ZeroExpander® effectiveness assessment in PEEK or PA12 in a group of paediatric patients with transverse maxillary deficiency.

AIM: The aim of this article is to compare the performance of ZeroExpander® realised using PEEK or PA12 for the expansion of the maxilla in paediatric patients, exploring a new concept for approaching maxillary expansion with a metal-free fixed automatic appliance, based on pre-programmed set-up and anchored on deciduous teeth. MATERIALS: It is a retrospective comparative study with a sample of 40 children in early or mixed deciduous dentition and transversal maxillary deficit, 20 treated with ZeroExpander® in PEEK and 20 treated with ZeroExpander® in PA12 with a mean age of 7.3 years old. The intraoral scans at T0 and at the end of the expansion were all performed by the same operator to obtain digital models on which were performed measurements by two other different operators. A descriptive analysis was conducted using frequencies and percentages for nominal variables and means and standard deviations for continuous variables. CONCLUSION: In cases of allergy or hypersensitivity to metals or to specific chronic or acute pathological conditions, which may require periodic magnetic resonance imaging (MRI), it may not be possible to use traditional and metal fixed expansion devices. Moreover the concept of autonomous driving in paediatric orthodontics is not only possible, but it is and will be more real and very useful in the future. The "ortho-paediatric dentistry concept" will increase the range of benefits for children and their families which, in addition to care and thanks to technology, demand well-being, safety, comfort and quality of life beyond clinics.

Measurement of the 2νßß Decay Half-Life of

We report on the results obtained with the global CUPID-0 background model, which combines the data collected in the two measurement campaigns for a total exposure of 8.82 kg×yr of ^{82}Se. We identify with improved precision the background sources within the 3 MeV energy region, where neutrinoless double ß decay of ^{82}Se and ^{100}Mo is expected, making more solid the foundations for the background budget of the next-generation CUPID experiment. Relying on the excellent data reconstruction, we measure the two-neutrino double ß-decay half-life of ^{82}Se with unprecedented accuracy: T_{1/2}^{2ν}=[8.69±0.05(stat)_{-0.06}^{+0.09}(syst)]×10^{19} yr.

Beyond the Clinic: why new bioactive restorative materials have really changed Paediatric Dentistry.

BACKGROUND: The aim of this paper is to remind how evidence-based paediatric dentistry should not only consider the best available scientific evidence relating to the patient's oral conditions but it should also consider the patient's needs beyond the clinic. In a child-family-oriented approach, the best restorative treatment for a primary tooth could not be the proper one for the child as a whole. Preservation of dental tissues as much as possible, without involving the pulp, is called minimal intervention dentistry (MID) and it is closely related to "selective caries removal" and "bioactive restorative materials". To preserve the vitality of a tooth as much as possible, many tools are available on the market (i.e. silver diamine fluoride, ozone) and this could play an important role in a "tailored fit treatment plan" mindset. CONCLUSION: Minimally invasive direct restorative strategies in paediatric dentistry, is a predictable evidence-based-restorative option for the treatment of vital primary teeth with no need of local anaesthesia and absolute isolation. Beyond the clinical aspect, the clinician expertise is crucial to evaluate the required materials and tools, not only to perform a minimal invasive paediatric dentistry in a safe, efficient and child-friendly way, but for the wellness of all parties involved. In this life-related paradigm new bioactive restorative materials are among the main protagonists.

Measurement of the 2νßß Decay Rate and Spectral Shape of

Neutrinoless double beta decay (0νßß) is a yet unobserved nuclear process that would demonstrate Lepton number violation, a clear evidence of beyond standard model physics. The process two neutrino double beta decay (2νßß) is allowed by the standard model and has been measured in numerous experiments. In this Letter, we report a measurement of 2νßß decay half-life of ^{100}Mo to the ground state of ^{100}Ru of [7.07±0.02(stat)±0.11(syst)]×10^{18} yr by the CUPID-Mo experiment. With a relative precision of ±1.6% this is the most precise measurement to date of a 2νßß decay rate in ^{100}Mo. In addition, we constrain higher-order corrections to the spectral shape, which provides complementary nuclear structure information. We report a novel measurement of the shape factor ξ_{3,1}=0.45±0.03(stat)±0.05(syst) based on a constraint on the ratio of higher-order terms from theory, which can be reliably calculated. This is compared to theoretical predictions for different nuclear models. We also extract the first value for the effective axial vector coupling constant obtained from a spectral shape study of 2νßß decay.

