'Study of the maxillary yaw on cone beam computed tomography: A preliminary report and comparison between two different dento-skeletal malocclusions'.

OBJECTIVES: To assess the skeletal and dental maxillary transverse compensation (yaw) on the cone beam computed tomography (CBCT) three-dimensional reconstructed image of the skull in two groups of patients, both clinically affected by a class III malocclusion with deviation of the lower midline. MATERIALS AND METHODS: An observational retrospective study was designed to analyse differences in two groups of patients, the first one was composed by patients affected by horizontal condylar hyperplasia, the second one by patients affected by dento-skeletal asymmetric class III malocclusion. Each group was composed by 15 patients. Transverse analysis was performed by measuring five landmarks (three bilateral and two uneven) with respect to a mid-sagittal plane; sagittal analysis was performed by measuring the sagittal distance on the mid-sagittal plane between bilateral points. Means were compared through inferential analysis. RESULTS: In the condylar hyperplasia group, all differences between the two sides were not statistically significant, nor for canines' difference (P = .0817), for molars (P = .1105) or for jugular points (.05871). In the class III group, the differences between the two sides were statistically significant for molars (P = .0019) and jugular points (P = .0031) but not for canines (P = .1158). Comparing the two groups, significant differences were found only for incisors' midline deviation (P = .0343) and canine (P = .0177). CONCLUSION: The study of the yaw on CBCT should be integrated into three-dimensional cephalometry and could help in differentiating the various malocclusion patterns.

Prevalence of craniomandibular disorders in orthodontic pediatric population and possible interactions with anxiety and stress.

AIM: To analyse the presence and prevalence of gnathologic problems in a sample of children, candidate for orthodontic treatment, and evaluate the relationship between psychological factors and gnathological problems. The purpose of this study was also to evaluate a simple protocol with specific psychological test and a questionnaire for the rapid diagnosis of gnathologic problems, useful for possible screening studies on a wider population. MATERIALS AND METHODS: Study Design: Observational, cross-sectional study. Among the patients coming for a first orthodontic evaluation 106 children, aged between 8 and 16 years, were examined. A complete orthodontic evaluation was performed in all patients; the RCMAS (Revised Children's Manifest Anxiety Scale) was used in the study to test the psychological condition, while the selected test for the diagnosis of gnathologic problems was the Fonseca Test. The prevalence of temporomandibular disorders (TMD) was evaluated with descriptive statistical analysis, and the eventually present correlation with a positive psycological test for anxiety has been evaluated with correlation parameters: c2 test of Pearson, and Cramer's V index. RESULTS: The mean age of the children was 10.74 years. Females accounted for 55.66% of the total compared to 44.34% males. Signs and symptoms of TMD were present on average in 82% and 32% respectively. A remarkable amount of children also showed signs of psychological problems, mostly represented by anxiety. Positive correlation resulted between TMD (Fonseca scores) and increased overbite. Cross-correlations have been obtained, tested with Pearson c2 test and Cramer's V index, between level of anxiety, muscle pain on palpation, bad habits, and headache. The Class II subdivision molar class and altered canine relationship have been related to the presence of articular noise. CONCLUSION: The protocol largely respected the need for speed of administration, comprehensiveness and reliability that we set out to achieve. Limited correlations have been assessed between occlusal conditions and positivity to the administrated tests. Further studies are desirable to increase the sample population.

Are intraoral radiographs reliable in determining peri-implant marginal bone level changes? The correlation between open surgical measurements and peri-apical radiographs.

This study was performed to evaluate the reliability of peri-apical radiographs in determining peri-implant marginal bone level changes. The STROBE guidelines were followed. Marginal bone levels were measured at the time of implant insertion using a straight periodontal probe and using peri-apical radiographs. These intraoperative and radiographic measurements were repeated at the time of second surgery. All radiographs were analysed by two examiners blinded to the intraoperative measurements. To standardize the radiographic images, the long-cone parallel technique and a film-holding system were used. Intra-observer agreement and inter-observer variability were assessed using the intra-class correlation coefficient (ICC). Descriptive statistics, the t-test, and the Pearson correlation coefficient were also used. A total of 268 implants were inserted in 142 patients. Inter-observer agreement was 0.950; intra-observer variability was 0.980 and 0.973. The mean difference between the radiographic and intraoperative measurements was 0.50±1.55mm (range 0-8mm); the difference was statistically significant (P=0.000). A significant linear correlation was found between the marginal bone level changes evaluated intraoperatively and radiographically (P<0.005). Radiographic analysis significantly overestimated the level of peri-implant marginal bone compared to intraoperative measurements, but peri-apical radiographs are reliable in determining the bone level changes at different follow-ups.

Palatal orthodontic miniscrew insertion using a CAD-CAM surgical guide: description of a technique.

The aim of this report was to describe a new computer-guided technique for a controlled site preparation and palatal orthodontic miniscrew insertion using a dedicated software. A surgical guide was designed after planning the appropriate insertion sites on three-dimensional images created by the fusion of cone-beam computed tomography (CBCT) and digital dental model images. Pre- and postoperative CBCT images were compared and the angular, coronal, and apical deviations between the planned and the placed miniscrews were calculated. The mean coronal and apical deviations were 1.38mm (range: 3.48-0.15mm; standard deviation (SD): 0.65) and 1.73mm (range: 5.41-0.10mm; SD: 1.03), respectively, while the mean angular deviation was 4.60° (range: 15.23-0.54°; SD: 2.54). The present surgical guide allows a controlled and accurate palatal miniscrew placement in three dimensions.

The Influence of a New Clinical Motion for Endodontic Instruments on the Incidence of Postoperative Pain.

