Riabilitazione protesica ed implanto-protesica di pazienti in età evolutiva affetti da Displasia Ectodermica

Introduction. Ectodermal Dysplasias are a heterogeneous group of inherited disorders characterized by dysplasia of tissues of ectodermal origin (hair, nails, teeth, skins and glands). Clinically, it may be divided into two broad categories: the X-linked hypoidrotic form and the hidrotic form. Hypohidrotic Ectodermal Dysplasia (H.E.D) is characterized by the triad oligo-anodontia, hypotricosis, hypo-anhydrosis (Christ-Siemens-Tourane syndrome). The incidence of HED is about 1/100,000. Mutation in the actodysplasin-A (EDA) and ectodysplasin-A receptor (EDAR) genes are responsible for X-linked and autosomal HED. The clinical features include sparse, fine hair, missing or conical-shaped teeth, decreased sweat and mucous glands, hypoplastic skin, and heat intolerance with exercise or increased ambient temperature. Complete or partial anodontia and malformation of teeth are the most frequent dental findings. Incisors and canines are often conical-shaped while primarily second molars, if present, are mostly affected by taurodontism. Treatment is supportive and includes protection from heat exposure, early prosthetic rehabilitation, skin, hair ear, nose and nail care, and genetic counseling for family planning. The diagnosis of HED in the neonatal and early infancy period may be difficult since sparse hair and absent teeth are normal finding at this age. In childhood the diagnosis is more easily made on the basis of history and clinical examination. Dental abnormalities are the most common complaint. Prosthetic rehabilitation has been recommended as an essential part of the management of HED because is important from functional, esthetic, and psychological standpoint. A team approach that includes input from a pediatric dentist, an orthodontist, a prosthodontist, and an oral and maxillofacial surgeon is necessary for a successful outcome. Conventional prosthodontic rehabilitation in young patient is often difficult because of the anatomical abnormalities of existing teeth and alveolar ridges. The conical shaped teeth and “knife-edge” alveolar ridges result in poor retention and instability of dentures. Moreover, denture must permit jaws expansion and a correct pattern of growth. Materials and Methods. Complete removable dentures were provided to allow for normal physiological development and a corrected masticatory function. Initial maxillary and mandibular impressions were made with smallest stock trays and irreversible hydrocolloid and then final impressions ware made with light-bodied polysulfide rubber base impression material. A base of autopolymerizing resin was constructed and a wax rim was added to the base. The patient’s vertical dimension of occlusion was established by assessing phonetic and esthetic criteria. Preliminary occlusal relations were recorded, and the mandibular cast was mounted on the articulator. Acrylic resin teeth specific for children dentures were selected and mounted. The dentures were tried in and, after proper adjustments, were inserted. The patients were monitored clinically every month to fit prostheses. Cephalometric radiographs were taken every 6 month with the prostheses in place in order to evaluate correct pattern of growth. Cephalometric measurements were realized and used to evaluate the effect of rehabilitation on craniofacial growth. Cephalometric measurements of sound patients were compared with ED patients. After two month expander screws (three-way screw in the upper denture and two-way the lower one)were inserted in each denture in order to permit the expansion of the denture and the jaws growth. Where conical teeth were present, composite crown were realized and luted to improve the esthetic and phonesis. In order to improve retention the placement of endosseous implants was carried out. TC 3D Accuitomo was performed and a resin model of mandibular bone of the patient was realized. At the age of 11 years two implants were inserted into anterior mandible in a child with anodontia. Despite a remarkable multi-dimensional atrophy of the mandibular alveolar process, the insertion of two tapered screw implants (SAMO Smiler, diameter 3.8, length 10 mm). After a submerged healing period of two-three month, the implants were exposed. Implants were connected with an expansion guide that permits mandibular growth and prosthetic retention. The amount of mandibular growth was also evaluate dusing the expansion guide. Results. Early oral rehabilitation improve oral function, phonesis and esthetic, reducing social impairment. Treated patients showed normal cephalometric measurement. Early rehabilitation is able to prevent the prognatissm of the mandibula . The number of teeth was significantly related to several changes in craniofacial morphology. Discussion. In the present study the 5,3% of ED patients showed hypodontia, the l’89,4% di oligodontia, and the 5,3% di anodontia. The cephalometric analysis supports that ED patients showed midface hypoplasia. ED groups showed an increased pogonion to nasion measurement than sound patients, indicative of class III tendency. The present study demonstrated that number of teeth was significantly correlated with deviation of cephalometric measurements from normality. Oligoanodontia is responsible for changing of cephalometric measuraments also on sagittal plane with a class III tendency. Maxillary jaw showed a retrused position related to the presence of hypodontia.

