Class II functional orthopaedic treatment: a systematic review of systematic reviews

This Systematic Review (SR) aims to assess the quality of SRs and Meta-Analyses (MAs) on functional orthopaedic treatment of Class II malocclusion and to summarise and rate the reported effects. Electronic and manual searches were conducted until June 2014. SRs and MAs focusing on the effects of functional orthopaedic treatment of Class II malocclusion in growing patients were included. The methodological quality of the included papers was assessed using the AMSTAR (Assessment of Multiple Systematic Reviews). The design of the primary studies included in each SR was assessed with Level of Research Design scoring. The evidence of the main outcomes was summarised and rated according to a scale of statements. 14 SRs fulfilled the inclusion criteria. The appliances evaluated were as follows: Activator (2 studies), Twin Block (4 studies), headgear (3 studies), Herbst (2 studies), Jasper Jumper (1 study), Bionator (1 study) and Fränkel-2 (1 study). Four studies reviewed several functional appliances, as a group. The mean AMSTAR score was 6 (ranged 2-10). Six SRs included only controlled clinical trials (CCTs), three SRs included only randomised controlled trials (RCTs), four SRs included both CCTs and RCTs and one SR included also expert opinions. There was some evidence of reduction of the overjet, with different appliances except from headgear; there was some evidence of small maxillary growth restrain with Twin Block and headgear; there was some evidence of elongation of mandibular length, but the clinical relevance of this results is still questionable; there was insufficient evidence to determine an effect on soft tissues

The Psychological Impact of Dental Aesthetics in Patients with Juvenile Idiopathic Arthritis Compared with Healthy Peers: A Cross-Sectional Study.

This study aimed to assess whether dental aesthetics had a different impact on the psychosocial domains of adolescents with juvenile idiopathic arthritis (JIA) as compared with healthy peers. Fifty JIA patients and eighty controls aged between 13 and 17 years were enrolled. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was administered along with tools for the self-assessment of malocclusion and self-esteem. An objective evaluation of malocclusion severity was performed through a clinical evaluation with the Dental Aesthetic Index (DAI). The sample was divided according to the DAI stages of malocclusion severity; a two-way analysis of variance (ANOVA) was performed to assess whether there was a difference in the studied variables according to the malocclusion and the presence of JIA. The results showed no interaction between the malocclusion severity and the presence of JIA in all analyzed variables (all p > 0.05). According to the DAI stages, the Dental Self-Confidence domain of the PIDAQ and the Perception of Occlusion Scale showed statistically significant differences only within the controls (p = 0.027 and p = 0.014, respectively). Therefore, JIA adolescents seem to be less concerned about their dental aesthetics compared with healthy peers, and clinicians should take particular care when proposing orthodontic treatments aiming only to improve dental aesthetic

The Ubiquitin Ligase RPM-1 and the p38 MAPK PMK-3 Regulate AMPA Receptor Trafficking

Ubiquitination occurs at synapses, yet its role remains unclear. Previous studies demonstrated that the RPM-1 ubiquitin ligase organizes presynaptic boutons at neuromuscular junctions in C. elegans motorneurons. Here we find that RPM-1 has a novel postsynaptic role in interneurons, where it regulates the trafficking of the AMPA-type glutamate receptor GLR-1 from synapses into endosomes. Mutations in rpm-1 cause the aberrant accumulation of GLR-1 in neurites. Moreover, rpm-1 mutations enhance the endosomal accumulation of GLR-1 observed in mutants for lin-10, a Mint2 ortholog that promotes GLR-1 recycling from Syntaxin-13 containing endosomes. As in motorneurons, RPM-1 negatively regulates the pmk-3/p38 MAPK pathway in interneurons by repressing the protein levels of the MAPKKK DLK-1. This regulation of PMK-3 signaling is critical for RPM-1 function with respect to GLR-1 trafficking, as pmk-3 mutations suppress both lin-10 and rpm-1 mutations. Positive or negative changes in endocytosis mimic the effects of rpm-1 or pmk-3 mutations, respectively, on GLR-1 trafficking. Specifically, RAB-5(GDP), an inactive mutant of RAB-5 that reduces endocytosis, mimics the effect of pmk-3 mutations when introduced into wild-type animals, and occludes the effect of pmk-3 mutations when introduced into pmk-3 mutants. By contrast, RAB-5(GTP), which increases endocytosis, suppresses the effect of pmk-3 mutations, mimics the effect of rpm-1 mutations, and occludes the effect of rpm-1 mutations. Our findings indicate a novel specialized role for RPM-1 and PMK-3/p38 MAPK in regulating the endosomal trafficking of AMPARs at central synapses

Predictability of Maxillary Molar Distalization and Derotation with Clear Aligners: A Prospective Study

