Stability of anterior open bite cases treated with upper and lower extrusion arches in adults: a follow-up study

OBJECTIVES

To investigate the post-treatment stability of anterior open bite (AOB) cases treated with upper and lower extrusion arches in adults.

MATERIALS AND METHODS

23 patients with AOB were treated with extrusion arches and evaluated for dentoskeletal changes using lateral cephalometric radiographs before treatment (T0), after treatment (T1), and 12 months post-treatment (T2). Patients received bondable tongue spurs and vacuum-formed retainers as post-treatment retention/stability measures for 12 months. Post-treatment stability was further assessed qualitatively by the Photographic Openbite Severity Index.

RESULTS

All the cases showed positive overlap between the anterior teeth at the end of orthodontic treatment, and 20 of 23 treated patients attended the recall visit after 12 months. A total of 85% of the cases maintained positive overlap at least 1 year post-treatment, 10% showed edge-to-edge bite, and only 5% showed no overbite.

CONCLUSIONS

Treatment of AOB in adults with extrusion arches proved to be stable 1 year post-treatment. Changes in the overbite after 1 year of follow-up were not significant.

Effect of maxillary and mandibular extrusion arches on dentoskeletal changes in adults with anterior open bite: a quantitative analysis

OBJECTIVE

To quantify dentoskeletal changes accompanying the use of extrusion arches during the treatment of anterior open bite (AOB) in adults.

MATERIALS AND METHODS

A total of 23 adult patients with an AOB of -3.05 mm ± 1.27 mm were treated with upper and lower extrusion arches after the alignment phase. Lateral cephalograms were taken before placement of the extrusion arch, immediately after closure of the open bite (T2), and at the end of orthodontic treatment (T3). Data were statistically analyzed using repeated-measures analysis of variance and the Bonferroni post hoc test for pairwise comparisons (α = 0.05).

RESULTS

Successful closure of AOB, with an overall change in overbite of 4.73 ± 1.93 mm, was achieved in an average of 3.8 months and remained stable at T3. Upper and lower incisors were significantly extruded by 2.05 mm ± 0.72 mm and 2.54 mm ± 1.63 mm, respectively, and significantly retroclined by 6.36° ± 1.63° and 8.45° ± 3.83°, respectively, with a resultant increase in the interincisal angle of 12.80° ± 2.09°. Statistically significant intrusion and mesial tipping (P < .001) of the maxillary and mandibular first molars were observed at T2. Dentoskeletal changes remained stable at T3, except for a significant reduction of the mesial tipping of the maxillary and mandibular first molars.

CONCLUSIONS

The combined use of maxillary and mandibular extrusion arches resulted in significant favorable dentoskeletal changes that led to the successful closure of AOB during a short duration of treatment.

Periodontal changes following distraction osteogenesis in patients with cleft lip and palate: a clinical trial

Objectives

To evaluate inflammatory mediator levels and periodontal changes following distraction osteogenesis (DO) in patients with cleft lip and palate (CLP) using mid-maxillary distraction (MMD).

Materials and Methods

A total of 20 healthy patients with CLP with Class III malocclusion were included. Segmental forward advancement of the anterior maxilla from the second premolars on both sides using DO was performed. A custom-made, tooth-borne distractor connecting buccal molar segments to the anterior maxilla was used for 7 days with 0.5-mm distraction for the first 2 days and then increased to 1 mm daily until overcorrection. Crevicular interleukin IL-1β and tumor necrosis factor TNF-α levels were measured during distraction. Periodontal clinical parameters and indices were recorded at baseline and 3 and 6 months postoperatively. Soft tissue healing was evaluated histologically at 2 and 4 weeks after distraction.

Results

The periodontal parameters remained stable during the follow-up periods. Insignificant increases in the level of inflammatory cytokines compared with the control were observed. Histological findings revealed mild inflammatory and structural changes in the gingiva immediately after distraction, whereas regeneration was noticed after 4 weeks.

Conclusions

MMD was an effective technique in treating patients with CLP, leading to new bone and soft tissue formation without significant detrimental effect on the periodontium of the adjacent teeth.

Multidisciplinary management of a fused maxillary incisor: Case report with 5-year follow-up

Detailed treatment planning and execution are crucial if regenerative approaches are to be attempted to retain fused permanent teeth. Long-term follow-up is necessary to monitor the stability of the final outcome, both esthetically and functionally.