New 3D printed polymers in orthodontics: a scoping review.

AIM: The aim of this scoping review is to assess the application of new 3D printed polymeric materials in orthodontics, including polyamide-12 (PA-12) and Shape Memory Polymers (SMPs). METHODS: A search for articles published until January 2023 was carried out using PubMed, Scopus, Web of Knowledge, Lilacs, Opengrey, Embase and Cochrane Library databases and by applying the search terms (orthodontic* OR paediatric* OR paedodontic*) AND ("3D printed" OR "three-dimensional printed") AND (polymer* OR material* OR resin* OR technopolymer*). Additional records were also screened through hand or electronic search. No restriction in terms of language or publication period was applied. CONCLUSION: Due to their mechanical, aesthetic and biocompatibility characteristics, PA12 and SMPs can be used in orthodontic practice. However, additional studies should be performed to evaluate the clinical efficiency of these recent materials.

Child/family-oriented approach: the teeth come after.

BACKGROUND: The aim of this paper is to promote reflection on the dentist's approach to the dental care of young patients, considering not only their oral care needs, but also the management of their behaviour, that is intrinsic to their life needs and to those of their families. CASE REPORT: This approach to dental care management stems from a thorough evaluation of the patient, the reason for dental visit, whether the child had previous dental visit(s), which might not have been positive, the family involvement and the emotional characteristics of the child and their parents. We should design a progressive customized path, sometimes starting only from secondary prevention in order to "comfortably" avoid the worsening of a given clinical condition, stimulate a concomitant positive behavioural response of all parties involved, until the child and their family are ready to take the next step, in terms of integrated restorative dentistry and/or paediatric orthodontics, where and when needed. CONCLUSION: "The teeth come after" means that dental and oral care of the children may not be achievable goals unless we first address their wellbeing and that of their families, and that sometimes "the perfect is the enemy of the good", especially when we incorrectly consider only the clinical outcome. In this scenario, psychological skills and clinical feelings, comfort techniques, technologies, new materials and a more "medical less" surgical approaches are the bases for a child/family-oriented approach.

DOP Dentistry: digitally embracing orthodontics and paediatric dentistry.

AIM: The aim of this paper is to illustrate the concept of DOP Dentistry (Digital Ortho Paediatric Dentistry) in daily practice. CASE REPORT: DOP Dentistry is a new concept introduced by the authors to express the perfect integration between two disciplines that for a long time have been separated: paediatric dentistry and paediatric orthodontics. In modern dentistry it is increasingly important for the paediatric dentist to have skills and abilities that embrace both of these disciplines. To these we have to add a third element, represented by new digital technologies, as well as new bioactive ionic resin composites and biocompatible technopolymers to perform fully digital, integrated paediatric orthodontic treatments. CONCLUSION: Based on the DOP Dentistry concept, that definitely changes the paradigm of taking care of children, new and fascinating scenarios open up, that will lead us to a more integrated management of our little patients, their needs and those of their family with a new, more ergonomic, efficient and tailor-made approach.

New Direct Limit on Neutrinoless Double Beta Decay Half-Life of

The Cryogenic Underground Observatory for Rare Events (CUORE) at Laboratori Nazionali del Gran Sasso of INFN in Italy is an experiment searching for neutrinoless double beta (0νßß) decay. Its main goal is to investigate this decay in ^{130}Te, but its ton-scale mass and low background make CUORE sensitive to other rare processes as well. In this Letter, we present our first results on the search for 0νßß decay of ^{128}Te, the Te isotope with the second highest natural isotopic abundance. We find no evidence for this decay, and using a Bayesian analysis we set a lower limit on the ^{128}Te 0νßß decay half-life of T_{1/2}>3.6×10^{24} yr (90% CI). This represents the most stringent limit on the half-life of this isotope, improving by over a factor of 30 the previous direct search results, and exceeding those from geochemical experiments for the first time.

