Clinical comparison of instrumentation systems for periodontal debridement: A randomized clinical trial.

OBJECTIVE: To compare clinical efficacy, chairside time and post-treatment hypersensitivity of four instruments used for subgingival periodontal debridement. MATERIALS & METHODS: Seventeen patients with stage II and III periodontitis were enrolled in this randomized clinical trial using a split-mouth design. Quadrants were randomly divided into four treatment groups: Group A: Gracey curettes-Hu-Friedy® ; Group B: piezoelectric ultrasonic (Satelec® ) with No.1S insert; Group C: diamond burs 40 µm (Intensiv Perioset® ); and Group D: piezosurgery ultrasonic (Mectron® ) with PP1 insert. Clinical outcomes, chairside time and hypersensitivity were assessed at 1, 2, 4 and 8 weeks after treatment. The primary outcome variable was improvement in clinical attachment level. RESULTS: At 8 weeks post-treatment, Gracey curettes, piezoelectric ultrasonic (Satelec® ) and piezosurgery ultrasonic (Mectron® ) were statistically more effective than diamond burs in increasing attachment level and reducing probing pocket depth. Comparison of piezoelectric ultrasonic (Satelec® ) and piezosurgery ultrasonic (Mectron® ) with the other instruments showed a statistical difference (p < 0.001) in chairside time. Regarding post-treatment hypersensitivity, no statistical differences were observed in any of the groups. CONCLUSIONS: Gracey curettes, piezoelectric ultrasonic (Satelec® ) and piezosurgery ultrasonic (Mectron® ) were clinically more effective than diamond burs 40 µm. The ultrasonic instruments showed a significant reduction in chairside time.

Psychosis, symbol, affectivity 1: etiopathogenesis and treatment through analytical psychology.

This is the first of two papers concerning our study into an integrated approach to psychotic disorders, conducted at the University of Palermo's Psychiatry Unit Polyclinic over approximately 15 years. Here we will explore and reflect upon the acute psychotic condition mainly from a theoretical and conceptual perspective, while in the second paper we will explore the clinical perspective. From the point of view of psychopathology, and in the light of C.G. Jung's conceptualization of analytical psychology, as well as calling on contributions from other authors from the systemic-relational and post-psychoanalytic field, we will clarify the ideas developed over these last few years by our team. From a more speculative perspective we will advance new interpretive hypotheses in an attempt to thoroughly understand the nature of the psychotic condition, both on a psychodynamic relational and a neuroscientific level. The paper describes how we revised our understanding of psychosis from a brain disease to a process aimed at the rearrangement of psychic functioning, as anticipated by John Weir Perry nearly 40 years ago.

Ceci est le premier de deux articles au sujet d'une étude sur une approche intégrée des troubles psychotiques. Cette étude a été conduite sur une quinzaine d'années à l'Université de Palerme, dans le service de Polyclinique en Psychiatrie. Dans ce premier article nous explorerons la condition psychiatrique aigue à partir d'un point de vue principalement théorique et conceptuel. Dans le deuxième article nous explorerons la perspective clinique. Du point de vue de la psychopathologie, à la lumière des conceptualisations de la psychologie analytique de C.G. Jung et en s'appuyant également sur l'apport d'autres auteurs du champ systémique-relationnel et post-psychanalytique, nous clarifierons les idées développées par notre équipe dans les dernières années. D'un point de vue plus spéculatif, nous proposerons de nouvelles hypothèses interprétatives pour tenter de comprendre pleinement la nature de la condition psychiatrique, à la fois sur le plan psychodynamique et relationnel et sur le plan des neurosciences. L'article décrit comment nous avons révisé notre compréhension de la psychose, la considérant au départ comme une maladie du cerveau, puis finalement comme un processus visant le réaménagement du fonctionnement psychique, comme John Weir Perry l'avait anticipé il y a presque 40 ans.

Este es el primero de dos ensayos acerca de nuestro estudio sobre un abordaje integrado de los trastornos psicóticos, conducido en la Unidad Policlínica Psiquiátrica de la Universidad de Palermo durante 15 años aproximadamente. Aquí vamos a explorar y reflexionar sobre la condición psicótica aguda desde una perspectiva teórica y conceptual. En el segundo trabajo exploraremos la perspectiva clínica. Desde el punto de vista de la psicopatología, y a la luz de la conceptualización de C.G. Jung de la psicología analítica, así como también tomando las contribuciones de otros autores del campo sistémico-relacional y pos-psicoanalítico, clarificaremos las ideas desarrolladas por nuestro equipo durante los últimos años. Desde una perspectiva más especulativa ofreceremos nuevas hipótesis interpretativas en un intento de comprender cabalmente la naturaleza de la condición psicótica, desde ambos niveles, psicodinámico relacional, y neurocientífico. El trabajo describe el modo en que hemos revisado nuestra comprensión de la psicosis, desde ser considerada una enfermedad cerebral hasta ser un proceso destinado a la reorganización del funcionamiento psíquico, tal como lo anticipó John Weir Perry hace aproximadamente 40 años.

In Vitro Evaluation of the Effect of Chemical and Thermal Stress of the Mechanical Properties of Periodontal Curettes under Simulated Conditions of Sharpening Wear.

PURPOSE: To determine whether chemical and thermal stress as well as sharpening are aspects that must be considered to determine when a curette has become too weak to be used safely without the threat of breakage. MATERIALS AND METHODS: A total sample of 35 curette blades was divided into 2 principal groups, control (groups 1 to 3) and experimental (groups 4 to 6). The control group was divided into 3 colour-coded groups of 19 similar curette blades and was only subjected to progressive sharpening wear (not sterilised). The test group included 16 Gracey curette blades that were subjected to various degrees of progressive wear and different numbers of sterilisation cycles in 3 subgroups (subgroup 4 had 5 sterilisation cycles; subgroup 5 had 30 cycles and experimental subgroup 6 had 55 cycles). Using a universal testing machine, all blades were tested for strength until they fractured. RESULTS: No evidence was found that the simple presence or absence of sterilisation cycles produced a statistically significant difference between the two studied groups (sterilised and not sterilised). However, when comparing the six subgroups that underwent different numbers of sterilisation cycles, the analysis showed that the more sterilisation cycles a curette underwent, the more likely the curette was to fracture (p = 0.047). CONCLUSION: Sterilisation by itself does not produce a significant change in the fracture strength, whereas the number of sterilisation cycles clearly weakens the instrument. Sterilisation is a factor to control when evaluating the life of a periodontal curette for the patients' and professionals' safety.