Accuracy of Artificial Intelligence Models in the Prediction of Periodontitis: A Systematic Review.

INTRODUCTION: Periodontitis is the main cause of tooth loss and is related to many systemic diseases. Artificial intelligence (AI) in periodontics has the potential to improve the accuracy of risk assessment and provide personalized treatment planning for patients with periodontitis. This systematic review aims to examine the actual evidence on the accuracy of various AI models in predicting periodontitis. METHODS: Using a mix of MeSH keywords and free text words pooled by Boolean operators ('AND', 'OR'), a search strategy without a time frame setting was conducted on the following databases: Web of Science, ProQuest, PubMed, Scopus, and IEEE Explore. The QUADAS-2 risk of bias assessment was then performed. RESULTS: From a total of 961 identified records screened, 8 articles were included for qualitative analysis: 4 studies showed an overall low risk of bias, 2 studies an unclear risk, and the remaining 2 studies a high risk. The most employed algorithms for periodontitis prediction were artificial neural networks, followed by support vector machines, decision trees, logistic regression, and random forest. The models showed good predictive performance for periodontitis according to different evaluation metrics, but the presented methods were heterogeneous. CONCLUSIONS: AI algorithms may improve in the future the accuracy and reliability of periodontitis prediction. However, to date, most of the studies had a retrospective design and did not consider the most modern deep learning networks. Although the available evidence is limited by a lack of standardized data collection and protocols, the potential benefits of using AI in periodontics are significant and warrant further research and development in this area. KNOWLEDGE TRANSFER STATEMENT: The use of AI in periodontics can lead to more accurate diagnosis and treatment planning, as well as improved patient education and engagement. Despite the current challenges and limitations of the available evidence, particularly the lack of standardized data collection and analysis protocols, the potential benefits of using AI in periodontics are significant and warrant further research and development in this area.

Comparative analysis of treatment outcomes between Bi-Maxillary Plates and Facemask for treating class III malocclusion in growing subjects. A retrospective study.

AIM: To comparatively analyse the skeletal and dento-alveolar changes after treatment with Class III Bi-Maxillary Plates (BMPs) and FM appliances in growing patients with Class III skeletal malocclusion. CONCLUSION: BMPs with class III elastics provided a similar pattern of skeletal and dento-alveolar changes compared to FMs, however supported by slightly greater dentoalveolar effects that contribute to the correction of the class III malocclusion in growing subjects.

A possible unique ecosystem in the endoglacial hypersaline brines in Antarctica.

Here, we present the results related to a new unique terrestrial ecosystem found in an englacial hypersaline brine found in Northern Victoria Land (Antarctica). Both the geochemistry and microbial (prokaryotic and fungal) diversity revealed an unicity with respect to all the other known Antarctic brines and suggested a probable ancient origin mainly due a progressive cryoconcentration of seawater. The prokaryotic community presented some peculiarities, such as the occurrence of sequences of Patescibacteria (which can thrive in nutrient-limited water environments) or few Spirochaeta, and the presence of archaeal sequences of Methanomicrobia closely related to Methanoculleus, a methanogen commonly detected in marine and estuarine environments. The high percentage (35%) of unassigned fungal taxa suggested the presence of a high degree of undiscovered diversity within a structured fungal community (including both yeast and filamentous life forms) and reinforce the hypothesis of a high degree of biological uniqueness of the habitat under study.

Digital analysis of the occlusal changes and palatal morphology using elastodontic devices. A prospective clinical study including Class II subjects in mixed dentition.

AIM: The aim of the present prospective study was to evaluate the effectiveness of elastodontic appliance (EAs) in the treatment of subjects presenting Class II sagittal discrepancy in mixed dentition, and to evaluate palatal morphological development during treatment. MATERIALS: The study group, composed of 19 subjects, received treatment with EA for 1 year. The control group consisted of 17 untreated subjects. INCLUSION CRITERIA: age between 6 and 11 years, mixed deciduous dentition and skeletal and/or dental Class II malocclusion. EXCLUSION CRITERIA: previous orthodontic therapy, systemic diseases and signs of temporal dysfunction. Skeletal and dentoalveolar parameters were compared between T0 and T1. A 3D imaging technology was used to compare palatal morphology obtained from intra-oral digital scans between T0 (pre-treatment) and T1 (post-treatment). CONCLUSION: EAs can successfully mitigate early signs of malocclusion in Class II subjects as well as contribute to the harmonious development of the palate.

[The management of confirmed cases of Covid-19 infection in schools: the experience of the prevention Department of the Azienda Sanitaria Friuli occidentale in the Pordenone area]. / L'attività del Dipartimento di prevenzione ASFO nella gestione dei casi confermati di Covid-19 nelle scuole del territorio pordenonese.

