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",isbn:"978-1-80356-363-3",printIsbn:"978-1-80356-362-6",pdfIsbn:"978-1-80356-364-0",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"969d1c6315b04584c2f011e03dad69c2",bookSignature:"Dr. Mansoor Zoveidavianpoor",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11929.jpg",keywords:"Drilling Performance, Drilling Tools, Well Design, Drilling Procedure, Rotary Drilling, Directional Drilling, Measuring-While-Drilling, Smart Well Technology, Environment Protection, Geothermal Drilling, Sustainable Drilling Fluids, Carbon Sequestration",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 18th 2022",dateEndSecondStepPublish:"March 18th 2022",dateEndThirdStepPublish:"May 17th 2022",dateEndFourthStepPublish:"August 5th 2022",dateEndFifthStepPublish:"October 4th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"2 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr. Zoveidavianpoor has over 18 years of multidisciplinary oil and gas experience, built upon his technical, operational, and management roles in the industry and academia. He is a member of the Society of Petroleum Engineers (SPE), the Energy Institute, UK and is registered as a chartered petroleum engineer. He has published more than 50 publications on International peer-reviewed Journals and conferences, has contributed to 5 textbooks, and served in many scientific committees.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"92105",title:"Dr.",name:"Mansoor",middleName:null,surname:"Zoveidavianpoor",slug:"mansoor-zoveidavianpoor",fullName:"Mansoor Zoveidavianpoor",profilePictureURL:"https://mts.intechopen.com/storage/users/92105/images/system/92105.jpg",biography:"Dr. Mansoor Zoveidavianpoor has over 24 years of experience, built upon his technical, operational, and management roles in the industry and academia. Mansoor holds a BSc degree in Geology, MSc, and Ph.D. degrees both in Petroleum Engineering. He was involved in different disciplines such as project management, geology, flow assurance, piping construction, artificial intelligence, environmental engineering, drilling and production engineering, He has lectured several courses at the University Technology Malaysia (UTM), Petroleum University of Technology (PUT), and Islamic Azad University (IAU). He is a member of the Society of Petroleum Engineers (SPE) and registered as a Chartered Petroleum Engineer at Energy Institute, and EIA subject specialist at DOE Malaysia. He has published more than 50 publications on International peer-reviewed Journals and conferences, has contributed to 5 textbooks, and served in many scientific committees. Currently, he is working as an Associate Professor at UTM and involved in several consultancies in petroleum engineering and energy transition. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"314",title:"Regenerative Medicine and Tissue Engineering",subtitle:"Cells and Biomaterials",isOpenForSubmission:!1,hash:"bb67e80e480c86bb8315458012d65686",slug:"regenerative-medicine-and-tissue-engineering-cells-and-biomaterials",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/314.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"66517",title:"Microbial Cellulases: An Overview and Applications",doi:"10.5772/intechopen.84531",slug:"microbial-cellulases-an-overview-and-applications",body:'\nBiomolecules derived from natural resources are playing a major role in manufacturing products needed for daily use. Enzymes are one of those molecules that are globally recognized for their multifarious applications in industries. For instance, their utility in brewing, dairy products, detergents, food and feed, pharmaceutical production, and paper and pulp industry is huge. One of those most widely used enzymes is cellulase. According to recent global cellulase market analysis reports, the demand for this enzyme is exponentially increasing.
\nCellulose, the substrate of cellulase, is the most abundant polysaccharide present on earth. It is the main substance in plant materials. Anselme Payne was the very first person to discover and isolate this amazing compound from green plants [1]. It happened more than two centuries ago. From the past, cellulosic materials have played a crucial role in daily human life. They used it to fertilize their soil for crop cultivation. It was also fodder for their cattle. It was firewood for cooking, and they were igniting cellulosic material to generate heat whenever they needed to produce energy.
\nCurrently, the role played by cellulose is not that simple. Especially, as it is recognized as a cost-effective raw material, the useful applications of cellulose in the industrial sector have become much more complex. This has laid a huge platform for scientists to do cellulose-based research in multidisciplinary approaches. One such area is hydrolysis of cellulose. In nature, this is usually accomplished by cellulases. Cellulase is catalyzing hydrolysis of cellulose.
\nHowever, cellulase is not a single enzyme. It is a group of enzymes which is mainly composed of endoglucanase and exoglucanases including cellobiohydrolases and β-glucosidase. Fungi, bacteria, and actinomycetes are recorded to be efficient cellulase enzyme producers in the natural environment. These microorganisms must secrete cellulases that are either free or cell surface bound. Their enzyme production efficiency and the enzyme complex composition are always diverse from each other. Although both aerobic and anaerobic microorganisms produce these enzymes, aerobic cellulolytic fungi, viz.,
According to recent enzyme market reports, the key areas of the industry where cellulase enzyme is increasingly being applied are healthcare, textile, pulp and paper, detergent, food, and beverages. Its wide application in coffee processing, wine making, and fruit juice production is related to food and beverage segment. In other industrial applications, it is broadly used to produce laundry detergents and cleaning and washing agents. Cellulase is also being highly recognized as an effective alternative to available antibiotics for treatment of biofilms produced by
Application of microorganisms or microbial enzymes for pretreatment of lignocellulosic material is currently earning a huge attention of the industry. This is a result of growing interest about depletion of fossil fuel resources in the world which have inspired the production of bioethanol from lignocellulosic biomass through enzymatic hydrolysis [3]. Lignocellulosic biomass is one of the best options as a low-cost, readily available, eco-friendly raw material. However, it is not found alone. Cellulose is forming lignocellulose in combination with hemicellulose and lignin which finally becomes a compact network structure [4]. Moreover, it has a crystalline structure which is hard to break down. Therefore, cellulose is insoluble in water and causes limitations in hydrolysis. That is why it is essential to pretreat lignocellulosic material in industries like bioethanol production. During pretreatment, it will loosen up the crystalline structure and facilitate the degradability to release fermentable sugar forms. There are several methods available for pretreatment of lignocellulose, viz., physical, chemical, and biological methods. Biological pretreatment using cellulolytic microorganisms and their enzymes is found to be the best way of addressing this problem.
\nBy all means, cellulase is an enzyme which can cause a huge economic impact. However, there are some considerable bottlenecks of utilizing this enzyme in the industry. For example, the higher cost of cellulase and less catalytic efficiency are especially understood. Another important point is less understanding of the relationship between hydrolysis mechanisms and molecular structure of the enzyme. This knowledge is important to carry out further improvements in the enzyme to enhance its catalytic activity. Therefore, this chapter is discussing about the structure and function of cellulase in order to understand its mechanisms of action. The details on current applications of the enzyme have also been summarized here. Furthermore, the efforts have been taken to bring together information on novel biotechnological trends of cellulase. Moreover, it is discussing about possible low-cost, enzymatic pretreatment methods that have been practiced for lignocellulosic materials in order to use it as an efficient raw material to produce bioethanol.
\nBefore moving on to cellulase, it is essential to understand cellulose which is the substrate of cellulase enzyme. This section will provide a short description about cellulose.
\nCellulose is a linear polysaccharide. In this polymer, D-glucose subunits are attached together by formation of β-1,4-glycosidic linkages between individual glucose molecules. The molecular formula of cellulose is (C6H12O6)n. The “n” indicates the degree of polymerization (DP). It symbolizes the number of glucose subunits connected with each other. This number is varying from hundreds to thousands. Two glucose repeating units together are called cellobiose. In other words, this polymer is made by β-(1 → 4)-D-glucopyranose units in 4C1 conformation. It consists of long chains of anhydro-D-glucopyranose units (AGU) with each cellulose molecule having three hydroxyl groups per AGU with the exception of the terminal ends. Cellulose has both crystalline and amorphous regions in its structure in various proportions [5]. Those regions are intertwined to form the structure of cellulose. There are four major crystalline forms, for instance, Iα, Iβ, II, and III. This crystalline structure is a result of intramolecular and intermolecular hydrogen bonding between glucose monomers in cellulose. These hydrogen bonds construct a huge network that directly contributes to the compact crystal structure of cellulose polymer. On the other hand, this strong intramolecular and intermolecular hydrogen bond formation leads to poor solubility of cellulose.
\nIn plant cell walls, cellulose exists as different levels of structures, i.e., single cellulose chains, elementary fibrils (consisting of tens of single cellulose chains), and microfibrils (bundles of elementary fibrils). It is proposed that the macrofibril is composed by the attachment of several newly synthesized elementary fibrils. With the cellular growth, the macrofibrils divide to form individual microfibrils. Microfibril is consisting of a single elementary fibril. Although elementary fibrils and macrofibrils are composed of mere cellulose, microfibril has noncellulosic polymers like hemicelluloses along with cellulose. It is noted that others consider a microfibril as consisting of a number of elementary fibrils. Microfibril is an elementary fibril associated with noncellulosic polymers. Each microfibril might contain up to 40 cellulose chains and is about ~10 to 20 nm in diameter. Many such cellulose chains aggregate into bundles called micelles and micelles into microfibrils. Micelles are interconnected with few cellulose fibers. The plant cell wall structure is stabilized by the macrofibrils. The cross-links between hemicellulose and pectin matrices also support this stabilization process. Lignin is a complex polymer which usually fills the spaces between cellulose and pectin matrices. It forms covalent bonds with hemicellulose. This provides more mechanical strength to the plant cell wall. This structure which is present in plants is collectively called lignocellulose. Other components known as extractives including fats, phenolic, resins, and minerals are also present in lignocellulosic biomass.