Clear aligners are employed daily for the treatment of Class II malocclusions, when a valid option involves distalization and derotation of the upper first and second molars. Evidence regarding the predictability of these movements is slight, and the treatment outcome that clinicians plan may not be achieved. Therefore, the purpose of this study is to assess the accuracy of distalization and derotation with clear aligners. Geomagic Control X, a 3D quality control software, was used to superimpose digital models of the pre-treatment, post-treatment, and virtual plan (ideal post-treatment) measurements of 16 patients (4 M, 12 F; mean age 25.7 ± 8.8 years). Linear and angular measurement tools were used to calculate the amount of tooth movement prescribed and achieved. Distal displacement of the buccal cusps had an overall accuracy of 69% for the first molar and 75% for the second molar. The accuracy of molar derotation was higher for the first molar (77.5%) than for the second molar (62.7%). The aligners were not able to achieve 100% of the ideal post-treatment result; thus, planning of refinements is often needed. However, clear aligners can be regarded as a valuable option for the distalization of first and second molars

Parallel Genetic Algorithms for calibrating Cellular Automata models: Application to lava flows

Cellular Automata are highly nonlinear dynamical systems which are suitable for simulating natural phenomena whose behaviour may be specified in terms of local interactions. The Cellular Automata model SCIARA, developed for the simulation of lava flows, demonstrated to be able to reproduce the behaviour of Etnean events. However, in order to apply the model for the prediction of future scenarios, a thorough calibrating phase is required. This work presents the application of Genetic Algorithms, general-purpose search algorithms inspired to natural selection and genetics, for the parameters optimisation of the modelSCIARA. Difficulties due to the elevated computational time suggested the adoption a Master-Slave Parallel Genetic Algorithm for the calibration of the model with respect to the 2001 Mt. Etna eruption. Results demonstrated the usefulness of the approach, both in terms of computing time and quality of performed simulations

A Probabilistic Approach to Hazard Mapping Based on Computer Simulations. An Example for Lava Flows at Mount Etna

Determining sectors that could be affected by lava flows in volcanic areas is essential for risk mitigation purposes. Traditionally, when adopting methods based on probabilistic numerical simulations, the hazard is assessed by analysing a huge set of simulations of hypothetical events, each characterized by a distinct probability of occurrence based on statistics of historical events. If lateral or eccentric eruptions are also taken into account, simulated lava flows usually start from the nodes of regular grids of potential vents, uniformly covering the study area. In this study, an alternative approach to evaluate flow-type hazard, based on a nonuniform grid of potential vents, is proposed. The method takes into account expected changes in the topographic context due to successive lava-flow bodies, and allows to obtain more detailed maps for the most exposed areas, besides significantly reducing the computational efforts. The approach has been tested to evaluate lava-flow hazard at Mt Etna (Eastern Sicily, Southern Italy), and a preliminary analysis has been performed to investigate the behaviour of the adopted technique with respect to the number of performed sets of simulations to better understanding its predictive capability

Effect of orthopedic and functional orthodontic treatment in children with obstructive sleep apnea: A systematic review and meta-analysis

Orthodontic treatment is suggested in growing individuals to correct transverse maxillary deficiency and mandibular retrusion. Since, as a secondary effect, these orthodontic procedures may improve pediatric obstructive sleep apnea (OSA), this systematic review assessed their effects on apnea-hypopnea index (AHI) and oxygen saturation (SaO2). Twenty-five (25) manuscripts were included for qualitative synthesis, 19 were selected for quantitative synthesis. Five interventions were analyzed: rapid maxillary expansion (RME, 15 studies), mandibular advancement (MAA, five studies), myofunctional therapy (MT, four studies), and RME combined with MAA (one study). RME produced a significant AHI reduction and minimum SaO2 increase immediately after active treatment, at six and 12 months from baseline. A significant AHI reduction was also observed six and 12 months after the beginning of MAA treatment. MT showed positive effects, with different protocols. In this systematic review and meta-analysis of data from mainly uncontrolled studies, interceptive orthodontic treatments showed overall favorable effects on respiratory outcomes in pediatric OSA. However, due to the low to very low level of the body evidence, this treatment cannot be suggested as elective for OSA treatment. An orthodontic indication is needed to support this therapy and a careful monitoring is required to ensure positive improvement in OSA parameters

Debris flows simulation by cellular automata: a short review of the sciddica models

Cellular Automata models are a promising solution for the simulation of debris flows moving over a 3D topography. In this paper, an extensive review of SCIDDICA, a Cellular Automata model based on the equivalent fluid approach, is presented. Moreover, the main steps in the development of SCIDDICA are described with a chronological criterion. The last version of SCIDDICA (SS2) is suitable for the simulation of completely subaerial, completely subaqueous and combined subaerial-subaqueous debris flows. Main features of a debris flow are accounted by the SS2 version such as erosion and deposition and triggering of secondary landslides along the path, presence of structures and buildings, run-up effects and, in the case of coastal landslides, impulsive loss of matter (water and finer grains) and energy dissipation at water impact. Moreover, buoyancy effects, drag forces and peculiar mechanisms like hydroplaning are also modeled for submerged events. Several past debris-flows like the 1998-1999 Campanian debris flows (Italy), the 1997 debris flow at Lake Albano (Italy) and the 2008 submarine debris flow at Bagnara Calabra (Italy) have been simulated in the last years by SCIDDICA. A short review of these case studies will be presented and the main limitations encountered will be also discussed, thus suggesting future improvements and perspectives, such as susceptibility analysis and interaction with man made structure