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Papers by giulio alessandri bonetti

Journal of Electromyography and Kinesiology, Jun 1, 2015

Background: It has been hypothesized that different plantar sensory inputs could influence the wh... more Background: It has been hypothesized that different plantar sensory inputs could influence the whole body posture and dental occlusion but there is a lack of evidence on this possible association. Objectives: To investigate the effects of experimental insoles redistributing plantar pressure on body posture, mandibular kinematics and electromyographic (EMG) activity of masticatory muscles on healthy subjects. Methods: A pilot study was conducted on 19 healthy volunteers that wore custom-made insoles normalizing the plantar pressure distribution for 2 weeks. Body posture parameters were measured by means of an optoelectronic stereophotogrammetric analysis; mandibular kinematics was analyzed by means of gothic arch tracings; superficial EMG activity of head and neck muscles was performed. Measurements were carried out 10 days before the insertion of the insoles, immediately before the insertion, the day after, 7 and 14 days after, in four different exteroceptive conditions. Results: The outcomes of the present study show that insoles do not modify significantly over time the parameters of body posture, SEMG activity of head and neck muscles and mandibular kinematics. Conclusions: In this pilot study the experimental insoles did not significantly influence the body posture, the mandibular kinematics and the activity of masticatory muscles during a 14-day follow up period.

Quintessence International, Apr 1, 2009

The contour of the interdental tissues, as well as the color and texture of the keratinized tissu... more The contour of the interdental tissues, as well as the color and texture of the keratinized tissues, are essential elements of anterior esthetics. Tissue loss in the interproximal regions, with related esthetic concerns, phonetic difficulties, and food impaction, can occur for a variety of reasons, including treatment of periodontal diseases. In periodontal surgical procedures, the soft tissues require elevation and resection to gain access to the root surfaces and osseous supporting structures. Compromised esthetics in the anterior region of the mouth could be a serious consequence of periodontal surgical procedures. Several articles have been devoted to flap designs and surgical techniques to maintain full papillary form and preserve the soft tissues during surgical access. Unfortunately, very little evidence of long-term results is available. The aims of the present article are to report a 22-year follow-up case of surgical interdental papilla preservation, discuss the anatomic variables that conditioned the outcome, and review and compare existing surgical techniques for maintaining the interproximal soft tissues.

American Journal of Orthodontics and Dentofacial Orthopedics, Oct 1, 2009

Few studies have investigated developmental norms for maxillary permanent canine eruption. In thi... more Few studies have investigated developmental norms for maxillary permanent canine eruption. In this observational cross-sectional study, we aimed to provide an age-related description of the percentiles relative to canine inclination in a large sample of nonorthodontic patients. Associations between inclination and sector were also analyzed. Methods: Canine inclination and sector location were measured on 1020 panoramic radiographs obtained from subjects of white ancestry aged between 8 and 11 years not seeking orthodontic treatment. The total sample comprised 2037 canines. Results: Canine inclination increases between 8 and 9 years and decreases between 9 and 11 years. The greatest value for each percentile is at 9 years. A linear model should be hypothesized for differences in canine inclination between 2 successive ages in correspondence to each percentile. The proportion of sector 2 canines decreases and that of sector 1 increases with age. In the same age group, the inclination generally decreases as the sector decreases. Conclusions: Percentiles by age show the average canine inclination in a certain population. Further studies are required to verify whether percentiles can be a diagnostic aid for determining normal canine inclination at a given age and for quantifying the risk of canine impaction or adjacent root resorption.

Journal of the American Dental Association, Aug 1, 1996

The Clinical Journal of Pain, Sep 1, 2010

Objectives: A randomized double-blind study was conducted to compare the efficacy of superpulsed ... more Objectives: A randomized double-blind study was conducted to compare the efficacy of superpulsed low-level laser therapy (SLLLT) with nonsteroidal anti-inflammatory drugs in the treatment of pain caused by temporomandibular joint disorders. Methods: A total of 99 patients with temporomandibular joint disorders, secondary to disc displacement without reduction or osteoarthritis were randomly divided into 3 groups. Thirty-nine patients received SLLLT in 10 sessions over 2 weeks, 30 patients received ibuprofen 800 mg twice a day for 10 days, and 30 patients received sham laser as placebo in 10 sessions over 2 weeks. Pain intensity was measured by visual analog scale at baseline, 2, 5, 10, and 15 days of treatment. Mandibular function was evaluated by monitoring active and passive mouth openings and right and left lateral motions at baseline, 15 days, and 1 month of treatment. Magnetic resonance imaging was performed at baseline and the end of therapy. Results: Mean visual analog scale pain scores in SLLLT group was significantly lower than in nonsteroidal anti-inflammatory drug group and control group (P=0.0001) from fifth day up to the end of the observation period. As for active and passive mouth openings and right and left lateral motions, superiority of SLLLT was evident 1 month after treatment (interaction time treatment, P=0.0001). Discussion: Mandibular function improved in all SLLLT patients proving the effectiveness in the treatment of pain, as demonstrated by a significant improvement in clinical signs and symptoms of temporomandibular joint disc displacement without reduction and osteoarthritis at the end of treatment and stability over a period of 1 month.