\nEnzymes are known to be very useful in many industrial processes. Their broad applicability has created a significant market demand in the recent years. According to market reports on world enzyme demand (2017), they have recognized several key factors which lead to huge consumer demand for enzymes. Some of them are completely bound with economical advances. For example, increased per capita income in developing countries causes huge growth in consumer-related industrial applications [6]. A recent industry study done by Freedonia in January 2018 on “Global Industrial Enzymes” reveals that global demand for industrial enzymes is projected to grow 4.0% per year to $5.0 billion in 2021. This report also emphasizes the gains in personal incomes in developing countries as the key factor which is supporting growth in demand for enzymes. The development of scientific research on enzymes is mainly based on disciplines such as biotechnology,molecular biology and genetics. Continued advances in these areas of research, particularly related to DNA manipulation and sequencing, result in extensive increases in enzyme demand worldwide. Cellulase is one such enzyme which earns consecutively increasing demand. Therefore, collection of knowledge about this enzyme is essential for further development of fundamental and applied research on cellulase and for consequent application in human life.
\nIt is produced by fungi, bacteria, actinomycetes, protozoans, plants, and animals. According to Carbohydrate-Active Enzymes database, there is information of the glycoside hydrolase families. Glycoside hydrolases, including cellulase, have been classified into 115 families based on amino acid sequence similarities and crystal structures. A large number of cellulase genes have now been cloned and characterized. They are found in 13 different families. Furthermore, there are 3D structures of more than 50 cellulases. All of cellulases cleave β-1,4-glucosidic bonds. However, they display a variety of topologies ranging from all β-sheet proteins to β/α-barrels to all α-helical protein.
\nIn the structure of cellulase, there are catalytic modules and non-catalytic modules. The catalytic modules of cellulases have been classified into numerous families based on their amino acid sequences and crystal structures. The non-catalytic carbohydrate-binding modules (CBMs) and/or other functionally known or unknown modules may be located at the N- or C-terminus of a catalytic module. Usually, fungal and bacterial cellulase mainly has two or more structural and functional domains. Both aerobic and anaerobic microorganisms are producing this enzyme. Therefore, there are two types of cellulase systems: noncomplex and complex. A noncomplex cellulase system is produced by aerobic cellulolytic microorganisms, and it is a mixture of extracellular cooperative enzymes. In a noncomplex cellulase system, the common arrangement is joining of a catalytic domain with a cellulose-binding domain (CBD). A complex cellulase system is produced by anaerobic microorganisms and it is called “cellulosome.” Cellulosome is assembled by joining a catalytic domain with a dockerin domain. The enzyme is a multiprotein complex anchored on the surface of the bacterium by non-catalytic proteins that serves to function like the individual noncomplex cellulases but is in one unit.
\nIn addition to these two major domains in the cellulase structure, there are some other domains that are present in many cellulases, for instance, S-layer homologous (SLH) domain, fibronectin-type 111 domains, and NodB-like domain, and there are also other regions of unknown function. These domains are often connected by Pro and hydroxy amino acid (threonine and serine) enriched linker sequences. Among all these domains, catalytic and cellulose-binding domains are the most important because they are the domains which are considered participating in hydrolytic mechanisms of the enzyme.
\nCellulase catalyzes the decomposition of cellulose polysaccharide by simply breaking down β-1,4-glycosidic bonds. Three major types of enzymes are generally involved in hydrolyzing cellulose microfibrils in the plant cell wall: endoglucanase, exoglucanase, and β-glucosidase. Complete cellulose hydrolysis is mediated by the combination of these three main types of enzymes. Endoglucanase usually attacks amorphous areas of cellulose. The random attack of this enzyme on internal bonds of loosely bound, amorphous areas of cellulose creates new chain ends. These new chain ends are then easily attacked by other types of enzymes. The highest activity of this enzyme usually occurs against soluble cellulose forms or acid-treated amorphous cellulose. The function of exoglucanase is to produce glucose or cellobiose units by attacking the reducing or nonreducing end of cellulose chains. Endoglucanase is different from exoglucanase because it is usually very active against crystalline cellulose substrates such as Avicel or cellooligosaccharides. Finally, β-glucosidase can hydrolyze cellobiose to glucose from the nonreducing ends, and it is inactive against amorphous or crystalline cellulose. Although an exact mechanism is not yet finalized, fragmentation of cellulose aggregations into short fibers has been observed and reported during the beginning of cellulose hydrolysis prior to releasing any detectable amount of reducing sugars. This is known as amorphogenesis.
\nThere are two catalytic mechanisms of cellulases. They are simply introduced as retaining mechanisms and inverting mechanisms. Cellulases cleave glucosidic bonds by using acid-based catalysis. The hydrolysis is performed by two catalytic residues of the enzyme: a general acid (proton donor) and a nucleophile/base. The catalytic mechanism which occurs depends on the spatial position of the catalytic residues. The retention and inversion of the anomeric configuration of cellulose are the two mechanisms which hydrolyze cellulose. The “retaining” cellulases retain the same configuration of anomeric C bearing the target glucosidic bond even after a double-displacement hydrolysis with two key glycosylation or deglycosylation steps. “Inverting” cellulases inverts the configuration of the anomeric C configuration after a single nucleophilic displacement hydrolysis [7].
\nFor many decades, cellulases have played a crucial role as biocatalysts. They have shown their potential application in a large number of industries. Textile, paper and pulp, laundry and detergent, agriculture, medicine, and food and feed industries are some of the major industries which employ microbial cellulases. According to Coherent Market Insights, the textile industry is the dominant market for cellulases in 2017. According to most of the enzyme market research reports published in 2018, food and beverages, textile industry, animal feed, and biofuels have been reported to be the major areas of applications.
\nAccording to another Global Cellulase (CAS 9012-54-8) Market Research Report published in 2018, Asia-Pacific is the largest consumer of cellulase, with a revenue market share nearly 32.84% by 2016. Furthermore, the reported data showed 29.71% of the cellulase market demand in animal feed, 26.37% in food and beverages, and 13.77% in the textile industry in 2016. This same report forecasts that the applications of cellulases will reach 2300 million USD by the end of 2025, growing at a compound annual growth rate (CAGR) of 5.5% during the 2018–2025 period. These data suggest that the application of cellulases in industries is drastically rising annually. Novozymes and DuPont from Denmark are key cellulase enzyme producers supplying these enzymes to the global market for industrial applications. From this point forward, in this chapter, our major effort was to discuss about the current applications of cellulases in major fields that have been listed above. The novel biotechnological trends emerging in those fields while understanding the key areas of research where further studies required also surfaced to an extent.
\nThe textile industry is one of the largest industries in the world. The customer demand for fashion is increasing as they want uniqueness in styles, colors, and the clothes they wear. There was a significant growth in this industry during the last few decades as a result of this increasing customer demand. This enzyme has now become the third largest group of enzymes used in these applications [8]. This creates a very competitive market platform for manufacturers that are always looking for environmentally friendly approaches of giving their products a unique look. Cellulase is used for many purposes in the industrial sector.
\nEspecially for textile wet processing, biostoning of denim fabric, biopolishing of textile fibers, softening of garments, and removal of excess dye from the fabrics are some of the major applications of this enzyme in the industry. Fungal cellulases from
Biostoning and biopolishing are well known for the best applications of cellulases in the current textile industry.
\nThe conventional washing process of denim usually has three steps. The denim fabric is first treated with amylase enzyme to remove the starch coating of the fabric. This process is called desizing. During this process, starch is broken down into maltose which is a water-soluble disaccharide composed of two glucose molecules. Then, the fabric is given treatment by providing abrasion to the material in pumice stones added to the washing machine. This wash was completely achieved by adding chemicals like sodium hypochlorite or potassium permanganate. This traditional process has several disadvantages. The addition of pumice stones must be done in larger quantities. This was affecting the machine’s productivity in an adverse way causing tear effects. After the wash is completed, the manual removal of stones is needed. This is causing further reduction of the process efficiency. The excessive back-staining was another disadvantage of the traditional process. Backstaining is the reaction by which the removed dye molecules are deposited on the denim fabric again.
\nApplication of microbial cellulases was found to be an efficient alternative for pumice stone washing. It was first staged in the 1980s. The use of stones is currently replaced by cellulases in a successful way. During this process, cellulases act on the denim fabric which is made of tough cotton. The indigo dye which is used to color the fabric is trapped inside the cellulose fiber in this cotton material. Usually, the indigo dye is mostly attached to the surface of the yarn and to the most exterior short cotton fibers. When the fabric is treated with the enzyme, it hydrolyzes and breaks small fibers coming out of the fabric which loosens the dye. For this purpose, the β-1,4-linkages of cellulose chains will be broken down, and simple water-soluble sugars will be formed. This will remove the fibers which traps indigo dye. Then, the dye is easily removed from the fabric giving a faded look.
\nThe major disadvantage associated with the application of microbial cellulases is again backstaining. The redisposition of dye on the fabric covers up the shaded look given by the treatment. In order to overcome this problem, several biotechnological approaches have been already experimented by researchers. Immobilization of cellulases on pumice stones is one such cost-effective way of doing this. It has also been observed that acidic endoglucanase causes a better abrasion and less backstaining compared to neutral endoglucanase. For example, the cellulase given by
The latest trend of biostone washing is to utilize an enzyme mixture composed of amylase, cellulase, and laccase [12]. The sizing is the process by which denim material surface is covered by a compound like starch to provide rigidity and stiffness to raw denim and provide strength and friction resistance during handling. During washing, this surface layer of starch must be removed first to facilitate interaction between cellulases and cotton fibers. The amylase hydrolyzes starch from the fabric and causes desizing. Cellulase hydrolyzes small cellulose fibers, and laccase usually causes bleaching of the fabric. Laccases (EC 1.10.3.2) with intrinsic electron-donating tendency can decompose indigo in the solution as well as on the fabric creating bleaching effect on denim garments. The indigo dye is converted into isatin and anthranilic acid like chemical forms. This prevents backstaining of dye on the fabric surface. Eventually, this will give a complete faded look to the denim fabric. The purpose of using a mixture is to improve the efficiency of biostone washing process by allowing those three enzymes to work together in a sequential manner.
