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ABSTRACT: This study evaluated the electromyographic (EMG) characteristics of masticatory muscles in patients with fixed implant-supported prostheses according to All-on-Four(®) principles and in control healthy dentate subjects. Twenty-six subjects aged 50-74 years were examined. Eighteen were edentulous and had been successfully rehabilitated with (i) mandibular All-on-Four(®) implant-supported fixed prostheses and maxillary complete dentures (10 patients) and (ii) mandibular and maxillary All-on-Four(®) implant-supported fixed prostheses (eight patients). Eight reference subjects had natural dentition. Surface EMG recordings of the masseter and temporalis muscles were performed during maximum voluntary teeth clenching and during unilateral gum chewing. All values were standardised as percentage of a maximum clenching on cotton rolls. During clenching, a good global neuromuscular equilibrium was found in all participants. During chewing, all groups had similar values of working-side muscle activities and of chewing frequency. No significant differences in the analysed EMG parameters were found between the patients with mandibular and maxillary All-on-Four(®) implant-supported prostheses and the reference subjects. In contrast, standardised pooled muscle activities and standardised muscular activities per cycle were larger in patients with a maxillary removable prosthesis than in control subjects (Kruskal-Wallis test, P < 0·01). Also, patients wearing a complete maxillary denture showed a poor neuromuscular coordination with altered muscular pattern and lower values of the index of masticatory symmetry than dentate control subjects (P < 0·01). EMG outcomes suggest that All-on-Four(®) implant-supported prostheses may be considered a functionally efficient treatment option for the rehabilitation of edentulous patients with reduced residual bone volume.
Journal of Oral Rehabilitation 09/2012; · 1.53 Impact Factor
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ABSTRACT: Morphological changes in three-dimensional (3D) dentolabial relationships during ageing were assessed in healthy individuals. 38 subjects with healthy dentition were analysed. They were divided into a youthful group (21-34 years, mean 26 years, SD 4) and an older group (45-65 years, mean 53 years, SD 5). Stone labial and dental models were made, digitized and 3D virtual reproductions of dentolabial morphology were obtained. From the digital reconstructions, the relative positions of the labial commissure and of the maxillary dental clinical crowns in the vertical direction were obtained. Sex and age effects were compared using two-way analysis of variance. Lip position relative to the teeth was significantly different in youthful and older subjects (P<0.01). No statistically significant effects of sex in dentolabial relationship were demonstrated, but a sex×age effect was found in the anterior labial segments (P<0.05). The perioral soft tissues drop down in older subjects and the soft tissue descends on the entire labial arch. These differences may help the clinician when estimating, planning and evaluating surgical, orthodontic and prosthetic treatments.
International Journal of Oral and Maxillofacial Surgery 05/2012; 41(11):1344-9. · 1.51 Impact Factor
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ABSTRACT: The effects of muscle pain and fatigue on the control of jaw elevator muscles are not well known. Furthermore, the myoelectric manifestations of fatigue and recovery from fatigue in the masticatory muscles are not reported in literature. The main aims of this study were (i) to evaluate the possible use of surface electromyography (sEMG) as an objective measure of fatigue of the jaw elevator muscles, (ii) to compare the myoelectric manifestations of fatigue in the temporalis anterior and masseter muscles bilaterally, (iii) to assess recovery of the investigated muscles after an endurance test and (iv) to compare fatigue and recovery of the jaw elevator muscles in healthy subjects and patients with muscle-related temporomandibular disorders (TMD). The study was performed on twenty healthy volunteers and eighteen patients with muscle-related TMD. An intra-oral compressive-force sensor was used to measure the voluntary contraction forces close to the intercuspal position and to provide visual feedback of submaximal forces to the subject. Surface EMG signals were recorded with linear electrode arrays during isometric contractions at 20%, 40%, 60% and 80% of the maximum voluntary contraction force, during an endurance test and during the recovery phase. The results showed that (i) the slope of the mean power spectral frequency (MNF) and the initial average rectified value (ARV) could be used to monitor fatigue of the jaw elevators, (ii) the temporalis anterior and masseter muscle show the same myoelectric manifestations of fatigue and recovery and (iii) the initial values of MNF and ARV were lower in patients with muscle-related TMD. The assessment of myoelectric manifestations of fatigue in the masticatory muscles may assist in the clinical assessment of TMDs.
