Cesare Lorenzo Debernardi

Bio: Cesare Lorenzo Debernardi is an academic researcher from University of Turin. The author has contributed to research in topics: Masticatory force & Mastication. The author has an hindex of 19, co-authored 41 publications receiving 1093 citations.

Efficacy of clear aligners in controlling orthodontic tooth movement: A systematic review

Abstract: Objective: To assess the scientific evidence related to the efficacy of clear aligner treatment (CAT) in controlling orthodontic tooth movement. Materials and Methods: PubMed, PMC, NLM, Embase, Cochrane Central Register of Controlled Clinical Trials, Web of Knowledge, Scopus, Google Scholar, and LILACs were searched from January 2000 to June 2014 to identify all peer-reviewed articles potentially relevant to the review. Methodological shortcomings were highlighted and the quality of the studies was ranked using the Cochrane Tool for Risk of Bias Assessment. Results: Eleven relevant articles were selected (two Randomized Clinical Trials (RCT), five prospective non-randomized, four retrospective non-randomized), and the risk of bias was moderate for six studies and unclear for the others. The amount of mean intrusion reported was 0.72 mm. Extrusion was the most difficult movement to control (30% of accuracy), followed by rotation. Upper molar distalization revealed the highest predictability (88...

Periodontal health during clear aligners treatment: a systematic review

Abstract: Background: Clear aligner treatment (CAT) has been cited as a safe and comfortable orthodontic procedure for adult patients. However, the available evidence is scarce. Objective: To perform a systematic review of the existing literature in order to assess periodontal health during CAT. Search methods and selection criteria: Pubmed, Pubmed Central, National Library of Medicine’s Medline, Embase, Cochrane Central Register of Controlled Clinical trials, Web of Knowledge, Scopus, Google Scholar, and LILACS were searched from January 1945 to September 2014 to identify all peer-reviewed papers potentially relevant to the review. Data collection and analysis: After duplicate selection and extraction procedures, the risk of bias was assessed according to the Centre for Reviews and Dissemination criteria, and a 3-point grading system, as described by the Swedish Council on Technology Assessment in Health Care (SBU), was used to rate the methodological quality of the selected papers. A PICOS table was used for data extraction. Results: Five relevant articles were selected from the 1247 identified articles. The level of evidence was moderate for all the studies. A significant improvement of the periodontal health indexes was revealed, in particular when CAT was compared to fixed appliances. No periodontal CAT adverse effects were observed in the selected studies. Conclusions: Periodontal health indexes were significantly improved during CAT. The results of this review should be interpreted with some caution because of the number, quality, and heterogeneity of the included studies.

Coronally advanced flap with or without enamel matrix derivative for root coverage : a 2-year study

Abstract: Aim The purpose of this study was to assess the ability of enamel matrix derivative (EMD) to improve root coverage with a coronally advanced flap (CAF) during a 2-year follow-up. Methods Fifteen patients each with two single and similar bilateral Miller Class I or II gingival recessions (30 recessions) were selected. Each recession was randomly assigned to the test group (CAF+EMD) or the control group (CAF only). Clinical parameters recorded at baseline and at 6, 12 and 24 months were recession depth (R), recession width (WR), probing depth (PD), clinical attachment level (CAL) and keratinized tissue (KT). Results Reduction of R resulted in a significant CAL gain in both groups, whereas PD was not altered. In the test group, R decreased from 4.07 mm (SD+/-0.59) at baseline to 0.47 mm (SD+/-0.74) at 24 months, corresponding to a mean root coverage (MRC) of 90.67%, whereas in the control group R shrank from 4.13 mm (SD+/-0.74) at baseline to 0.60 mm (SD+/-0.83) at 24 months (MRC=86.67%). Complete root coverage was achieved at 24 months in 73.33% and 60% of the two groups. A significant KT increase was observed in both groups. Conclusions Root coverage outcomes were similar in both groups and no statistically significant differences were found at all between them. Hence, the additional use of EMD to CAF is not justified for clinical benefits of root coverage, but as an attempt of achieving periodontal regeneration rather than repair.

Detection of sleep bruxism: comparison between an electromyographic and electrocardiographic portable holter and polysomnography.

