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1.
Acta Odontol Scand ; : 1-13, 2021 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-34855562

RESUMO

OBJECTIVES: To assess the efficacy and safety of hyaluronic acid (HA) injections to restore the lost interproximal papilla. MATERIALS AND METHODS: A systematic literature search was conducted in PubMed/MEDLINE, Scopus and Cochrane electronic databases with no time restriction up to September 2021. Any clinical study evaluating HA injection into the interproximal papilla loss Class I and II according to Norland & Tarnow, were included based on the following PICO questions (1) Are HA injections effective for the reconstruction of the interproximal papilla loss? (2) What are the side/adverse effects of using HA for the reconstruction of interproximal papilla loss? The risk of bias assessment was performed using the Cochrane Collaboration's the Newcastle Ottawa and Joanna Briggs institute tools. RESULTS: A total of 1497 titles were retrieved. From these, eleven were included and underwent full data extraction. However, due to heterogeneity in the data among the included articles, a meta-analysis could not be performed. Three articles reported no-differences in term of papilla tip to contact point distance or the papilla fill reduction. Finally, five studies showed a reduction in the black triangle with a percentage range between 19 and 47%. CONCLUSION: The non-surgical use of HA injection seems to have a positive effect on the re-establishment of interproximal papilla lost. However post-operative complications might develop.

2.
J Clin Med ; 10(19)2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34640596

RESUMO

Periodontal disease seems to be correlated with low vitamin D serum levels, preterm birth (PTB) and low birth weight (LBW), although the literature still lacks a consensus. This study aimed to investigate this correlation in a cohort of pregnant women over 20 weeks of gestation from the University Hospital "Maggiore della Carità", Novara, Italy. We assessed serum levels of vitamin D and oral health status through the following indexes: Oral Hygiene Index (OHI), Plaque Control Record (PCR), Gingival Bleeding Index (GBI), and Community Periodontal Index of Treatment Needs (CPTIN). Moreover, we assessed the number of PTB and LBW among the newborns. Out of 121 pregnant women recruited, 72 (mean age 29.91 ± 3.64 years) were included. There was a statistically significant correlation between preterm and OHI > 3 (p = 0.033), and between LBW and OHI > 3 (p = 0.005) and CPITN = 3 (p = 0.027). Both pregnant women with vitamin D deficiency ((25-hydroxy-vitamin D) < 30 ng/mL) and PTB plus LBW newborns were significantly correlated (p < 0.05) with poor levels of all oral health status indexes during pregnancy. Furthermore, these conditions (women with hypovitaminosis D and combination of PTB and LBW) were shown to be significantly correlated (p < 0.001). Taken together, our findings reported a high prevalence of PTB and LBW with poor oral health and vitamin D deficiency in pregnant women.

3.
J Back Musculoskelet Rehabil ; 34(6): 925-936, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33998532

RESUMO

BACKGROUND: Radiographic methods to assess skeletal maturity (SM) have a key role in adolescent idiopathic scoliosis (AIS) management, allowing to predict risk of spinal curve progression. Cervical vertebral maturation (CVM) has been recently introduced as an alternative tool to assess skeletal maturity; however, its clinical role is still debated. OBJECTIVE: This systematic review aimed to investigate the reliability of CVM in the SM assessment of growing subjects, comparing it to hand wrist maturation (HVM). METHODS: PubMed, Scopus, and Web of Science databases were systematically searched from inception until 31st December 2020 to identify observational studies presenting: growing subjects as participants; CVM methods as intervention; HVM methods as comparator; reliability for SM assessment as outcome. A 10-item quality tool has been used to assess study quality. RESULTS: Out of 205 papers, 12 papers were included in the data synthesis. We classified 10 studies (83.3%) as medium-quality studies and 2 studies (16.7%) as high-quality studies. Eight studies reported a significant correlation between CVM Baccetti and different HWM methods. CONCLUSION: Taken together, these findings suggested that CVM might be considered as reliable SM assessment method compared to HWM in growing subjects. However, further studies are warranted to confirm these findings.