Bioglass in Alveolar Bone Regeneration in Orthodontic Patients: Randomized Controlled Clinical Trial

This study was designed as a split-mouth randomized controlled clinical trial to evaluate the effects of a novel bioactive glass scaffold-tailored amorphous multiporous (TAMP)-for the preservation of alveolar bone following tooth extraction in class II orthodontic patients. TAMP scaffolds were prepared and sterilized. Patients were screened for eligibility, and 6 patients accounting for 14 extraction sockets were included in this stage. Sockets were randomly allocated to either control (left empty) or test (grafted with TAMP scaffold particles). Follow-up was done after 1, 2, 4, 8, and 12 to 17 wk with digital periapical radiographs to evaluate changes in crestal bone height and bone mineral density (BMD), 3-dimensional volumetric analysis of impression casts, and histologic analysis of core biopsies. Furthermore, alveolar bone marrow mesenchymal stem cells were cultured from control and test sockets following biopsy retrieval to evaluate the ability of TAMP bioactive glass scaffolds to recruit host progenitor cells. Results showed that sockets grafted with TAMP bioactive glass scaffolds better preserved height after 3 mo where mesially 57.1% of test cases showed preservation of socket height, compared with 28.6% of control cases. Distally, this was 42.9% of test cases versus none of the control cases. Regarding BMD, the test sides had higher BMD in all 3 sections of the socket, with the greatest reduction in BMD found in the coronal third. Results were not statistically significant. Histologically, sockets grafted with TAMP bioactive glass scaffolds showed a distinct pattern of bone healing characterized by vertical trabeculae and large vascularized marrow spaces with sockets showing corticalization. Volumetric analysis showed a better preservation of socket contour with TAMP bioactive glass scaffolds. TAMP bioactive glass scaffolds appeared to enhance the recruitment of stem cells from the grafted sockets. In conclusion, TAMP scaffolds appear to better preserve alveolar bone following extraction and allow for a more active bone modeling and remodeling process( ClinicalTrials.gov identifier:NCT01878084). Knowledge Transfer statement: The results of this study set the stage for the recommended use of novel biomimetic scaffolds, such as the tailored amorphous multiporous bioactive glass for preservation of the socket following extraction. This can be valuable for patients and clinicians alike when deciding on long-term prosthetic alternatives that not only result in immediate bone preservation but will accommodate the dynamic nature of bone.

[VENTILOP survey. Survey in peroperative mechanical ventilation]

INTRODUCTION

Mechanical ventilation can initiate ventilator-associated lung injury and postoperative pulmonary complications. The aim of this study was to evaluate (1) how mechanical ventilation was comprehended by anaesthetists (physician and nurses) and (2) the need for educational programs.

METHODS

A computing questionnary was sent by electronic-mail to the entire anaesthetist from Alsace region in France (297 physicians), and to a pool of 99 nurse anaesthetists. Mechanical ventilation during anaesthesia was considered as optimized when low tidal volume (6-8mL) of ideal body weight was associated with positive end expiratory pressure, FiO2 less than 50%, I/E adjustment and recruitment maneuvers.

RESULTS

The participation rate was 50.5% (172 professionals). Only 2.3% of professionals used the five parameters for optimized ventilation. Majority of professionals considered that mechanical ventilation adjustment influenced the patients' postoperative outcome. Majority of the professionals asked for a specific educational program in the field of mechanical ventilation.

DISCUSSION

Only 2.3% of professionals optimized mechanical ventilation during anaesthesia. Guidelines and specific educational programs in the field of mechanical ventilation are widely expected.

Molecular background of D-negative phenotype in the Tunisian population

BACKGROUND

Most studies of the molecular basis of Rhesus D-negative phenotype have been conducted in Caucasian and African populations. A comprehensive survey of RHD alleles was lacking in people from North Africa (Tunisians, Moroccans and Algerians) which could be very efficient for managing donors and patients carrying an RHD molecular variant. We analyse the molecular background of D-negative population in Tunisia in the present study.

MATERIALS AND METHODS

Blood samples were collected from native Tunisians. A total of 448 D-negative donors from different regions of Tunisia were analysed by RHD genotyping according to an adopted strategy using real-time PCR, ASP-PCR and sequencing.

RESULTS

Among the 448 D-negative samples, 443 were phenotyped unequivocally as true D-negative including three molecular backgrounds which were RHD gene deletion (n = 437), RHDψ pseudogene (n = 2) and RHD-CE-D hybrid gene (n = 4) with the respective frequencies of 0·9900, 0·0023 and 0·0046. The remaining five samples, in discordance with the serological results, were identified as two weak D type 11, one weak D type 29, one weak D type 4·0 and one DBT-1 partial D.

CONCLUSION

This study showed that the Tunisian population gets closer to Caucasians, given that the RHD gene deletion is the most prevalent cause of D-negative phenotype, but it is slightly different by the presence of the RHDψ pseudogene which was found with a very low frequency compared with that described in the African population. Nevertheless, the relative occurrence of weak D variants among studied serologically D-negative samples make necessary the adaptation of RHD genotyping strategy to the spectrum of prevalent alleles.

