BackgroundScientific evidence showed that rapid maxillary expansion (RME) affects naso-maxillary complex, increasing nasal width and volume. This study aimed to evaluate nasal changes induced by rapid maxillary expansion with different anchorage and appliance design by using low dose and cone beam computed tomography.MethodsA total of 44 patients (20 males, mean age 8y 8 m ± 1y 2 m; 24 females mean age 8y 2 m ± 1y 4 m) were included in the investigation and divided into three groups according to the appliance: Hyrax-type expander anchored to permanent teeth, modified Hyrax-type expander anchored to deciduous teeth, modified Haas-type expander anchored to deciduous teeth. Maxillary expansion was performed until overcorrection and the expander was passively kept in situ for 7 months at least. All patients had three-dimensional imaging before expansion (T0) and after the retention period (T1). Nasal floor width, nasal wall width, maxillary inter-molar width were measured by means of Mimics software. The paired sample t-test was employed to assess the significance of the differences between the time points; the analysis of variance test (ANOVA) was used to compare differences between groups.ResultsThe statistical analysis revealed significant differences between T0 and T1 for each recorded measurement in each group; no significant differences were found by comparing groups.ConclusionsRapid maxillary expansion produces a significant skeletal transverse expansion of nasal region in growing patients. No significant differences in nasal effects are expected when the appliance is anchored onto deciduous teeth, with or without the palatal acrylic coverage.

BackgroundThe fetal and infant life are periods of rapid development, characterized by high susceptibility to exposures. Birth cohorts provide unique opportunities to study early-life exposures in association with child development and health, as well as, with longer follow-up, the early life origin of adult diseases. Piccolipiù is an Italian birth cohort recently set up to investigate the effects of environmental exposures, parental conditions and social factors acting during pre-natal and early post-natal life on infant and child health and development. We describe here its main characteristics.Methods/designPiccolipiù is a prospective cohort of expected 3000 newborns, who will be recruiting in six maternity units of five Italian cities (Florence, Rome, Trieste, Turin and Viareggio) since October 2011. Mothers are contacted during pregnancy or at delivery and are offered to participate in the study. Upon acceptance, their newborns are recruited at birth and followed up until at least 18 years of age. At recruitment, the mothers donate a blood sample and complete a baseline questionnaire. Umbilical cord blood, pieces of umbilical cord and heel blood spots are also collected. Postnatal follow-up currently occurs at 6, 12, and 24 months of age using on-line or postal self administered questionnaire; further questionnaires and medical examinations are envisaged. Questionnaires collect information on several factors, including mother’s and/or child’s environmental exposures, anthropometric measures, reproductive factors, diet, supplements, medical history, cognitive development, mental health and socioeconomic factors. Health promotion materials are also offered to parents.DiscussionPiccolipiù will broaden our understanding of the contribution of early-life factors to infant and child health and development. Several hypotheses on the developmental origins of health can be tested or piloted using the data collected from the Piccolipiù cohort. By pooling these data with those collected by other existing birth cohorts it will be possible to validate previous findings and to study rare exposures and outcomes.

The vertical dimension was not significantly altered after cervical headgear treatment although the anterior facial height was higher at the beginning of treatment. There was significant counterclockwise rotation of the mandible, and clockwise rotation and distal displacement of the maxilla after treatment.

Background: Although general practitioners (GPs) are frequently the first healthcare professionals whom asthma patients refer to for their symptoms, few studies have explored the extent of adherence to guidelines for asthma management based on data provided directly by GPs.

This retrospective research aimed to highlight the changes of occlusal plane in Class II hyperdivergent subjects that received cervical headgear treatment and compared them to untreated controls in order to evaluate the occlusal changes that might be connected to a potential mandibular rotation. The sample of this investigation was represented by 20 hyperdivergent Class II subjects (10 males, 10 females; mean age 8.54) corrected by using cervical headgear (treated group) and 21 Class II patients (11 males, 10 females; mean age 8.41) hyperdivergent who had no therapy (control group). Lateral head films were studied for all the patients before treatment (T1) and after therapy (T2) for both groups; cephalometric analysis was used in order to seek the modifications between time points and between groups. Means and standard deviation have been computed for both groups. In order to confront the modification between the time points within the same group the Wilcoxon test was applied. The Mann–Whitney U test was applied to confront the dissimilarities between groups at T2. As a result of the Class II correction by using the cervical headgear treatment the occlusal plane was lowered and flattened compared to T1 and to the control group; the upper molars showed extrusion to the palatal plane, there was a significant forward rotation of mandible and the vertical dimension was not significantly modified. Downward and backward displacement of the upper jaw occurred.