Final Result on the Neutrinoless Double Beta Decay of

CUPID-0, an array of Zn^{82}Se cryogenic calorimeters, was the first medium-scale demonstrator of the scintillating bolometers' technology. The first project phase (March 2017-December 2018) allowed the most stringent limit on the neutrinoless double beta decay half-life of the isotope of interest, ^{82}Se, to be set. After a six month long detector upgrade, CUPID-0 began its second and last phase (June 2019-February 2020). In this Letter, we describe the search for neutrinoless double beta decay of ^{82}Se with a total exposure (phase I+II) of 8.82 kg yr^{-1} of isotope. We set a limit on the half-life of ^{82}Se to the ground state of ^{82}Kr of T_{1/2}^{0ν}(^{82}Se)>4.6×10^{24} yr (90% credible interval), corresponding to an effective Majorana neutrino mass m_{ßß}<(263-545) meV. We also set the most stringent lower limits on the neutrinoless decays of ^{82}Se to the 0_{1}^{+}, 2_{1}^{+}, and 2_{2}^{+} excited states of ^{82}Kr, finding 1.8×10^{23} yr, 3.0×10^{23} yr, and 3.2×10^{23} yr (90% credible interval) respectively.

Face Scan for Ceph 3D: a green way for diagnosis in children.

BACKGROUND: The aim of this paper is to illustrate how new opportunities offered by technology and diagnostic imaging can more easily create a 3D integration of soft tissue Face Scan and IOS (intra oral scan) for orthodontic evaluation in children. CASE REPORT: Through TrueDepth technology, a software commonly used for digital devices such as smartphones and tablets, the authors illustrate the acquisition of facial scans by means of different applications, and their integration with IOS to perform diagnostic evaluations and treatment planning at zero biological cost for patients. CONCLUSION: TrueDepth technology is both accurate and easy to use for all clinicians, even those less accustomed to digital innovations. In the past, stereophotogrammetric systems and devices were used, and they are the gold standard for three-dimensional acquisitions. However, there is a major drawback associated with this technology as it is expensive and non-portable. Truedepth technology is an effective substitute, as smartphone applications are portable, cheaper, and more accessible, giving each orthodontist the ability to take advantage of the benefits of facial scanning in their daily practice.

Post-COVID-19 Lung Transplantation Italian Pivotal Protocol: Some Ethical Considerations.

SARS­CoV­2 mostly affects the respiratory system with clinical patterns ranging from the common cold to fatal pneumonia. During the first wave of the COVID-19 pandemic, owing to the high number of patients who were infected with SARS­CoV­2 and subsequently recovered, it has been shown that some patients with post-COVID-19 terminal respiratory failure need lung transplantation for survival. There is increasing evidence coming from worldwide observations that this procedure can be performed successfully in post-COVID-19 patients. However, owing to the scarcity of organs, there is a need to define the safety and efficacy of lung transplant for post-COVID-19 patients as compared to patients waiting for a lung transplant for other pre-existing conditions, in order to ensure that sound ethical criteria are applied in organ allocation. The Milan's Policlinic Lung Transplant Surgery Unit, with the revision of the National Second Opinion for Infectious Diseases and the contribution of the Italian Lung Transplant Centres and the Italian National Transplant Centre, set up a pivotal observational protocol for the lung transplant of patients infected and successively turned negative for SARS­CoV­2, albeit with lung consequences such as acute respiratory distress syndrome or some chronic interstitial lung disease. The protocol was revised and approved by the Italian National Institute of Health Ethics Committee. Description of the protocol and some ethical considerations are reported in this article.

Spa-Inspired Oral Care: A new approach in paediatric dentistry.