American Journal of Orthodontics and Dentofacial Orthopedics, Oct 1, 2009

ABSTRACT Introduction Few studies have investigated developmental norms for maxillary permanent c... more ABSTRACT Introduction Few studies have investigated developmental norms for maxillary permanent canine eruption. In this observational cross-sectional study, we aimed to provide an age-related description of the percentiles relative to canine inclination in a large sample of nonorthodontic patients. Associations between inclination and sector were also analyzed. Methods Canine inclination and sector location were measured on 1020 panoramic radiographs obtained from subjects of white ancestry aged between 8 and 11 years not seeking orthodontic treatment. The total sample comprised 2037 canines. Results Canine inclination increases between 8 and 9 years and decreases between 9 and 11 years. The greatest value for each percentile is at 9 years. A linear model should be hypothesized for differences in canine inclination between 2 successive ages in correspondence to each percentile. The proportion of sector 2 canines decreases and that of sector 1 increases with age. In the same age group, the inclination generally decreases as the sector decreases. Conclusions Percentiles by age show the average canine inclination in a certain population. Further studies are required to verify whether percentiles can be a diagnostic aid for determining normal canine inclination at a given age and for quantifying the risk of canine impaction or adjacent root resorption.

Scanning, Apr 23, 2015

The purpose of this in vivo study was to compare the morphology of the enamel surfaces before bra... more The purpose of this in vivo study was to compare the morphology of the enamel surfaces before bracket bonding and 6 and 12 months after debonding. Replicas of thirty-two maxillary second premolars of 16 volunteers were made before bracket bonding (T0), after debonding (T1), 6 months (T2), and 12 months (T3) later. Scanning electron microscope (SEM) images of the labial enamel surfaces were taken at T0, T1, T2, and T3 at increasing magnifications and analyzed according to the enamel damage index EDI. Data evaluation by using Friedman test followed by Wilcoxon signed ranks test with Bonferroni adjustment did not reveal statistically significant differences in the mean EDI at T0, T2, and T3, whereas the mean EDI at T1 was significantly higher than at T0, T2, and T3 (p < 0.05). The debonding procedure tested in this study produces no clinically relevant enamel damage. These alterations are reversible indeed, as a progressive restoration to pretreatment condition is evident after 6 months already and even more after 12 months. SCANNING 37:322-326, 2015.

Progress in orthodontics, Jun 18, 2013

Background: So far, a few studies have tried to investigate the relationship between the placemen... more Background: So far, a few studies have tried to investigate the relationship between the placement of fixed orthodontic appliances and the change of nonmicrobial salivary properties, mostly with conflicting outcomes and short-term assessment (up to 6 months from bracket placement). The purpose of this study was to evaluate the salivary flow rate, pH and buffer capacity prior to the beginning of therapy and after 1 year from bracket placement using a simple and commercially available chairside saliva check kit. Methods: The study population consisted of 20 healthy patients (mean age, 16.5 ± 4 years) scheduled for fixed orthodontic treatment. Salivary samples were taken just before bracket bonding (T0; baseline assessment) and after 1 year of treatment (T1; half-treatment assessment) using the GC Saliva-Check Kit (GC Corp., Leuven, Belgium). Results: No statistically significant difference was detected between T0 and T1 for the salivary parameters examined in the present study. Conclusions: Under the conditions of this study, the placement of fixed orthodontic appliances did not change the salivary pH, buffer capacity and flow rate after 1 year of treatment if compared with the baseline assessment.

Progress in Orthodontics, Nov 1, 2011

The aim of this study was to determine linear regression equations for a Northern Italian populat... more The aim of this study was to determine linear regression equations for a Northern Italian population to predict mandibular permanent premolars and canines widths, and particularly, second premolar widths, using the sum of the widths of the four mandibular incisors, canines and first premolars. Materials and methods: Mesiodistal tooth widths were measured from 230 dental casts obtained from Northern Italian patients (130 females and 100 males). Student's t-test or Wilcoxon test for independent and paired samples were used to determine right/left side and male/female differences. Correlation coefficients and linear regression equations were constructed to evaluate the relationship between 1) the combined mesiodistal widths of the permanent mandibular incisors (independent variable) and the combined mesiodistal widths of the canine and premolars (dependent variable); 2) the combined mesiodistal widths of the incisors, canines and first premolars (independent variable) and the widths of the second premolars (dependent variable). Significance value was set a priori at 0.05. Results: A linear regression equation was found, y = 0.585x + 7.927 (r = 0.734) considering right and left sides of mandibular arch together, to predict canines and premolars widths. For second premolar width, the linear regression equation was y = 0.201x + 2.149 (r = 0.641), even when considering the right and left sides of the mandibular arch together. Conclusions: New regression equations were derived for a Northern Italian population.

Progress in Orthodontics, May 1, 2012

The aim of this in vitro study was to evaluate the effectiveness of a fluoridereleasing bonding a... more The aim of this in vitro study was to evaluate the effectiveness of a fluoridereleasing bonding agent in inhibiting enamel demineralization around orthodontic brackets after the exposure to a demineralizing solution. Materials and methods: Twenty-six extracted upper molars were bonded with two different composites: Transbond XT (TXT) and Transbond Plus (TPlus), fluoride-releasing (both 3 M Unitek, Monrovia, CA, USA). The samples were exposed to an acid lactic solution for three days and then subjected to Metallographic Optical Microscope (MOM) and Scanning Electron Microscope/Energy Dispersive X-Ray (SEM/EDX) analyses. Enamel surface was examined in different areas: untreated , etched and primer-painted, untreated area with no acid exposure, central area with bracket bonded. The maximum demineralization depths and the fluoride content at 100, 200 and 300 m depth were evaluated. Results: MOM analysis showed statistically significant (p < 0.001) differences in demineralization depth for TPlus group compared to TXT group with lower values for the first one. EDX analysis confirmed the presence of fluoride in TPlus group.

