Hypoplastic arteries of the cerebral arterial ring in the blind spot of computed tomography angiography

BACKGROUND

Some variations of the cerebral arterial circle (CAC) are associated with an increased risk for the development of various pathological conditions. This paper aimed to determine the prevalence of hypoplastic arteries of CAC and to emphasize the limited possibility of their visualization by computed tomography angiography (CTA).

MATERIALS AND METHODS

The research was performed on 400 adult cadavers by macro- and microdissection of the cerebral arteries. Each case was photographed and the diameter of the arteries was measured digitally, by analyzing photographs of the bases of the brain in the ImageJ program.

RESULTS

The largest prevalence of artery diameter <1mm (<0.6mm) in CAC had the posterior communicating artery (PCoA). PCoA on the left side was hypoplastic in 44.9% (11.4%) of cases, while the same artery on the right side was hypoplastic in 44.3% (6.6%) of cases. The posterior cerebral artery was hypoplastic on the left side in 3% (0.6%) and on the right side in 4.2% (0.6%) of cases. The anterior cerebral artery had a hypoplastic caliber only on the right side in 2.4% (0.6%) of the cases, while the internal carotid arteries did not have a diameter <1mm in any case. The anterior communicating artery showed the greatest variability in morphology. Studies on CTA describe the occurrence of aplasia in a statistically significantly higher percentage, and the occurrence of hypoplastic arteries in a statistically significantly lower percentage compared to studies on cadavers.

CONCLUSIONS

Due to significant differences between cadaveric and radiological studies, it is necessary to analyze their results regarding arterial hypoplasia and aplasia separately. A diameter of less than 1 mm has been suggested as a criterion for arterial hypoplasia.

Olanzapine decreased osteocyte maturation and Wnt/β-catenin signaling during loading of the alveolar bone in rats

Several studies indicate the influence of olanzapine on bone metabolism; however, the results are contradictory. We evaluated the effects of olanzapine on the Wnt/β-catenin signaling pathway, physiological alveolar bone turnover, and alveolar bone modeling due to an applied orthodontic force. Adult male rats (n=48) were treated with either olanzapine or a vehicle for 21 days; then 8 rats from each group were sacrificed and the rest were divided into 4 groups: control, appliance-only, olanzapine-only, and olanzapine-appliance. The rats in the appliance groups were mounted with a superelastic closed coil spring that maintained constant orthodontic force between molars and incisors. We studied the effects of olanzapine on physiological alveolar bone turnover on day 21 of the experiment, and on alveolar bone modeling due to orthodontic force on day 56. We determined tooth movement, alveolar bone volume, activity of bone-specific cells, serum alkaline phosphatase (ALP) activity, and gene expression levels of Wnt/β-catenin signaling target genes. During forced bone modeling, olanzapine increased osteoblast volume (P<0.0001) and ALP activity (P=0.0011) and decreased osteoclast volume (P<0.0001) and gene expression of the Wnt/β-catenin signaling target genes Fosl1, Axin2, and Dkk1(P=0.001, P=0.0076, and P=0.036, respectively), and the osteocyte markers Sost and Dmp1 (P=0.0432 and P=0.0021, respectively). Similar results were obtained during physiological alveolar bone turnover on day 21, when olanzapine downregulated the gene expression of osteocyte markers and Wnt/β-catenin signaling target genes. We concluded that olanzapine attenuated osteocyte maturation during forced bone modeling and physiological alveolar bone turnover, potentially through downregulation of the Wnt/β-catenin signaling pathway.

Maxillary arch dimensions, occlusion assessment and space conditions in patients with cleft palate in the period of deciduous dentition-A retrospective study

PURPOSE

The aim of this study was to evaluate the maxillary arch dimensions, dentoalveolar relationships and spacing conditions in patients with cleft palate in comparison with the control group.