\nIn a recent study, it is reported that an alkali-stable cellulase in combination with xylanase from
These two processes are simply similar to each other. Cellulosic fibrous materials like cotton and linen are always loosing appearance because of fuzz formation on the fabric surface. Fuzz occurred due to short fibers protruding out from the surface of the fabric. Fuzz is sometimes loosely attached to the fabric forming a ball-like appearance which gives an unattractive look to the fabric. This is called pilling. The biopolishing process basically aims on removing microfibrils of cotton. It enhances fabric look, hand feel, and color by giving a smooth and a glossy appearance. This is also leading to improvement of color brightness, hydrophilicity, and moisture absorbance by the fabric [13]. The acidic cellulases produced by
The repeated washing of a cotton garment makes it fluffy and dull. This is due to partially removed microfibrils on the fabric surface. Biofinishing by cellulases can remove these fibrils and give back the smooth surface and original color to the fabric. This will also give a soft hand feel to the material, and also this is a good way of removing stains and dirt spots that are trapped within the cotton fiber network [14, 15].
\nThis is the process that removes noncellulosic material from the surface of the cotton. This is usually done with cellulase alone or in combination with other enzymes such as pectinase. Pectinase digests the pectin substance present among cellulose fibers. This helps to remove the intact connection between the cuticle and the main body of the cellulose fiber. This helps to degrade the primary cellulosic wall of the fiber. The ultimate result is the destruction of the cuticle [16]. This reaction increases the softness of the fabric.
\nThis is a kind of a biological mode of cleaning the fabric from the cellulosic or vegetative impurities with the help of enzymes. When a pure cotton or cotton blend fabric is prepared, some traces of unwanted cellulosic material still may remain in the fabric. They may result in imperfect finishing and lower quality of the fabric. The earliest methods of carbonization involved application of sulfuric acid. It was not only expensive but also corrosive, unsafe, and hazardous. Being a nonhazardous, non-corrosive, and eco-friendly method, enzymatic carbonization was a promising alternative. This method was perfect for removal of cellulosic impurities from the material because it was least affecting the color and the hand feel of the fabric. The removal of vegetative impurities from the surface of raw wool using cellulases is called wool scouring [17]. Cellulases can be used alone or in combination with other enzymes such as pectinases to increase the efficiency of this process. These methods are doing less damage to the fabric when compared to the treatment with sulfuric acid.
\nLyocell is the generic name for a biodegradable fabric that is made out of treated wood pulp. This material is used in everything from clothing to cars. This is obtained from wood pulp using a solvent-spinning method. The solvent system which is usually applied is an organic compound called N-methylmorpholine N-oxide. Some main characteristics of lyocell fibers are that they are soft, absorbent, and very strong when wet or dry and resistant to wrinkles. One chief defect of this material is fibrillation. This is the formation of small tangled fibrils on the surface of the fabric. Cellulases can be efficiently applied to remove these fibrils and give the fabric an increased softness and an improved appearance. This is also good for preventing fuzz and pill formation.
\nAlthough the applied enzymes are nontoxic and biodegradable in the above processes, the final effluent produced will show increased biological oxygen demand (BOD), chemical oxygen demand (COD), total dissolved solids (TDS), and total suspended solids (TSS) to a certain extent because the effluent may contain digested sugar and cellulosic forms. Direct release of this effluent to natural water bodies may cause water pollution. Alkalinity and pH fluctuations of the effluent will also result in polluted water which is not good for human and animal consumption. This may cause health issues like skin irritations in humans. On the other hand, the enzymatic treatments need an incubation period to facilitate the reaction between enzyme and fabric. As this is a fermentation reaction, this may release certain odors to the environment which may cause air pollution to a certain extent. Moreover, textile dyes are removed during textile processing. Most of the dyes are toxic and some are highly carcinogenic. Mixing this type of dyes with water is definitely causing adverse health effects in humans. Therefore, direct release of effluent without applying any pretreatments to neutralize these toxic compounds will breach the stability in ecosystems to which they are released. Therefore, establishment of pretreatment facilities and water quality testing procedures are essential for these enzymatic textile processing plants.
\nLyocell production has a different impact on the environment compared to the other textile polishing and finishing processes. The solvent which is used to manufacture this textile is N-methylmorpholine N-oxide. This is usually causing acute toxicity (oral, dermal, inhalation), skin irritation, serious eye damage and irritation, skin sensitization, and specific target organ toxicity. These are also hazardous to aquatic environments. These possible environmental impacts must be always addressed although application of enzymes in textile processing is eco-friendly.
\nThis is one of the largest industrial sectors in the world. According to the World Wildlife Fund (WWF), the pulp and paper industry, which includes products such as office and catalog paper, glossy paper, tissue, and paper-based packaging, uses over 40% of all industrial wood traded globally [18]. On the other hand, the latest paper industry statistics reveal China, the United States, and Japan as the three countries where the largest paper production occurs in the world. Half of the total paper manufacture of the world is done by these three countries. However, Germany and the United States are the world’s leading paper importers and exporters [19]. Moreover, the United States is reported to be the largest consumer of papers.
\nPapers and pulp are renewable resources. Therefore, recycling and reusing are two popular concepts related to this industry. Application of microbial cellulases is usually utilized for this purpose. The application of cellulases in this industry is broader. Starting from the 1980s up to now the possible applications are branching toward many areas. For instance, deinking, pulping, bioremediation of industry wastes, bleaching, and fiber enhancement can be taken.
\nThe drawbacks in mechanical pulping processes of woody raw materials such as refining and grinding resulted in pulps with higher amounts of fines, bulk, and stiffness. On the other hand, the process was high energy consuming which was not a profitable option for an industry. Meanwhile, biopulping using enzymes such as cellulases is an energy-saving way, and also it is eco-friendly [20]. The substantial energy saving is reported around 20%–40%. During the refining process, it generates small particles of the pulps. These particles reduce the drainage rate during the paper-making process. These particles can be readily degraded by cellulases in order to increase the drainage ability of the pulp. Mixtures of cellulases (endoglucanases I and II) and hemicellulases have also been used for bio-modification of coarse pulp material to improve fiber properties. It is strengthening the hand sheets. On the other hand, biological pulping has the potential to improve the quality of pulp and properties of the paper while reducing energy costs and environmental impact [21].
\nIn traditional deinking, large quantities of chemicals are used which make the method expensive and environmentally damaging and increase the release of contaminants [22]. The main advantage of bio-deinking is the ability of avoiding the alkali use during the process. This prevents yellowing of the paper. Cellulases alone, or used in combination with xylanase, are beneficial for deinking of different types of paper wastes. In most of the applications, partial hydrolysis of carbohydrate molecules releases ink from the fiber surface. This is done by a mixture of cellulases alone or in combination of cellulases and hemicellulases. The advantages associated with enzymatic deinking are clean look of paper, enhanced brightness, as well as environmental pollution reduction..
\nSuccessful application of cellulase and hemicellulase mixtures has been reported to modify properties of fibers. Usually in the paper industry, the making of paper is made easier by improving the beatability, runnability, and drainage of paper pulp during the process. Modifications of fiber properties are also achieved through treatment of paper by cellulase enzyme [20]. Not only that but also the enzymatic hydrolysis helps in characterization of fiber using various techniques such as scanning electron microscopy (SEM) and HPLC [23].
\nThe application of enzymes in manufacturing enzymatic washing agents or biological detergents dates back to the 1960s. Using enzymes in detergent formulae is a common practice today. In fact, according to market reports, by 2014, the detergent industry was the largest single market for enzymes at about 25–30% of total sales [22]. Another market research report published in 2017 on laundry detergent market stated that its global market size valued at 133.3 billion USD in 2016. The latest trend in the industry is to use alkaline enzymes in large amounts. For instance, protease, cellulase, α-amylase, lipase, and mannanase are broadly applied in heavy-duty laundry and automatic dishwashing detergents..
\nThe capability of enzymes to remove stains is the major focus of using them in manufacturing detergents. Cellulases are available in the market in different brands. For instance, Celluzyme® and Carezyme® are two main brands applied in detergent blends. These detergent blends are mainly applied in washing fabrics made of cotton and cotton blends. These detergents are making fiber modifications in the fabric in order to improve color brightness, softness, and particulate soil removal.
\nCellulases extracted from fungi like
The most recent innovation is to use combinations of enzymes in detergents. Cellulases are used in combination with other enzymes like proteases and lipases. The combination of enzymes is used to increase efficiency on stain cleaning and fabric care. For instance, SaniZyme® is a four-enzyme liquid detergent containing lipase, cellulase, amylase, and protease. This is a bacteriostatic enzymatic detergent for the removal of blood, protein, mucous, fats, lipids, and carbohydrates from all types of endoscopic equipment and surgical instruments. Another example is Getinge Clean MIS Detergent® which is also a formulation which includes protease, lipase, amylase, and cellulase enzymes, surfactants, sequestering agents, and corrosion inhibitors (typical pH in use dilution 8) which is specifically designed to clean complex, minimal invasive instrumentation.