Lasers in Medical Science, May 11, 2013

The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perc... more The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perception in orthodontic patient was tested. Overall, 76 patients [55 women and 21 men; age 35.1(6.4) years] who met the inclusion criteria participated in the study. Immediately after fixed orthodontic appliance placement, the patients were exposed to a pain relief treatment (one single session) using either 635-nm diode laser (SmartM, Lasotronix, Warsaw, Poland) or ozone therapy (OzoneDTA, Apoza, New Taipei City, Taiwan) by placing the handpieces in the area of each teeth apex and interdental papillae, from the maxillary right first molar to the maxillary left first molar. Subjects were divided into three groups: control group (G1, n = 26), ozone (G2, n = 26, exposed to ozone therapy, generator probe type 3, working time per point 5 s, 23 points, application time 1 min and 55 s), and laser group (G3, n = 25, exposed to continuous mode diode laser, 400 mW, handpiece diameter 8 mm, spot area 0.5024 cm 2 , power density per second 1.59 W/cm 2 , dose 2 J per point, time: 5 s per point, 23 points, total energy per session 46 J, application time 1 min and 55 s). The level of teeth crowding was assessed using the Lundstrom indicator. The patients received a questionnaire for pain assessment (the Numeric Rating Scale, NRS-11, grade level 0-10) and recorded at 7 time points (1 h, 6 h, and 1, 2, 3, 4, and 5 days) after the fixed orthodontic appliance placement. The mean pain values for the diode laser, ozone, and control group were 3.6 (1.31) (95% CI, 2.95-4.25), 5.25 (3.37) (95% CI, 3.52-6.98), and 5.75 (2.40) (95% CI, 4.69-6.81), respectively. We observed lower pain values in the diode laser group compared to the control group (p = 0.0237). The use of ozone in this study did not result in significant pain reduction in comparison to control (p = 0.8040) and laser groups (p = 0.1029). There were no differences in pain perception between patients with crowded teeth and non-crowded teeth in each group (G1, p = 0.66, G2, p = 0.86, G3, p = 0.24). The use of 635-nm diode laser led to decreased pain perception; however, ozone and presence of teeth crowding/spacing did not affect the pain perception in orthodontic patients during the first 5 days after the fixed orthodontic appliance placement.

Journal of the American Dental Association, Mar 1, 2004

Background. The authors conducted a study to evaluate the predictive value of five radiographic m... more Background. The authors conducted a study to evaluate the predictive value of five radiographic markers on the panoramic radiograph, or PR, to point out the relationship between the mandibular canal and the impacted third molar. Methods. The authors evaluated the accuracy of the radiographic markers by comparing the PR with an axial computed tomographic, or CT, scan. They identified a sample of 73 third molars that showed a close relationship between the tooth roots and the mandibular canal on the PR, and then classified them on the basis of five radiographic markers. They also detected contact between the third molar and the mandibular canal on the CT scan. Results. The distribution of the five radiographic markers was as follows: 37 teeth exhibited increased radiolucency, 13 exhibited superimposition, 14 exhibited interruption of the radiopaque border, 14 exhibited narrowing of the canal and seven exhibited diversion of the canal. In 11 cases, two or more markers were recognizable. The predictive values of a positive test result were as follows: increased radiolucency, 73 percent; superimposition, 38.5 percent; interruption of the radiopaque border, 71.4 percent; narrowing, 78.6 percent; and diversion, 100 percent. The authors detected contact in all of the cases that exhibited two or more markers. Conclusion. Increased radiolucency, narrowing and interruption of the radiopaque border, as well as the concomitant presence of two or more radiographic markers, on the PR were highly predictive of contact between the third molar and the mandibular canal. An axial CT scan probably is indicated in such cases. Clinical Implications. The results of this study may lead to some guidelines for oral surgeons evaluating whether to obtain an axial CT scan for further investigation after examining an impacted mandibular third molar via PR.

Dalla descrizione di un caso di lesione cistica follicolare con profonda i stretta cnclusione di ... more Dalla descrizione di un caso di lesione cistica follicolare con profonda i stretta cnclusione di un terzo molare a stretta contiguit\ue0 col canale mandibolare si pu\uf2 evincere come l'Ortodonzia Estrattiva possa rappresentare una vera risorsa terapeutica, utile non solo nel limitare il possibile rischioneurologico a carico del nervo mandibolare, ma anche nell'indurre, per l'insito stimolo derivante dalla trazione del legamento parodontale dell'ottavo incluso, una pi\uf9 naturale ed omogenea ricostruzione della normale anatomia ossea-parodontale delle aree interessate dal trattamento. La facilit\ue0 d'esecuzione, la sicurezza terapeutica e gli insiti vantaggi anatomici derivanti suggeriscono l'uso di tale approccio clinico anche e specialmente da parte del dentista generico

