Surgical Orthodontic Treatment of an Impacted Canine in the Presence of Dens Invaginatus and Follicular Cyst

Introduction. “Dens invaginatus” is a dental anomaly which originates from the invagination of the ameloblastic epithelium into the lingual surface of the dental crown during the odontogenesis. It can cause early pulpal necrosis, abscesses, retention or dislocation of contiguous elements, cysts, and internal resorptions. It normally affects the upper lateral incisors. In the following study the authors will discuss the etiology, the physiopathology, and the surgical-orthodontic management of a rare case of impacted canine associated with dens invaginatus and follicular cyst, with the aim of highlighting the importance of taking any therapeutic decision based on the data available in the literature. Case Report. The present study describes a combined surgical-orthodontic treatment of an impacted canine associated with a lateral incisor (2.2) suffering from type III dens invaginatus with radicular cyst, in a 15-year-old patient. Discussion. When treating a dens invaginatus there are different therapeutic solutions: they depend on the gravity of the anomaly and on the association with the retention of a permanent tooth. The aesthetic and functional restoration becomes extremely important when performing a surgical-orthodontic repositioning

Treatment of Gastrointestinal Sphincters Spasms with Botulinum Toxin A

Botulinum toxin A inhibits neuromuscular transmission. It has become a drug with many indications. The range of clinical applications has grown to encompass several neurological and non-neurological conditions. One of the most recent achievements in the field is the observation that botulinum toxin A provides benefit in diseases of the gastrointestinal tract. Although toxin blocks cholinergic nerve endings in the autonomic nervous system, it has also been shown that it does not block non-adrenergic non-cholinergic responses mediated by nitric oxide. This has promoted further interest in using botulinum toxin A as a treatment for overactive smooth muscles and sphincters. The introduction of this therapy has made the treatment of several clinical conditions easier, in the outpatient setting, at a lower cost and without permanent complications. This review presents current data on the use of botulinum toxin A in the treatment of pathological conditions of the gastrointestinal tract

Intravenous self-administration of benzydamine, a non-steroidal antiinflammatory drug with a central cannabinoidergic mechanism of action

Benzydamine (BZY) is a non-steroidal anti-inflammatory drug used for the topical treatment of inflammations of the oral and vaginal mucosae. Virtually nothing is known about the central pharmacological actions of BZY. Yet there are reports of voluntary systemic overdosage of BZY in drug addicts, resulting in a euphoric, hallucinatory state. In the present study, we investigated the reinforcing properties of BZY in a rat self-administration paradigm. We found that BZY has a powerful reinforcing effect and that this effect is greatly facilitated in animals that already had substance experience, having previously self-administered heroin and cocaine, indicating cross sensitization between BZY and other common drugs of abuse. We then assessed the effect of BZY on prelimbic cortex-to-nucleus accumbens glutamatergic transmission, using field recordings in rat parasagittal brain slices. BZY dose-dependently reduced both field excitatory post synaptic potential amplitude and paired pulse ratio, suggesting a presynaptic mechanism of action. Similarly to the in vivo paradigm, also the electrophysiological effects of BZY were potentiated in slices from animals that had undergone cocaine and heroin self-administration. Furthermore, BZY-induced Long Term Depression (LTD)-like responses in the prelimbic cortex-to-nucleus accumbens circuitry were significantly reduced in the presence of the CB1 receptor antagonist AM251. These findings provide firm evidence of the abuse liability of BZY and suggest a possible cannabinoidergic mechanism of action. Further research is needed in order to give insights into the molecular mechanism underlying BZY psychoactive and reinforcing effects, to better understand its abuse potential

Anabolic Hormone Deficiencies in Heart Failure with Reduced or Preserved Ejection Fraction and Correlation with Plasma Total Antioxidant Capacity

While anabolic hormone deficit is a common finding in heart failure with reduced ejection fraction (HFrEF), few data are available in heart failure with preserved ejection fraction (HFpEF). Methods. Blood samples were collected for metabolic (total cholesterol, HDL cholesterol, LDL cholesterol, creatinine, and glucose) and hormonal (IGF-1, DHEA-S, TSH, fT3, fT4, and T) determination, comparing 30 patients with HFpEF and 20 patients with HFrEF. Total antioxidant capacity was evaluated by using the spectrophotometric method using the latency time in the appearance of the radical species of a chromogen (LAG, sec) as a parameter proportional to antioxidant content of the sample. Echocardiographic parameters were also assessed in the two groups. Results. A high prevalence of testosterone (32% in HFrEF and 72% in HFpEF, ) and DHEA-S deficiencies was observed in HFpEF patients. Echocardiographic parameters did not correlate with hormone values. A significant direct correlation between T (r2\u2009=\u20090.25, ) and DHEA-S (r2\u2009=\u20090.19, ) with LAG was observed only in HFpEF. Conclusion. Anabolic hormone deficiency is clearly shown in HFpEF, as already known in HFrEF. Although longitudinal studies are required to confirm the prognostic value of this observation, our data suggest different mechanisms in modulating antioxidants in the two conditions, with possible therapeutic implications

