Tunnel technique through three vertical buccal incisions to reduce nasolabial changes due to surgically assisted rapid palatal expansion.

The aim of this technical note is to present a minimally invasive approach to the maxilla for segmental Le Fort I osteotomy in surgically assisted rapid palatal expansion (SARPE). This approach reduces the nasolabial changes that occur with the traditional circumvestibular approach.

Distribution of craniomandibular disorders, occlusal factors and oral parafunctions in a paediatric population.

AIM: The aim of this work was to gather clinical data on craniomandibular (CMD)/temporomandibular joint (TMJ) disorders in a paediatric population. METHODS: The clinical study population comprised patients with TMJ disorders who were being treated in the orthognathic ambulatory clinic of the University of Naples, where an instrumental and clinical study was performed. Data were recorded for extra and intraoral findings, Angles classification and malocclusions. Radiographic examinations were carried out. Study models were fabricated for evaluation. TMJs were assessed by palpation as well as masseter, temporal, suprahyoid, sternocleidomastoid, suboccipital, paravertebral and trapezius muscles to evaluate any possible pain. Auscultation of the TMJ was used to determine presence of articular sounds and their type (cracks, crunches, clicks) by the use of a stethoscope. Pain localisation was evaluated according to these movements taking into account site, intensity, frequency, and duration. Episodes of headache were recorded according to its intensity (mild, moderate, intense), frequency (daily, weekly, monthly), site (top of the head, occiput, temple, frontal, overorbital region, back of the head) and the duration of the episodes (in minutes, hours or whether constant). RESULTS: A substantial number of the 106 patients included in the study showed a malocclusion with prevalence in Angles Class II cases. Bruxism, onychophagy, TMJ pain, headache, mouth opening partial inability, mastication difficulty and articular sound were the most representative symptoms. CONCLUSION: The identification and recognition of factors, such as malocclusions and parafunctions, are considered fundamental to early diagnosis of TMJ problems, which is the most useful way to avoid a dysfunctional state of the stomatognathic system.

[Cephalometric evaluation of patients with Turner syndrome. Authors' experience]. / Valutazioni cefalometriche di pazienti affette da sindrome di Turner. Nostra esperienza.

BACKGROUND AND METHODS: The cranio-facial morphology has been evaluated on the basis of cephalometric studies in nine patients with Turner's syndrome. The aim of this study is to identify the growth model and the typical malocclusions of this syndrome. This study has been completed with an evaluation of mesio-distal dimension of permanent teeth. RESULTS: According to the literature, the results show: a flattening of the basal skull; a cross-bite coming from a transversal dimension reduction of the upper maxilla. A Class II malocclusion was found in two patients. All the patients showed a mandibular retrusion associated to maxillary retrusion in eight cases. The growth direction was normal in all the patients. CONCLUSIONS: A reduction of the mesio-distal diameter in all of the permanent teeth, was also found. This last measure was evaluated using the study casts.

[The role of soft tissues in the planning of bimaxillary orthognathic surgery. Review of the literature and two clinical cases]. / L'influenza dei tessuti molli nella progettazione di un intervento bimascellare in chirurgia ortognatica. Revisione della letteratura e presentazione di due casi clinici.

The authors have investigated the clinical role of the soft tissues and of their influence in the planning phase of the orthognathic surgery, with the purpose to emphasize their capital influence in the face armony. Most of the patients really ask for an aesthetic result, that is in a tight relation with the correct prediction of the morphological changes of the soft tissues. The aesthetics excite nowadays the research, especially in all the surgical fields, and so the orthognatic surgery is more than ever from the soft tissues influenced. Subsequently the authors have investigated the principal indications to the bimaxillary surgery and have suggested a personal diagnostic-therapeutic protocol for a correct and opportune evaluation of the soft tissues relations. Finally the authors have described the whole prediction phase and have shown as the maxillary bones influence the whole facial skelett, and as frequently the chin correction and the rhinoplasty are necessary for a better result in the time.

[Diagnostic-therapeutic protocol in orthodontic surgery]. / Protocollo diagnostico-terapeutico di chirurgia ortognatica.

The authors describe the diagnostic-therapeutic protocol of orthodontical-surgical treatments of Angle-class I, II and III used by the Oral and Maxillo-Facial Surgery Department of Second University of Naples. They also present a personal survey.

[Dento-skeletal recurrence in cases of surgical treatment of dysmorphism]. / Recidiva dento-scheletrica nei casi di dismorfismi trattati chirurgicamente.

The purpose of the present study is to investigate the factors contributing to skeletal relapse after surgical correction of mandibular prognathism. Postoperative follow-up after mandibular setback is carried out to clarify the timing and causes of the relapse. The subjects are mandibular prognathism patients. The etiology of relapse is discussed.

[The functional therapy of fractures of the mandibular condyle. Our experience]. / Terapia funzionale delle fratture del condilo mandibolare. Nostra esperienza.