Abstract: Summary Recent polysomnographic (PSG) studies showed that the sleep bruxism (SB) event is preceded by a sudden shift in autonomic cardiac activity. Therefore, heart rate could be the simplest-to-record parameter for use in addition to portable home EMG monitoring to improve the accuracy in automatic detection of SB events. The aim of the study was to compare the detection of SB episodes by combined surface electromyography and heart rate (HR) recorded by a compact portable device (Bruxoff®), with the scoring of SB episodes by a PSG recording. Twenty-five subjects (14 ‘probable’ bruxers and 11 non-bruxers) were selected for the study. Each subject underwent the Bruxoff and the PSG recordings during the same night. Rhythmic masseter muscle activities (RMMAs) were scored according to published criteria. Correlation coefficients and the Bland–Altman plots were calculated to measure the correlation and agreement between the two methods. Results showed a high correlation (Pearson's r = 0·95, P < 0·0001) and a high agreement (bias = 0·05) between Bruxoff and the PSG. Furthermore, the receiver operating characteristic curve analysis showed a high sensitivity and specificity of the portable device (92·3% and 91·6%, respectively) when the cut-off was set at 4 SB episodes per hour according to published criteria. The Bruxoff device showed a good diagnostic accuracy to differentiate RMMA from other oromotor activities. These findings are important in the light of the need for simple and reliable portable devices for the diagnosis of SB both in the clinical and research settings.

Harrison's Principles of Internal Medicine

Abstract: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

International consensus on the assessment of bruxism : Report of a work in progress

Abstract: In 2013, consensus was obtained on a definition of bruxism as repetitive masticatory muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible and specified as either sleep bruxism or awake bruxism. In addition, a grading system was proposed to determine the likelihood that a certain assessment of bruxism actually yields a valid outcome. This study discusses the need for an updated consensus and has the following aims: (i) to further clarify the 2013 definition and to develop separate definitions for sleep and awake bruxism; (ii) to determine whether bruxism is a disorder rather than a behaviour that can be a risk factor for certain clinical conditions; (iii) to re-examine the 2013 grading system; and (iv) to develop a research agenda. It was concluded that: (i) sleep and awake bruxism are masticatory muscle activities that occur during sleep (characterised as rhythmic or non-rhythmic) and wakefulness (characterised by repetitive or sustained tooth contact and/or by bracing or thrusting of the mandible), respectively; (ii) in otherwise healthy individuals, bruxism should not be considered as a disorder, but rather as a behaviour that can be a risk (and/or protective) factor for certain clinical consequences; (iii) both non-instrumental approaches (notably self-report) and instrumental approaches (notably electromyography) can be employed to assess bruxism; and (iv) standard cut-off points for establishing the presence or absence of bruxism should not be used in otherwise healthy individuals; rather, bruxism-related masticatory muscle activities should be assessed in the behaviour's continuum.

Treatment of gingival recession with coronally advanced flap procedures: a systematic review

Abstract: Background: The treatment of buccal gingival recessions is a common requirement due to aesthetic concern or root sensitivity. The aim of this manuscript was to systematically review the literature on coronally advanced flap (CAF) alone or in combination with tissue grafts, barrier membranes (BM), enamel matrix derivative (EMD) or other material for treating gingival recession. Material and Methods: Randomized clinical trials on treatment of Miller Class I and II gingival recessions with at least 6 months of follow-up were identified. Data sources included electronic databases and hand-searched journals. The primary outcome variable was complete root coverage (CRC). The secondary outcome variables were recession reduction, clinical attachment gain, keratinized tissue gain, aesthetic satisfaction, root sensitivity, post-operative patient pain and complications. Results: A total of 794 Miller Class I and II gingival recessions in 530 patients from 25 RCTs were evaluated in this systematic review. CAF was associated with mean recession reduction and CRC. The addition of connective tissue graft (CTG) or EMD enhanced the clinical outcomes of CAF in terms of CRC, while BM did not. The results with respect to the adjunctive use of acellular dermal matrix were controversial. Conclusions: CTG or EMD in conjunction with CAF enhances the probability of obtaining CRC in Miller Class I and II single gingival recessions.

Periodontal Soft Tissue Root Coverage Procedures: A Systematic Review From the AAP Regeneration Workshop

Abstract: Background: This paper aims to create a “bridge” between research and practice by developing a practical, extensive, and clinically relevant study that translates evidence-based findings on soft tissue root coverage (RC) of recession-type defects to daily clinical practice.Methods: This review is prepared in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement based on the proposed focused questions. A literature search with no restrictions regarding status or the language of publication was performed for MEDLINE and EMBASE databases up to and including June 2013. Systematic reviews (SRs), randomized clinical trials, controlled clinical trials, case series, and case reports evaluating recession areas that were treated by means of RC procedures were considered eligible for inclusion through the three parts of the study (part I, an overview of the base of SRs; part II, an alternative random-effects meta-analyses on mean percentage of RC and sites exhibiti...