Journal of Oral Rehabilitation 04/2012; 39(9):648-58. · 1.53 Impact Factor
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ABSTRACT: Facial nerve paralysis is one of several possible complications following conservative parotidectomy. To assess three-dimensional facial movements non-invasively in patients with unilateral facial palsy following parotidectomy for benign tumours, the three-dimensional coordinates of 21 soft-tissue facial landmarks were recorded in 32 patients (21 HB I, 5 HB II, 6 HB III-IV; 3 months post-surgery follow-up), and 40 control subjects, during the performance of facial movements (smile, 'surprise', eye closure, single eye closure). For all symmetric animations, control subjects had larger total mobility than patients; mobility progressively decreased in patients with larger clinical grades. For asymmetric eye closures, HB I patients and control subjects had similar total movements, while HB II patients had smaller movements, especially for the paretic side eye closure; smaller total movements were found in HB III-IV patients. The method allowed the quantitative detection of alterations in facial movements. Significant differences between patients and control subjects in the magnitude and asymmetry of movements were found.
International Journal of Oral and Maxillofacial Surgery 03/2012; 41(8):986-93. · 1.51 Impact Factor
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ABSTRACT: Morphological changes in the lips during ageing, including labial volume, area and thickness were assessed in healthy individuals. 40 healthy volunteers (20 men and 20 women) were selected and divided into two groups according to age: 21-34 years ('youthful' group) and 45-65 years ('aged' group). Three-dimensional (3D) stone labial models were made, digitized, and 3D virtual reproductions obtained. Labial thickness, vermilion area, and volume of the upper and lower lips were measured from the digital reconstructions. The data were compared using three-way ANOVA. All data were significantly larger in men than in women (p<0.05), the lower lip was thicker than the upper lip (p<0.001). A significant effect of age for labial thickness and area were found (p<0.001 and p=0.014): the youthful group had higher values than the aged group. Upper to lower lip ratios were not significantly different between sexes or ages. Generally, young people have a larger lip area and thickness than aged ones and men had larger lips than women. The upper/lower lip ratios for area and volume were similar in the two genders.
International Journal of Oral and Maxillofacial Surgery 04/2011; 40(8):856-61. · 1.51 Impact Factor
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ABSTRACT: We aimed to define a standardised protocol for the electromyographic evaluation of trapezius muscle in dentistry and to assess its within- and between-session repeatability. Surface electromyography of trapezius, masseter and temporal muscles was performed in 40 healthy subjects aged 20-35 years during shoulder elevation, and maximum teeth clenching with and without cotton rolls. Two repetitions were made both within (same electrodes) and between sessions (different electrodes). Maximum voluntary clench on cotton rolls was used to standardise the potentials of the six analysed muscles with tooth contact; shoulder elevation was used to standardise the upper trapezius potentials. From the standardised electromyographic potentials, several indices (muscle symmetry; masticatory muscle torque and relative activity; total masticatory muscle activity; trapezius cervical load, percentage co-contraction of trapezius during teeth clenching) were computed; random (technical error of measurement) and systematic (Student's t-test, Analysis of Variance) errors were assessed. For all indices, no systematic errors were found between the two separate data collection sessions. Within session, limited (lower than 8%) technical errors of measurement were found for temporalis and masseter symmetry, torque and activity indices, and the trapezius cervical load. Larger random errors were obtained for trapezius symmetry and total masticatory muscle activity (up to 20%). Between sessions, no significant differences were found for trapezius co-contraction. In conclusion, a protocol for the standardisation of trapezius muscle that may be used within dental clinical applications was defined, and the repeatability of masseter, temporalis and trapezius electromyographic recordings for serial assessments was assessed in healthy subjects.