The SARS-Cov-2 pandemic that exploded in 2020 resulted in an exceptional school closure involving at least 188 countries worldwide, leaving more than 90% of children at home. This event excluded children and teenagers from the opportunity to learn, socialize, experiment and increased early school leaving. In light of these premises, during the summer months of 2020 the Azienda sanitaria Friuli Occidentale (AsFO) decided to set up a working group to accompany schools in the prevention and containment of the spread of the SARS-CoV-2 infection in the course of the school year 2020-21, with the aim of guaranteeing the right to study and favoring teaching activities in presence in the highest conditions of health and safety. The school reality of the Pordenone area is made up of 40 Comprehensive Institutes for a total of about 206 school complexes of all levels (public, equal and private). In total, the local school population is about 33,000 pupils and 4,000 units of school staff (teachers, ATA, etc ...). The activities of the Schools Group were analyzed by monitoring all interventions with carrying out rapid antigen tests at school and by assessing the incidence of infections within schools. From September 2020 to June 2021, the AsFO Schools Group participated in about 35 teaching colleges and more than 10 dedicated meetings with the families of school pupils of all levels. In total, 170 interventions with rapid antigen tests were carried out at school, involving all the schools in the Pordenone area and a total of 206 classes. During the interventions at school, a total of 6,370 rapid antigen tests were carried out, of which 70% concerned pupils (4,458 total tests) and 30% concerned school staff (1,912 total tests). The antigen tests carried out at school found 173 total positivity (equal to 3% of all tests carried out at school). Out of 173 positives found, 121 are students (70% of the total) and 52 are school staff (30% of the total). During the observation period, the results of the interventions with rapid antigen tests carried out at school led to the continuation of the teaching activity in the presence (with respect to the hygiene and behavioral measures defined by the DP) in 69% of cases (118 interventions). In 9% of cases (15 interventions) the "cross" quarantine was carried out, while in 17% of cases (29 interventions) the quarantine was established for the entire class / section. In 7 circumstances, following the intervention at school, quarantine was established for several classes. Only in 4 circumstances was the institution of quarantine for all school staff, a situation that led to the interruption of all educational activities for the quarantine period.

Blue light-emitting diodes in hair regrowth: the first prospective study.

Different studies highlight photo-receptors' presence on the hair follicle that seems to be capable of eliciting hair growth. This study aims to demonstrate blue light's effectiveness on hair growth in patients affected by androgenetic alopecia. Twenty patients enrolled at Magna Graecia University Unit of Dermatology, affected by androgenetic alopecia, were treated with a blue LED light device at 417 ± 10 nm, fluence of 120 J/cm2, and power intensity of 60 mW/cm2 ± 20%. The treatments were performed twice a week for ten consecutive weeks. Patients were evaluated before and 1 month after the end of therapy clinically using standardized global photographs and dermoscopically estimating hair density and hair shaft width. An increase in hair density and hair shaft width was recorded in 90% of patients after 10 weeks. Photographic improvement was noted in 80% of the patients. No serious adverse events have been reported. The only side effect consisted in a darkening of the hair, perhaps due to melanic stimulation due to blue light in 2 patients. Blue light therapy is a promising therapy for patients affected by androgenetic alopecia and other diseases characterized by hair loss. Further studies will be necessary to confirm the findings of this preliminary study.

The Evolution of the Cephalometric Superimposition Techniques from the Beginning to the Digital Era: A Brief Descriptive Review.

Superimposition of craniofacial structures from radiographic examination has been always used for assessing changes in the maxilla-mandibular complexes, especially for the evaluation of potential changes occurring during growth as well as after orthodontic treatment and/or maxillofacial surgery. However, the availability of cone beam computed tomography (CBCT) and the recent advancement in 3D imaging have allowed the development of specific techniques for the registration and superimposition of virtual three-dimensional anatomical structures, improving the diagnosis and treatment plan strategies. In the present paper, it will be discussed the evolution of superimposition techniques from the beginning (2D) to the newest 3D approach, describing the most used methods and their main advantages and disadvantages, focusing primarily on accuracy and reproducibility of each technique.

Medication-Related Osteonecrosis of the Jaw with Spontaneous Hemimaxilla Exfoliation: Report of a Case in Metastatic Renal Cancer Patient under Multidrug Therapy.