Low dose of gamma irradiation enhanced drought tolerance in soybean

Drought stress is the main limiting factor in soybean production. However, no work has been done on how the application of a low dose of gamma rays could help to overcome water deficits during critical stages of soybean development. Gamma rays at a dose of 20 Gray (Gy) were applied to dry seeds of soybean before planting. Two levels of soil moisture (80% field capacity for well-watered control and 35% for drought-stressed treatment) were applied at pod initiation. Gamma irradiation increased biomass accumulation and seed yield in both treatments. It also increased the chlorophyll content, photosynthetic activity (14CO2fixation) and leaf water potential and enhanced the enzyme activities of RuBPCase and PEPCase of control plants compared with drought-stressed plants. Gamma irradiation (20 Gy) increased the soluble sugars, protein and proline content and the activities of peroxidase and superoxide dismutase in drought-stressed soybean leaves. It also increased the chloroplast size, which was reduced by drought treatment, and rebuilt, to some extent, the chloroplast ultrastructure. However, it decreased the malondialdehyde concentration and the electrical conductivity of the leaves under drought stress. Overall, the results indicated that pre-treatment with gamma rays (20 Gy) to dry seeds of soybean before planting could be used to enhance drought tolerance and minimize the yield loss caused by water deficit.

Accumulation of mercury and its effects on testicular functions in rats intoxicated orally by methylmercury

All forms of mercury are considered poisonous. Methylmercury, one organic form, is highly toxic to many organs. The aim of the present study was to assess the effects of this form on the reproductive system in the rat. For this, 20 male rats were divided into two groups. One, which is considered as reference, received tap water. The second group received tap water containing methylmercury at the rate of 20 mg l⁻¹ for 8 weeks. At the end of the experiment, blood samples were collected for the determination of total mercury and plasma testosterone. The left testes were used for the determination of total mercury and histological examination. Appropriate centrifugation was applied on right testes to extract interstitial and seminiferous tubular fluids. The epididymides were homogenised for the sperm count. Our results showed a dramatic fall in the plasma testosterone in the contaminated animals. The fall in plasmatic testosterone seems to be in relation with the decrease in the secretion of testosterone. In association with this, the concentration of testosterone in seminiferous tubules fluid dropped about 55% in the poisoned animals in comparison with the controls. Despite this, no decrease in the epididymal sperm count in contaminated rats was observed.

Role of salicylic acid in regulation of cadmium toxicity in wheat ( Triticum aestivum L.)

Treatment with CdCl 2 (0, 100, 400 and 1000 μM) resulted in the inhibition of root dry biomass and root elongation and to increased Cd accumulation in the roots. These treatments also decreased the relative water content, chlorophyll content, 14 CO fixation, phosphoenol pyruvate carboxylase and ribulose-1,5-bisphosphate carboxylase activity and abscisic acid (ABA) content, while increasing the malondialdehyde, hydrogen peroxide and free proline contents and causing changes in the chloroplast and root ultrastructure. Pretreatment of seeds with SA (500 μM) for 20 h resulted in the amelioration of these effects.

Effect of gamma radiation on antioxidant enzymes and G 6 PDH activities in Vicia faba plants

The effect of gamma irradiation on Vicia faba L. plants was investigated by exposing dry seeds to doses ranging from 0 to 100 Gray (Gy) and studying the activities and isozyme patterns of the key enzymes involved in oxidative stress defence, such as superoxide dismutases (SOD, EC 1.15.1.1), catalases (CAT, EC 1.11.1.6), peroxidases (POX, EC 1.11.1.7), ascorbate peroxidases (APOX, EC 1.11.1.11), monodehydroascorbate reductase (MDHAR, EC 1.6.5.4) and glutathione reductase (GR, EC 1.6.4.2), as well as the activity of an enzyme involved in a specific intermediary metabolic pathway, glucose-6-phosphate dehydrogenase (G 6 PDH, EC 1.1.1.49). The H 2 O 2 contents of faba bean leaves were also measured. None of the γ-irradiation doses used (0–100 Gy) had any effect on the activity of MDHAR, but they increased the enzyme activities of GR, APOX, SOD and G 6 PDH. Gamma rays at 20 Gy decreased the H 2 O 2 content, but the 100 Gy dose significantly increased the H 2 O 2 content compared with the non-irradiated plants. The results implied that the isozymes of SOD, CAT and POX present in faba bean cells growing in the presence of 0–15 Gy γ-irradiation are required to remove the reactive oxygen species (ROS) produced during normal, physiological processes. When the dose of γ-irradiation is ≥20 Gy, the level of ROS (produced indirectly by γ-irradiation) becomes too high to be dealt with by the existing antioxidant isozymes. The present research shows for the first time that the switch between the physiological oxidative response and a stress-related one occurs within a very narrow range of stress factor intensities, i.e. γ-irradiation doses. In the present study, this change took place between 15 and 20 Gy. Further investigations, using molecular biology techniques will be needed to determine the mechanisms involved in enzyme induction under ionizing conditions in order to evaluate changes in the gametic genomes at two possible levels: (i) the structural level, for studying mutations occurring in the DNA, and (ii) the functional level, by studying differential genetic expression between irradiated and non-irradiated plants.