Journal of Oral Rehabilitation 02/2011; 38(9):648-54. · 1.53 Impact Factor
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ABSTRACT: To compare the electromyographic characteristics of masticatory muscles with and without a new elastomeric oral device proposed for masticatory muscle training, 10 healthy subjects aged 23 to 32 were examined. Surface electromyography of masseter and temporal muscles was performed during maximum teeth clenching without and with the device and during unilateral chewing with either gum or the device. During clenching, a significant increment of the overall muscular activity was promoted by the occlusal device in comparison with the intercuspal teeth clenching (P=0·05). Muscular standardised activity during device chewing was significantly higher than that during gum chewing (P=0·005), and it was more evenly distributed between working and balancing sides (P=0·023 right side, P=0·039 left side), and between masseter and temporal muscles (right side test, P=0·014). No significant differences were found for the global neuromuscular co-ordination, the masticatory symmetry and the chewing frequency. Clenching and chewing with the analysed occlusal prostheses was performed with a relative increment of muscular activity. These findings may be the basis for the training effect proposed for this device.
Journal of Oral Rehabilitation 11/2010; 37(11):840-7. · 1.53 Impact Factor
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ABSTRACT: To assess sex- and age-related characteristics in standardized facial movements, 40 healthy adults (20 men, 20 women; aged 20-50 years) performed seven standardized facial movements (maximum smile; free smile; "surprise" with closed mouth; "surprise" with open mouth; eye closure; right- and left-side eye closures). The three-dimensional coordinates of 21 soft tissue facial landmarks were recorded by a motion analyser, their movements computed, and asymmetry indices calculated. Within each movement, total facial mobility was independent from sex and age (analysis of variance, p>0.05). Asymmetry indices of the eyes and mouth were similar in both sexes (p>0.05). Age significantly influenced eye and mouth asymmetries of the right-side eye closure, and eye asymmetry of the surprise movement. On average, the asymmetry indices of the symmetric movements were always lower than 8%, and most did not deviate from the expected value of 0 (Student's t). Larger asymmetries were found for the asymmetric eye closures (eyes, up to 50%, p<0.05; mouth, up to 30%, p<0.05 only in the 20-30-year-old subjects). In conclusion, sex and age had a limited influence on total facial motion and asymmetry in normal adult men and women.
International Journal of Oral and Maxillofacial Surgery 10/2010; 39(10):990-9. · 1.51 Impact Factor
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ABSTRACT: This study documented: (i) the curriculum in special care dentistry in the Italian dental schools, as perceived by Deans and by students, (ii) the rate of satisfaction of dental students with their curricular education in special care dentistry, (iii) the attitude of the dental students towards special care dentistry and towards the 'Special Smiles' programme.
The quality and amount of didactic and clinical training delivered by each dental school for subjects with intellectual disability (ID), the interest of students towards this health field and the 'Special Smiles' programme were collected. Self-administered surveys were sent to the Dean and to all the final year students of all dental schools in 20 Italian Universities.
Only four Deans of the 20 dental schools answered the survey, stating to provide didactic and clinical education in special care dentistry. A 51% of student response rate was obtained. Dental students reported to spend about 4% of didactic and 5% of clinical training in the dental care for ID subjects. Most students (83%) rated the training they had received on the topic to be poor. Over 50% of students expressed interest in working in dental offices specifically dedicated to ID patients and 25% of students wished to become Special Smiles volunteers.
Although the paucity of didactic and clinical training in dental care for ID patients, this survey demonstrated a high level of student's interest in learning more about treating these subjects. The current results could suggest to revise the curricular standards of dental schools, by promoting ID-oriented education programmes.