PubMed, Jul 1, 2015

Mixed dentition analysis forms a critical aspect of early orthodontic treatment. In fact an accur... more Mixed dentition analysis forms a critical aspect of early orthodontic treatment. In fact an accurate space analysis is one of the important criteria in determining whether the treatment plan may involve serial extraction, guidance of eruption, space maintenance, space regaining or just periodic observation of the patients. The aim of the present study was to calculate linear regression equations in mixed dentition space analysis, measuring 230 dental casts mesiodistal tooth widths, obtained from southern Italian patients (118 females, 112 males, mean age 15±3 years). Student’s t-test or Wilcoxon test for independent and paired samples were used to determine right/left side and male/female differences. On the basis of the sum of the mesiodistal diameters of the 4 mandibular incisors as predictors for the sum of the widths of the canines and premolars in the mandibular mixed dentition, a new linear regression equation was found: y = 0.613x+7.294 (r= 0.701) for both genders in a southern Italian population. To better estimate the size of leeway space, a new regression equation was found to calculate the mesiodistal size of the second premolar using the sum of the four mandibular incisors, canine and first premolar as a predictor. The equation is y = 0.241x+1.224 (r= 0.732). In conclusion, new regression equations were derived for a southern Italian population.

International Journal of Oral and Maxillofacial Surgery, Sep 1, 2014

In this study we investigated periodontal healing of mandibular second molars following 'orthodon... more In this study we investigated periodontal healing of mandibular second molars following 'orthodontic extraction' of adjacent impacted third molars, under the null hypothesis that there would be no difference in probing pocket depths (PPD) and clinical attachment levels (CAL) at the distal aspect of second molars before and after treatment. A retrospective survey was conducted of 64 patients who consecutively underwent 'orthodontic extraction' of mandibular third molars in close anatomical relationship with the mandibular canal from January 1997 to January 2011. Age, smoking habit, and PPD and CAL at the distal aspect of second molars before and after treatment were recorded. A statistically significant difference was found in PPD and CAL before and after treatment for the overall sample and for the sample classified by age (>25 or 25 years), smoking habit (smoker or non-smoker), and type of third molar impaction (horizontal, mesioangular, or vertical). Median PPD and CAL reductions amounted to 6 mm and 5 mm, respectively. The null hypothesis was rejected and orthodontic extraction proved to be indicated for those impacted mandibular third molars at high risk of a postoperative periodontal defect at the distal aspect of the adjacent second molar.

Angle Orthodontist, Mar 26, 2013

Objective: To evaluate whether the debonding procedure leads to restitutio ad integrum of the ena... more Objective: To evaluate whether the debonding procedure leads to restitutio ad integrum of the enamel surface by investigating the presence of enamel within the bracket base remnants after debonding. Materials and Methods: Sixty patients who completed orthodontic treatment with fixed appliances were included. A total of 1068 brackets were microphotographed; the brackets presenting some remnants on the base (n 5 818) were selected and analyzed with ImageJ software to measure the remnant area. From this population a statistically significant sample (n 5 100) was observed under a scanning electron microscope to check for the presence of enamel within the remnants. Energy dispersive x-ray spectrometry was also performed to obtain quantitative data. Results: Statistically significant differences in the remnant percentage between arches were observed for incisor and canine brackets (P , .0001 and P 5 .022, respectively). From a morphologic analysis of the scanning electron micrographs the bracket bases were categorized in 3 groups: group A, bases presenting a thin enamel coat (83%); group B, bases showing sizable enamel fragments (7%); group C, bases with no morphologic evidence of enamel presence (10%). Calcium presence was noted on all evaluated brackets under energy dispersive x-ray spectrometry. No significant difference was observed in the Ca/Si ratio between group A (16.21%) and group B (18.77%), whereas the Ca/Si ratio in group C (5.40%) was significantly lower than that of the other groups (P , .323 and P 5 .0001, respectively). Conclusion: The objective of an atraumatic debonding is not achieved yet; in some cases the damage could be clinically relevant.

American Journal of Orthodontics and Dentofacial Orthopedics, Mar 1, 2011

In this research project, we aimed to compare the effectiveness of single (1 deciduous canine) an... more In this research project, we aimed to compare the effectiveness of single (1 deciduous canine) and double (deciduous canine and first molar) extractions in subjects with retained maxillary permanent canines positioned palatally or centrally in the alveolar crest, at risk for root resorption of adjacent permanent teeth. Methods: Subjects at risk for canine impaction or resorptive situations were randomly assigned to 1 of 2 treatment modalities: single extraction (17 patients, 28 canines) or double extraction (20 patients, 37 canines). Thirty-one patients with 53 canines judged to be not at risk constituted the untreated control group. Panoramic radiographs were taken at the initial observation and after 18 months on average. Between-group statistical comparisons were carried out on the changes in canine inclination and sector location (measured on panoramic radiographs) and on the percentages of successful permanent canine eruptions. Results: The double-extraction group showed significant improvements in the success rate and the intrabony position of the permanent canine, in terms of uprighting the canine's long axis with a crown movement in a distal direction. Conclusions: Concomitant deciduous canine and first molar extractions proved to be more effective as a preventive approach to promote eruption of retained maxillary permanent canines positioned palatally or centrally.

