Biomedical subjects
Publications and source records attributed to Ettore Epifania.
This article describes a new method of preparing trays for indirect bracket bonding. Computer-aided technology is used to design the individualized trays, which are then produced with a rapid prototyping procedure. Application in clinical practice and the advantages of time savings and accurate bracket placement are discussed.
STATEMENT OF PROBLEM: There is little agreement regarding a palatal extension of the preparation for porcelain veneers, as it represents a more invasive technique than a preparation limited to the facial surface of a tooth. PURPOSE: The purpose of this study was to detect the stress in maxillary anterior teeth restored with porcelain veneers and compare the resistance to fracture of porcelain veneers prepared using different preparation designs. MATERIAL AND METHODS: Forty-five maxillary anterior teeth were restored with porcelain veneers and divided into 9 groups as follows: Ca, canines with no preparation; Ca-Ch, canines with palatal chamfer preparation; Ca-W, canines with window preparation; LI, lateral incisors with no preparation; LI-Ch, lateral incisors with palatal chamfer preparation; LI-W, lateral incisors with window preparation; CI, central incisors with no preparation; CI-Ch, central incisors with palatal chamfer preparation; CI-W, central incisors with window preparation. Shear-flexural fracture tests were performed. The fractured specimens were subjected to scanning electron microscope (SEM) analysis. Data were statistically analyzed with univariate analysis of variance and the Tukey post hoc test for multiple comparisons (alpha=.05). RESULTS: The following mean fracture load values (N) were recorded: Ca, 395 +/- 6; Ca-Ch, 310 +/- 8; Ca-W, 322 +/- 8; LI, 309 +/- 8; LI-Ch, 242 +/- 6; LI-W, 225 +/- 8; CI, 298 +/- 8; CI-Ch, 255 +/- 8; CI-W, 221 +/- 6. The SEM analysis showed that both adhesive and cohesive fractures were primarily concentrated at the cervical region. Statistical analysis showed that both the type of tooth and the design of the preparation significantly influenced the resistance to fracture of the restored teeth (P<.001). CONCLUSION: The chamfer preparation is recommended for central incisors, whereas the window preparation showed better results for canines. Both preparations can be adopted in the restoration of lateral incisors.
Previous studies on the relationship between morphological structure of the face and cervical posture have predominantly focused on vertical dimensions of the face. The aim of this study was to investigate whether there are significant differences in cervical posture in subjects with a different sagittal morphology of the face, i.e., a different skeletal class. One hundred twenty (120) children (60 males and 60 females, average age 9.5 yrs., SD+/-0.5) were admitted for orthodontic treatment. Selection criteria was: European ethnic origin, date of birth, considerable skeletal growth potential remaining and an absence of temporomandibular joint dysfunction (TMD). Lateral skull radiographs were taken in mirror position. Subjects were divided into three groups based on their skeletal class. The cephalometric tracings included postural variables. The most interesting findings were: 1. children in skeletal class III showed a significantly lower cervical lordosis angle (p<0.001) than the children in skeletal class I and skeletal class II; 2. children in skeletal class II showed a significantly higher extension of the head upon the spinal column compared to children in skeletal class I and skeletal class III (p<0.001 and p<0.01, respectively). This is probably because the lower part of their spinal column was straighter than those of subjects in skeletal class I and II (p<0.01 and p<0.001, respectively). Significant differences among the three groups were also observed in the inclination of maxillary and mandibular bases to the spinal column. The posture of the neck seems to be strongly associated with the sagittal as well as the vertical structure of the face.
The literature reports evidence of various types of correlations between cervical alterations and cervical pain, and the existence of cervical pain in subjects with temporomandibular joint internal derangement (TMD). The hypothesis of this study is that cervical lordosis angle (CVT/EVT angle) alteration on cephalometrics could be correlated to the presence of TMD. The cephalometric records of 50 females with documented TMD were compared with those of a control group of 50 females. The subjects in the sample were 25-35 years of age, average 28.9 years (SD, 3.2). Radiographs were taken in mirror position, and seventeen variables, including the CVT/EVT angle, were traced. Double measurements were made to evaluate method error using Dahlberg's formula. Pearson's correlation coefficient and Mann-Whitney's t-test were used to evaluate the data. Intra-group analysis showed significant correlations between the CVT/EVT angle and mandibular length (p<0.01), mandibular position (p<0.05), mandibular divergence (p<0.01), and overjet (p<0.01) in both groups. Between groups, the analysis showed significant differences in CVT/EVT angle (p<0.05), maxillary protrusion (p<0.01), mandibular protrusion (p<0.01), mandibular length (p<0.01), mandibular divergence (p<0.05), and overbite (p<0.05).
Pain and joint noises associated with temporomandibular joint (TMJ) internal derangement are often treated by using an intra-oral splint. This study evaluated whether an anterior repositioning splint (AR splint) could be more effective in the treatment of these symptoms than a full-arch maxillary stabilization splint (FAMS splint), because of its capability to re-establish immediately the normal condyle/disk relationship. The authors treated 40 patients (average age 16.8; range 8.0-24.0) with confirmed internal derangement, joint pain, and joint noises in at least one TMJ for at least two months, with AR splint (20 subjects) or FAMS splint (20 subjects); 10 untreated patients comprised the control group. Joint noise, joint pain, and the intensity of pain were assessed using a visual analogic scale (VAS), and the pain was characterized (i.e., constant or chewing/biting pain) and evaluated monthly for eight months. Significantly fewer AR splint patients experienced pain after four months of treatment. A significantly lower intensity of pain was experienced by the AR splint patients after two months of treatment. Significantly fewer AR splint patients experienced chewing/biting pain after eight months of treatment. The frequency of joint noises decreased over time, with no significant differences between the groups. In conclusion, the AR splint seems to be more effective in decreasing pain, but it seems to make no difference in the treatment of joint noises.
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