\nThe application of cellulases in agriculture is usually reported in enhancement of crop growth and a control agent of plant diseases. For this purpose, combinations of cellulases, hemicellulases, and pectinases are broadly applied. Certain fungal cellulases are with the ability to degrade cell wall of plant pathogens. There are lots of details about application of bacteria such as plant growth-promoting rhizobacteria (PGPR) to improve plant performance. It is reported that these bacteria play a major role in reducing application of chemical fertilizers increasing plant development and also controlling potential plant pathogens and protecting plants from diseases. Moreover, many fungi including
According to available information, it is evident that cellulolytic microorganisms are participating in many processes, viz., rhizosphere soil decomposition, increasing the availability of nutrient for the plant, controlling plant pathogens, facilitating root colonization, and penetration of cereal crops improving yields and nutritional contents. However, as there are no solid evidence to prove the mechanisms behind these, this area needs further research. The studies should be performed in order to characterize and improve applications of microbial cellulases in this field.
\nDuring traditional agriculture practices, especially in countries like Sri Lanka, farmers used to add straw and
Medical pharmacology is currently a very active field of research that novel discoveries are coming into action. One such area is cellulases for development of medicine. By the way, humans are not cellulase producers, but the recent research on health and medicine reveals the benefits of consuming blends of enzymes including cellulase. As a result of global demand for enzyme blends, cellulase produced by the natural fermentation process of
In some records, the direct and indirect applications of cellulase in medicine have been mentioned apart from using it as consumable enzyme blends.
\nCellulase of fungal origin in combination with chitinases and lysozymes has a reported use in chitosan degradation. To obtain chitosan, a partial degradation of chitin must take place. As cellulose, chitin is a structural polysaccharide present in animals such as marine animals like shrimp and insect exoskeleton as well as participates in the formation of some parts of fungal cell walls. Chitin is a poly-ß-1,4-N-acetyl-D-glucosamine, conforming crystalline microfibrils. This polysaccharide provides structural integrity, stability, and protection to animals. Chitosan is the most important semicrystalline derivative form of chitin. This is obtained by partial deacetylation of chitin (around 50%, soluble in aqueous solution) under alkaline conditions or enzyme hydrolysis. Chitosan and its derivatives have many medical applications, viz., surgical sutures, bone rebuilding, production of artificial skin, anticoagulant, antibacterial agent, hemostatic dressings, anticancer and antidiabetic agents (in combination with metals), hypocholesterolemic effectors, elaboration of cosmetics, production of biopharmaceutics, and encapsulation of diverse materials [24, 25].
\nApart from these applications, a lot of reports have been published on several studies which discuss how cellulases hydrolyze chitosan and their potential biomedical effects. For instance, antitumor activity of cellulase-treated chitosan [26] and antimicrobial activity of low-molecular-weight chitosan obtained by
A bezoar is a mass found trapped in the gastrointestinal system. Phytobezoars, as its name suggests, are composed of indigestible plant material (e.g., cellulose). In other words, it is a gastric concretion formed by vegetable fibers, seeds and skins of fruits, and sometimes starch granules and fat globules trapped inside the gastrointestinal tract. This is a common problem frequently reported in patients with impaired digestion and decreased gastric motility. Although sometimes surgeries are needed to remove these stagnated substances, certain minor conditions can be treated by cellulases. The common application reported is fungal cellulases. As there are no much reports about application of bacterial cellulases, research can be conducted to find out the application of potential cellulolytic bacterial cellulases to treat this condition. However, what is most important is that any of these individual enzymes or enzyme cocktails should not adversely affect the healthy body cells.
\nAnother possible direct application of cellulase in medicine is degradation of cell walls of pathogenic organisms.
Pathogenic microorganisms usually form biofilms. A biofilm is an assemblage of microbial cells that is irreversibly associated (not removed by gentle rinsing) with a surface and is enclosed in an extracellular polymeric substance (EPS) matrix. Usually, pathogenic microorganisms form this type of assemblages. They may be found on a wide range of surfaces including living tissues and indwelling medical devices. Artificial hip prosthesis, central venous catheter, prosthetic heart valve, intrauterine device, and urinary catheter are some examples for indwelling medical devices that are commonly associated with biofilms. Most of the microorganisms produce extracellular polymeric substances composed of backbone structures that contain 1,3- or 1,4-β-linked hexose residues and tend to be more rigid, less deformable, and in certain cases poorly soluble. This is the exact linkages present in cellulose polymer. Therefore, cellulases can be further studied for their efficient application in removing this type of biofilms from medical devices.
\nFood is essential for all living organisms to obtain nutritional support for their growth and well-being. The huge demand for food has laid a path to a very complex, interconnected global business that supplies most of the food consumed by the world’s population.
\nFood biotechnology nowadays considers cellulases as an invaluable resource due to their increased applicability in a broad range of processes. Fruit and vegetable juice clarification, reducing the viscosity of nectars, concentrating purees, alteration of fruit sensory properties, carotenoid extraction, olive oil extraction, and the quality improvement of bakery products are among the various processes in food biotechnology that cellulase is exploited worldwide.
\nThe cloudiness which is usually present in fruit and vegetable juices is a result of floating polysaccharide materials such as cellulose, hemicellulose, lignin, pectin, starch, metals, proteins, and tannins. The presence of these materials in the juice makes it low quality and draws less consumer demand. “Rapidase pomaliq” is a commercially available enzyme preparation composed of cellulase, hemicellulases, and pectinases obtained from
Modification of sensory parameters of food is another important area where application of cellulases is highly recommended. The aroma properties, flavor, and texture of fruits are some sensory properties which play a crucial role in food biotechnology. The infusions of pectinases and cellulase enzymes have been found to be effective in altering the sensory properties of fruits and vegetables [29].
\nThese enzymes are also applied in degradation of grape fruit peels to release sugars. These sugars will be used in many industries including food production. Another important application of cellulase is extraction of phenolic compounds from grape pomace.
\nDuring extraction of olive oil, malaxing (mixing) is an indispensable step. This period allows the tiny oil droplets to attach with bigger ones and increase the oil yield which is coming from the olive paste. The use of cellulases alone or in combination with other hydrolytic enzymes like pectinases in this step has been found to have an enhancing effect on the extraction as well as the quality of olive oil. The enzymatic treatment of olive oil at the extraction stage causes significant enhancements in phenolic content and antioxidant activity of olive oil, thereby ultimately improving its quality.
\nThe enzyme cocktails of cellulases with other hydrolytic enzymes such as amylases, proteases, and xylanase result in increased loaf volume, improvement in bread quality, and production of softer crumb. Enzyme cocktail containing cellulases, hemicellulases, amylases, lipases, and phospholipases results in dough conditioning with improvement of flavor, prolonged shelf life, and increase in volume after baking [30].
\nAnother important application of cellulases is in pigment extraction from plants and plant products. Natural pigments such as carotenoids are nowadays earning a huge consumer demand as food colorants because of their natural origin, less toxicity, and availability of a wide range of colors. Brightly colored fruit peels such as orange, sweet potatoes, tomatoes, and carrot cell walls are rich in carotenoids. These are applicable as natural food colorants. The treatment of fruit peels with enzyme cocktails including cellulase leads to carotenoid extraction.
\nIn animal feed production, cellulases are applied to enhance digestibility of cereal-based food and to increase nutritive values for a higher quality of forages. There are reports about efficiently using
Furthermore, cellulases play an important part in increasing the rate and extent of fiber digestion. This can be used as a positive effect on natural gastrointestinal processes of the ruminants. The ultimate result will be the increased availability of absorbable nutrients by digestibility enhancement of fodder. The partial hydrolysis of lignocellulose materials also leads to better emulsification of food in the animal digestive tract resulting in ultimate improvement of nutrients availability.
\nEnergy is the life blood of the modern world. Fossil fuel, among all energy sources, holds the highest consumer demand. Since the industrial revolution, there is a drastic increase in fuel consumption. As fossil fuels are not renewable resources, the depletion of its natural deposits is inevitable. Therefore, we are in an era of limited and expensive energy. With the recent rise in fossil fuel prices, along with growing concern about its adverse effects on environment such as global warming caused by carbon dioxide emissions and subsequent climate change problems, biofuels have been gaining popularity. In our study area, we are focusing on bioethanol production using cellulolytic microorganisms as well as fermentative yeast using cellulose as the substrate.
\nBioethanol is a renewable form of energy. Especially, second-generation bioethanol production is an emerging trend because of the abundance of low-cost raw materials. The largest potential feedstock for this purpose is lignocellulosic biomass, which includes materials such as agricultural residues (corn stover, crop straws, and bagasse), herbaceous crops (alfalfa, switch grass), short-rotation woody crops, forestry residues, waste paper, and other wastes (municipal and industrial). Lignocellulose is the most abundant renewable biomass. The yield of lignocellulose can reach approximately 200 billon metric tons worldwide per year [34]. Bioethanol production from these feedstocks has certain advantages. It is an attractive method of disposing those lignocellulosic materials which is the nonedible part of plants. Less production of pollutants makes it environmentally friendly. Most importantly, bioethanol production using lignocellulosic biomass does not create any food insecurity because it does not utilize any food crops before harvesting. Finally, it is abundant all around the year as a raw material.
\nHowever, the major drawback of this production process is associated with the structure of lignocellulosic biomass. It mainly consists of lignin, cellulose, and hemicellulose which collectively form a very stable structure. In order to release fermentable sugars from this substrate, it needs to undergo a pretreatment process to break open the stable structure. One of the main focuses of this chapter is to discuss about the possible biological pretreatment of lignocellulosic biomass with special references to the current studies conducted by scientists. It also includes a description about our own attempts in this particular area of research.
