2 resultados para Arco Dental. Face. Maloclusão. Ortodontia. Morfologia

em AMS Tesi di Dottorato - Alm@DL - Università di Bologna


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The thesis of this paper is based on the assumption that the socio-economic system in which we are living is characterised by three great trends: growing attention to the promotion of human capital; extremely rapid technological progress, based above all on the information and communication technologies (ICT); the establishment of new production and organizational set-ups. These transformation processes pose a concrete challenge to the training sector, which is called to satisfy the demand for new skills that need to be developed and disseminated. Hence the growing interest that the various training sub-systems devote to the issues of lifelong learning and distance learning. In such a context, the so-called e-learning acquires a central role. The first chapter proposes a reference theoretical framework for the transformations that are shaping post-industrial society. It analyzes some key issues such as: how work is changing, the evolution of organizational set-ups and the introduction of learning organization, the advent of the knowledge society and of knowledge companies, the innovation of training processes, and the key role of ICT in the new training and learning systems. The second chapter focuses on the topic of e-learning as an effective training model in response to the need for constant learning that is emerging in the knowledge society. This chapter starts with a reflection on the importance of lifelong learning and introduces the key arguments of this thesis, i.e. distance learning (DL) and the didactic methodology called e-learning. It goes on with an analysis of the various theoretic and technical aspects of e-learning. In particular, it delves into the theme of e-learning as an integrated and constant training environment, characterized by customized programmes and collaborative learning, didactic assistance and constant monitoring of the results. Thus, all the aspects of e-learning are taken into exam: the actors and the new professionals, the virtual communities as learning subjects, the organization of contents in learning objects, the conformity to international standards, the integrated platforms and so on. The third chapter, which concludes the theoretic-interpretative part, starts with a short presentation of the state-of-the-art e-learning international market that aims to understand its peculiarities and its current trends. Finally, we focus on some important regulation aspects related to the strong impulse given by the European Commission first, and by the Italian governments secondly, to the development and diffusion of e-learning. The second part of the thesis (chapters 4, 5 and 6) focus on field research, which aims to define the Italian scenario for e-learning. In particular, we have examined some key topics such as: the challenges of training and the instruments to face such challenges; the new didactic methods and technologies for lifelong learning; the level of diffusion of e-learning in Italy; the relation between classroom training and online training; the main factors of success as well as the most critical aspects of the introduction of e-learning in the various learning environments. As far as the methodological aspects are concerned, we have favoured a qualitative and quantitative analysis. A background analysis has been done to collect the statistical data available on this topic, as well as the research previously carried out in this area. The main source of data is constituted by the results of the Observatory on e-learning of Aitech-Assinform, which covers the 2000s and four areas of implementation (firms, public administration, universities, school): the thesis has reviewed the results of the last three available surveys, offering a comparative interpretation of them. We have then carried out an in-depth empirical examination of two case studies, which have been selected by virtue of the excellence they have achieved and can therefore be considered advanced and emblematic experiences (a large firm and a Graduate School).

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This thesis evaluated in vivo and in vitro enamel permeability in different physiological and clinical conditions by means of SEM inspection of replicas of enamel surface obtained from polyvinyl siloxane impressions subsequently later cast in polyether impression ma-terial. This technique, not invasive and risk-free, allows the evaluation of fluid outflow from enamel surface and is able to detect the presence of small quantities of fluid, visu-alized as droplets. Fluid outflow on enamel surface represents enamel permeability. This property has a paramount importance in enamel physiolgy and pathology although its ef-fective role in adhesion, caries pathogenesis and prevention today is still not fully under-stood. The aim of the studies proposed was to evaluate enamel permeability changes in differ-ent conditions and to correlate the findings with the actual knowledge about enamel physiology, caries pathogenesis, fluoride and etchinhg treatments. To obtain confirmed data the replica technique has been supported by others specific techniques such as Ra-man and IR spectroscopy and EDX analysis. The first study carried out visualized fluid movement through dental enamel in vivo con-firmed that enamel is a permeable substrate and demonstrated that age and enamel per-meability are closely related. Examined samples from subjects of different ages showed a decreasing number and size of droplets with increasing age: freshly erupted permanent teeth showed many droplets covering the entire enamel surface. Droplets in permanent teeth were prominent along enamel perikymata. These results obtained through SEM inspection of replicas allowed innovative remarks in enamel physiology. An analogous testing has been developed for evaluation of enamel permeability in primary enamel. The results of this second study showed that primary enamel revealed a substantive permeability with droplets covering the entire enamel sur-face without any specific localization accordingly with histological features, without changes during aging signs of post-eruptive maturation. These results confirmed clinical data that showed a higher caries susceptibility for primary enamel and suggested a strong relationship between this one and enamel permeability. Topical fluoride application represents the gold standard for caries prevention although the mechanism of cariostatic effect of fluoride still needs to be clarified. The effects of topical fluoride application on enamel permeability were evaluated. Particularly two dif-ferent treatments (NaF and APF), with different pH, were examined. The major product of topical fluoride application was the deposition of CaF2-like globules. Replicas inspec-tion before and after both treatments at different times intervals and after specific addi-tional clinical interventions showed that such globule formed in vivo could be removed by professional toothbrushing, sonically and chemically by KOH. The results obtained in relation to enamel permeability showed that fluoride treatments temporarily reduced enamel water permeability when CaF2-like globules were removed. The in vivo perma-nence of decreased enamel permeability after CaF2 globules removal has been demon-strated for 1 h for NaF treated teeth and for at least 7 days for APF treated teeth. Important clinical consideration moved from these results. In fact the caries-preventing action of fluoride application may be due, in part, to its ability to decrease enamel water permeability and CaF2 like-globules seem to be indirectly involved in enamel protection over time maintaining low permeability. Others results obtained by metallographic microscope and SEM/EDX analyses of or-thodontic resins fluoride releasing and not demonstrated the relevance of topical fluo-ride application in decreasing the demineralization marks and modifying the chemical composition of the enamel in the treated area. These data obtained in both the experiments confirmed the efficacy of fluoride in caries prevention and contribute to clarify its mechanism of action. Adhesive dentistry is the gold standard for caries treatment and tooth rehabilitation and is founded on important chemical and physical principles involving both enamel and dentine substrates. Particularly acid etching of dental enamel enamel has usually employed in bonding pro-cedures increasing microscopic roughness. Different acids have been tested in the litera-ture suggesting several etching procedures. The acid-induced structural transformations in enamel after different etching treatments by means of Raman and IR spectroscopy analysis were evaluated and these findings were correlated with enamel permeability. Conventional etching with 37% phosphoric acid gel (H3PO4) for 30 s and etching with 15 % HCl for 120 s were investigated. Raman and IR spectroscopy showed that the treatment with both hydrochloric and phosphoric acids induced a decrease in the carbonate content of the enamel apatite. At the same time, both acids induced the formation of HPO42- ions. After H3PO4 treatment the bands due to the organic component of enamel decreased in intensity, while in-creased after HCl treatment. Replicas of H3PO4 treated enamel showed a strongly reduced permeability while replicas of HCl 15% treated samples showed a maintained permeability. A decrease of the enamel organic component, as resulted after H3PO4 treatment, involves a decrease in enamel permeability, while the increase of the organic matter (achieved by HCl treat-ment) still maintains enamel permeability. These results suggested a correlation between the amount of the organic matter, enamel permeability and caries. The results of the different studies carried out in this thesis contributed to clarify and improve the knowledge about enamel properties with important rebounds in theoretical and clinical aspects of Dentistry.