European Journal Of Dental Education 11/2009; 13(4):218-22. · 1.18 Impact Factor
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British Journal of Oral and Maxillofacial Surgery 06/2009; 48(4):322. · 1.95 Impact Factor
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ABSTRACT: The determination of normal parameters is an important procedure in the evaluation of the stomatognathic system. We used the surface electromyography standardization protocol described by Ferrario et al. (J Oral Rehabil. 2000;27:33-40, 2006;33:341) to determine reference values of the electromyographic standardized indices for the assessment of muscular symmetry (left and right side, percentage overlapping coefficient, POC), potential lateral displacing components (unbalanced contractile activities of contralateral masseter and temporalis muscles, TC), relative activity (most prevalent pair of masticatory muscles, ATTIV) and total activity (integrated areas of the electromyographic potentials over time, IMPACT) in healthy Brazilian young adults, and the relevant data reproducibility. Electromyography of the right and left masseter and temporalis muscles was performed during maximum teeth clenching in 20 healthy subjects (10 women and 10 men, mean age 23 years, s.d. 3), free from periodontal problems, temporomandibular disorders, oro-facial myofunctional disorder, and with full permanent dentition (28 teeth at least). Data reproducibility was computed for 75% of the sample. The values obtained were POC Temporal (88.11 +/- 1.45%), POC masseter (87.11 +/- 1.60%), TC (8.79 +/- 1.20%), ATTIV (-0.33 +/- 9.65%) and IMPACT (110.40 +/- 23.69 microV/microV.s %). There were no statistical differences between test and retest values (P > 0.05). The Technical Errors of Measurement (TEM) for 50% of subjects assessed during the same session were 1.5, 1.39, 1.06, 3.83 and 10.04. For 25% of the subjects assessed after a 6-month interval, the TEM were 0.80, 1.03, 0.73, 12.70 and 19.10. For all indices, there was good reproducibility. These electromyographic indices could be used in the assessment of patients with stomatognathic dysfunction.
Journal of Oral Rehabilitation 06/2009; 36(8):577-83. · 1.53 Impact Factor
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Journal of Oral Rehabilitation 02/2009; 36(1):9-10. · 1.53 Impact Factor
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ABSTRACT: WE AIMED AT CHARACTERIZING THE AGING GINGIVA ANALYZING: i) collagen content and turnover in human gingival tissues and fibroblasts obtained from healthy young and aging subjects. ii) the effect of cyclosporin A administration in human cultured gingival fibroblasts obtained from aging compared to young subjects.
Morphological analysis was performed on haematoxylin-eosin and Sirius red stained paraffin-embedded gingival biopsies from young and aging healthy subjects. The expression of the main genes and proteins involved in collagen turnover were determined by real time PCR, dot blot and SDS-zymography on cultured young and aging gingival fibroblasts, and after cyclosporin A administration.
Our results suggest that in healthy aged people, gingival connective tissue is characterized by a similar collagen content and turnover. Collagen turnover pathways are similarly affected by cyclosporin A treatment in young and aging gingival fibroblasts.
Cyclosporin A administration affects gingival collagen turnover pathways in young and aging fibroblasts at the same extent, suggesting that during aging cyclosporin A administration is not related to relevant collagen turnover modifications.
The Open Dentistry Journal 01/2009; 3:219-26.
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British dental journal official journal of the British Dental Association: BDJ online 10/2008; 205(5):221-3; author reply 223. · 1.09 Impact Factor
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ABSTRACT: The objective of the study was to analyse quantitatively palatal morphology in bruxist and non-bruxist children with mixed dentition. Twenty-three children with mixed dentition were classified as bruxist according to their anxiety level, audible occlusal sounds related by the parents and signs of temporomandibular disorders; 23 children were control subjects matched for gender, age, and dental formula. The maxillary dental arches of all subjects were reproduced from alginate impressions cast in dental stone with a standardized technique. The casts were digitalized and mathematical equations were used to obtain the form of the palate in the sagittal, frontal and horizontal planes. Bruxist children had a statistically significant longer palate in the sagittal plane than control children; palatal shape differed especially in correspondence of the third, fourth and fifth teeth, bruxist children showing a relatively higher palate than control children. In this pilot study, sagittal plane differences in the palate between bruxist and non-bruxist children matched for age and gender were found. Further investigations are needed to understand better the clinical implications of the findings. Results should be taken into account in the diagnosis of the occlusal development in children with parafunctions to prevent future abnormalities: a bruxist child may have bigger dental arches than a normal child.