Assuntos
Escoliose , Punho , Adolescente , Determinação da Idade pelo Esqueleto , Vértebras Cervicais/diagnóstico por imagem , Humanos , Reprodutibilidade dos Testes , Escoliose/diagnóstico por imagem
4.
Turk J Phys Med Rehabil ; 67(1): 32-40, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33948541

RESUMO

Objectives: This study aims to evaluate the effectiveness of upper Michigan occlusal splint (OS) compared to mandibular OS in terms of pain, range of motion (ROM), and muscle activity as assessed by surface electromyography (sEMG) in patients affected by muscle-related temporomandibular disorders (TMD). Patients and methods: In this randomized-controlled trial, a total of 40 adult patients (13 males, 27 females; mean age: 47.2±12.8 years; range, 22 to 56 years) with a diagnosis of myofascial pain, lasting from at least three months on at least one masseter muscle. The patients were randomly allocated into two groups: Group 1 (n=20) using upper Michigan OS and Group 2 (n=20) using mandibular OS. At baseline (T0), at one (T1), three (T2), and six months (T3), the following outcomes were assessed: myofascial pain by Visual Analog Scale (VAS) and ROM of mandible movements, activity of the main masticatory muscles through sEMG. Results: There were no significant intra-group differences in the outcome measures assessed in both groups. However, Group 2 had a significantly higher right lateral mandibular ROM at T2 (7.1±3.1 vs. 9.8±2.3, respectively; p<0.05) and a significantly higher left lateral mandibular ROM at T3 (7.6±3.5 vs. 10.5±2.1, respectively; p<0.05). We found no significant difference in none of the sEMG parameters. Conclusion: Our study results suggest that OS, independently from being built on the upper or lower arch, seems to not have significant effects in reducing pain over a six-month period in TMD patients.

5.
Eur J Phys Rehabil Med ; 57(3): 443-450, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33393278

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic is quickly spreading worldwide, with survivors that suffer functional impairments with a consequent key role of rehabilitation in this context. To date, there is a lack of findings on the role of rehabilitation in postacute COVID-19 patients. AIM: Thus, we aimed at describing the role of a patient-tailored rehabilitation plan on functional outcome in hospitalized COVID-19 patients. DESIGN: Real-practice retrospective study. SETTING: Inpatients Rehabilitation Unit. POPULATION: Postacute COVID-19 patients. METHODS: Medical records of patients referred to an Italian COVID-19 Rehabilitation Unit from March 10th, 2020 to April 30th, 2020 were collected. All patients underwent a rehabilitative (30 minutes/set, 2 times/day), aimed to improve gas exchanges, reducing dyspnoea, and improving muscle function. At the admission (T0) and at the discharge (T1), we evaluated as outcome measures: Barthel Index (BI), modified Medical Research Council Dyspnea Scale, 6-Minute Walking Test (6-MWT) and Borg Rating of Perceived Exertion (RPE) scale. We also assessed: type of respiratory supports needed, pulmonary function, coagulation and inflammation markers and length of stay (LOS) in Rehabilitation Unit. RESULTS: We included 41 postacute COVID-19 patients (25 male and 19 female), mean aged 72.15±11.07 years. Their mean LOS in the Rehabilitation Unit was 31.97±9.06 days, as 39 successfully completed the rehabilitation treatment and 2 deceased. We found statistically significant improvement in BI (84.87±15.56 vs. 43.37±26.00; P<0.0001), 6-MWT (303.37±112.18 vs. 240.0±81.31 meters; P=0.028), Borg RPE scale (12.23±2.51 vs. 16.03±2.28; P<0.0001). CONCLUSIONS: These findings suggest that postacute COVID-19 patients might beneficiate of a motor and respiratory rehabilitation treatment. However, further studies are advised to better understand long-term sequelae of the disease. CLINICAL REHABILITATION IMPACT: This study provides evidence on the role of rehabilitation COVID-19 postacute inpatients through a patient-tailored treatment.