Medication-related osteonecrosis of the jaw (MRONJ) is a well-recognized complication of drug therapies for bone metabolic disorders or cancer related to administration of antiresorptive (bisphosphonates and denosumab) and antiangiogenic drugs. This report describes an advanced and unusual case of stage III peri-implantitis-induced MRONJ involving the right upper jaw which was attempting to self-exfoliate. A 61-year-old male patient, rehabilitated with the placement of two implants when he was still healthy, was suffering from metastatic renal cancer previously treated with bevacizumab, interleukin-2, zoledronic acid, denosumab, cabozantinib and nivolumab. He had been under treatment of nonsurgical therapy over a year, based on antibiotic and antiseptic mouth rinse, without improvement of oral conditions. Surgical treatment consisted of massive sequestrectomy and complete surgical debridement of necrotic bone tissues. The specimen was sent for histopathologic analysis, which confirmed bone tissue necrosis with no evidence of metastatic disease. Two-month follow-up revealed a considerable life quality improvement. Although this complication is well known, the uniqueness of this case is given by its severity, related to the administration of multiple antiresorptive and antiangiogenic drugs, by the natural response of the oral cavity with the almost complete self-exfoliation of the massive necrotic zone. This case is emblematic in highlighting the controversies in the management of MRONJ, which certainly require effective collaboration of the multidisciplinary health care team that could improve patient safety and reduce the risk of developing MRONJ.

Dose-Dependent Effects of Zoledronic Acid on Human Periodontal Ligament Stem Cells: An In Vitro Pilot Study.

Bisphosphonates (BPs) are widely used to treat several metabolic and oncological diseases affecting the skeletal system. Despite BPs' well-known therapeutic potential, they also displayed important side effects, among which is BPs-related osteonecrosis of the jaw, by targeting osteoclast activities, osteoblast, and osteocyte behavior. The aim of this study is to evaluate the biological effects of zoledronic acid (ZOL) in an in vitro model of periodontal ligament stem cells (PDLSCs) by using an experimental setting that resembles the in vivo conditions. PDLSCs were treated with different concentrations of ZOL ranging from 0.1 to 5 µM. The effects of ZOL exposure were evaluated on cell viability via 3-[4,5-Dimethylthiaoly]-2,5-diphenyltetrazolium bromide (MTT), cell cycle analysis, apoptosis detection, and immunofluorescence. Quantitative real-time polymerase chain reaction (PCR), colorimetric detection of alkaline phosphatase activity, and Alizarin Red S staining were performed to investigate the osteogenic potential of PDLSCs exposed to ZOL. MTT analysis showed that the viability of PDLSCs exposed to ZOL concentration ≥1.5 µM for 3 and 6 days was significantly lower (P < 0.001) than that of untreated cells. The percentage of apoptotic cells was significantly higher in PDLSCs exposed for 4 days to ZOL at 2 µM (P < 0.01) and 5 µM (P < 0.001) when compared to the control. Moreover, ZOL treatment (3 days) accounted for alterations in cell cycle distribution, with an increase in the proportion of cells in G0/G1 phase and a reduction in the proportion of cells in S phase. Chronic exposure (longer than 7 days) of PDLSCs to ZOL accounted for the downregulation of ALP, RUNX2, and COL1 genes at all tested concentrations, which fit well with the reduced alkaline phosphatase activity reported after 7 and 14 days of treatment. Reduced Col1 deposition in the extracellular matrix was reported after 14 days of treatment. Increased calcium deposits were observed in treated cells when compared to the control cultures. In conclusion, chronic exposure to 1 µM ZOL induced significant reduction of osteogenic differentiation, while ZOL concentrations ≥1.5 µM are required to impair PDLSCs viability and induce apoptosis.

Enhancing the diagnosis of maxillary transverse discrepancy through 3-D technology and surface-to-surface superimposition. Description of the digital workflow with a documented case report.

BACKGROUND: Maxillary transverse discrepancy is often diagnosed in childhood. The evaluation of morphological characteristics of the maxilla is crucial for appropriate treatment of this condition, however conventional diagnostic method is based on visual inspection and transversal linear parameters. In this paper, we described a user-friendly diagnostic digital workflow based on the surface-to-surface analysis. We also described a case report. CASE REPORT: A 6-year-old female patient presenting mild transversal maxillary deficiency associated with functional posterior crossbite was treated by using maxillary removable appliance. In this respect, the appliance was designed in accordance to the morphological characteristics of the maxilla obtained by using the diagnostic digital work-flow and the maxillary surface-to-surface analysis. CONCLUSION: The present user-friendly diagnostic digital workflow based on surface-to-surface analysis helps clinicians to detect specific morphological characteristics of the maxilla, such as shape and area of asymmetry, in order to reach a comprehensive diagnosis and choose the correct biomechanics for treating the condition.