Journal of Oral Rehabilitation 06/2008; 35(5):353-60. · 1.53 Impact Factor
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ABSTRACT: In medical practice, the analysis of facial soft tissues often complement (or even supplement) the evaluation of the hard-tissue relationships. Current technology provides reference data in three dimensions, but clinical practice still uses two-dimensional photographs. In the current study, two-dimensional photographic and computerized, three-dimensional angles measured on the facial profile of children were compared.
Two-dimensional angular measurements (facial convexity including/excluding the nose; maxillary prominence; nasal prominence; nasolabial; mentolabial; maxillo-labio-mandibular; interlabial) were obtained on the facial profile photographs of 55 boys and 31 girls aged 6; measurements were compared to three-dimensional computerized data collected on 27 boys and 28 girls of the same age and ethnic group.
On average, in boys, only the angles of facial convexity including the nose, interlabial, nasolabial and maxillo-labio-mandibular showed differences between the means larger than 2 degrees (up to 2.5 degrees). Statistically significant differences (P<0.05, Watson-Williams' test) were found for the angle of facial convexity including the nose and the maxillary prominence angle. In girls, differences between the two methods larger than 2 degrees were found for the interlabial, maxillo-labio-mandibular (statistically significant), and mentolabial angles (differences up to 7 degrees, corresponding to 4% of the relevant mean).
The two-dimensional photographic and the three-dimensional computerized data compared in the current study, even not superimposable, seemed sufficiently interchangeable, at least from a clinical point of view. A particular attention should be given to the recording of lip position.
Minerva stomatologica 05/2007; 56(5):253-65.
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ABSTRACT: Alterations in facial motion severely impair the quality of life and social interaction of patients, and an objective grading of facial function is necessary. A method for the non-invasive detection of 3D facial movements was developed. Sequences of six standardized facial movements (maximum smile; free smile; surprise with closed mouth; surprise with open mouth; right side eye closure; left side eye closure) were recorded in 20 healthy young adults (10 men, 10 women) using an optoelectronic motion analyzer. For each subject, 21 cutaneous landmarks were identified by 2-mm reflective markers, and their 3D movements during each facial animation were computed. Three repetitions of each expression were recorded (within-session error), and four separate sessions were used (between-session error). To assess the within-session error, the technical error of the measurement (random error, TEM) was computed separately for each sex, movement and landmark. To assess the between-session repeatability, the standard deviation among the mean displacements of each landmark (four independent sessions) was computed for each movement. TEM for the single landmarks ranged between 0.3 and 9.42 mm (intrasession error). The sex- and movement-related differences were statistically significant (two-way analysis of variance, p=0.003 for sex comparison, p=0.009 for the six movements, p<0.001 for the sex x movement interaction). Among four different (independent) sessions, the left eye closure had the worst repeatability, the right eye closure had the best one; the differences among various movements were statistically significant (one-way analysis of variance, p=0.041). In conclusion, the current protocol demonstrated a sufficient repeatability for a future clinical application. Great care should be taken to assure a consistent marker positioning in all the subjects.
European journal of histochemistry: EJH 01/2007; 51 Suppl 1:45-52. · 1.69 Impact Factor
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ABSTRACT: A cross-sectional investigation to study the relations between aerobic fitness and somatic growth of Italian adolescents within a school context.
The Léger and Lambert 20-m shuttle run test scores were used to estimate the oxygen uptake (VO2max) of 290 high school adolescent students aged 14-18 years. Descriptive statistics of body mass, standing height, body mass index (BMI) and of predicted VO2max were calculated within age and sex group.
Body mass and standing height were significantly larger in males than in females, and significantly increased with age (P < 0.002, analysis of variance). For standing height, a significant sex age interaction was found (P = 0.0004), with a larger age-related increment in males than in females. No significant differences in BMI were found. VO2max was significantly influenced by sex and age. The age-related decrement in VO2max was larger in females than in males (P = 0.001). Predicted VO2max was significantly related to BMI (males: r = -0.41; females: r = -0.336) and to body mass (females: r = -0.34; males: r = -0.352). A negative relationship between BMI and VO2max was found also in the overweight adolescents.
In both sexes, aerobic fitness declined with age. The decline was particularly evident in females. Low-cost methods to detect the nutritional level and aerobic performance of adolescents should be encouraged at school.