Assuntos
COVID-19/reabilitação , Modalidades de Fisioterapia , Pneumonia Viral/reabilitação , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pacientes Internados , Itália , Masculino , Pessoa de Meia-Idade , Pandemias , Recuperação de Função Fisiológica , Estudos Retrospectivos , SARS-CoV-2 , Teste de Caminhada
6.
NeuroRehabilitation ; 48(1): 49-57, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33386822

RESUMO

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting upper and lower motor neurons. The current practice of caring for patients affected by ALS involves a multidisciplinary team without any indication about oral health care. OBJECTIVE: We sought to investigate the functional status and oral health in patients with ALS to define a specific multidisciplinary management. METHODS: In this cross-sectional study, we included patients affected by ALS, evaluating their functional status, using the Revised ALS Functional Rating Scale (ALSFRS-R) and their oral health status through specific parameters, including Brief Oral Health Status Examination (BOHSE), Winkel Tongue Coating Index (WTCI), and Oral Food Debris Index (OFDI). RESULTS: All 37 patients (mean age: 61.19±11.56 years) showed a poor oral status, independent from the functional status and strictly correlated to the severity of sialorrhea (p = 0.01). OFDI index was negatively correlated with the ALSFRS-R upper limb (p = 0.03). Patients with bulbar onset had significantly lower ability to perform adequate tongue movements in terms of protrusion (p = 0.006) and lateralization (p < 0.001). Significant negative correlations between survival rate and BOHSE (p = 0.03) was found. CONCLUSIONS: Taken together, our findings showed that a poor oral health status might be correlated to a worse functional status and survival time. Thus, an adequate oral health care and rehabilitation should be considered as crucial in the multidisciplinary management of patients with ALS.


Assuntos
Esclerose Amiotrófica Lateral/fisiopatologia , Progressão da Doença , Estado Funcional , Saúde Bucal/tendências , Idoso , Esclerose Amiotrófica Lateral/diagnóstico , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Extremidade Superior/fisiopatologia
7.
Eur J Phys Rehabil Med ; 56(5): 633-641, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32667150

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic is quickly spreading, putting under heavy stress health systems worldwide and especially Intensive Care Units (ICU). Rehabilitation Units have a crucial role in reducing disability in order to reintroduce patients in the community. AIM: The aim of this study is to characterize pulmonary function and disability status and to propose an early rehabilitation protocol in a cohort of post-acute COVID-19 patients admitted to an Italian Rehabilitation Unit. DESIGN: Cross-sectional observational study. SETTING: Inpatients Rehabilitation Unit. POPULATION: Post-acute COVID-19 patients. METHODS: Demographic, anamnestic and clinical characteristics, laboratory exams and medical imaging findings were collected for the entire cohort. Outcome measures evaluated at the admission in Rehabilitation Unit were: type of respiratory supports needed, fraction of inspired oxygen (FiO2), partial pressure of oxygen (PaO2), FiO2/PaO2, Barthel Index (BI), modified Medical Research Council (mMRC) Dyspnoea Scale, and 6-Minute Walking Test (6-MWT). Furthermore, we proposed an early rehabilitation protocol for COVID-19 patients based on baseline FiO2. RESULTS: We included 32 post-acute COVID-19 patients (22 male and 10 female), mean aged 72.6±10.9 years. BI was 45.2±27.6, with patients in need of higher FiO2 (≥40%) showing lower values: 39.6±25.7 vs. 53.3±29.3. All patients had grade 4 or 5 on the mMRC Dyspnea Scale. Only 14 COVID-19 patients were able to walk (43.7%). 6-MWT was feasible in 6 (18.8%) patients with a mean distance of 45.0±100.6 meters. CONCLUSIONS: Taken together, our findings suggest that post-acute COVID-19 patients suffered from dyspnea and shortness of breath even for minimal activities, with a resulting severe disability, and only a few of them were able to perform 6-MWT with poor results. An early rehabilitation protocol was proposed according to the baseline conditions of the patients. CLINICAL REHABILITATION IMPACT: This study could provide an accurate description of COVID-19 sub-acute patients admitted to a Rehabilitation Unit along with a proposal of treatment to help physicians to tailor the best possible rehabilitative treatment.


