MANEJO ORTOPÉDICO DE PACIENTE CLASE III DENTOESQUELÉTICA, PRESENTACIÓN DE CASO CLÍNICO

La maduración es un proceso gradual en el tiempo y el grado de maduración es el estado en que se encuentra individualmente un organismo en un momento específico. Durante la pubertad ocurren cambios físicos predeterminados genéticamente, pero modulados por la acción ambiental.La intervención temprana de maloclusiones ayuda a restablecer la excitación neural adecuada en el complejo craneofacial y proveer las condiciones necesarias para que cada paciente exprese su potencial de crecimient

Improved in vitro angiogenic behavior on anodized titanium dioxide nanotubes

[Background] Neovascularization over dental implants is an imperative requisite to achieve successful osseointegration onto implanted materials. The aim of this study was to investigate the effects on in vitro angiogenesis of anodized 70 nm diameter TiO2 nanotubes (NTs) on Ti6Al4V alloy synthesized and disinfected by means of a novel, facile, antibacterial and cost-effective method using super oxidized water (SOW). We also evaluated the role of the surface roughness and chemical composition of materials of materials on angiogenesis.[Methods] The Ti6Al4V alloy and a commercially pure Ti were anodized using a solution constituted by SOW and fluoride as electrolyte. An acid-etched Ti6Al4V was evaluated to compare the effect of micro-surface roughness. Mirror-polished materials were used as control. Morphology, roughness, chemistry and wettability were assessed by field emission scanning electron microscopy (FE-SEM), transmission electron microscopy, atomic force microscopy, energy dispersive X-ray spectroscopy (EDX) and using a professional digital camera. Bovine coronary artery endothelial cells (BCAECs) were seeded over the experimental surfaces for several incubation times. Cellular adhesion, proliferation and monolayer formation were evaluated by means of SEM. BCAEC viability, actin stress fibers and vinculin cellular organization, as well as the angiogenic receptors vascular endothelial growth factor 2 (VEGFR2) and endothelial nitric oxide synthase (eNOS) were measured using fluorescence microscopy.[Results] The anodization process significantly increased the roughness, wettability and thickness of the oxidized coating. EDX analysis demonstrated an increased oxygen (O) and decreased carbon (C) content on the NTs of both materials. Endothelial behavior was solidly supported and improved by the NTs (without significant differences between Ti and alloy), showing that endothelial viability, adhesion, proliferation, actin arrangement with vinculin expression and monolayer development were evidently stimulated on the nanostructured surface, also leading to increased activation of VEGFR2 and eNOS on Ti6Al4V-NTs compared to the control Ti6Al4V alloy. Although the rougher alloy promoted BCAECs viability and proliferation, filopodia formation was poor.[Conclusion] The in vitro results suggest that 70 nm diameter NTs manufactured by anodization and cleaned using SOW promotes in vitro endothelial activity, which may improve in vivo angiogenesis supporting a faster clinical osseointegration process.The authors wish to thank to the Program Number UABC-PTC-469 from PRODEP and Program Number 2058 of UABC for financial support. They are also grateful to CONACYT, Mexico, for scholarship 348737-114359.Peer reviewe

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

Atherosclerotic-Derived Endothelial Cell Response Conducted by Titanium Oxide Nanotubes

Atherosclerosis lesions are described as the formation of an occlusive wall-vessel plaque that can exacerbate infarctions, strokes, and even death. Furthermore, atherosclerosis damages the endothelium integrity, avoiding proper regeneration after stent implantation. Therefore, we investigate the beneficial effects of TiO2 nanotubes (NTs) in promoting the initial response of detrimental human atherosclerotic-derived endothelial cells (AThEC). We synthesized and characterized NTs on Ti6Al4V by anodization. We isolated AThEC and tested the adhesion long-lasting proliferation activity, and the modulation of focal adhesions conducted on the materials. Moreover, ultrastructural cell-surface contact at the nanoscale and membrane roughness were evaluated to explain the results. Our findings depicted improved filopodia and focal adhesions stimulated by the NTs. Similarly, the NTs harbored long-lasting proliferative metabolism after 5 days, explained by overcoming cell-contact interactions at the nanoscale. Furthermore, the senescent activity detected in the AThEC could be mitigated by the modified membrane roughness and cellular stretch orchestrated by the NTs. Importantly, the NTs stimulate the initial endothelial anchorage and metabolic recovery required to regenerate the endothelial monolayer. Despite the dysfunctional status of the AThEC, our study brings new evidence for the potential application of nano-configured biomaterials for innovation in stent technologies