The Journal of sports medicine and physical fitness 10/2006; 46(3):412-8. · 0.85 Impact Factor
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ABSTRACT: The electromyographic (EMG) characteristics of masseter, temporalis and sternocleidomastoid (SCM) muscles during maximum voluntary teeth clench were assessed in 27 male and 35 female healthy young adults. Subjects were divided into two groups: (i) 'complete' Angle Class I (bilateral, symmetric canine and molar Class I relationships), and (ii) 'partial' Angle Class I (one to three canine/molar Class I relationships, the remaining relationships were Class II or Class III). On average, standardized muscular symmetry ranged 80.7-87.9%. During maximum voluntary teeth clench, average co-contraction of SCM muscle was 13.7-23.5% of its maximum contraction. On average, all torque coefficients (potential lateral displacing component) were >90%, while all antero-posterior coefficients (relative activities of masseter and temporalis muscles) were >85%. The average integrated areas of the masseter and temporalis EMG potentials over time ranged 87.4-106.8 muV/muV s%. Standardized contractile muscular activities did not differ between 'complete' and 'partial' Angle Class I, and between sexes (two-way analysis of variance). A trend toward a larger intragroup variability in EMG indices was observed in the subjects with 'partial' Angle Class I than in those with 'complete' Angle Class I (significant difference for the temporalis muscle symmetry, P = 0.013, analysis of variance). In conclusion, the presence of a complete or partial Angle occlusal Class I did not seem to influence the standardized contractile activities of masseter, temporalis and SCM muscles during a maximum voluntary clench. Subjects with a 'complete' Angle Class I were somewhat a more homogenous group than subjects with 'partial' Angle Class I.
Journal of Oral Rehabilitation 05/2006; 33(5):341-8. · 1.53 Impact Factor
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ABSTRACT: Skin reaction is the most common side-effect of radiation therapy. Radiation-induced dermal fibrosis has been characterized histologically, but little is known about the epidermis overlying fibronecrotic lesions.
To characterize the epidermal response 24 h after a single clinically relevant dose of gamma-rays in cultured human breast skin.
Biopsies obtained from cosmetic surgery (n = 7) were placed epidermis upwards in a Transwell system, and were exposed to a single dose of gamma-irradiation (2 Gy). A parallel set of nonirradiated skin fragments was incubated under the same conditions. Both irradiated and nonirradiated fragments were harvested 24 h after irradiation and processed for light microscopy and molecular biology analysis. A quantitative analysis of cell proliferation was performed after 5-bromo-2'-deoxyuridine incorporation. Cytokeratin 10 (CK10) and desmocollin 1 (Dsc1) expression was evaluated by immunofluorescence. Dsc1 and transforming growth factor (TGF)-beta1 gene expression was measured by reverse transcriptase-polymerase chain reaction analysis.
The mean percentage inhibition of epidermal proliferation in irradiated samples was 53.7% (P < 0.01, paired Student's t-test). The inhibition of cell proliferation was significant in five of seven samples (P < 0.05, unpaired Student's t-test). Normal cell architecture was found in irradiated samples. Throughout the epithelial compartment, the distribution patterns of CK10 and Dsc1 were comparable in nonirradiated and irradiated fragments. Condensation of CK10 filaments suggested a cytoskeletal rearrangement in irradiated samples. Dsc1 and TGF-beta1 mRNA levels were, respectively, reduced and unmodified 24 h after irradiation.
A perturbation of epidermal homeostasis occurs as early as 24 h after a single dose of gamma-rays. Our immunofluorescence observations indicate that keratinocyte terminal differentiation is not yet affected at the protein level 24 h after exposure to gamma-rays. The lack of an inverse relationship between TGF-beta1 gene expression and epidermal proliferation, together with decreased Dsc1 gene expression, may represent the early molecular basis for the development of the late effects of radiotherapy observed many months/years after radiotherapy. Our findings set the stage for further investigation of the best time to begin topical treatment at the start of radiation therapy.
British Journal of Dermatology 12/2005; 153(5):881-6. · 3.67 Impact Factor