METHODS

The subjects consisted of 31 children with cleft palate only (CP) aged 5.5 ± 0.51 (20 with a cleft of hard and soft palate (SHPC group) and 11 with a cleft of soft palate only (SPC group)). In the control group 30 subjects had a normal occlusion at age 5. Maxillary arch dimensions, dentoalveolar relationship according to the Huddard Bodenham index (HBI) and space conditions were compared with the control group.

RESULTS

In all variables of maxillary arch dimensions except for total arch height the control group exhibited greater values. Most of the significant differences were on account of differences between the control and the SHPC group, with only three comparisons yielding significant results when comparing the two groups of children with clefts (SHPC vs SPC, IV-IV central: p_{Dunnett T3}= 0.0002, 95%CI_Difference=-9.9-(-3.18); V-V distopalatal cusps: p_{Dunnett T3}= 0.0002, 95%CI_Difference=-9.97-(-3.17); Total arch length: p_{Dunnett T3}= 0.0014, 95%CI_Difference=1.74-7.85). The three groups differed significantly in anterior HBI only (H_{Kruskal-Wallis}=15.56, p = 0.0067). The spacing conditions in both jaws were also shown to be significantly dependent on the group of subjects studied (Upper jaw: χ²_omnibus= 16.79, p = 0.0018; lower jaw: χ²_omnibus= 13.75, p = 0.0102).

CONCLUSIONS

The growth of the upper dental arch at the age of five is impeded in participants with CP in comparison to a control group. It is important to assess the effect of cleft subtypes on growth and development to get a better understanding.

Specifies of the fetal median callosal artery

BACKGROUND

A variable artery in the anterior cerebral circulation, named median callosal artery (MdCA) belongs to one of the three groups of anteromedial central branches of the anterior communicating artery (ACoA). The lack of information on MdCA in human fetuses inspired the authors to explore and present its morphological features.

METHODS

The arteries of the brain base were analyzed and measured on 193 specimens of human fetuses, whose values are preserved from the time of preparation of PhD thesis.

RESULTS

The median callosal artery was observed in 45% (87/193) of fetuses from 12.5 to 25 weeks of gestation. The MdCA originating from the single ACoA was found in 4.66% cases. MdCAs originating from the so-called anterior communicating rete (16.58%), as well from the partially duplicated (5.69%) and total duplicated ACoA (10.88%) were also found. A statistically significant difference of the artery OD between male and female fetuses was not found. There was a non-significant positive correlation between fetal age presented in gestational weeks and the artery OD (r = 0.214). The OD of the MdCA did not correlate with the diameters of the anterior cerebral artery (ACA). An unusual convergent union of initial ACA medial vessels and partial duplication at MdCA beginning and its trunk fenestrations were shown, along with bilateral distribution of MdCA branches.

CONCLUSIONS

The wide range of variability of the median callosal artery in human fetuses, presented in this paper, contributes to anatomical knowledge on the anterior part of cerebral circulation.

Marital status and survival in cancer patients: A systematic review and meta-analysis

BACKGROUND

In recent years, authors have repeatedly reported on the significance of social support in cancer survival. Although overall the studies appear to be convincing, little is known about which types of social support promote better survival rates, and which subgroups of cancer patients are more susceptible to the benefits of it. The aim of this study was to identify, organize, and examine studies reporting on the significance of social support in cancer survival.

METHODS

The PubMed, CINAHL and EBSCO databases were searched using the keywords social support/marital status, cancer, and survival/mortality. Where possible we used a meta-analytical approach, specifically a random effect model, in order to combine the results of the hazard ratios in studies from which this information could be obtained. When interpreting clinical relevance, we used the number needed to treat (NNT).

RESULTS

Better survival was observed in married patients when compared to unmarried (single, never-married, divorced/separated, and widowed) in overall and cancer-specific survival. Gender group differences showed that the association was statistically significant only in cancer-specific survival when comparing divorced/separated male and female cancer patients (p < 0.001), thus confirming results from the previous meta-analysis.