Journal of Electromyography and Kinesiology, Jun 1, 2015

Background: It has been hypothesized that different plantar sensory inputs could influence the wh... more Background: It has been hypothesized that different plantar sensory inputs could influence the whole body posture and dental occlusion but there is a lack of evidence on this possible association. Objectives: To investigate the effects of experimental insoles redistributing plantar pressure on body posture, mandibular kinematics and electromyographic (EMG) activity of masticatory muscles on healthy subjects. Methods: A pilot study was conducted on 19 healthy volunteers that wore custom-made insoles normalizing the plantar pressure distribution for 2 weeks. Body posture parameters were measured by means of an optoelectronic stereophotogrammetric analysis; mandibular kinematics was analyzed by means of gothic arch tracings; superficial EMG activity of head and neck muscles was performed. Measurements were carried out 10 days before the insertion of the insoles, immediately before the insertion, the day after, 7 and 14 days after, in four different exteroceptive conditions. Results: The outcomes of the present study show that insoles do not modify significantly over time the parameters of body posture, SEMG activity of head and neck muscles and mandibular kinematics. Conclusions: In this pilot study the experimental insoles did not significantly influence the body posture, the mandibular kinematics and the activity of masticatory muscles during a 14-day follow up period.

Quintessence International, Apr 1, 2009

The contour of the interdental tissues, as well as the color and texture of the keratinized tissu... more The contour of the interdental tissues, as well as the color and texture of the keratinized tissues, are essential elements of anterior esthetics. Tissue loss in the interproximal regions, with related esthetic concerns, phonetic difficulties, and food impaction, can occur for a variety of reasons, including treatment of periodontal diseases. In periodontal surgical procedures, the soft tissues require elevation and resection to gain access to the root surfaces and osseous supporting structures. Compromised esthetics in the anterior region of the mouth could be a serious consequence of periodontal surgical procedures. Several articles have been devoted to flap designs and surgical techniques to maintain full papillary form and preserve the soft tissues during surgical access. Unfortunately, very little evidence of long-term results is available. The aims of the present article are to report a 22-year follow-up case of surgical interdental papilla preservation, discuss the anatomic variables that conditioned the outcome, and review and compare existing surgical techniques for maintaining the interproximal soft tissues.

American Journal of Orthodontics and Dentofacial Orthopedics, Oct 1, 2009

Few studies have investigated developmental norms for maxillary permanent canine eruption. In thi... more Few studies have investigated developmental norms for maxillary permanent canine eruption. In this observational cross-sectional study, we aimed to provide an age-related description of the percentiles relative to canine inclination in a large sample of nonorthodontic patients. Associations between inclination and sector were also analyzed. Methods: Canine inclination and sector location were measured on 1020 panoramic radiographs obtained from subjects of white ancestry aged between 8 and 11 years not seeking orthodontic treatment. The total sample comprised 2037 canines. Results: Canine inclination increases between 8 and 9 years and decreases between 9 and 11 years. The greatest value for each percentile is at 9 years. A linear model should be hypothesized for differences in canine inclination between 2 successive ages in correspondence to each percentile. The proportion of sector 2 canines decreases and that of sector 1 increases with age. In the same age group, the inclination generally decreases as the sector decreases. Conclusions: Percentiles by age show the average canine inclination in a certain population. Further studies are required to verify whether percentiles can be a diagnostic aid for determining normal canine inclination at a given age and for quantifying the risk of canine impaction or adjacent root resorption.

Journal of the American Dental Association, Aug 1, 1996

The Clinical Journal of Pain, Sep 1, 2010

Objectives: A randomized double-blind study was conducted to compare the efficacy of superpulsed ... more Objectives: A randomized double-blind study was conducted to compare the efficacy of superpulsed low-level laser therapy (SLLLT) with nonsteroidal anti-inflammatory drugs in the treatment of pain caused by temporomandibular joint disorders. Methods: A total of 99 patients with temporomandibular joint disorders, secondary to disc displacement without reduction or osteoarthritis were randomly divided into 3 groups. Thirty-nine patients received SLLLT in 10 sessions over 2 weeks, 30 patients received ibuprofen 800 mg twice a day for 10 days, and 30 patients received sham laser as placebo in 10 sessions over 2 weeks. Pain intensity was measured by visual analog scale at baseline, 2, 5, 10, and 15 days of treatment. Mandibular function was evaluated by monitoring active and passive mouth openings and right and left lateral motions at baseline, 15 days, and 1 month of treatment. Magnetic resonance imaging was performed at baseline and the end of therapy. Results: Mean visual analog scale pain scores in SLLLT group was significantly lower than in nonsteroidal anti-inflammatory drug group and control group (P=0.0001) from fifth day up to the end of the observation period. As for active and passive mouth openings and right and left lateral motions, superiority of SLLLT was evident 1 month after treatment (interaction time treatment, P=0.0001). Discussion: Mandibular function improved in all SLLLT patients proving the effectiveness in the treatment of pain, as demonstrated by a significant improvement in clinical signs and symptoms of temporomandibular joint disc displacement without reduction and osteoarthritis at the end of treatment and stability over a period of 1 month.

