In vivo evaluation of periodontal microcirculatory changes associated with endodontic treatment.

AIM: The purpose of this study was to investigate in vivo the gingival microcirculatory changes associated with endodontic treatment using the continuous wave of condensation technique. MATERIALS AND METHODS: Twenty necrotic one canal roots of 20 cooperative patients of both sexes, aged between 20 and 43 years, were selected. All patients were examined by capillaroscopy before, immediately after endodontic treatment, and after 7 days. The last examination was carried out by the same operator, and repeated twice for each examined area: masticatory, buccal and labial mucosa corresponding to the endodontically treated root. All canals were prepared using a simultaneous technique with Ni-Ti files (MTwo files). RESULTS: The images of the masticatory mucosa after root canal obturation showed evident micro-areas of extravasation, with significant bleeding and angio-morphological alterations due to heat. One hour after the endodontic treatment evident extravasation was observed, but a decrease of all altered parameters, was present. After seven days from treatment, in the periodontal tissues, a complete healing was observed. The in vivo evaluation of the vascular pattern during root canal obturation with System B showed that the high temperature in the canal determines visible effects on the vasculature of adjacent sites. It was found that microangiotectonic alterations decrease up to a complete healing after 7 days from treatment. CONCLUSION: All the changes in microcirculation, due to thermal shock of periodontal tissues, are reversible.

Evaluation of gingival microcirculation in patients undergoing fixed orthodontic treatment: a pilot study.

AIM: Among the many biological effects which occur during orthodontic movement, we decided to investigate gingival microcirculation. The aim of the study was to evaluate the biological microvascular response to the application of orthodontic force in vivo. MATERIALS AND METHODS: Forty patients (case group) between 9-22 years of age (average± DS 12±3.01) were selected for the study (M/F ratio: 20/20). They needed fixed orthodontic treatment due to several types of malocclusion. Forty healthy subjects (control group) were also recruited (M/F ratio 20/20; average age 12 years ± 4.01; Mean±SD =10.04±1.7). A videocapillaroscopic examination was performed on each patient on the buccal alveolar mucosa at the pre- treatment time (t0), 1 month after the beginning of the treatment (t1), after 2 months (t2), after 6 months (t3), and after 12 months (t4). RESULTS: Capillary density increases significantly from t0 to t1. Between t1 to t2, t2 to t3 the density underwent another increase. Between t3 and t4 (69.22 ± 3.63) the density showed no increase. In the control group no statistical differences were observed. CONCLUSION: Videocapillaroscopy allows the in vivo evaluation and quantification of the microcirculatory changes consequent to the application of orthodontic force, managing to detect subclinical changes in angiogenesis. In fact, the study revealed an increase in the density of the capillaries which is directly proportionate to the application time of the orthodontic device, i.e. the exogenous mechanical force. This research offers new perspectives for the future of monitoring fixed orthodontic therapy.

In vivo evaluation of labial microcirculation in diabetics: a comparison with healthy subjects.

AIM: Diabetes mellitus, a systemic chronic disease considered an epidemic by the World Health Organization (WHO) due to the rate of increase in the prevalence of diabetes, is a cause of microvascular and macrovascular complications leading to a significant burden for the individual and society. The aim of this study was to evaluate in vivo the effects of type II diabetes mellitus on the microcirculation of oral mucosa. METHODS: Forty-six subjects, 23 patients with type II diabetes mellitus (10 men, 13 women) and 23 healthy patients (9 men, 14 women) were examined in our laboratory. Oral microcirculation was evaluated on labial mucosa using oral video-capillaroscopy: a diagnostic method that permits the in vivo analysis of oral microcirculation. RESULTS: Capillary density, total loop length and total diameter resulted significantly altered in diabetics. The density of loops, observed on labial mucosa, is on average lower in diabetics than in healthy patients. The length and total diameter of loops are increased in diabetics. CONCLUSION: This study shows the capillary alterations that occur in the oral mucosa of diabetics. The loop density decrease is probably a symptom of peripheral microangiopathy. Ultimately, this study demonstrates that there is peripheral damage to microcirculation at the level of the labial mucosa in diabetic subjects and that these alterations are instrumentally "objectivable" and "quantifiable" through the videocapillaroscope technique.

Aviation spatial orientation in relationship to head position and attitude interpretation.