Assuntos
Infecções por Coronavirus/reabilitação , Estado Terminal/reabilitação , Deambulação Precoce/métodos , Pneumonia Viral/reabilitação , Centros de Reabilitação/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Bases de Dados Factuais , Terapia por Exercício/métodos , Feminino , Seguimentos , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Itália , Masculino , Pessoa de Meia-Idade , Pandemias/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Recuperação de Função Fisiológica , Terapia Respiratória/métodos , Resultado do Tratamento
8.
Top Stroke Rehabil ; 27(3): 208-214, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31714187

RESUMO

Background: Unilateral spatial neglect (USN) is the most frequent cognitive impairment after right brain stroke, characterized by inattention to sensory stimuli in the opposite hemispace. It has been recently hypothesized a novel condition defined as "buccal hemineglect," a particular form of USN with detrimental oral effects on right stroke survivors.Objective: The aim of our study was to compare the oral hygiene between the two halves of oral cavity in right stroke survivors.Methods: In this cross-sectional study, we assessed a cohort of right-handed subjects affected by right brain stroke with left hemiparesis, divided into two groups based on the presence of USN. We administered an evaluation protocol, including New Method of Plaque Scoring, Oral Hygiene Index (OHI), Gingival Index, Oral Food Debris Index, and Winkel Tongue Coating Index (WTCI). All outcome measures were assessed in the entire cohort considering both left and right halves of oral cavity.Results: Of the 21 patients included (mean aged 64.19 ± 7.60 years), the 14 affected by USN (mean aged 64.50 ± 8.06 years) had significantly worse values in all outcome measures in the left oral cavity compared to the right one (P < .01). On the other hand, the seven patients not affected by USN (mean aged 63.57 ± 7.16 years) showed statistically significant differences only in OHI (P = .03) and WTCI (P = .03).Conclusion: Hygiene of left oral cavity was significantly worse than contralateral in right brain stroke survivors with USN. This study highlights the need to develop an adequate oral rehabilitation program in these patients.


Assuntos
Lateralidade Funcional/fisiologia , Boca/fisiopatologia , Transtornos da Percepção , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Idoso , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Percepção/diagnóstico , Transtornos da Percepção/etiologia , Transtornos da Percepção/fisiopatologia , Transtornos da Percepção/reabilitação , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/terapia , Sobreviventes
9.
Eur J Orthod ; 40(6): 592-596, 2018 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-29726936

RESUMO

Objectives: To evaluate the association between maxillary dental arch transverse dimensions, palatal depths, palatal area and volume with buccally displaced canine (BDC) in mixed dentition subjects when compared to non-BDC subjects using laser scanner 3D technology. Materials and methods: Sixty Caucasian subjects, 8-11 years of age (mean, 9.26 ± 1.48 years), were included. In each group (BDC and non-BDC) 30 children were matched. Digital dental casts were obtained using a 3 Shape D700 laser scanner. Intercanine and intermolar widths (cusp and gingival levels), anterior and posterior palatal depth (cusp level), palatal surface area and volume were measured. An independent sample Student's t-test and an ANOVA were undertaken with significance level set as P < 0.05. Results: Intercanine widths at the cusp (1.76 mm; P = 0.020) and the gingival level (1.6 mm; P = 0.006), palatal area (133 mm2; P = 0.021) and volume (790 mm3; P = 0.046) were significantly lower in the BDC compared to the control group. Limitations: A smaller part of the subjects was in late mixed dentition phase. To overcome this limitation a matched control group was used. Some subjects did not have some teeth because of the transition phase which might have had an influence on the dental measurements. However, these subjects were not excluded to avoid introducing a bias. Conclusions: 3D evaluation of the maxillary arch and palate highlighted significant differences between BDC and non-BDC mixed dentition subjects. Maxillary dental arch dimensions and palate morphology may allow early identification and prevention of maxillary canine impaction.


Assuntos
Dente Canino/patologia , Arco Dental/patologia , Palato/patologia , Dente Impactado/patologia , Estudos de Casos e Controles , Moldes Cirúrgicos , Criança , Dente Canino/diagnóstico por imagem , Arco Dental/diagnóstico por imagem , Dentição Mista , Feminino , Humanos , Imageamento Tridimensional , Masculino , Maxila/diagnóstico por imagem , Maxila/patologia , Odontometria/métodos , Palato/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem
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