BACKGROUND: The aim of this paper is to illustrate a different way to take care of our little patients, starting from creating child-oriented environmental conditions and proceeding using a specific comfort technique in paediatric dentistry. CASE REPORT: This concept of treatment arises from the inseparable relationship between body and psyche. It starts with instructions aimed at informing parents or caregivers not to prepare the child for the visit but to explain the child that he/she will be taken care in new ways. This is accomplished by approaching the child in an original setting without the traditional dental chair, and that can be the same dedicated room in which we will be able to provide the first care, as a part of a customised treatment, which does not consider only the clinical outcomes. CONCLUSION: Spa-inspired oral care is the name we chose to describe this new way to treat our little patients, putting them at ease with a dedicated environment, characterised not only by drawings hung on the walls, but also by lights, music, videos and scents. Importance is also given to the choice of words, the dental team appearance, and instruments that allow the application of treatment and comfort techniques tailored to them, where 'how' can be more important than 'what'.

PEEK polymer in orthodontics: a scoping review.

AIM: The aim of this scoping review was to evaluate the application of polyether-ether-ketone (PEEK) in orthodontics. METHODS: Search strategies were executed for electronic databases through PubMed, Scopus, Web of Science, Lilacs, Opengrey, Embase, Cochrane Library and records identified through hand or electronic search. The keywords used were: "PEEK" OR "Polyether-ether-ketone" AND "orthodontics". The period selected of article publication was from January 2015 to June 2021. CONCLUSION: Due to excellent physical, mechanical, aesthetic properties and biocompatibility, its low plaque affinity and flexural modulus close to enamel and dentin, PEEK can be used also in orthodontics. However, more clinical research should be done to find out all the advantages and disadvantages of this material.

When 'How' is more important than 'What'.

Clinical goals are not everything and in paediatric dentistry, in fact an adequate approach to the child is the first step toward oral health. Before reaching the therapeutic outcomes planned with the child and their family, we must ask ourselves 'how' we can achieve them. The ancient philosophers postulated that the mind is not separate from the body, yet many modern dentists ignore it, and approach the dental treatment of children without being prepared to do so, since often they do not consider the extent of how much, context and behaviours can influence the psycho-physical balance of the little patient. The World Health Organization (WHO) already in 1946 defined health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". Child health problems cannot be solved by simply treating functions and organs, but attention must be paid to psychological, social and family aspects, as well as to the emotional sphere of the child. Therefore, we cannot fail to consider the well-being and comfort of our therapies as indispensable before, during and after delivery of the treatment. Unfortunately today this approach is not sufficiently valued and implemented, and only measurable therapeutic outcomes appear important. We must not forget that around a milk tooth there is a child with his/her unique characteristics and qualities, a family and the desire to receive the best treatment possible, while paying attention to the well-being of all the parties involved, where 'how' may be more important than 'what'. For children, the environment, the sounds, the smells, in addition to the words and time dedicated to them mirror the way we take care of them and are already a cure in itself. This scenario describes the idea and the principles on which the concept of Spa-inspired oral care is based, which is described in detail in the Avantgarde section of this issue: when borrowing the definition from the ancient Latin Salus per Aquam, we are referring to feeling good, not just being cared for. The time "to cure a child" is over, but the time of "to take care of a child" has definitely come.

Fully digital fixed orthodontic prosthesis: use of PEEK technopolymer in cases of early loss of primary incisors.

BACKGROUND: The aim of this paper is to illustrate a new, fully digital approach to temporary rehabilitation in the case of premature loss of deciduous incisors, using a metal-free fixed orthodontic prosthesis made of polyether ether ketone (PEEK). CASE REPORT: Clinical report: Technopolymer Orthodontic Prosthesis (TOP) is a complete CAD-CAT (Computer Aided Design-Computed Aided Technofacturing) fixed device that can be used to rehabilitate the mouth of very young patients, both from an aesthetic and functional point of view as well as maintaining space and controlling growth. The appliance is customised, designed to be cemented with adhesive technique, using deciduous teeth as anchorage. Two cases of patients in deciduous dentition with early loss of incisors are illustrated to present this procedure. In the first case the patient lost 2 central incisors and in the second one 3 lower incisors were lost due to trauma. CONCLUSION: TOP, made by metal-free technopolymer and cemented on deciduous teeth, proved to be comfortable, aesthetic, easy to apply and efficient in rehabilitating smile and mastication in case of trauma or premature loss of deciduous incisors.

Background identification in cryogenic calorimeters through α - α delayed coincidences.