CONCLUSIONS

Being unmarried is associated with significantly worse overall and cancer-specific survival. The most vulnerable group found in our study were divorced/separated men. The results of this review can motivate physicians, oncologists, and other healthcare professionals to be aware of the importance of patients' social support, especially in the identified sub-group.

Evaluation of fluoride varnish treatment of postorthodontic white spot lesions by visual inspection and laser fluorescence-A randomized controlled study

OBJECTIVES

White spot lesions (WSLs), as a side effect of orthodontic therapy, can be treated with fluoride varnish, with the difference in efficiency reported.

MATERIAL AND METHODS

Patients with buccal WSLs were consecutively included in a randomized controlled double-blind study. At first inspection and at three follow-ups over 6 months, 0.1% fluoride varnish and placebo (water) were applied in the test group (N = 21) and control group (N = 21), respectively. The maximum laser fluorescence value (LFV) of WSLs was recorded using DIAGNOdent. Between the groups, differences in the mean numbers of WSLs and the mean LFV of WSLs per patient at different time points were analyzed with mixed-design analysis of variance. Orthodontic therapy duration (OTD) was included in the model as a covariate.

RESULTS

A decrease in the mean WSLs number and LFV was observed; however, there were no significant differences between study groups at any time point. OTD was in interaction only with LFV. Analysis showed a different pattern of mean LFV changes for patients with OTD of >48 months compared to patients with OTD of ≤24.

CONCLUSION

The changes in numbers of WSLs and LFV over the study period indicated regression of WSLs, but an additional effect of FV was not confirmed.

Frequently applied ketamine, medetomidine and thiopental anaesthesia induces high mortality in Wistar rats

OBJECTIVE

Fatal reactions to the combination of ketamine-medetomidine and thiopental in Wistar rats are described in two different models of orthodontic tooth movement.

MATERIALS AND METHODS

Thirty male rats were divided into two groups that required repeated anaesthesia during a 42-day study period, once a week or more frequently depending on the experimental group. The combination of ketamine [50 mg/kg body weight (b.w.)] and medetomidine (67 µg/kg b.w.) was administered intraperitoneally. Thiopental (8.3 mg/kg b.w.) was administered intraperitoneally 5 minutes later, barring any observable adverse reactions to the anaesthesia.

RESULTS

Twelve animals died, though none during the first two procedures. Three animals died shortly after the administration of a ketamine-medetomidine combination, and the remainder died 10-25 minutes later. Only four of the affected animals received thiopental before their death on a particular day. As ten rats died in the more frequently anaesthetized group, repeated anaesthesia was suspected to be the cause of the increased mortality.

CONCLUSIONS

Obstruction of the respiratory airways by saliva with subsequent suffocation may have been one of the causes of death, as it appeared in all the affected animals. Although the combination of ketamine and an alpha-2 adrenergic agonist is generally considered to be safe in rats, we propose that studies utilizing protocols requiring repeated anaesthesia adhere to a minimum safety period of 8.5 days between anaesthesia events. Alternative anaesthetic protocols should be employed if adherence to this is not possible due to the nature of the study.

Periodontal ligament regulatory role in experimental diabetic rat model of periodontium remodelling

BACKGROUND

Diabetes, among multiple systemic harmful health issues, also may deteriorate normal regenerative and reparative functions of periodontium. The aim of this research was to study the role of periodontal ligament in tissue remodelling under the orthodontic appliance stimulation in two rat experimental models (healthy Wistar rats and Goto-Kakizaki, rodent model of non-obese type 2 diabetes).

MATERIALS AND METHODS

Four groups of rats were defined: Wistar (WI; n = 8) and Goto-Kakizaki (GK; n = 8) control groups without orthodontic appliances, and Wistar (n = 16) and Goto-Kakizaki (n = 16) appliance groups with orthodontic appliances. After 42 days, rats were sacrificed and histopathology descriptive analysis about periodontal ligament and adjacent structures was performed as well as cellularity of periodontal ligament and Kappa curvature of tooth roots were measured.