This work dealt with clinical experience since 1992, in management by functional therapy of mandibular condyle fractures, of the Institute of Oral and Maxillo-Facial Surgery in the I Policlinico of Naples. In this work from 87 treated patients, only a group of 8 has been considered because it expresses the heterogeneity of all cases about the age, the sex, the kind and the level of fracture and the association with other fracture of the skull. The results obtained show that the functional therapy must be considered the first opinion in the mandibular condylar fractures at least there are specific conditions.

[The characteristics and properties of calcium phosphates in biomaterial formulations used in dentistry. 1]. / Caratteristiche e proprietà di alcuni fosfati di calcio presenti nella formulazione di biomateriali impiegati in odontostomatologia. Nota 1.

In this work we present the features and the properties of natural and synthetic apatites, which we use in an experimental study of various commercial products composed by calcium phosphate. After having considered the general concepts of biomaterials and biocompatibility, we describe non biological tests used for the characterization of these products. Biomaterials used in this study are: reabsorbable Dac Blu, non reabsorbable Dac Blu, non reabsorbable atomized Dac Blu, non reabsorbable thin Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12, Orthogel, Apagen, BTF 65, Calcitite 4060-2 Osprogel, Bio-oss, Biostite, Osprovit, Merck Hydroxiapatite. Tests used are: X-ray fluorescence (XRF), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), thermogravimetric and thermodifferential analysis (TG, DTG, DTA), scanner-ing electron microscopy (SEM) morphological analysis. Last but not least, we underline the particular features of these tests whose interpretation allows a more precise definition of the bioactivity of a biocompatible material.

[The thermal analysis of mineral-based biomaterials used in dentistry. 5]. / Analisi termiche di biomateriali a base minerale utilizzati in odontostomatologia. Nota 5.

In this study the following commercial products were thermo-analysed (TG, DTG, DTA): reabsorbable Dac Blu, non reabsorbable Dac Blu, non reabsorbable atomized Dac Blu, non reabsorbable thin Dac Blu, reabsorbable Biocoral 450, non reabsorbable thin Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12, Orthogel, Apagen, BTF 65, Calcitite 4060-2, Osprogel, Bio-Oss, Biostite, Osprovit, Merck Hydroxiapatite. The apparatus utilized was a Setaram TAG 24, in a symmetrical set up, which gave the TG, DTG and DTA analysis simultaneously. The analysis of all the materials were performed in correct operative conditions. The thermo analyses gave useful information about the thermal stability of the samples. The TG analysis gave the data relative to the percentage of weight loss due to the volatile substances in the samples (H2Oass C, OH-, CO2). The DTG graph made it possible to establish the presence of carbonate apatite and/or hydroxyapatite or the absence of both the substances. Finally, DTA and DTG analyses allowed show the presence of various organic substances. These data were very useful to characterize the examined materials and confirmed the extreme importance and sensibility of this method.

[The X-ray fluorescence (XRF) spectrometry of biomaterials used in dentistry. 2]. / Analisi in spettrometria per fluorescenza di raggi X (XRF) di biomateriali utilizzati in odontostomatologia. Nota 2.

In this work we analyze the following biomaterial: biomaterials used in this study are: reabsorbable Dac Blu, non reabsorbable Dac Blu, non reabsorbable atomized Dac Blu, non reabsorbable thin Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12, Orthogel, Apagen, BTF 65, Calcitite 4060-2, Osprogel, Bio-Oss, Biostite, Osprovit, Merck Hydroxiapatite. The quantitative XRF analysis was performed by a Philips PW 1480 with Rh tube. This research, besides underlining the possibility of applying the XRF method to the analysis of biomaterials. This study, shows the facility and the rapidity in the preparation of samples and standards in the form of tablets to undergo the analysis: furthermore the study shows the possibility of verify the analysis on the same sample in the future, because the tablet if well conserved, does not deteriorate. We can also verify a good analytic accuracy both for the principal elements (Ca, P) and for trace elements. The analyses show a moderate variability in the Ca/P ratio in the hydroxylapatites, and a greater variability in the secondary and trace elements.

[X-ray powder diffraction (XRD) in the study of biomaterials used in dentistry. 3]. / La diffrattometria X (XRD) a polveri nello studio di biomateriali utilizzati in odontostomatologia. Nota 3.

This study considers X-ray power diffraction (XRD) applied to the study of mineral-based biomaterials used in odontostomatology. By means of this method the following materials were analysed: reabsorbable Dac Blu, non reabsorbable Dac Blu, non reabsorbable atomized Dac Blu, non reabsorbable fine Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12, Orthogel, Apagen, BTF 65, Calcitite 4060-2, Osprogel, Bio-oss, Biostite, Osprovit, Merck Hydroxyapatite. These analysis allow the identification of the crystalline phases, the study of the crystallinity and the crystal chemistry of the samples prepared as powder mixtures. This method permits the determination of the physical chemical and crystalline characteristics of these mineral based biomaterials formed by powders or transformable in powders. All of this information is indispensable for the evaluation of the functional biocompatibility of a biomaterial when its reaction in a biological environment is already known. This method has a great number of advantages against the traditional methods, marking with solid phases, it does not destroy the sample, it does not modify the physical or chemical characteristics and gives more information.