BACKGROUND: Conventional wisdom describing aviation spatial awareness assumes that pilots view a moving horizon through the windscreen. This assumption presupposes head alignment with the cockpit "Z" axis during both visual (VMC) and instrument (IMC) maneuvers. Even though this visual paradigm is widely accepted, its accuracy has not been verified. The purpose of this research was to determine if a visually induced neck reflex causes pilots to align their heads toward the horizon, rather than the cockpit vertical axis. HYPOTHESIS: Based on literature describing reflexive head orientation in terrestrial environments it was hypothesized that during simulated VMC aircraft maneuvers, pilots would align their heads toward the horizon. METHODS: Some 14 military pilots completed two simulated flights in a stationary dome simulator. The flight profile consisted of five separate tasks, four of which evaluated head tilt during exposure to unique visual conditions and one examined occurrences of disorientation during unusual attitude recovery. RESULTS: During simulated visual flight maneuvers, pilots tilted their heads toward the horizon (p < 0.0001). Under IMC, pilots maintained head alignment with the vertical axis of the aircraft. CONCLUSION: During VMC maneuvers pilots reflexively tilt their heads toward the horizon, away from the Gz axis of the cockpit. Presumably, this behavior stabilizes the retinal image of the horizon (1 degree visual-spatial cue), against which peripheral images of the cockpit (2 degrees visual-spatial cue) appear to move. Spatial disorientation, airsickness, and control reversal error may be related to shifts in visual-vestibular sensory alignment during visual transitions between VMC (head tilt) and IMC (Gz head stabilized) conditions.

Aviation spatial orientation in relationship to head position, altitude interpretation, and control.

INTRODUCTION: Recently, a visually driven neck reflex was identified as causing head tilt toward the horizon during VMC flight. If this is the case, then pilots orient about a fixed rather than moving horizon, implying current attitude instruments inaccurately present spatial information. The purpose of this study was to determine if the opto-kinetic cervical neck reflex has an effect dependent on passive (autopilot) or active control of the aircraft. Further, findings could help determine if the opto-kinetic cervical reflex is characteristic of other flight crewmembers. METHODS: There were 16 military pilots who flew two 13-min VMC low-level routes in a large dome flight simulator. Head position in relation to aircraft bank angle was recorded by a head tracker device. During one low-level route, the pilot had a supervisory role as the autopilot flew the aircraft (passive). The other route was flow manually by the pilot (active). RESULTS: Pilots consistently tilted the head to maintain alignment with the horizon. Similar head tilt angles were found in both the active and passive flight phases. However, head tilt had a faster onset rate in the passive condition. CONCLUSION: Results indicate the opto-kinetic cervical reflex affects pilots while actively flying or in a supervisory role as the autopilot flies. The consistent head tilt angles in both conditions should be considered in attitude indicator, HUD, and HMD designs. Further, results seem to indicate that non-pilot flight crewmembers are affected by the opto-kinetic cervical reflex which should be considered in spatial disorientation and airsickness discussions.

The optokinetic cervical reflex in pilots of high-performance aircraft.

BACKGROUND: For over 60 yr, researchers and engineers have based investigations and the design of cockpit displays and structures upon the presupposition that during flight the pilot maintains a head alignment coincident with the aircraft's vertical axis (z-axis). Recent simulator studies have verified the existence of a pilot neck reflex which refutes this long-standing assumption. This reflex, named the opto-kinetic cervical reflex (OKCR), occurs during visual flight and is theorized to be an attempt by the pilot to stabilize a retinal image of the horizon to maintain spatial orientation. As a result, during initial banking maneuvers, pilots view a fixed-horizon image and not a moving-horizon. The research objectives were to determine if the OKCR occurs during actual flight of high performance jet aircraft and to model the response. HYPOTHESIS: Pilots of high performance aircraft will exhibit the OKCR. Additionally, the OKCR is dependent on the phase of banking (entering into or exiting from a banked position). METHODS: This was an observational study in which the head positions of nine pilots were recorded during actual F-15 aircraft flight and subsequently analyzed. RESULTS: Objective data indicate the OKCR caused pilots to tilt their heads during aircraft bank (p < 0.0001). Also, the reflex was found to be independent of the bank phase. CONCLUSION: The OKCR was shown to be a strong, natural response and the flight results correlated closely with simulator results. The effect of these results on pilot training, spatial disorientation, physiological injury and safety, and the redesign of displays for aircraft attitude and virtual reality are discussed.

The interaction of chromostereopsis and stereopsis in stereoscopic CRT displays.

To give operators of high-speed, highly-manoeuvrable vehicles the ability to keep pace with their increasingly dynamic environment, stereoscopic 3-D displays may soon replace conventional 2-D displays. Important to the development of stereoscopic 3-D displays is the interaction of perceived depth created by hues (chromostereopsis) and perceived depth created by presenting different images of a single object to the left and right eye of the observer (stereopsis). The purpose of this research is to evaluate the interaction of chromostereopsis and stereopsis on a stereoscopic CRT by determining the level of accuracy with which subjects can properly interpret the relative depth differences of adjacent symbols containing six levels of hue and seven levels of stereoscopic disparity. This research demonstrated that hue, disparity, and the interaction of hue and disparity significantly influenced one's perception of depth on a stereoscopic monitor. The results suggest that caution should be exercised by the stereoscopic 3-D display format designer when choosing hues to represent images located in close proximity on a stereoscopic display. Due to the chromostereoscopic effect on the perception of depth, hues on extreme ends of the colour spectrum should not be used in situations where less than 3.39 arc minutes of disparity difference is being portrayed on a stereoscopic display, unless the hues are consistently being used to alter the depth presented by stereoscopic disparity, or the chromostereoscopic depth resulting from certain hues is consistently nullified by altering disparity levels accordingly.