American Journal of Orthodontics and Dentofacial Orthopedics, Oct 1, 2009

ABSTRACT Introduction Few studies have investigated developmental norms for maxillary permanent c... more ABSTRACT Introduction Few studies have investigated developmental norms for maxillary permanent canine eruption. In this observational cross-sectional study, we aimed to provide an age-related description of the percentiles relative to canine inclination in a large sample of nonorthodontic patients. Associations between inclination and sector were also analyzed. Methods Canine inclination and sector location were measured on 1020 panoramic radiographs obtained from subjects of white ancestry aged between 8 and 11 years not seeking orthodontic treatment. The total sample comprised 2037 canines. Results Canine inclination increases between 8 and 9 years and decreases between 9 and 11 years. The greatest value for each percentile is at 9 years. A linear model should be hypothesized for differences in canine inclination between 2 successive ages in correspondence to each percentile. The proportion of sector 2 canines decreases and that of sector 1 increases with age. In the same age group, the inclination generally decreases as the sector decreases. Conclusions Percentiles by age show the average canine inclination in a certain population. Further studies are required to verify whether percentiles can be a diagnostic aid for determining normal canine inclination at a given age and for quantifying the risk of canine impaction or adjacent root resorption.

Scanning, Apr 23, 2015

The purpose of this in vivo study was to compare the morphology of the enamel surfaces before bra... more The purpose of this in vivo study was to compare the morphology of the enamel surfaces before bracket bonding and 6 and 12 months after debonding. Replicas of thirty-two maxillary second premolars of 16 volunteers were made before bracket bonding (T0), after debonding (T1), 6 months (T2), and 12 months (T3) later. Scanning electron microscope (SEM) images of the labial enamel surfaces were taken at T0, T1, T2, and T3 at increasing magnifications and analyzed according to the enamel damage index EDI. Data evaluation by using Friedman test followed by Wilcoxon signed ranks test with Bonferroni adjustment did not reveal statistically significant differences in the mean EDI at T0, T2, and T3, whereas the mean EDI at T1 was significantly higher than at T0, T2, and T3 (p < 0.05). The debonding procedure tested in this study produces no clinically relevant enamel damage. These alterations are reversible indeed, as a progressive restoration to pretreatment condition is evident after 6 months already and even more after 12 months. SCANNING 37:322-326, 2015.

Progress in orthodontics, Jun 18, 2013

Background: So far, a few studies have tried to investigate the relationship between the placemen... more Background: So far, a few studies have tried to investigate the relationship between the placement of fixed orthodontic appliances and the change of nonmicrobial salivary properties, mostly with conflicting outcomes and short-term assessment (up to 6 months from bracket placement). The purpose of this study was to evaluate the salivary flow rate, pH and buffer capacity prior to the beginning of therapy and after 1 year from bracket placement using a simple and commercially available chairside saliva check kit. Methods: The study population consisted of 20 healthy patients (mean age, 16.5 ± 4 years) scheduled for fixed orthodontic treatment. Salivary samples were taken just before bracket bonding (T0; baseline assessment) and after 1 year of treatment (T1; half-treatment assessment) using the GC Saliva-Check Kit (GC Corp., Leuven, Belgium). Results: No statistically significant difference was detected between T0 and T1 for the salivary parameters examined in the present study. Conclusions: Under the conditions of this study, the placement of fixed orthodontic appliances did not change the salivary pH, buffer capacity and flow rate after 1 year of treatment if compared with the baseline assessment.

Progress in Orthodontics, Nov 1, 2011

The aim of this study was to determine linear regression equations for a Northern Italian populat... more The aim of this study was to determine linear regression equations for a Northern Italian population to predict mandibular permanent premolars and canines widths, and particularly, second premolar widths, using the sum of the widths of the four mandibular incisors, canines and first premolars. Materials and methods: Mesiodistal tooth widths were measured from 230 dental casts obtained from Northern Italian patients (130 females and 100 males). Student's t-test or Wilcoxon test for independent and paired samples were used to determine right/left side and male/female differences. Correlation coefficients and linear regression equations were constructed to evaluate the relationship between 1) the combined mesiodistal widths of the permanent mandibular incisors (independent variable) and the combined mesiodistal widths of the canine and premolars (dependent variable); 2) the combined mesiodistal widths of the incisors, canines and first premolars (independent variable) and the widths of the second premolars (dependent variable). Significance value was set a priori at 0.05. Results: A linear regression equation was found, y = 0.585x + 7.927 (r = 0.734) considering right and left sides of mandibular arch together, to predict canines and premolars widths. For second premolar width, the linear regression equation was y = 0.201x + 2.149 (r = 0.641), even when considering the right and left sides of the mandibular arch together. Conclusions: New regression equations were derived for a Northern Italian population.

Progress in Orthodontics, May 1, 2012

The aim of this in vitro study was to evaluate the effectiveness of a fluoridereleasing bonding a... more The aim of this in vitro study was to evaluate the effectiveness of a fluoridereleasing bonding agent in inhibiting enamel demineralization around orthodontic brackets after the exposure to a demineralizing solution. Materials and methods: Twenty-six extracted upper molars were bonded with two different composites: Transbond XT (TXT) and Transbond Plus (TPlus), fluoride-releasing (both 3 M Unitek, Monrovia, CA, USA). The samples were exposed to an acid lactic solution for three days and then subjected to Metallographic Optical Microscope (MOM) and Scanning Electron Microscope/Energy Dispersive X-Ray (SEM/EDX) analyses. Enamel surface was examined in different areas: untreated , etched and primer-painted, untreated area with no acid exposure, central area with bracket bonded. The maximum demineralization depths and the fluoride content at 100, 200 and 300 m depth were evaluated. Results: MOM analysis showed statistically significant (p < 0.001) differences in demineralization depth for TPlus group compared to TXT group with lower values for the first one. EDX analysis confirmed the presence of fluoride in TPlus group.