Influence of electrical parameters on morphology of nanostructured TiO 2

Ti6Al4V alloy micro rough surfaces with TiO2 self-organized nanostructured layers were synthesized using electrochemical anodization in phosphate/fluoride electrolyte, at different end potentials (5V, 10V, 15V, and 20 V). The current – time characteristics were recorded, and the link between current evolution and the morphology of developing oxide layers was investigated. On flat surfaces of Ti6Al4V alloy we developed TiO2 layers with different morphologies (random pores, nanopores of 25…50 nm, and highly organized nanotubes of 50…100 nm in diameter) depending on electrical parameters of anodization process. In our anodization cell, in optimized conditions, we are able to superimpose nanostructured oxide layers (nanotubular or nanoporous) over micro structured surfaces of titanium based materials used for biomedical implants

Improvement of the antibacterial and skin-protective performance of alcohol-based sanitizers using hydroglycolic phytocompounds

AbstractThe Coronavirus disease 2019 (COVID-19) outbreak increased the usage of hand rub disinfectants, resulting in skin damage. The World Health Organization (WHO) proposed hand rubs formulations incorporating glycerine due to its moisturizing effect; nonetheless, glycerine can reduce the antimicrobial activity of alcohol-based hand rubs. Here we demonstrated that incorporating hydroglycolic extract as a substitute for glycerol in hand rub formulations reduces epidermis damage while improving antimicrobial effectiveness. We applied the hydroglycolic extracts from Cucumis sativus L., Fragaria sp. and Calendula officinalis instead of glycerol to modify the formula proposed by the WHO. The antimicrobial activity and the healing skin action were evaluated using the agar diffusion test and a human skin tolerability trial. Furthermore, we assessed the cytotoxicity and wound repair capability of the formulated hydroglycolic extracts against human gingival fibroblasts (HGFs) and the phenotype of murine macrophages. The hand rubs containing Fragaria sp. and C. officinalis hydroglycolic extracts showed improved antimicrobial activity even after six months of fabrication. Moreover, the formulated hand rubs had similar cellular viability behaviour to glycerol. Interestingly, the tolerability and acceptability response were promoted by the C. sativus extract, showing skin protection and increased integrity by up to 14.12%. Our results represent an alternative, ecofriendly and cost-effective option for formulating new potential hand rubs that improve skin protection without compromising the disinfection functionality

Improved Osteoblast and Chondrocyte Adhesion and Viability by Surface-Modified Ti6Al4V Alloy with Anodized TiO2 Nanotubes Using a Super-Oxidative Solution

Titanium (Ti) and its alloys are amongst the most commonly-used biomaterials in orthopedic and dental applications. The Ti-aluminum-vanadium alloy (Ti6Al4V) is widely used as a biomaterial for these applications by virtue of its favorable properties, such as high tensile strength, good biocompatibility and excellent corrosion resistance. TiO2 nanotube (NTs) layers formed by anodization on Ti6Al4V alloy have been shown to improve osteoblast adhesion and function when compared to non-anodized material. In his study, NTs were grown on a Ti6Al4V alloy by anodic oxidation for 5 min using a super-oxidative aqueous solution, and their in vitro biocompatibility was investigated in pig periosteal osteoblasts and cartilage chondrocytes. Scanning electron microscopy (SEM), energy dispersion X-ray analysis (EDX) and atomic force microscopy (AFM) were used to characterize the materials. Cell morphology was analyzed by SEM and AFM. Cell viability was examined by fluorescence microscopy. Cell adhesion was evaluated by nuclei staining and cell number quantification by fluorescence microscopy. The average diameter of the NTs was 80 nm. The results demonstrate improved cell adhesion and viability at Day 1 and Day 3 of cell growth on the nanostructured material as compared to the non-anodized alloy. In conclusion, this study evidences the suitability of NTs grown on Ti6Al4V alloy using a super-oxidative water and a short anodization process to enhance the adhesion and viability of osteoblasts and chondrocytes. The results warrant further investigation for its use as medical implant materials