RESULTS

Goto-Kakizaki control rats showed statistically significantly higher cellularity in comparison with Wistar control rats (p < 0.001). Both applied groups (WI 44.63 ± 6.68; GK 79.58 ± 10.06) also showed statistically significantly higher cellularity (p < 0.001) in comparison with control groups (WI 34.48 ± 6.92; GK 45.31 ± 11.18). Applied groups (WI 0.197 ± 0.2; GK 0.126 ± 0.083) had statistically significant higher values of Kappa curvature in comparison with control groups (WI 0.023 ± 0.011; GK 0.037 ± 0.011) (WI appliance vs. WI control: p < 0.001; GK appliance vs. GK control: p < 0.05). Agitated periodontal ligament caused different degrees of cementoclasia and additionally dentinoclasia, altering the natural root curvature.

CONCLUSIONS

Although not significantly different (WI and GK appliance groups) according to degree of molar roots odontoclasia, higher cellularity of agitated GK periodontal ligament could be influencing factor for, as previously reported, elevated osteoclast mobilization and possible prolonged periodontium reconstitution.

Double unilateral fenestration of the anterior cerebral artery in the pre-communicating segment: a report of a unique case

A unique example of two fenestrations of the pre-communicating (A1) segment of the right anterior cerebral artery (ACA) in a 78-year-old woman was a special case among 388 cadaveric specimens. It was found by a retrospective review of the personal data obtained during graduate and undergraduate studies at the Faculty of Medicine. Two unequal fenestrations of the right A1 segment were associated with the presence of a pseudo anterior communicating artery, hypoplasia of the right posterior communicating artery and the left superior cerebellar artery, absence of the right anterior inferior cerebellar artery, and ectasia of the basilar artery; however, the cerebral arteries were without aneurysm(s) or other pathology. The reason could be the almost equal ACA diameter on both sides.

Anterior Esthetic Rehabilitation of an Alveolar Cleft Using Novel Minimally Invasive Prosthodontic Techniques: A Case Report

Missing lateral incisors are the most frequent dental disorder associated with cleft alveolus. When orthodontic closure of the edentulous space is not possible, more aggressive prosthodontic treatments are required. Contemporary resin-bonded fixed dental prostheses (RBFDPs) represent a promising, time-efficient alternative treatment with fewer biological complications. This clinical report proposes a modified approach to the esthetic rehabilitation of a patient with a complete unilateral cleft lip and palate on the left side and an incomplete cleft lip and alveolar cleft on the right side. Digital diagnostics, treatment planning, and clinical procedures involved in the fabrication of facially bonded RBFDPs are presented. This modified technique enables the concurrent replacement of lateral incisors and correction of the malformed central incisors as well as increasing the retention of the restorations.

Bone remodeling during orthodontic tooth movement in rats with type 2 diabetes

INTRODUCTION

Type 2 diabetes is known to affect bone metabolism. In this study, we aimed to determine the effects of type 2 diabetes on bone remodeling during orthodontic tooth movement.

METHODS

The 48 rats were divided into 4 groups: Wistar control group (n = 8), Goto-Kakizaki (GK) control group (n = 8), Wistar appliance group (n = 16), and GK appliance group (n = 16). The distances between the teeth were measured weekly. On day 42, maxillary alveolar bone specimens were obtained for histologic evaluation and determination of the gene expression levels of the receptor activator of nuclear factor ҡB (RANK), RANK ligand (RANKL), and osteoprotegerin (OPG).

RESULTS

No significant difference was observed in the levels of tooth movement between the 2 appliance groups. After orthodontic force application, the alveolar bone volume and osteoblast surface in the GK rats were diminished compared with those in the Wistar rats. The increase in the osteoclast surface relative to the control groups was 2.4-fold greater in the GK rats than in the Wistar rats. Significant upregulations of the RANK and OPG gene expression levels in the Wistar appliance group were observed. The RANKL/OPG ratio was increased in the GK appliance group compared with the Wistar appliance group.