Early mandibular morphological differences in patients with FGFR2 and FGFR3-related syndromic craniosynostoses: A 3D comparative study.

Syndromic craniosynostoses are defined by the premature fusion of one or more cranial and facial sutures, leading to skull vault deformation, and midfacial retrusion. More recently, mandibular shape modifications have been described in FGFR-related craniosynostoses, which represent almost 75% of the syndromic craniosynostoses. Here, further characterisation of the mandibular phenotype in FGFR-related craniosynostoses is provided in order to confirm mandibular shape modifications, as this could contribute to a better understanding of the involvement of the FGFR pathway in craniofacial development. The aim of our study was to analyse early mandibular morphology in a cohort of patients with FGFR2- (Crouzon and Apert) and FGFR3- (Muenke and Crouzonodermoskeletal) related syndromic craniosynostoses. We used a comparative geometric morphometric approach based on 3D imaging. Thirty-one anatomical landmarks and eleven curves with sliding semi-landmarks were defined to model the shape of the mandible. In total, 40 patients (12 with Crouzon, 12 with Apert, 12 with Muenke and 4 with Crouzonodermoskeletal syndromes) and 40 age and sex-matched controls were included (mean age: 13.7 months ±11.9). Mandibular shape differed significantly between controls and each patient group based on geometric morphometrics. Mandibular shape in FGFR2-craniosynostoses was characterized by open gonial angle, short ramus height, and high and prominent symphysis. Short ramus height appeared more pronounced in Apert than in Crouzon syndrome. Additionally, narrow inter-condylar and inter-gonial distances were observed in Crouzon syndrome. Mandibular shape in FGFR3-craniosynostoses was characterized by high and prominent symphysis and narrow inter-gonial distance. In addition, narrow condylar processes affected patients with Crouzonodermoskeletal syndrome. Statistical analysis of variance showed significant clustering of Apert and Crouzon, Crouzon and Muenke, and Apert and Muenke patients (p < 0.05). Our results confirm distinct mandibular shapes at early ages in FGFR2- (Crouzon and Apert syndromes) and FGFR3-related syndromic craniosynostoses (Muenke and Crouzonodermoskeletal syndromes) and reinforce the hypothesis of genotype-phenotype correspondence concerning mandibular morphology.

Bruma MAD: a new way of treating OSAS patients.

The aim of this study was to introduce a new adjustable device in the treatment of obstructive sleep apnea syndrome (OSAS). The new appliance has a different way to regulate and move the mandible through the presence of two occlusal lifts, that can leave an open posterior space, and the complex system formed by the peduncle and the steel plate that can easily move forward the mandible. This system guarantees a posterior space for the tongue but mostly for the passage of air. The principal aim of Bruma MAD is to contrast the pharyngeal collapsing and to prevent hypopnea or apnea. Further clinical studies are needed to confirm and to evaluate the predictability of this new device.

The use of three-dimensional reconstructions of CT scans to evaluate anomalies of hyoid bone in Pierre Robin sequence: A retrospective study.

AIM: The aim of the study was to investigate hyoid bone anomalies in patients with Pierre Robin sequence (PRS) compared to the control group, using computed tomography (CT) examination and three-dimensional reconstruction of the hyoid bone and mandible. METHODS: A retrospective study was performed of patients between birth and 12 months old with isolated PRS (i-PRS) and syndromic PRS (ni-PRS), who had undergone CT examination, and whose results were compared to the control group of the same age. DICOM data was processed to highlight bone tissue. The mandible and hyoid bones were the main targets of the three-dimensional reconstruction. The study outcomes were the analysis of hyoid bone ossification, volume, and position (distance between hyoid and mandibular symphysis). Univariate and multivariate statistical analyses were performed with α=0.05 as level of significance. RESULTS: The study sample included 29 i-PRS and 21 ni-PRS patients, while 43 infants in the control group. Hyoid ossification was present in 26/50 (52%) PRS patients (14 i-PRS; 12 ni-PRS) but in 31/43 controls (72%). Statistical analysis showed that absence of hyoid ossification was significantly associated with the diagnosis of PRS (P<0.05). Only ni-PRS patients showed a significant reduction of the distance between hyoid and mandible compared to the control group (P<0.001). Hyoid volume was significantly lower only in the ni-PRS group than in controls (P<0.001). CONCLUSION: I-PRS and ni-PRS patients differ both etiologically and clinically. Ni-PRS patients confirmed their worst clinical condition than i-PRS with severe anomalies of hyoid development, helping for their ontogeny classification.

