Intrusione selettiva di un molare mediante un sistema costituito da un doppio cantilever

Scopo del lavoro. Gli autori descrivono la tecnica adottata per l\u2019intrusione selettiva di un singolo molare dell\u2019arcata superiore in un paziente adulto. Materiale e metodi. Vengono presentate le caratteristiche tecniche e biomeccaniche del sistema utilizzato costituito da due cantilever: ognuno di loro fornisce una forza intrusiva ai lati del dente; la risultante di queste due forze equivale a una forza intrusiva applicata al centro di resistenza del dente. Il cantilever vestibolare \ue8 modellato in beta titanio (TMA), una lega che presenta una curva carico/deflessione molto favorevole e restituisce una forza costante e leggera per ampie deformazioni del filo. Quello palatale \ue8 costituito da una barra palatale preformata, inserita nel lingual sheath da un solo lato e modellata con un occhiello sul lato opposto: viene attivato legando il dente da intrudere all\u2019occhiello della barra. Conclusioni. I pazienti adulti sono spesso parzialmente edentuli: questo comporta da un lato la necessit\ue0 di reintrudere elementi dentari sovraerotti per mancanza dell\u2019antagonista, dall\u2019altro problemi nel reperire il necessario ancoraggio. E\u2019 opinione degli autori che il metodo descritto posa essere considerato un valido strumento per ottenere l\u2019intrusione di un elemento singolo in modo predicibile e alquanto semplice.Aim of the study. The Authors describe a technique for selective intrusion of a singular upper molar in an adult patient. Materials and methods. The technical and biomechanical characteristics of the system are presented: two cantilevers exert an intrusive force tooth sides and their resultant in equal to an intrusive force applied on the tooth center od resistance. The vestibular cantilever in made of beta.titanium (TMA), an alloy presenting a good load/deflection curve and it returns a constant and light force wide wire deformations. The palatal cantilever is made of a preformed transpalatal arch fitted in the lingual sheath on one side and shaped with an eyelet on the other side: it\u2019s activated by typing up the tooth to be intruded to the transpalatal arch eyelet. Conclusions. Adult patients are often partially edentulous: this involves, on the one hand intrusion of over erupted teeth for antagonist lack, on the other problems to find the anchorage required. The method describe has proven to permit the intrusion of a single tooth in a predictable and simple way

Reduction of pulmonary pressure values after PGE1 infusion in sclerodermic patients with pulmonary involvment

Pulmonary involvement is a common finding in progressive systemic sclerosis, a generalized autoimmune disorder with an abnormal interstitial collagen accumulation and deterioration of small arteries and capillary vessels. In SS her's an evidence of abnormal vascular tone regulation that is evident in the lung as an increase of arterial pulmonary pressure. Aim of this study was to assess acute effect of PGE1 administration on pulmonary vascular bed-flows affected by sclerodermic alterations evaluating the response of pulmonary arterial pressure and exhaled NO to prostaglandin administration. We studied 10 female normotensive patients (age 60\ub12 yr.) with systemic sclerosis and pulmonary involvement (P) documented with high resolution CT with no evidence or clinical history of cardiovascular or chronic pulmonary disease The data obtained were compared with 10 sclerodermic patients (age 58\ub18 yr.) without pulmonary involvement (NP). All the patients underwent infusion of PGE1 (Alprostadil,60 mcg, 5 days a week for 4 weeks). An echocardiographic evaluation was performed at baseline (B), acutely post-treatment (A) and after 4 weeks stopping therapy (S) to evaluate Right Ventricular Systolic Pressure (RVSP). We also measured left and right ventricle telediastolic and systolic diameters and left ventricular mass were calculated. We also measured transmitralic flows to evaluate diastolic function and the left ventricular ejection fraction (EF%). At the same times we measured exhaled NO concentrations (ppb) with a chemi-luminescence NO gas analyzer device. (\ub7p<0.05 A1 vs B1; 1ep<0.05 S1 vs A1; \ub0p<0.05 B2 vs B1 See the table at the bottom). Our data showed that P patients had increased RVSP values and lower NO concentrations in exhaled air compared to NP. PGE1 infusion is accompanied in these patients by a significant decrease in RVSP values and by a concomitant increase in exhaled NO concentration which both return to B conditions in follow up evaluations. A similar acute increasing trend in NO concentrations with RVSP decrease was observed in NP although it did not reached statistical significance. In conclusion PGE1 infusion may have a favorable effect on pulmunary vassels flows due to an increased of NO sensitivity and production