\nBiomass contains about 40–50% of cellulose, a glucose polymer; 25–35% of hemicellulose, a sugar heteropolymer; 15–20% of lignin, a non-fermentable phenyl-propane unit; and lesser amounts of minerals, oils, soluble sugars, and other components. Biological pretreatment of lignocellulosic biomass uses the ligninolytic potential of certain microorganisms (fungi and bacteria and actinomycetes) to reduce the recalcitrant nature which is mainly caused by lignin component of the feedstock and enhance its digestibility by hydrolytic enzymes [35]. The breakdown of lignin barrier changes the structure of lignocellulose and enhances the access to the cellulose and hemicellulose carbohydrate components present.
\nBiological pretreatment seems to be a promising approach due to its low capital cost, low energy, and little dependence of chemicals, mild environmental conditions, eco-friendly nature, and the absence of inhibitor generation during the process which affects in bioethanol production. Moreover, this process does not release any toxic materials or any toxic effluents to the environment.
\nHowever, there are few limitations in this strategy. The main drawback against the industrial scale application is the prolonged incubation time consumed to achieve the efficient delignification [36]. This is because of low hydrolysis rate of the microorganisms. Another possible drawback that comes into mind is the possible consumption of carbohydrates as well as fermentable sugar formed by the same microorganisms used to pretreat the material. This is possible to take place because most of the lignolytic microorganisms are producing cellulolytic enzyme batteries as well. Then, the substrate left for fermentative organisms will be minimal which could consequently lead to lower bioethanol yields. Therefore, it is essential to have poor cellulolytic microorganisms for delignification process.
\nTo minimize this type of drawbacks in a biological way, it is possible to use cocultures or biofilms of efficient ligninolytic microorganisms. Introduction of fermentative yeast isolates into the same microbial coculture would also be a perfect approach. However, developing the most efficient microbial consortium is not that simple. Excessive laboratory-scale studies are required to understand the optimum physiological as well as biochemical parameter setup.
\nFungi are found to be more efficient in degrading lignocellulosic biomass. For instance, white-rot fungi, brown-rot fungi, and soft-rot fungi can be taken. The first two are basidiomycetes and soft-rot fungi are classified in ascomycete group.
\nAmong these efficient ligninolytic microorganisms that have been studied so far, white-rot basidiomycete fungi are found to be more versatile in the process. Most research has been concentrated on species such as
Recently, some bacterial laccases have also been characterized from
The biological pretreatment can be performed by growing the microorganism directly on the feedstock or using the enzyme extracts. Solid-state fermentation is the method of choice for biological delignification. Thus, from the reports available, it is evident that white-rot fungi and actinomycetes can be used to remove lignin from lignocellulosic substrates. However, further studies are required to shorten the incubation time and to optimize the delignification process.
\nThe importance of enhancing enzymatic hydrolysis has been increased because of the urgent need for efficient biological pretreatment processes. For this purpose it is essential to search for high enzyme-producing organisms from the natural environment. Selecting the most effective strain and its culture conditions can make the process more efficient. Another important aspect is to find unique microbial communities for biological pretreatment. These communities can be called consortia. The efficient biodegradation of lignocellulosic biomass could be achieved by the synergistic action of various bacteria and fungi in a microbial consortium. There are a number of advantages in using a microbial consortium for biological pretreatment. The increase of adaptability, improved productivity, improved efficiency of enzymatic saccharification, control of pH during sugar utilization, and increase in substrate utilization are some of them. With the development of biotechnology and molecular biology, the production of hyperlignolytic mutants by genetic modification of wild-type species is one approach that could be studied further. Furthermore, complete understanding of the theoretical basis behind the mechanisms of actions of these hydrolytic enzyme systems is very useful in the process of enhancing hydrolytic efficiency.
\nVarious process parameters affecting biological pretreatment like incubation temperature, incubation time, inoculums concentration, moisture, aeration, and conditions of pH have to be optimized. This must be done with well-planned laboratory-scale experiments. It is essential to pay attention to the microorganism used as well as the type of lignocellulosic material utilized because these parameters obviously change based on these two factors. Accessory enzymes are those enzymes which act on less abundant linkages found in plant cell walls. These include arabinases, lyases, pectinases, galactanases, and several types of esterases. Some studies have reported that addition of these accessory enzymes will improve hydrolysis efficiency.
\nRecently, several studies have been conducted in Sri Lanka on efficient lignocellulose-degrading microorganisms isolated from the natural environment. The effect of coculturing these fungal isolates for degradation of lignocellulosic material has also been reported. Coculturing of
The current progress in applications of cellulases is truly remarkable and attracting worldwide attention. It has already conquered the global market in an unbeatable way. Microbes are an attractive topic of interest for the production of cellulases due to their immense potential for cellulase production. However, it is apparent that more efficient species are still out there in the environment unnoticed by researchers. Further exploration and understanding of hidden mechanisms behind the activity of these enzymes are much more important. Microbial cellulases are preferred for their potential applications in a broad range of industries. Their ventures are expanding day by day. More and more researches are required to produce scientific knowledge to meet the growing demands for microbial cellulase. The advances in the emerging fields such as biotechnology, microbiology, and molecular biology will open up novel strategies to magnify the still-unlocked potentials of these enzymes. Eventually, it will be able to fine-tune the areas which still are dragging on the way to their utmost success.
\nSpecial thanks go to Research Assistant, Mr. K. Mohanan and Technical Officer Mrs. Kumuduni Karunarathna at Bioenergy and Soil Ecosystems Research Project, National Institute of Fundamental Studies, Kandy Sri Lanka and the National Research Council (Grant No: 12-021) for financial support.
\nNo conflicts of interest.
\nOrthodontic treatment aims globally to improve dentofacial esthetic and stomatognathic system functions in harmony with the patient’s wishes. To achieve these objectives, inter- and intra-arch occlusion is the guiding field of action. Therefore, any orthodontic movement must be carefully considered including in the molar area. Indeed, permanent molars are considered as significant determinants for normal tooth development and facial growth [1, 2]. They play a central role in the mastication of food, in supporting the vertical dimension of the face, and as anchorage teeth against orthodontic forces [3]. Moreover, posterior dental contacts are important to adapt and coordinate growth between the mandible and maxilla and a lack of chewing function in children will disrupt their maxillofacial growth [1, 4]. Hence, every orthodontist must ensure a well-thought-out management of missing molar spaces mostly in children.
The molar missing may be primary, due to the agenesis phenomenon, or secondary to extraction not compensated by prosthetic rehabilitation. It complicates decision-making process, since the orthodontist’s first vocation is to balance dentofacial pattern with a better cost-benefit ratio, especially in young patients. What is more, molar absence is generally accompanied with other complicated dental and skeletal problems, which affect treatment planning and outcomes.
Molar agenesis may be an isolated anomaly or associated with particular syndromes. It is an uncommon clinical condition not well documented in the literature. Moreover, it has also been reported that anterior agenesis may depend more on genes while posterior missing might be sporadic [5]. Its prevalence rate has been reported to fluctuate between 0 and 0.05% in the general population for the first permanent molar (FPM) [1] and to revolve around 0.8% for the second permanent molar (SPM) [4]. This phenomenon was reported to be associated with a higher prevalence of other permanent tooth agenesis and advanced tooth agenesis [3]. Consequently, when treating patients with molar agenesis, the orthodontist should consider that observed alterations of craniofacial dimensions might occur beyond the variations associated with age and gender [6].
On the other hand, in case of acquired lack of molars, many factors can be incriminated. Carious lesions, dental hypoplasia including molar-incisor hypomineralization (MIH), and periodontal disease are the major concerns [7, 8]. Several authors have dealt with the best time to extract first permanent molar when this is unavoidable in the young patient. There is only little scientific evidence about the extraction timing in order to minimize unwanted negative effects. In a recent meta-analysis [6], authors suggested that it is when the second permanent molar is at Demirjian stage E. Otherwise, several consequences can occur and if orthodontic need arises, the treatment plan can be complicated or modified to adapt to these modifications, especially in adults.
In this section, we will address the main etiologies and dentoskeletal consequences of molar missing and focus on decision-making factors related to orthodontic management of residual space of one or several missing molars. We will discuss some clinical situations to illustrate this topic.
The consequences of permanent molar extraction and all consequences and treatment considerations have been largely discussed in the literature for the first molar. Second molar is less commonly addressed. Currently, the majority of first permanent molars are extracted because of dental caries [9]. The eruption of the first permanent molar occurs, as its name suggests, around the age of 6 years. Its early eruption, as well as the immaturity of its histological components and its occlusal anatomy (grooves, pits, and fissures), makes it vulnerable to various microbial, periodontal, or structural pathologies, and more prone to possible premature extraction before 15 years [6, 10]. The period between the eruption of the tooth and the definitive maturation of its histological components, especially that of the enamel, is considered to be cario-susceptible.
As said above, permanent molars act as a guide for the permanent teeth since they control the establishment of dental occlusion and participate in the maxillary growth and physiology of the mandibular apparatus. Therefore, loss of permanent molars without any remedy could disturb the developing dentition, generate numerous malocclusions, and affect dental health [6]. It typically leads to occlusal disturbances by pathological migration of neighboring teeth and periodontal lesions as alveolar melting or false periodontal pocket adjacent to the tipped teeth which is induced by bone contour remodeling following the cementoenamel junction [11] (Figures 1–3).
Case of MIH in a 11-year-old boy, with severe molar damage and loss of 26. We can observe displacement of second left upper molar: (a and b) lateral occlusion views; (c) occlusal view of maxillary arch.
Orthopantomogram (OPG) of an adult showing the absence of 16 and 26 with version and false periodontal pocket in the mesial side of 17 and 27. We can note the low floor level of the right maxillary sinus, which may complicate orthodontic mesial movement of posterior teeth.
Case of an adult with multiple molars missing. The over eruption of 17 is due to no-compensated extraction of 47.