Localization and modeling of radioactive contaminations is a challenge that ultra-low background experiments are constantly facing. These are fundamental steps both to extract scientific results and to further reduce the background of the detectors. Here we present an innovative technique based on the analysis of α - α delayed coincidences in 232 Th and 238 U decay chains, developed to investigate the contaminations of the ZnSe crystals in the CUPID-0 experiment. This method allows to disentangle surface and bulk contaminations of the detectors relying on the different probability to tag delayed coincidences as function of the α decay position.

ZeroExpander: Metal-free automatic palatal expansion for special-needs patients.

AIM: The aim of this paper is to illustrate a new concept for approaching maxillary expansion in paediatric orthodontics with a metal-free fixed automatic appliance in special-needs patients. CASE REPORTS: The ZeroExpander is a complete CAD-CAT full digital and automatic metal-free fixed device. It is designed to expand the maxilla in a pre-programmed automatic way using deciduous teeth as anchorage. Two cases of growing patients with a narrow upper arch are illustrated to present this innovative system, one in complete deciduous dentition and the second in mixed dentition. Both patients were successfully treated with palatal expansion. In the first case we present the use of PEEK, and in the second one the use of PA12. CONCLUSION: The ZeroExpander, fabricated using metal-free technopolymers and anchored on deciduous teeth, proved to be comfortable and efficient in treating palatal transverse deficiency, without the need of any compliance, even in young patients who must periodically undergo MRI.

New Limit for Neutrinoless Double-Beta Decay of

The CUPID-Mo experiment at the Laboratoire Souterrain de Modane (France) is a demonstrator for CUPID, the next-generation ton-scale bolometric 0νßß experiment. It consists of a 4.2 kg array of 20 enriched Li_{2}^{100}MoO_{4} scintillating bolometers to search for the lepton-number-violating process of 0νßß decay in ^{100}Mo. With more than one year of operation (^{100}Mo exposure of 1.17 kg×yr for physics data), no event in the region of interest and, hence, no evidence for 0νßß is observed. We report a new limit on the half-life of 0νßß decay in ^{100}Mo of T_{1/2}>1.5×10^{24} yr at 90% C.I. The limit corresponds to an effective Majorana neutrino mass ⟨m_{ßß}⟩<(0.31-0.54) eV, dependent on the nuclear matrix element in the light Majorana neutrino exchange interpretation.

Paediatric endodontics Part 2: Pulp regeneration: current approaches.

Dental pulp regeneration: An overview of the current approaches. Regenerative Endodontic Procedures (REPs) are biologically based procedures aimed at restoring the damaged structures and physiological functions of the pulp-dentine complex. Clinically, two strategies have been proposed so far to induce REP: cell transplantation and cell homing. REPs success relies primarily on the clinical and biological conditions of the tooth; therefore, cell homing strategies will not be consistently successful in every condition. Root canal treatment remains the standard of care for mature teeth with necrotic pulps and closed apex.

Investigation into powder tribo-charging of pharmaceuticals. Part II: Sensitivity to relative humidity.

Environmental conditions can have a profound impact on the bulk behaviour of pharmaceutical powders, including their tribo-charging tendency. Typically, high relative humidity (RH) has been associated to a reduction in the electrostatic charge of the material. However, the occurrence of charge mitigation seems to be related to the quantity of water molecules at the powder surface, which depends on intrinsic material attributes (i.e., water sorption propensity), and external factors (i.e., RH level). In the present study, pharmaceutical powders (i.e., microcrystalline cellulose, D-mannitol, paracetamol and magnesium stearate) were conditioned at three levels of RH, relevant for pharmaceutical operations, and their bulk behaviour, including charging propensity, was analyzed. Depending on the material type, powders sorbed water from the humid atmosphere to different extents, resulting in different charging behaviours. Overall, the charge density of the materials was found to decrease after a certain RH or monotonically decrease with an increase of RH, except for D-mannitol. For this material, a contrasting trend of increase in charging was observed with an increase in RH. Moreover, the powders showed a distinct tribo-charging sensitivity to RH, with paracetamol being the most affected. These findings suggest that a careful consideration on solid material-moisture interactions is needed when using RH as strategy to minimize electrostatic effects in powder processing.