Lasers in Medical Science, May 11, 2013

The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perc... more The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perception in orthodontic patient was tested. Overall, 76 patients [55 women and 21 men; age 35.1(6.4) years] who met the inclusion criteria participated in the study. Immediately after fixed orthodontic appliance placement, the patients were exposed to a pain relief treatment (one single session) using either 635-nm diode laser (SmartM, Lasotronix, Warsaw, Poland) or ozone therapy (OzoneDTA, Apoza, New Taipei City, Taiwan) by placing the handpieces in the area of each teeth apex and interdental papillae, from the maxillary right first molar to the maxillary left first molar. Subjects were divided into three groups: control group (G1, n = 26), ozone (G2, n = 26, exposed to ozone therapy, generator probe type 3, working time per point 5 s, 23 points, application time 1 min and 55 s), and laser group (G3, n = 25, exposed to continuous mode diode laser, 400 mW, handpiece diameter 8 mm, spot area 0.5024 cm 2 , power density per second 1.59 W/cm 2 , dose 2 J per point, time: 5 s per point, 23 points, total energy per session 46 J, application time 1 min and 55 s). The level of teeth crowding was assessed using the Lundstrom indicator. The patients received a questionnaire for pain assessment (the Numeric Rating Scale, NRS-11, grade level 0-10) and recorded at 7 time points (1 h, 6 h, and 1, 2, 3, 4, and 5 days) after the fixed orthodontic appliance placement. The mean pain values for the diode laser, ozone, and control group were 3.6 (1.31) (95% CI, 2.95-4.25), 5.25 (3.37) (95% CI, 3.52-6.98), and 5.75 (2.40) (95% CI, 4.69-6.81), respectively. We observed lower pain values in the diode laser group compared to the control group (p = 0.0237). The use of ozone in this study did not result in significant pain reduction in comparison to control (p = 0.8040) and laser groups (p = 0.1029). There were no differences in pain perception between patients with crowded teeth and non-crowded teeth in each group (G1, p = 0.66, G2, p = 0.86, G3, p = 0.24). The use of 635-nm diode laser led to decreased pain perception; however, ozone and presence of teeth crowding/spacing did not affect the pain perception in orthodontic patients during the first 5 days after the fixed orthodontic appliance placement.

Journal of the American Dental Association, Mar 1, 2004

Background. The authors conducted a study to evaluate the predictive value of five radiographic m... more Background. The authors conducted a study to evaluate the predictive value of five radiographic markers on the panoramic radiograph, or PR, to point out the relationship between the mandibular canal and the impacted third molar. Methods. The authors evaluated the accuracy of the radiographic markers by comparing the PR with an axial computed tomographic, or CT, scan. They identified a sample of 73 third molars that showed a close relationship between the tooth roots and the mandibular canal on the PR, and then classified them on the basis of five radiographic markers. They also detected contact between the third molar and the mandibular canal on the CT scan. Results. The distribution of the five radiographic markers was as follows: 37 teeth exhibited increased radiolucency, 13 exhibited superimposition, 14 exhibited interruption of the radiopaque border, 14 exhibited narrowing of the canal and seven exhibited diversion of the canal. In 11 cases, two or more markers were recognizable. The predictive values of a positive test result were as follows: increased radiolucency, 73 percent; superimposition, 38.5 percent; interruption of the radiopaque border, 71.4 percent; narrowing, 78.6 percent; and diversion, 100 percent. The authors detected contact in all of the cases that exhibited two or more markers. Conclusion. Increased radiolucency, narrowing and interruption of the radiopaque border, as well as the concomitant presence of two or more radiographic markers, on the PR were highly predictive of contact between the third molar and the mandibular canal. An axial CT scan probably is indicated in such cases. Clinical Implications. The results of this study may lead to some guidelines for oral surgeons evaluating whether to obtain an axial CT scan for further investigation after examining an impacted mandibular third molar via PR.

Dalla descrizione di un caso di lesione cistica follicolare con profonda i stretta cnclusione di ... more Dalla descrizione di un caso di lesione cistica follicolare con profonda i stretta cnclusione di un terzo molare a stretta contiguit\ue0 col canale mandibolare si pu\uf2 evincere come l'Ortodonzia Estrattiva possa rappresentare una vera risorsa terapeutica, utile non solo nel limitare il possibile rischioneurologico a carico del nervo mandibolare, ma anche nell'indurre, per l'insito stimolo derivante dalla trazione del legamento parodontale dell'ottavo incluso, una pi\uf9 naturale ed omogenea ricostruzione della normale anatomia ossea-parodontale delle aree interessate dal trattamento. La facilit\ue0 d'esecuzione, la sicurezza terapeutica e gli insiti vantaggi anatomici derivanti suggeriscono l'uso di tale approccio clinico anche e specialmente da parte del dentista generico