These complications are all the more serious, as the period of molar absence on the arch is extended; hence, the importance of the multidisciplinary approach with a large communication between the pediatric dentist and the orthodontist in order to establish the best care and to plan potential extraction, which is useful to correct discrepancies and prevent the development of malocclusions [10].
For managing this space problem, the orthodontist can adopt two therapeutic strategies including space reopening or space closing. The orthodontist ought to use his/her critical sense and clinical common sense to make the right choice, which must not only take into consideration dental arch length and occlusion [12] but also all the technical and biological specificities of treated case. Space can be reopened for implant insertion, autotransplantation, and prosthetic restoration; while space closing can be undertaken to correct the other associate malocclusions. Either way, his/her choice must meet the patient’s expectations and correct the clinical problem without risking overtreatment, or extending duration care, especially since patients with missing molars often need a compensatory treatment in the opposite arch.
Besides, some authors [11, 13, 14] claim that space closure by molar orthodontic movement is time-consuming and more problematic mainly in the mandibular arch and in atrophic extraction sites exhibiting a reduction in vertical height and a decrease in width of the residual ridge. The orthodontist must avoid teeth tipping, damage of the gingiva and marginal bone. Hence, this decision requires confrontation with the alternative prosthetic treatment especially in old adults who usually show less bone apposition around moved molars into the narrowed space, and poor stability of the closed space, leading in some, if not several, cases to an orthodontic compromise. Nevertheless, fixed appliances can achieve excellent outcomes at different ages following permanent molars’ loss particularly with the advent of temporary anchorage devices. Studies have reported that posterior spaces have been closed by protracting posterior teeth, which prevent detrimental effects without reopening of the edentulous spaces or increased pocket depth in the follow-up period [15]. In case of related orthodontic abnormalities, it is necessary to use all or part of the space given by molar extraction to correct the dysmorphy. A golden rule is to determine the anchorage value and location as well as any associated auxiliary devices.
On the other hand, before any prosthetic rehabilitation succeeding space redevelopment, the practitioner has to upright and to parallelize the adjacent teeth in order to gain sufficient space, even apically at the root level [14]. Moreover, in these cases, wisdom teeth are often removed [16]. Consequently, the orthodontist has always to wonder which of the two options is better: (a) close residual molar space to control the wisdom tooth positioning or (b) remove the third molar and place a prosthesis on the missing molar, which is more expensive. Obviously other biomechanical considerations must be taken into account, to be explained later.
On another note, over the years of craniofacial growth, teeth and their supporting tissues are able to adapt to functional demands. Thus, continuous changes are observed after tooth missing, and the orthodontist has to choose optimal treatment for his/her patient taking into account several decision factors. In his literature review [14], Thilander has shown that both closure and space opening alternatives have their advantages as well as disadvantages, but the evidence base is weak, with currently no randomized trials reporting on the outcome of different interventions [9]. More research is needed with relevant clinical follow-up, varying craniofacial morphology, different ages, and large sample. This will be of great value for comprehension of tissue reaction to orthodontic space management and continuous changes of the dentition and its supporting tissues. From then on, treatment choice can be standardized.
The direct consequence of molar extraction is the creation of a 10- to 12-mm diastema. The movements of the neighboring and antagonistic teeth will cause occlusal and periodontal imbalance. It was reported that post-extraction migration occurred in the following ways: over eruption of opposing teeth, horizontal migration of neighboring teeth, space reduced by tipping, dual drift (horizontal and vertical), or complete space closure [6]. In addition to this, authors investigated contour changes of the alveolar processes of posterior extraction sites and demonstrated a reduction in width of the residual alveolar ridge of up to 50% during a 12-month healing period, of which two-thirds of the reduction occurred within the first 3 months of healing in [17]. In case of an extraction on one arch, the opposing tooth can significantly over erupt (Figures 4 and 5). In general terms, malocclusions are complicated by the early loss of a first permanent molar without treatment [10].
Over eruption of tooth 16 after extraction of tooth 46.
OPG of the same patient showing the consequences of extraction of tooth 46: over eruption of 16, distal displacement of 45 germ and slight mesial displacement of 47.
Moreover, sinus pneumatization was identified after extraction of maxillary posterior teeth. This phenomenon occurs within 4–6 months of healing duration, and is caused by atrophy associated with the replacement of dental socket by non-functional bone [18, 19]. The expansion of the sinus was larger following extraction of teeth enveloped by a superiorly curving sinus floor, extraction of several adjacent posterior teeth, and extraction of second molars in comparison with first molars [19].
A systematic review reported that the post-extraction space of first permanent molar was closed mostly by the SPM rather than by the second premolar [6]. For certain authors [20, 21], no significant relation was found between patient Angle’s Classification or the timing of FPM extraction based upon SPM development stage and complete spontaneous space closure in both arches, contrary to the usual recommendations indicating that the ideal time for FPM extraction, with fewer undesirable consequences, is when the SPM is at Demirjian stage E (early bifurcation) [6, 9]. For these authors, apart from extraction timing of the FPM, the presence of the third permanent molar, mesioangulation of the SPM in relation to the FPM, and the engagement of second premolar in the bifurcation of the second primary molar are better predictors of spontaneous space closure of the FPM mainly in mandibular arch where closure space is more problematical and leads frequently to mesial tipping and distobuccal rotation of the SPM or angulation and distal movement of the second premolar. This might be due to the differences in the eruption paths of SPM in the mandible and maxilla [10].
The occlusal and skeletal consequences in the vertical direction after extraction of FPM were much discussed. Some authors noted counterclockwise rotation of the occlusal plane and an improvement in infraclusion [6, 13] but most studies did not notice a significant influence on the vertical dimension [6]. Also, there was no significant effect described on the maxillomandibular relationship in the anteroposterior direction.
Furthermore, it was stated that the FPM and SPM extraction accelerated significantly the development and eruption of the third molars when a posterior space is created [13, 22, 23, 24] and led to lingual tipping and retrusion of incisors mostly in lower arch [6]. However, some authors have discussed the effect of various extraction patterns on provision of space both anteriorly and posteriorly within the arch and they highlighted the fact that FPM extraction seems to have less effect on the profile than premolar extraction [13].
Finally, in the aforementioned systematic review, the authors concluded that the published studies have too many weaknesses to draw sufficient evidence. Therefore, further prospective studies are needed to investigate the consequences of FPM extraction and to confirm the ideal time of this extraction.
In patients with missing molar, a standard treatment plan does not exist. There are essentially two orthodontic treatment approaches to manage this problem, which are space closure or reopening for prosthetic replacements, and implant or autotransplantation. Several elements guide the therapeutic decision, ranging from the patient’s age to economic possibilities, not to mention the technical complexity, therapeutic predictability, and patient comfort, which determine proper compliance and therefore success.
Patients with missing molars often manifest with many underlying skeletal and dental problems and a multidisciplinary approach is recommended and depends on several factors. The amount of crowding, type of malocclusion, facial profile, age of the patient, periodontal conditions, bone volume in alveolar process, vertical or horizontal growth pattern, the number of missing teeth, and the available space should be considered in treatment plan [5]. Moreover, all the consequences that occurred after an old extraction must also be taken into account since they determine the choice of the biomechanical system.
The main advantage of the space closure resides in the fact that the whole treatment can be finished immediately after completion of orthodontics. When possible, it must be systematically preferred because better longer term outcomes can be achieved without growth-related infraocclusion, blue coloring of the gingiva, or periodontal problems as the tooth has displaced along with its supporting tissues [5]. Additionally, orthodontic space closure will reduce the financial expenses for the patient along with resolving arch crowding or anteroposterior malocclusion. Nevertheless, space closure is one of the most challenging approaches to molar extraction cases [13]. Like any treatment, this procedure presents indications and contraindications that have to be rigorously considered. For example, in hypodivergent patients, the closure of the space cannot be indicated due to the muscular and cortical anchoring, making it difficult or impossible to move the molars horizontally and to reduce the overbite [25]. Likewise, the practice of compensating and balancing the extraction of lost permanent molars along with space closing should be discussed. It aims to preserve occlusal relationships and arch symmetry within the whole dentition. A compensating extraction is the removal of a permanent molar from the opposing quadrant, while a balancing extraction signifies the extraction of a permanent molar from the opposite side of the same dental arch [9]. The long-term prognosis of the remaining permanent molars, the developmental status of the dentition including third molars as well as the underlying malocclusion were the main decision factors for or against balancing and compensating treatment [9, 13].
As regards patient age, this result is of great interest for a young adult or an adolescent by guiding the erupting teeth into a stable occlusion and can be considered a cost-effective alternative to complex restorations that require replacement over the life span [20]. Indeed, despite cessation of statural growth, vertical growth of the face permits continued teeth eruption past puberty and could adversely affect the alignment of teeth after orthodontic therapy. Facial growth in the horizontal plane is ended significantly sooner than growth in the vertical plane predominantly in patients with vertical growth patterns [26]. Accordingly, if an implant is placed before growth and eruption completion, it will become in infraocclusion, as it behaves like ankylosed teeth while the adjacent teeth continue to erupt. The magnitude of the vertical changes after age 20 seems to have little clinical importance [26].
In other words, in case of residual molar space in children, it is largely indicated to choose closure option in order to avoid all restrictions related to the periodontal immaturity. In other cases where the extraction space is preserved in growing children, autotransplantation of the tooth is preferable to the implant option [25]. However, other parameters must be studied before deciding treatment plan.