[The characterization by Fourier-transform infrared vibration spectroscopy of mineral-based biomaterials commonly used in dentistry. 4]. / Caratterizzazione mediante spettroscopia vibrazionale infrarossa a trasformata di Fourier (FTIR) di alcuni biomateriali a base minerale di uso comune in odontostomatologia. Nota 4.

In this study the following biomaterials were analysed by means of Fourier transform infrared vibrational spectroscopy (FTIR); they are: reabsorbable Dac Blu, non reabsorbable Dac Blu, non reabsorbable atomized Dac Blu, non reabsorbable fine Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12, Orthogel, Apagen, BTF 65, Calcitite 4060-2 Osprogel, Bio-Oss, Biostite, Osprovit, Merck Hydroxyapatite. The analysis was performed with a Jasco 5300-FTIR. At 64 readings for spectrum with a 2 cm-1 resolution. By means of this method it has been possible to perform a structural study at a molecular level of the commercial products mentioned before. The analysis showed which of the samples examined had lost the apatite OH- group during production. It also allowed the identification of some of the hydroxyapatites examined as carbonate apatites. Finally, it allowed the identification and quantification of the organic substances in the examined products.

[Scanning electron microscopy (SEM) and microanalysis (EDS) applied to the study of biomaterials for dental use. 6]. / La microscopia elettronica a scansione (SEM) e microanalisi (EDS) applicata allo studio dei biomateriali per uso odontostomatologico. Nota 6.

The study considers the use of scanning electron microscopy (SEM) and EDS microanalysis applied to the study of numerous mineral-based biomaterials of common use in odontostomatology. The products studied are the following: reabsorbable Dac Blu, non reabsorbable Dac Blu, non reabsorbable atomized Dac Blu, non rabsorbable fine Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12, Orthogel, Apagen, BTF 65, Calcitite 4060-2, Osprogel, Bio-Oss, Biostite, Ospro-vit, Merck Hydroxyapatite. By means of SEM it was possible to study the morphology and the microchemistry of the various biomaterials so as to have information about their physical and chemical characteristics, such as the crystalline form, the crystalline aggregations, the space dimensional distribution of the pores and check the possibilities of composition variability. All of these factors are fundamental to evaluate the functional biocompatibility of a biomaterial, once that its performance in a biological environment is known.

[The specific characteristics determined by nonbiological tests of mineral-based biomaterials used in dentistry. 7]. / Considerazioni sulle specifiche ottenute da test non biologici relative a biomateriali a base minerale utilizzati in odontostomatologia. Nota 7.

In this work we relate about the results coming from crystallographic, physical and mineral tests taken on following biomaterials used in odontostomatology: reabsorbable Dac Blu, non reabsorbable Dac Blu, not reabsorbable atomized Dac Blu, not reabsorbable thin Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12, Orthogel, Apagen, BTF 65, Calcitite 4060-2, Osprogel, Bio-Oss, Biostite, Osprovit, Merck Hydroxiapatite. The data were obtained using the following tests: XRF, XRD, FTIR, TG, DTG, DTA, SEM. The results, although taken on few samples, showed that these biomaterials present a variability in some features, which can define the structural functionality.

[A critical note on bioceramics]. / Nota critica sulle bioceramiche.

In this note I, the authors point out the uncertainty and confusion which exists in the bioceramics field. They then list the calcium phosphate biomaterials today in use.

[The importance of esthetics in orthognathic surgery]. / L'importanza dell'estetica in chirurgia ortognatica.

The authors deal with an analytic method utilized in the diagnosis and treatment of dysmorphosis of the oral-maxillo-facial area. The aesthetic improvement that patients obtain as a result of surgical operation is also pointed out. An aesthetic improvement that offers the patient the conditions of a more comfortable social life. The psychological troubles which are a consequence of their outward appearance are also eliminated in this way.

[A case of a carcinoma arising in lichen planus in a subject with diabetes mellitus and arterial hypertension (Grinspan's syndrome)]. / Su di un caso di carcinoma insorto su lichen planus in soggetto con diabete mellito ed ipertensione arteriosa (sindrome di Grinspan).

The authors describe a clinical case observed at the Inst of Oral & Maxillofacial Surgery characterized by three simultaneous symptoms: arterious hypertension, diabetes mellitus, oral erosive lichen planus. Grinspan & his co-workers observed this syndrome. The results of their research were exposed at the Congress on Dermatology in Buenos Aires, 1963. In 1965 in a repetitive study Grupper & Avul seemed confirm the existence of this symptomatological triad; therefore the authors defined this complex as "Grinspan's syndrome". Further researches conducted by other authors (Jolly, Powell. Howell e Rick) confirmed the association hypertension-diabetes-"erosive" lichen. However there were other worthwhile studies (Lozada-Nur, Christensen) which emphasized a not significant high frequency of patients with diabetes and high blood pressure and the oral sugar tolerance like random specimens of common people. Besides the authors notice that their clinical case is interesting not only because of their simultaneous presence of the three symptoms but also because of the bioptic appearance of a cancer likely appeared on a pre-existing inveterate lichenoid lesion.