Low-level laser therapy protocols in dental movement acceleration and in pain management during orthodontic treatment.

In recent years various studies about the biostimulatory effects of the laser therapy in orthodontics have been carried out. This study investigates the potential advantages obtainable using the Low-level Laser Therapy during orthodontic treatment and the most efficient clinical protocols. Recently published randomized controlled trials (RCTs) have been obtained through a search on electronic databases (Cochrane Library and Pubmed). Clinical studies in humans in which Low-level Laser Therapy was applied during orthodontic treatment were included. In conclusion, 14 relevant clinical studies were identified. This study shows the possibility to obtain an increase in tooth movement between 31% and 100% depending on the laser therapy considered and the time interval for measuring the value. In addition, there is a potential impact in reducing orthodontic pain limited to the day following the application of laser therapy when orthodontic therapy includes canine retraction, and during a period not exceeding five days from the placement of fixed orthodontic appliances in the others clinical cases.Low-level Laser Therapy is considered effective both to increase the movement of the dental elements and to reduce pain during orthodontic therapy. Different clinical protocols have been identified depending on the orthodontic cases considered. Both an LED device and an AlGaAs diode device can be used. In the future paying more attention to the therapeutic possibilities offered by laser devices with greater power is recommended. A greater energy density directed to the target tissues has been proven to provoke more significant therapeutic effects.

Hong-Ou-Mandel interference between independent III-V on silicon waveguide integrated lasers.

The versatility of silicon photonic integrated circuits has led to a widespread usage of this platform for quantum information-based applications, including quantum key distribution (QKD). However, the integration of simple high-repetition-rate photon sources is yet to be achieved. The use of weak-coherent pulses (WCPs) could represent a viable solution. For example, measurement device independent QKD (MDI-QKD) envisions the use of WCPs to distill a secret key immune to detector side channel attacks at large distances. Thus, the integration of III-V lasers on silicon waveguides is an interesting prospect for quantum photonics. Here we report the experimental observation of Hong-Ou-Mandel interference with 46±2% visibility between WCPs generated by two independent III-V on silicon waveguide integrated lasers. This quantum interference effect is at the heart of many applications, including MDI-QKD. This Letter represents a substantial first step towards an implementation of MDI-QKD fully integrated in silicon and could be beneficial for other applications such as standard QKD and novel quantum communication protocols.

No Compliance Correction of Class II Malocclusion in Growing Patients Whit HERBST Appliance: A Case Report.

BACKGROUND: Class II malocclusion is the most common sagittal skeletal discrepancy, with a prevalent skeletal pattern of mandibular retrusion. The correction of mandibular retrusion with functional removable appliance needs a good patient's compliance; for this reason, some clinicians prefer to use no compliance apparatus. OBJECTIVE: Objective of the present therapy note is to demonstrate that the use of no compliance apparatus can provide a good correction of skeletal class II malocclusion. METHODS: In the present study, authors report a therapy note referred to a 10 years old patient, woman, affected by Class II, with mandibular retrusion and deep bite, treated in 2013 at the Dep. of Orthodontics of Messina University. An orthodontic treatment has been planned with the aim of stimulating mandibular growth; an Herbst appliance with a cantilever design, bonded on first maxillary and mandibular molars, has been used. After eleven months of functional therapy a bilateral molar class I have been obtained. RESULTS: In the therapy note proposed, authors obtained a resolution of mandibular retrusion, a correction of overjet, overbite and dental crowding in both arches, and a bilateral molar and canine class I has been achieved. CONCLUSION: Herbst appliance seems to be efficient in the correction of II Class Malocclusion, independently from patient's cooperation; moreover , early correction of Class II malocclusion with functional appliances produces several clinical advantages.

Pierre Robin sequence: A comprehensive narrative review of the literature over time.

Pierre Robin syndrome (PRS) is characterized of a triad of clinical signs: micrognathia, glossoptosis and obstruction of the upper airways frequently associated with palatal cleft. It is a heterogenic pathological entity and it can be found as isolated disease (nsPRS) or in association with other syndromes (sPRS), with more pronounced symptoms and systemic involvement. This review aims to summarize the principal features of PRS, analysing the different aspects of the disease. Epidemiological data highlight incidence, severity and mortality of PRS; pathophysiological mechanism reports the etiology and pathogenesis of the disease distinguishing between isolated and syndromic form. Because of the clinical importance of PRS, it's fundamental to describe the features of the Robin sequence to clearly define its primary and secondary clinical signs useful to diagnosis. A complete evaluation of the syndrome allows choosing the most appropriate therapeutic treatment, opting for conservative or surgical management, in order to improve the quality of life of the patient.