CONCLUSIONS

Diminished bone formation and slightly increased bone resorption were observed during orthodontic tooth movement in the rats with type 2 diabetes.

Palate Dimensions in Six-Year-Old Children with Unilateral Cleft Lip and Palate: A Six-Center Study on Dental Casts

Objective

To compare palatal dimensions in 6-year-old children with unilateral cleft lip and palate (UCLP) treated by different protocols with those of noncleft children.

Design

Retrospective intercenter outcome study.

Patients

Upper dental casts from 129 children with repaired UCLP and 30 controls were analyzed by the trigonometric method.

Setting

Six European cleft centers.

Main outcome measures

Sagittal, transverse, and vertical dimensions of the palate were observed.

Statistics

Palate variables were analyzed with descriptive methods and nonparametric tests. Regarding several various characteristics measured on a relatively small number of subjects, hierarchical, k-means clustering, and principal component analyses were used.

Results

Mean values of the observed dimensions for five cleft groups differed significantly from the control (p < .05). The group with one-stage closure of the cleft differed significantly from all other cleft groups in most variables (p < .05). Principal component analysis of all 159 cases identified three clusters with specific morphologic characteristics of the palate. A similar number of treated children were classified into each cluster, while all children without clefts were classified in the same cluster. The percentage of treated children from a particular group that fit this cluster ranged from 0% to 70% and increased with age at palatal closure and number of primary surgical procedures.

Conclusion

At 6 years of age, children with stepwise repair and hard palate closure after the age of two more frequently result in palatal dimensions of noncleft control than children with earlier palatal closure and one-stage cleft repair.

Evaluation of NiTi Superelastic Retraction Coil Springs for orthodontic tooth movement in rats

The purpose of this investigation was to assess mechanical properties of Superelastic Retraction Coil Springs for orthodontic use. To reach a goal, a test frame, comprising measuring force transducers was developed. To perform metallographic analyses of the nickel-titanium wire the samples of Superelastic Retraction Coil Springs were observed by scanning electron microscope. For in vivo testing, twenty male Wistar rats, 11-12 weeks of age, were used (Group I with Superelastic Retraction Coil Springs, Group II controls). To simulate human distraction as close as possible, all the applied Superelastic Retraction Coil Springs were modified. The Superelastic Retraction Coil Springs creating a constant force of 25 cN were then attached between the upper left first molars and upper left incisors. Results showed that the reproducible force of 25 cN was shown over a range of 1-11 mm extension. Results also showed that the distance between aforementioned teeth, measured on days 0, 7, 14, 21, 24, 32, 37 and 40, decreased in Group I. Contrary, in Group II the distance between the teeth increased during the study (p<0.001).

Sagittal maxillary growth in children with unilateral cleft of the lip, alveolus and palate at the age of 10 years: an intercentre comparison

OBJECTIVE

Aim of this intercentre study was to compare sagittal facial growth in children with unilateral cleft lip and palate treated with different surgical protocols. A first evaluation had been carried out at the age of 6 years, now the patients have been re-evaluated at the age of 10 years.

MATERIAL AND METHOD

22 patients had been analyzed in centre 1, 32 patients in centre 2. All patients had presurgical orthopaedics. Centre 1 had lip repair at the age of 3 months and one-stage palatal closure with 1 year. Centre 2 had lip repair with 6 months, soft palate repair at 12 and hard palate repair at the age of 30 months. Sagittal growth was evaluated on lateral cephalograms. As control, data of 35 non-cleft children were used. Statistical analysis was carried out with student's t-test, multiple comparisons with Bonferroni.

RESULTS

There was considerably normal sagittal facial growth in centre 1, with tendency of forward growth of the mandible. In centre 2 there was a slight decrease in sagittal maxillary and mandibular growth with unchanged intergnathic relation. There was no statistically significant difference in sagittal growth between the centres. A re-evaluation has to be carried out after the final growth spurt.