by using a custom radiograph holder and parallel technique. Marginal bone levels were assessed using digital image analysis. Implant and prosthetic survival and success rates were evaluated. Patient satisfaction was further assessed using a 100-mm visual analog scale (VAS). Data were compared by means of the Mantel-Haenszel test. RESULTS No drop-outs occurred. The overall implant survival rates were 100% and 98.38% for the vertical and tilted implants respectively. Two of the 62 definitive fixed prostheses were lost during the observation period due to implant failure. Since restoration replacement due to implant failure was not judged a prosthodontic failure according to the survival criteria provided in this study, the overall prosthetic survival rate was 100%. No statistically significant differences in marginal bone levels between vertical and tilted implants were detected at 24-month follow-up evaluation in either jaw. All participants were functionally and esthetically satisfied with their definitive restorations after 2 years functioning, as confirmed by the average VAS scores (masticatory function: 99.7; phonetic function: 99.5, esthetics: 99.2). CONCLUSIONS The preliminary 24-month results indicate that immediate loading of vertical and tilted implants using the evaluated prefabricated bar system may be a viable solution for edentulous jaw rehabilitation; however, more long-term prospective clinical trials are needed to affirm the effectiveness of this surgical-prosthetic protocol.

Evidences of a New Psychobiotic Formulation on Body Composition and Anxiety

Background Gut microbiota is implied in obesity, because of its ability to harvest energy from diet, and in the regulation of behavior. Given the link between gut microbiota, body composition, obesity, and anxiety, the aim of this study was to evaluate the effects of a new psychobiotic formulation. Methods Eligible patients were randomly divided into three groups: psychobiotics oral suspension group (POSG); dietary treatment group (DTG); combined treatment group (CTG). All subjects underwent body composition and psychological profile evaluation. Results Significant changes in body composition parameters in each group were relieved after all treatments. Hamilton anxiety rating scale (HAM-A) highlighted a significant reduction of the total score for all study population after treatments in POSG (p = 0.01) and CTG (p = 0.04). A reduction of HAM-A total score in anxious subjects in POSG or CTG and a significant reduction of positive subjects for HAM-A in POSG (p = 0.03) and in CDG (p = 0.01) were shown. Discussion Three-week intake of selected POS represents a good approach to solve problems related to obesity and behavior disorders. However, new clinical trials need to be performed on a larger population and for a longer period of treatment before definitive conclusions can be made. This trial is registered with NCT01890070.

Orthodontic archwire composition and phase analyses by neutron spectroscopy

Quantitative metallurgical and phase analyses employing neutron diffraction technique were conducted on two as-received commercial rectangular austenitic stainless steel orthodontic archwires, G&H and Azdent, 0.43×0.64 mm (0.017×0.025 inch). Results showed a bi-phase structure containing martensitic phase (45.67% for G&H and 6.62% for Azdent) in addition to the expected metastable austenite. The former may be a strain-induced phase-transformation arising during the cold working process of wire fabrication. Further neutron resonance capture analysis determinations provided atomic and isotopic compositions, including alloying elements in each sample, complementary to the results of traditional energy dispersive X-ray spectroscopy. Together, these results assist in relating commercial alloying recipes and processing histories with mechanical performance, strength and ductility in particular.

Differences between warfarin and new oral anticoagulants in dental clinical practice

The oral anticoagulant therapy is used for the cure and the prevention of thromboembolic diseases. In the last fifty years the warfarin has been considered the oral anticoagulant of choice. However, its use is limited by a narrow therapeutic index and by a complex pharmacodynamics, which requires regular adjustments and monitoring of the dose. Recently, three new oral anticoagulant - dabigatran etexilato (direct thrombin inhibitor), rivaroxaban and apixaban (Xa factor direct inhibitor) - have been approved for use in europe. Increasing the number of patients taking these drugs, it is important that the dentist knows these new oral anticoagulants, their indications and methods of action, in particular for the management of patients, who require invasive treatments. With regard to the management of the patient threated with the new oral anticoagulants (NAO), there have been new significant changes in the procedure compared to the one followed by patients treated with warfarin. This led to the development of new guidelines that the dentist has to follow in order to ensure a safe and appropriate dental treatment and reduce any postoperative complications. The aim of this work is to evaluate the effectiveness of the new oral anticoagulants compared to warfarin, especially in terms of risks of bleeding events and intra and postoperative complications, in patients requiring multiple dental extractions.