On the other hand, in adults undergoing comprehensive orthodontic therapy, coexisting dental and periodontal problems require multidisciplinary treatment approaches to manage malocclusions often complicated by the migration of adjacent teeth into the extraction sites. Periodontal defects, multiple missing teeth, and atrophic extraction sites make it difficult to close all the extraction spaces, which require remodeling of cortical bone [11]. Also, adults show less bone apposition when moving molars into the narrowed space, poor maintenance of the closed space, and, in some cases, resorption of the second molar roots when moved in place of first molar [11]. Duration of treatment has to be considered and adapted to patient needs. For these reasons, the placement of an implant may be the treatment of choice for adults with missing molars. Be that as it may, this proposition may be in some instances valid for an adult patient whose biological and biomechanical therapeutic specificities must be kept in mind. Precise 3-D control of tooth movement during closure of extraction spaces is very important in meeting treatment goals. Second molar protraction is time-consuming and relatively difficult. Therefore, this treatment option may be justified only when the periodontal health of the protracted second molar is not compromised [24]. Protracting the molars may be advantageous for the patient by increasing alveolar ridge width that had previously been lost in the edentulous space. It should ideally be done before significant vertical bone resorption occurs [27]. In respect of orthodontic force system, bodily movement of molars can be obtained by using temporary skeletal anchorage devices and rational biomechanics [24]. Several authors have reported some useful clinical tips and tricks that surround providing this therapy [11, 13, 15, 27]: a long buccal hook, an uprighting spring, a toe-in bend in the posterior portion of the archwire with constriction, or a balancing lingual force can be used to prevent side effects such as posterior tooth tipping, mesial rotation, and buccal sweep.
Regardless of the chosen option, the fate of wisdom teeth must be assessed. The final success of the treatment depends on its satisfactory positioning [16]. So, it is important to evaluate angulation, eruption space, root developmental stage, and periodontal status of this tooth before deciding to close molar space [27]. Actually, space reopening is indicated when the wisdom tooth is absent.
Furthermore, closure can be difficult, in the maxillary posterior area with sinus proximity, because tooth movement through the maxillary sinus is limited. The increased difficulty of moving teeth in the maxillary sinus is similar to moving a tooth in the atrophic posterior mandibular ridge. In severe cases, the pneumatization can extend completely to the alveolar bone adjacent to the gap. This not only makes it difficult to move teeth through the sinus but also to place an implant without sinus wall lifting surgery [18, 19]. Closing the space should not be chosen as the usual treatment method, as it extends the duration of the treatment without predictable results.
In this section, we will review some clinical cases with one or more missing molars and will justify our therapeutic choices for each situation.
Pretreatment intraoral photographs of a 32-year-old woman with 36 and 46 missing. We can note mesial tipping of 37 associated to a mesiolingual rotation. The space of 36 is more closed than that of 46. (a and c) Buccal occlusion views,(b) Frontal occlusion view, (d) Occlusal view of the lower arch.
Radiographic image of the mesial tipping of teeth 37 and 47, after extraction of lower FPM. Pseudo-pocket was formed adjacent to 37. Tooth 28 is absent.
Intraoral photographs of treatment progress. Extraction site of 36 was closed along with reopening of 46 space. (a) Frontal occlusion view, (b and c) Buccal occlusion views, (d) Occlusal view of the lower arch.
Root correction and mesializing spring used to close left lower space with miniscrew-reinforced anchorage. (a) Buccal left occlusion view, (b) Design and activation of the spring used.
Case no. 2 (Figures 10–13).
This case of an adult shows dilapidated 46 with slight over eruption of 16 but not remarkable drifting of 47. (a and c) Buccal occlusion views, (b) Frontal occlusion view, (d) Occlusal view of the lower arch.
OPG showing difference in molar level at the upper right side. Tooth 46 was unpreservable and enforced extraction was indicated.
Orthodontic treatment was undertaken with the objective to correct the malocclusion while keeping the 46 space.
Posttreatment illustrations. Correction of the dentomaxillary abnormality and prosthetic restoration of missing 46. (a and d) Buccal occlusion views, (b) Frontal occlusion view, (c) Occlusal view of the lower arch, (e) OPG showing the parallelism of the root axes, (f) Occlusal view of the mandibular arch with the provisional prosthesis of 46.
Case no. 3 (Figures 14 and 15).
Case of 47 extraction with large alveolar ridge and no notable migration of opposite and adjacent teeth, except for 48 that slightly drifted mesially. (a and d) Buccal occlusion views, (b) Frontal occlusion view, (c) Occlusal view of the lower arch.
Lower molar space closure was chosen. After mesializing tooth 48 in place of tooth 47, teeth 46 and 48 have been united to prevent space reopening in waiting for adaptation of periodontal ligament fibers. (a and d) Buccal occlusion views, (b) Frontal occlusion view, (c) Occlusal view of the lower arch.
Case no. 4 (Figures 16 and 17).
Case of dentoskeletal class II with absence of 16. We can observe mesial tipping and mesiopalatal rotation of 17. The width of edentulous alveolar ridge was not very narrow. (a) Frontal occlusion view, (b and c) Buccal occlusion views, (d and e) Occlusal views of the upper and lower arches.
Posttreatment intraoral photographs. Remaining space was used to correct dental class II relationship and to mesialize 17 in place of 16. In the left side, first bicuspid was extracted. Extraction of 48 was indicated to compensate upper right molars’ mesializing. (a) Frontal occlusion view, (b and c) Buccal occlusion views, (d and e) Occlusal views of the upper and lower arches.
In all the cases presented above, the molar missing was due to dental decay. Indeed, it is the most common infectious disease worldwide [6]. According to the World Health Organization (WHO), 60–90% of school children have dental caries [6]. The molars are the most affected teeth as they evolve early.
When planning orthodontic treatment with molars missing, the patient age correlated to the amount of residual space, even apically, and the wisdom tooth condition are main decision factors described in the literature [1, 9, 16]. Patient wishes and cooperation must also be taken into account.
Case 1 concerns an adult woman who had chief complaints of upper incisors protrusion and smile asymmetry. She also wanted to resolve the residual mandibular spaces of missing 36 and 46 by the same orthodontic treatment. According to some authors [28], the ideal dimensions for the closure of the lower molars’ spaces are 6 mm or less for the mesiodistal space and 7 mm for the buccolingual width. In this clinical case, the 36 space was almost closed. Furthermore, since tooth 28 was absent and tooth 18 was in functional occlusion, the treatment plan consisted of reopening the 46 space and completely closing that of 36. Also, due to mesial tipping of teeth 37, the mesializing movement was performed at the same time as the root correction using a miniscrew-supported spring. Temporary anchorage devices were indeed widely described and reported to be efficient in achieving accurate control of anchorage [15, 29] provided that the orthodontists master their biomechanics well. In case 3, as the space of lost 47 was quite large and the orthodontic abnormality not very complicated, the ideal choice was to maintain 47 space and a prosthetic rehabilitation. However, because of the absence of 18 in addition to a low economic profile of the patient, the residual space of 47 was closed at the expense of treatment duration.
In case 2 of an adult patient, all wisdom teeth have evolved and there was no need to extract to correct the anomaly. Thus, orthodontic treatment was undertaken while keeping the 46 space for a subsequent prosthetic restoration. By contrast, in case 4 that required premolars’ extraction, remaining space of tooth 16 was used to mesialize 17 in place of 16 and to correct dental class II relationship with retraction of anterior teeth instead of taking out right first bicuspid.
In summary, in case of orthodontic management of molar absence, whether the residual space is closed or maintained, the control of the orthodontic movement including control of anchorage units and vertical forces as well as axial tipping and rotations is crucial to the success of the chosen therapeutic option [28].
In case of missing molars, orthodontic solutions consist of either closing or opening the space. A careful case assessment must be undertaken before treatment to ensure that the benefits of treatment will outweigh any potential risk of the treatment decided upon.
Space closure remains the best choice if the suitable conditions, notably in children whose prosthetic rehabilitation is still problematic and should be postponed until the growth and eruption process is completed. In adult patients, biological and psychological characteristics must be taken into account to achieve expected outcomes.
The decision-making process depends also on other factors like concomitant malocclusions, third molar development, absence of other teeth, and patient compliance. An orthodontic treatment based on reasoned biomechanic principles will help accomplishment of initial objectives in accordance with patient expectations.
In the majority of cases, treatment is complicated by all the side effects of the uncompensated absence of molars. Management is sometimes a veritable challenge. Hence, the prevention and early multidisciplinary management are of major importance.
The authors declare that they have no conflict of interest.
