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.

Guidelines of Special Care Dentistry in Patients with Chromosomal and Genetic syndromes

Chromosomal and genetic syndromes are frequently associated with dental and cranio-facial alterations. The aim of our study is to identify and describe the dental and craniofacial alterations typical of six genetic and chromosomal syndromes examined. Materials and Methods- A dental visit was performed to 195 patients referred from Sant’Orsola Hospital of Bologna, University of Bologna, to Service of Special Need Dentistry, Dental Clinic, Department of Biomedical and Neuromotor Science, University of Bologna. The patients recruited were 137 females and 58 males, in an age range of 3-49 years (mean age of 13.8±7.4). The total sample consisted of subjects affected with Down Syndrome (n=133), Familiar Hypophosphatemic Ricket (n=10), Muscular Dystrophies (n=12), Noonan Syndrome (n=13), Turner Syndrome (n=17), Williams Syndrome(n=10). A questionnaire regarding detailed medical and dental history, oral health and dietary habits, was filled by parents/caregivers, or patients themselves when possible. The intra-oral and extra-oral examination valued the presence of facial asymmetries, oral habits, dental and skeletal malocclusions, dental formula, dental anomalies, Plaque Index (Silness&LÖe Index), caries prevalence (dmft/DMFT index), gingivitis and periodontal disease, and mucosal lesions. Radiographic examinations (Intraoral radiographies, Orthopanoramic, Skull teleradiography) were executed according to patient’s age and treatment planning. A review of literature about each syndrome and its dental and cranio-facial characteristics and about caries, hygiene status and malocclusion prevalence on syndromic and non-syndromic population was performed. Results - The data of all the patients were collected in the “Data Collection Tables” created for each syndrome. General anamnesis information, oral hygiene habits and dmft/DMFT, PI, malocclusion prevalence were calculated and compared to syndromic and non-syndromic population results found in literature. Discussions and conclusions - Guidelines of Special Care dentistry were indicated for each syndrome, in relation to each syndrome features and individual patient characteristics.

Studio di ausili tecnologici compensativi di supporto all'iter di apprendimento matematico secondario e universitario degli studenti con dislessia

Data coming out from various researches carried out over the last years in Italy on the problem of school dispersion in secondary school show that difficulty in studying mathematics is one of the most frequent reasons of discomfort reported by students. Nevertheless, it is definitely unrealistic to think we can do without such knowledge in today society: mathematics is largely taught in secondary school and it is not confined within technical-scientific courses only. It is reasonable to say that, although students may choose academic courses that are, apparently, far away from mathematics, all students will have to come to terms, sooner or later in their life, with this subject. Among the reasons of discomfort given by the study of mathematics, some mention the very nature of this subject and in particular the complex symbolic language through which it is expressed. In fact, mathematics is a multimodal system composed by oral and written verbal texts, symbol expressions, such as formulae and equations, figures and graphs. For this, the study of mathematics represents a real challenge to those who suffer from dyslexia: this is a constitutional condition limiting people performances in relation to the activities of reading and writing and, in particular, to the study of mathematical contents. Here the difficulties in working with verbal and symbolic codes entail, in turn, difficulties in the comprehension of texts from which to deduce operations that, once combined together, would lead to the problem final solution. Information technologies may support this learning disorder effectively. However, these tools have some implementation limits, restricting their use in the study of scientific subjects. Vocal synthesis word processors are currently used to compensate difficulties in reading within the area of classical studies, but they are not used within the area of mathematics. This is because the vocal synthesis (or we should say the screen reader supporting it) is not able to interpret all that is not textual, such as symbols, images and graphs. The DISMATH software, which is the subject of this project, would allow dyslexic users to read technical-scientific documents with the help of a vocal synthesis, to understand the spatial structure of formulae and matrixes, to write documents with a technical-scientific content in a format that is compatible with main scientific editors. The system uses LaTex, a text mathematic language, as mediation system. It is set up as LaTex editor, whose graphic interface, in line with main commercial products, offers some additional specific functions with the capability to support the needs of users who are not able to manage verbal and symbolic codes on their own. LaTex is translated in real time into a standard symbolic language and it is read by vocal synthesis in natural language, in order to increase, through the bimodal representation, the ability to process information. The understanding of the mathematic formula through its reading is made possible by the deconstruction of the formula itself and its “tree” representation, so allowing to identify the logical elements composing it. Users, even without knowing LaTex language, are able to write whatever scientific document they need: in fact the symbolic elements are recalled by proper menus and automatically translated by the software managing the correct syntax. The final aim of the project, therefore, is to implement an editor enabling dyslexic people (but not only them) to manage mathematic formulae effectively, through the integration of different software tools, so allowing a better teacher/learner interaction too.

Reconceptualising professional development in early childhood education. A study on teachers' professionalism carried out in Bologna province.

The research undertaken for this doctoral thesis explores the issue of teachers professionalism within pre-school institutions. The issue of early childhood professionalism has become increasingly important in the academic debate over the last decade as it is documented by a growing body of research published on the topic both nationally (Contini & Manini, 2007; Bondioli & Ferrari, 2004) and internationally (Peeters, 2008; Urban & Dalli, 2008; Urban, 2010). The study presented in this thesis aims at investigating teachers’ conceptualisations of professionalism by focusing on their understandings of educational work. The idea standing at the core of this research is that exploring the concept of professionalism from a ground-up perspective could lead to important reflections for a re-conceptualisation of professional development as a space for change directed from within institutions. The study is framed within a broadly sociological concern that inform the data analysis by contextualising the issue of early childhood professionalism in the contemporary socio-political arena. The research involves sixty teachers operating in state, municipal and private pre-school institutions located in Bologna province that took part to focus groups and interviews. The empirical materials, consisting of oral and written statements, are interpreted through phenomenographical analysis that gives account of how features of professionalism vary across the different institutional settings in which they are played out. This thesis, written in English and informed by an European research background, offers a contribution to the furthering of systemic approaches to the investigation of early childhood education professionalism in the context of the national and international academic debate.

Epos orale russo tra oralità e scrittura: problemi e proposte di traduzione

In the present thesis, I discuss the role of orality in translation, taking into account the problems arising while translating Russian folk epics. I investigate the meaning of orality in the context of folkloristic translation, trying to define a concept of oral poetry, and exploring its consequences for translation. In the first chapter, I try to identify the main differences between written literature and oral modes of expression, with special reference to folklore. Oral verbal art is performed, sung or recited, and based on a vital and dynamic interrelation between kinesics, sound, speech and gestures. According to Muhawi (2006), performance provides an interpretive frame enabling a correct interpretation of the message conveyed beyond the literal meaning. Transposing certain performance elements into print is one of the most controversial problems in folklore studies. However, formulas and formal stylistic devices may be rendered in transcription, building a bridge between oral and written elements. In the translation of oral poetry in transcription, this interconnection between orality and literacy might be emphasized, thus creating a hybrid dimension where oral and literary features coexist. In the second chapter, I introduce and describe the genre of Russian folk epics, transmitted orally, and transcribed between the 19th and 20th centuries, from a historical, linguistic and stylistic point of view. In the third and fourth chapters, I explore the issue of translation of Russian oral poetry. I first analyse existing Italian translations of Russian epics, and then present and discuss my own translation, based on a philological, scholarly approach. Thus, in my translation, which is followed by a rich commentary, I try to focus on the rendering of formulas as one of the most relevant aspects of Russian epics. At the same time, oral devices combine with literary features, thus creating a sort of frozen orality.