Effects of gamma radiation on Brugia malayi infective larvae and their intracellular Wolbachia bacteria

Prior studies have shown that irradiated filarial larvae are developmentally stunted but capable of inducing partial immunity to filariasis in animals. The mechanisms for these effects are poorly understood. Recent studies suggest that intracellular Wolbachia bacteria are necessary for the normal development, reproduction and survival of filarial nematodes. The purpose of this study was to examine the effects of irradiation on Wolbachia in Brugia malayi infective larvae (L3) and on L3 development. The L3 were exposed to 0, 25, 35, 45, 55, 65 or 75 krad of gamma irradiation from a (137) Cesium source and cultured in vitro at 37 degrees C in NCTC/IMDM medium with 10% FCS for 12 days. Irradiation prevented molting of L3 to the L4 stage in a dose-dependent manner. Electron microscopy studies showed that irradiation damaged Wolbachia (25 krad) or cleared them from worm tissues (45 krad). In addition, majority of the irradiated L3s failed to develop the L4 cuticle. Real-time PCR studies showed that irradiation reduced Wolbachia DNA in worm tissues. Parallel in vivo studies confirmed decreased development of irradiated L3 in jirds, with associated effects on Wolbachia. Jirds injected s.c with normal L3 developed antibodies to Wolbachia surface protein (wsp) shortly after the onset of microfilarial patency. In contrast, jirds injected with irradiated L3 did not develop microfilaremia or antibodies to wsp. Additional studies are needed to test the hypothesis that irradiation retards growth and development of filarial L3 by killing Wolbachia.

[Urinary incontinence in the elderly: what management for which patient?]

THERAPEUTIC OPTIONS

Appropriate management of urinary incontinence in the elderly basically depends on the patient's medical status and degree of dependence and the type of incontinence. For outpatients, secondary effects of drugs limit their use, in favor of behavioral intervention and pelvic floor training, with good success. Recently proposed surgical approaches offer a promising alternative for the aged population. TEAM MANAGEMENT: Assessment and management of institutional urinary incontinence should be systematically elaborated by the medical care team. Potentially reversible conditions and precipitating factors may be causing or contributing to the incontinence. Their correction and bladder training are the principal items of the management scheme.

Cell-cell contact increases radioresistance in head and neck carcinoma cell lines

PURPOSE

To investigate the in vitro radiosensitivity of microcolonies from head and neck cancers of varying degrees of differentiation.

MATERIALS AND METHODS

The location of individual squamous-cell carcinoma (SCC) cells in tissue culture flasks was recorded using computerized microscopy. This allowed the positions of the cells to be continually revisited, which enabled manual sizing of individual microcolonies, both at the time of irradiation (0-5 Gy) and following a post-irradiation incubation period during which the microcolonies were assessed for clonogenic survival.

RESULTS

When irradiated as microcolonies with 0-3 Gy, malignant cells had plating efficiencies (PE; applying multiplicity corrections) that were lower than expected when compared with the PE of cells irradiated individually. However, at between 2 Gy and 3 Gy the PE values became similar and at higher doses the 'corrected PE' of microcolonies became higher than that of individually irradiated cells.

CONCLUSION

These data show that cell cell interactions can occur in malignant cells in a manner similar to that demonstrated previously in non-malignant cells. Cells within microcolonies demonstrate increased radioresistance compared with cells irradiated singly.

Abha septuplets and total infant survival

Full text is available as a scanned copy of the original print version.

[Anthropologic research and understanding pediatric visceral leishmaniasis in Tunisia]

In order to determine the social and cultural factors which delay hospitalization of children suffering from visceral leishmaniasis (VL), a study was carried out in the rural area of Kairouan (Tunisia). Qualitative techniques were used to investigate beliefs and behaviours associated with the symptoms of VL. The study has demonstrated that the folk interpretation of the disease interferes largely with the choice of the therapy. Regarding VL, the subdivision of the disease into two groups of symptoms, fever and splenomegaly, incites parents to consult doctors in the presence of fever and use traditional healers when splenomegaly appears. This is responsible for long delays before the patients can have access to official health care. This investigation clearly demonstrated that a health education programme is needed in VL endemic areas in Tunisia in order to shorten delays between the appearance of symptoms and their diagnosis. For this objective to be achieved, it would also seem necessary to implement simple serodiagnostic techniques at the periphery level.