The effect of teriparatide treatment on circulating periostin and its relationship to regulators of bone formation and BMD in postmenopausal women with osteoporosis

Context: Treatment of postmenopausal osteoporosis with teriparatide (PTH 1-34) increases bone formation and improves bone microarchitecture. A possible modulator of this mechanism of action is periostin. In vitro experiments have shown that periostin may regulate osteoblast differentiation and bone formation through Wnt signaling. Periostin secretion is increased by PTH in preclinical models, but the effect of teriparatide treatment of postmenopausal osteoporosis on periostin is not currently known. Objectives, to: i) determine the effect of teriparatide treatment on circulating levels of periostin and other regulators of bone formation and ii) investigate how changes in periostin relate to changes in bone turnover markers, regulators of bone formation and bone mineral density. Participants and design: 20 women with postmenopausal osteoporosis, a two-year open-label single-arm study. Intervention: Teriparatide 20 mcg was administered by subcutaneous injection daily over 104 weeks. Periostin, sclerostin and DKK-1, PINP and CTX were measured in fasting serum collected at baseline (two visits) then at weeks 1,2,4,12,26,52,78 and 104. BMD was measured at the lumbar spine, total hip and femoral neck by DXA. Results: Periostin levels increased by 6.6% (95% CI -0.4, 13.5) after 26 weeks teriparatide treatment and significantly by 12.5% (95% CI 3.3,21.0, P<0.01) after 52 weeks. Change in periostin was positively correlated with change in lumbar spine BMD at week 52 (r=0.567(95% CI 0.137,0.817), P<0.05) and femoral neck BMD at week 104(r=0.682(95% CI 0.261,0.885), P<0.01). Conclusion: Teriparatide therapy increases periostin secretion; it is unclear whether this increase mediates the effect of the drug on bone

Early diagnostic evaluation of mandibular symmetry using orthopantomogram

AIMS: The aim of this research was to complete Habets's method on orthopantomogram, in order to measure mandibular symmetry horizontally and diagonally in mixed dentition as the first diagnostic evaluation.SETTINGS AND DESIGN: Mixed dentition subjects were consecutively selected according to skeletal maturity.MATERIALS AND METHODS: Inclusion criteria were: Mixed dentition, cervical vertebral stages 1-2, Class II or Class III malocclusions, with or without unilateral posterior cross-bite. Fourteen subjects with cross-bite (mean age 8 y, 9 m) cross group (CG) and 14 subjects with normal transverse occlusion (mean age 8 y, 6m) non-cross group (NCG) were selected. Nine measurements were determined. An asymmetry index was performed for all linear variables.STATISTICAL ANALYSIS USED: NCG patients' data were compared with CG data using parametric t-tests. Probabilities of <0.05 were accepted as significant.RESULTS: In CG, comparing right and left side, single values showed no significant differences up to 6% (twice if compared to the 3% threshold value). T-tests showed statistically significant differences between the groups for ramus + condyle height (index 2.5% vs 4.5%, P = 0.04), condylar height (index 3.7% vs 6.6%, P = 0.02) and mandibular length (index 1.4% vs 2.3%, P = 0.04). Overall CG group was more asymmetrical than NCG.CONCLUSIONS: In mixed dentition (CS1-2), a first appraisal of mandibular symmetry may be performed on orthopantomogram utilizing this modified Habets's method. This tracing method provides an early evaluation about mandibular symmetry and is able to show slight asymmetries in mixed dentition thereby reducing the number of cone beam computed tomograms performed

Maxillary dento-skeletal outcomes after orthopedic forward (class III) and backward (class II) traction in growing subjects

BACKGROUND: This retrospective study investigated the treatment effects produced by two orthopedic appliances, an extraoral orthopedic traction on Stephenson plate (SP) in skeletal Class II malocclusion and Delaire Facial Mask (FM) in skeletal Class III malocclusion.METHODS: FM Group comprised 25 patients (13 males; 12 females, mean age 9.3 years, CS 1-2) undergoing Delaire Facial Mask therapy (mean treatment duration 1.5 years \ub1 1.2, 700-800 gr per side). SP Group comprised 24 patients (9 males; 15 females, mean age 10.5 years \ub1 1.9, CS 1-3) treated with extraoral orthopedic traction on Stephenson plate (mean treatment duration 1.6 years \ub1 0.8, 700-900 gr per side). For all subjects lateral cephalograms before (T0) and after (T1) therapy were obtained and traced. Descriptive statistics, Shapiro-Wilks and T test were calculated for each variable.RESULTS: A mesial movement of the maxillary bone of 2.4 mm in the FM group and a distal movement in the PS group (0.4 mm) was found. SNA\ub0 was reduced 1.4\ub0 after SP and increased 0.7\ub0 after FM. The overjet decreased by 4 mm after SP, while it grew after FM by 2.4 mm, as well as molars relationships (4.5 vs 0.8 mm).CONCLUSIONS: Facemask induced greater skeletal movements than extraoral traction on Stephenson plate. PS produced a limited downward movement of the whole maxilla together with notable incisors and molars back corrections. Based on our results, it could be speculated that orthopedic mesial traction of maxillary bone may result easier than the distal movement