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Although this is a trivial problem in theory, in the practice of OMA, this is a troublesome problem. Errors, such as truncation errors, measurement noise, modeling errors, estimation errors make the separation difficult if not impossible. This leads to the appearance of nonphysical modes, and their separation from physical modes is difficult. An engineering solution to this problem is based on the so-called stability diagram which shows alignments for physical modes. This still does not solve the problem since it is rare to find modes stable in the same order. Moreover, nonphysical modes may also stabilize. Recently, the stochastic modal appropriation (SMA) algorithm was introduced as a valid competitor for existing OMA algorithms. This algorithm is based on isolating the modes mode by mode with the advantage that the modal parameters are identified simultaneously in a single step for a given mode. This is conceptually similar to ground vibration testing (GVT). SMA is based on the data correlation sequence which enjoys a special physical structure making the identification of nonphysical modes impossible under the isolating conditions. 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For this reason, simulation codes, based on Monte Carlo, have been proposed. The codes currently available are MNCP, EGSnrc, Geant, FLUKA, PENELOPE, as well as GAMOS and TOPAS. These simulation codes have become a tool for dose and dose distributions, essentially, but also for other applications such as design clinical, tool for commissioning of an accelerator linear, shielding, radiation protection, some radiobiologic aspect, treatment planning systems, prediction of data from results of simulation scenarios. 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He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University, Kuwait. His research interests include optimization, computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, and intelligent systems. Prof. Sarfraz has been a keynote/invited speaker at various platforms around the globe. He has advised/supervised more than 110 students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He has authored and/or edited around seventy books. Prof. Sarfraz is a member of various professional societies. He is a chair and member of international advisory committees and organizing committees of numerous international conferences. He is also an editor and editor in chief for various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:null},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:"Beijing University of Technology",institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Lakhno Igor Victorovich was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPhD – 1999, Kharkiv National Medical Univesity.\nDSc – 2019, PL Shupik National Academy of Postgraduate Education \nLakhno Igor has been graduated from an international training courses on reproductive medicine and family planning held in Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor of the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s a professor of the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics and gynecology department of Kharkiv Medical Academy of Postgraduate Education . He’s an author of about 200 printed works and there are 17 of them in Scopus or Web of Science databases. Lakhno Igor is a rewiever of Journal of Obstetrics and Gynaecology (Taylor and Francis), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for DSc degree \\'Pre-eclampsia: prediction, prevention and treatment”. Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: obstetrics, women’s health, fetal medicine, cardiovascular medicine.",institutionString:"V.N. Karazin Kharkiv National University",institution:{name:"Kharkiv Medical Academy of Postgraduate Education",country:{name:"Ukraine"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"243698",title:"M.D.",name:"Xiaogang",middleName:null,surname:"Wang",slug:"xiaogang-wang",fullName:"Xiaogang Wang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243698/images/system/243698.png",biography:"Dr. Xiaogang Wang, a faculty member of Shanxi Eye Hospital specializing in the treatment of cataract and retinal disease and a tutor for postgraduate students of Shanxi Medical University, worked in the COOL Lab as an international visiting scholar under the supervision of Dr. David Huang and Yali Jia from October 2012 through November 2013. Dr. Wang earned an MD from Shanxi Medical University and a Ph.D. from Shanghai Jiao Tong University. Dr. Wang was awarded two research project grants focused on multimodal optical coherence tomography imaging and deep learning in cataract and retinal disease, from the National Natural Science Foundation of China. He has published around 30 peer-reviewed journal papers and four book chapters and co-edited one book.",institutionString:"Shanxi Eye Hospital",institution:{name:"Shanxi Eye Hospital",country:{name:"China"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRZkkQAG/Profile_Picture_2022-05-09T12:55:18.jpg",biography:null,institutionString:null,institution:null},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. RELACION DE PONENCIAS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGIA. 10/2014.",institutionString:null,institution:null},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:null},{id:"318905",title:"Prof.",name:"Elvis",middleName:"Kwason",surname:"Tiburu",slug:"elvis-tiburu",fullName:"Elvis Tiburu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Ghana",country:{name:"Ghana"}}},{id:"336193",title:"Dr.",name:"Abdullah",middleName:null,surname:"Alamoudi",slug:"abdullah-alamoudi",fullName:"Abdullah Alamoudi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"318657",title:"MSc.",name:"Isabell",middleName:null,surname:"Steuding",slug:"isabell-steuding",fullName:"Isabell Steuding",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Harz University of Applied Sciences",country:{name:"Germany"}}},{id:"318656",title:"BSc.",name:"Peter",middleName:null,surname:"Kußmann",slug:"peter-kussmann",fullName:"Peter Kußmann",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Harz University of Applied Sciences",country:{name:"Germany"}}},{id:"338222",title:"Mrs.",name:"María José",middleName:null,surname:"Lucía Mudas",slug:"maria-jose-lucia-mudas",fullName:"María José Lucía Mudas",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Carlos III University of Madrid",country:{name:"Spain"}}},{id:"147824",title:"Mr.",name:"Pablo",middleName:null,surname:"Revuelta Sanz",slug:"pablo-revuelta-sanz",fullName:"Pablo Revuelta Sanz",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Carlos III University of Madrid",country:{name:"Spain"}}}]}},subseries:{item:{id:"40",type:"subseries",title:"Ecosystems and Biodiversity",keywords:"Ecosystems, Biodiversity, Fauna, Taxonomy, Invasive species, Destruction of habitats, Overexploitation of natural resources, Pollution, Global warming, Conservation of natural spaces, Bioremediation",scope:"\r\n\tScientists have long researched to understand the environment and man’s place in it. The search for this knowledge grows in importance as rapid increases in population and economic development intensify humans’ stresses on ecosystems. Fortunately, rapid increases in multiple scientific areas are advancing our understanding of environmental sciences. Breakthroughs in computing, molecular biology, ecology, and sustainability science are enhancing our ability to utilize environmental sciences to address real-world problems.
\r\n\tThe four topics of this book series - Pollution; Environmental Resilience and Management; Ecosystems and Biodiversity; and Water Science - will address important areas of advancement in the environmental sciences. They will represent an excellent initial grouping of published works on these critical topics.
\r\n\tPollution is caused by a wide variety of human activities and occurs in diverse forms, for example biological, chemical, et cetera. In recent years, significant efforts have been made to ensure that the environment is clean, that rigorous rules are implemented, and old laws are updated to reduce the risks towards humans and ecosystems. However, rapid industrialization and the need for more cultivable sources or habitable lands, for an increasing population, as well as fewer alternatives for waste disposal, make the pollution control tasks more challenging. Therefore, this topic will focus on assessing and managing environmental pollution. It will cover various subjects, including risk assessment due to the pollution of ecosystems, transport and fate of pollutants, restoration or remediation of polluted matrices, and efforts towards sustainable solutions to minimize environmental pollution.
",annualVolume:11966,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/38.jpg",editor:{id:"110740",title:"Dr.",name:"Ismail M.M.",middleName:null,surname:"Rahman",fullName:"Ismail M.M. Rahman",profilePictureURL:"https://mts.intechopen.com/storage/users/110740/images/2319_n.jpg",institutionString:null,institution:{name:"Fukushima University",institutionURL:null,country:{name:"Japan"}}},editorTwo:{id:"201020",title:"Dr.",name:"Zinnat Ara",middleName:null,surname:"Begum",fullName:"Zinnat Ara Begum",profilePictureURL:"https://mts.intechopen.com/storage/users/201020/images/system/201020.jpeg",institutionString:null,institution:{name:"Fukushima University",institutionURL:null,country:{name:"Japan"}}},editorThree:null,editorialBoard:[{id:"252368",title:"Dr.",name:"Meng-Chuan",middleName:null,surname:"Ong",fullName:"Meng-Chuan Ong",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRVotQAG/Profile_Picture_2022-05-20T12:04:28.jpg",institutionString:null,institution:{name:"Universiti Malaysia Terengganu",institutionURL:null,country:{name:"Malaysia"}}},{id:"63465",title:"Prof.",name:"Mohamed Nageeb",middleName:null,surname:"Rashed",fullName:"Mohamed Nageeb Rashed",profilePictureURL:"https://mts.intechopen.com/storage/users/63465/images/system/63465.gif",institutionString:null,institution:{name:"Aswan University",institutionURL:null,country:{name:"Egypt"}}},{id:"187907",title:"Dr.",name:"Olga",middleName:null,surname:"Anne",fullName:"Olga Anne",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBE5QAO/Profile_Picture_2022-04-07T09:42:13.png",institutionString:null,institution:{name:"Klaipeda State University of Applied Sciences",institutionURL:null,country:{name:"Lithuania"}}}]},{id:"39",title:"Environmental Resilience and Management",keywords:"Anthropic effects, Overexploitation, Biodiversity loss, Degradation, Inadequate Management, SDGs adequate practices",scope:"\r\n\tThe environment is subject to severe anthropic effects. Among them are those associated with pollution, resource extraction and overexploitation, loss of biodiversity, soil degradation, disorderly land occupation and planning, and many others. These anthropic effects could potentially be caused by any inadequate management of the environment. However, ecosystems have a resilience that makes them react to disturbances which mitigate the negative effects. It is critical to understand how ecosystems, natural and anthropized, including urban environments, respond to actions that have a negative influence and how they are managed. It is also important to establish when the limits marked by the resilience and the breaking point are achieved and when no return is possible. The main focus for the chapters is to cover the subjects such as understanding how the environment resilience works, the mechanisms involved, and how to manage them in order to improve our interactions with the environment and promote the use of adequate management practices such as those outlined in the United Nations’ Sustainable Development Goals.
",annualVolume:11967,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/39.jpg",editor:{id:"137040",title:"Prof.",name:"Jose",middleName:null,surname:"Navarro-Pedreño",fullName:"Jose Navarro-Pedreño",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRAXrQAO/Profile_Picture_2022-03-09T15:50:19.jpg",institutionString:"Miguel Hernández University of Elche, Spain",institution:null},editorTwo:null,editorThree:null,editorialBoard:[{id:"177015",title:"Prof.",name:"Elke Jurandy",middleName:null,surname:"Bran Nogueira Cardoso",fullName:"Elke Jurandy Bran Nogueira Cardoso",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRGxzQAG/Profile_Picture_2022-03-25T08:32:33.jpg",institutionString:"Universidade de São Paulo, Brazil",institution:null},{id:"211260",title:"Dr.",name:"Sandra",middleName:null,surname:"Ricart",fullName:"Sandra Ricart",profilePictureURL:"https://mts.intechopen.com/storage/users/211260/images/system/211260.jpeg",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}}]},{id:"40",title:"Ecosystems and Biodiversity",keywords:"Ecosystems, Biodiversity, Fauna, Taxonomy, Invasive species, Destruction of habitats, Overexploitation of natural resources, Pollution, Global warming, Conservation of natural spaces, Bioremediation",scope:"