Studio analitico della cultura materiale fra VII e IX secolo d.C. nella Regione di Samarcanda (Uzbekistan): analisi morfo-tipologica, produzione e commercio della ceramica di Kafir Kala

Kafir Kala is a key-site to understand the historical dynamics of the Samarkand Region in the Early Middle Ages (5th - 8th centuries CE). The site is clearly associated with a Sogdian occupation, as both literature and archaeological research testify. But the chronological phase that follows the Sogdian period, as the Islamic occupation became stable, is still little known. Structures and finds (an hoard of 133 silver coins, in particular) clearly testify a new occupation of some parts of the citadel; and some rooms, dug in the northern side of it, present structures and materials connected with an Islamic activity. The study of material culture from these rooms, and from more ancient contexts, will help to understand the eventual continuity of traditions and the new productions. Besides the citadel, as a matter of fact, also some kilns have been dug, near the main site. Their material culture is very interesting because it represents an example of the typical Sogdian production (ceramics covered with white mica, and stamped). The work on the ceramic material has consisted in cataloguing and classifying all the diagnostics. Three main morphological classes have been individuated: cooking, coarse and table ware), and some other ones (lamps, ossuaries). A catalogue of the finds organized them in a typological system based on their morphology, function, fabric, and eventually decoration style. Crossing the stratigraphical data with information from this typological study, it has been possible to provide a chronological arrangement of the sites investigated by the italo-uzbek archaeological mission from 2001 to 2008.

L’instrumentum fittile inscriptum della colonia romana di Mutina e del suo territorio

Il presente lavoro è incentrato sulla raccolta e l’analisi dell’instrumentum fittile inscriptum – in particolare laterizi, dolia, lucerne, ceramica fine da mensa, anfore e tappi d’anfora - rinvenuto a Modena e nel suo territorio. L’attenzione è stata concentrata sul materiale bollato e, per quanto riguarda le anfore, anche sullo studio degli esemplari recanti tituli picti. Si è proceduto ad una raccolta di tutto il materiale edito, a cui si è aggiunto lo studio di un’ingente quantità di reperti provenienti da due recenti scavi suburbani: quello presso il Parco Novi Sad, che si segnala soprattutto per la ricchezza del materiale anforico, e quello di Viale Reiter, ove sono venuti alla luce numerosi scarti di cottura di lucerne a canale recanti le firme di alcuni dei più noti produttori di tali oggetti nel mondo romano. A ciascuna categoria di instrumentum è stato dedicato un capitolo, corredato di tabelle in cui è stato raccolto tutto il materiale considerato; inoltre, per i reperti del Parco Novi Sad e di Viale Reiter, è stato realizzato un catalogo corredato di riproduzioni grafiche e fotografiche. Per quanto concerne le iscrizioni dipinte, un capitolo è stato dedicato a quelle presenti sulle anforette adriatiche da pesce; quanto ai tituli picti su anfore di morfologia betica per il trasporto di salse di pesce è stato effettuato un confronto con esemplari rinvenuti in due scavi inediti a Parma, che presentano significative analogie col materiale modenese. Dall’analisi dell’instrumentum inscriptum di Mutina, pur consapevoli dei limiti insiti in una ricerca incentrata unicamente su tale tipo di materiale, è emersa un’immagine della colonia, tra la tarda età repubblicana ed il I sec. d.C., congruente con quella delineata dalle fonti letterarie, dall’epigrafia lapidaria e dai rinvenimenti archeologici, ossia di una città di notevole importanza e ricchezza.