PubMed, Jul 1, 2015

Mixed dentition analysis forms a critical aspect of early orthodontic treatment. In fact an accur... more Mixed dentition analysis forms a critical aspect of early orthodontic treatment. In fact an accurate space analysis is one of the important criteria in determining whether the treatment plan may involve serial extraction, guidance of eruption, space maintenance, space regaining or just periodic observation of the patients. The aim of the present study was to calculate linear regression equations in mixed dentition space analysis, measuring 230 dental casts mesiodistal tooth widths, obtained from southern Italian patients (118 females, 112 males, mean age 15±3 years). Student’s t-test or Wilcoxon test for independent and paired samples were used to determine right/left side and male/female differences. On the basis of the sum of the mesiodistal diameters of the 4 mandibular incisors as predictors for the sum of the widths of the canines and premolars in the mandibular mixed dentition, a new linear regression equation was found: y = 0.613x+7.294 (r= 0.701) for both genders in a southern Italian population. To better estimate the size of leeway space, a new regression equation was found to calculate the mesiodistal size of the second premolar using the sum of the four mandibular incisors, canine and first premolar as a predictor. The equation is y = 0.241x+1.224 (r= 0.732). In conclusion, new regression equations were derived for a southern Italian population.

International Journal of Oral and Maxillofacial Surgery, Sep 1, 2014

In this study we investigated periodontal healing of mandibular second molars following 'orthodon... more In this study we investigated periodontal healing of mandibular second molars following 'orthodontic extraction' of adjacent impacted third molars, under the null hypothesis that there would be no difference in probing pocket depths (PPD) and clinical attachment levels (CAL) at the distal aspect of second molars before and after treatment. A retrospective survey was conducted of 64 patients who consecutively underwent 'orthodontic extraction' of mandibular third molars in close anatomical relationship with the mandibular canal from January 1997 to January 2011. Age, smoking habit, and PPD and CAL at the distal aspect of second molars before and after treatment were recorded. A statistically significant difference was found in PPD and CAL before and after treatment for the overall sample and for the sample classified by age (>25 or 25 years), smoking habit (smoker or non-smoker), and type of third molar impaction (horizontal, mesioangular, or vertical). Median PPD and CAL reductions amounted to 6 mm and 5 mm, respectively. The null hypothesis was rejected and orthodontic extraction proved to be indicated for those impacted mandibular third molars at high risk of a postoperative periodontal defect at the distal aspect of the adjacent second molar.

Angle Orthodontist, Mar 26, 2013

Objective: To evaluate whether the debonding procedure leads to restitutio ad integrum of the ena... more Objective: To evaluate whether the debonding procedure leads to restitutio ad integrum of the enamel surface by investigating the presence of enamel within the bracket base remnants after debonding. Materials and Methods: Sixty patients who completed orthodontic treatment with fixed appliances were included. A total of 1068 brackets were microphotographed; the brackets presenting some remnants on the base (n 5 818) were selected and analyzed with ImageJ software to measure the remnant area. From this population a statistically significant sample (n 5 100) was observed under a scanning electron microscope to check for the presence of enamel within the remnants. Energy dispersive x-ray spectrometry was also performed to obtain quantitative data. Results: Statistically significant differences in the remnant percentage between arches were observed for incisor and canine brackets (P , .0001 and P 5 .022, respectively). From a morphologic analysis of the scanning electron micrographs the bracket bases were categorized in 3 groups: group A, bases presenting a thin enamel coat (83%); group B, bases showing sizable enamel fragments (7%); group C, bases with no morphologic evidence of enamel presence (10%). Calcium presence was noted on all evaluated brackets under energy dispersive x-ray spectrometry. No significant difference was observed in the Ca/Si ratio between group A (16.21%) and group B (18.77%), whereas the Ca/Si ratio in group C (5.40%) was significantly lower than that of the other groups (P , .323 and P 5 .0001, respectively). Conclusion: The objective of an atraumatic debonding is not achieved yet; in some cases the damage could be clinically relevant.

American Journal of Orthodontics and Dentofacial Orthopedics, Mar 1, 2011

In this research project, we aimed to compare the effectiveness of single (1 deciduous canine) an... more In this research project, we aimed to compare the effectiveness of single (1 deciduous canine) and double (deciduous canine and first molar) extractions in subjects with retained maxillary permanent canines positioned palatally or centrally in the alveolar crest, at risk for root resorption of adjacent permanent teeth. Methods: Subjects at risk for canine impaction or resorptive situations were randomly assigned to 1 of 2 treatment modalities: single extraction (17 patients, 28 canines) or double extraction (20 patients, 37 canines). Thirty-one patients with 53 canines judged to be not at risk constituted the untreated control group. Panoramic radiographs were taken at the initial observation and after 18 months on average. Between-group statistical comparisons were carried out on the changes in canine inclination and sector location (measured on panoramic radiographs) and on the percentages of successful permanent canine eruptions. Results: The double-extraction group showed significant improvements in the success rate and the intrabony position of the permanent canine, in terms of uprighting the canine's long axis with a crown movement in a distal direction. Conclusions: Concomitant deciduous canine and first molar extractions proved to be more effective as a preventive approach to promote eruption of retained maxillary permanent canines positioned palatally or centrally.