OBJECTIVES: Previous studies showed that motor motions play an important role in determining apical extrusion of debris. Therefore a new clinical motion (MIMERACI) has been proposed. The basic idea is to progress slowly (1mm advancement), and after each 1mm, to remove the instrument from the canal, clean flutes and irrigate. The aim of the study was to prove whether the clinical use of MIMERACI technique would influence or not postoperative pain. MATERIALS AND METHODS: 100 teeth requesting endodontic treatment were selected for the study and divided into two similar groups based on anatomy, pre-operative symptoms and vitality, presence or absence of periapical lesion. All teeth were shaped, cleaned and obturated by the same operator, using the same NiTi instruments. The only difference between the two groups was the instrumentation technique: tradional (group A) vs MIMERACI (group B). Assessment of postoperative pain was performed 3 days after treatment. Presence, absence and degree of pain were recorded with a visual analogue scale (VAS), validated in previous studies. Collected data statistically analyzed using one-way ANOVA post hoc Tukey test. RESULTS: For VAS pain scores MIMERACI technique showed significantly better results than group A (p=0,031). Overall, both incidence and intensity of symptoms were significantly lower. Flare ups occurred in 3 patients, but none treated with the MIMERACI Technique. CONCLUSIONS: Since extruded debris can elicit more postoperative pain, results obtained by using MIMERACI technique are probably due to many factors: better mechanical removal and less production of debris and more efficient irrigation during instrumentation.

MicroRNA signatures predict dysregulated vitamin D receptor and calcium pathways status in limb girdle muscle dystrophies (LGMD) 2A/2B.

miRNA expression profile and predicted pathways involved in selected limb-girdle muscular dystrophy (LGMD)2A/2B patients were investigated. A total of 187 miRNAs were dysregulated in all patients, with six miRNAs showing opposite regulation in LGMD2A versus LGMD2B patients. Silico analysis evidence: (1) a cluster of the dysregulated miRNAs resulted primarily involved in inflammation and calcium metabolism, and (2) two genes predicted as controlled by calcium-assigned miRNAs (Vitamin D Receptor gene and Guanine Nucleotide Binding protein beta polypeptide 1gene) showed an evident upregulation in LGMD2B patients, in accordance with miRNA levels. Our data support alterations in calcium pathway status in LGMD 2A/B, suggesting myofibre calcium imbalance as a potential therapeutic target. Copyright © 2016 John Wiley & Sons, Ltd.

Expression of transglutaminase 2 does not differentiate focal myositis from generalized inflammatory myopathies.

OBJECTIVES: Idiopathic inflammatory myopathies (IIM), including dermatomyositis (DM), polymyositis (PM), sporadic inclusion-body myositis (s-IBM) and focal myositis (FM) are a heterogeneous group of autoimmune disorders of skeletal muscle. An increased transglutaminase 2 (TG2) expression has been found in DM, PM and s-IBM. The aim of our study was to investigate TG2 expression in FM in comparison with other IIM. MATERIALS AND METHODS: We re-examined tissue material we have gathered in the course of our previous studies on IIM, investigating muscle expression of TG2 in patients with FM in comparison with DM, PM and s-IBM using immunocytochemistry and real-time RT-PCR. RESULTS: Immunocytochemistry revealed an increased TG2 signal in endomysial vessels, in atrophic and degenerating/regenerating muscle fibres in PM, DM, s-IBM and FM; in s-IBM, some vacuoles were immunostained too. Real-time RT-PCR study confirmed a significantly increased expression of TG2 in all IIM muscles examined. CONCLUSIONS: Our study demonstrates the presence of TG2 in FM muscles. The study suggests that TG2 expression does not represent a distinctive marker to differentiate FM from generalized IIM. TG2 over-expression in inflamed skeletal muscle does not seem have a pathogenetic role in such a disease, but it could represent a way to contain the inflammatory process.

RAGE-NF-kappaB pathway activation in response to oxidative stress in facioscapulohumeral muscular dystrophy.

OBJECTIVES: An increased expression of adenine nucleotide translocator (ANT1), found in facioscapulohumeral muscular dystrophy (FSHD), is known to lead to a decrease in nuclear factor-kappaB (NF-kappaB) DNA binding and to sensitize muscle cells to oxidative stress and apoptosis. Receptor for advanced glycation end products (RAGE) mediated by NF-kappaB activation is involved in proinflammatory pathomechanism and in muscle fiber regeneration in inflammatory myopathies and in limb girdle muscular dystrophy. Oxidative stress can stimulate RAGE- NF-kappaB pathway. Our purpose was to verify if oxidative stress may induce RAGE- NF-kappaB pathway activation in FSHD, contributing to the pathogenesis of such a disease. MATERIALS AND METHODS: On muscle samples of eight patients with FSHD, eight patients with Duchenne muscular dystrophy and eight normal controls the following studies were carried out: immunocytochemistry for activated NF-kappaB; electrophoretic mobility shift assay of NF-kappaB DNA binding activity; Western blot studies of RAGE and ANT1; hydrogen peroxide (HP), peroxidase and glutathione peroxidase (GPx) assays. RESULTS: An increased RAGE and ANT1 expression in FSHD with moderate increase of NF-kappaB DNA binding activity was found together with an increased production of HP and a reduced activity of peroxidase and GPx. CONCLUSIONS: Our data confirm that response to oxidative stress and ANT1 increased activity are early events in FSHD muscle. The study also reveals that the RAGE- NF-kappaB pathway, induced by oxidative stress, is activated independently of the presence of a clear histochemical evidence of muscle damage in FSHD.

Hemolytic crisis in a non-ketotic and euglycemic child with glucose-6-phosphate dehydrogenase deficiency and onset of type 1 diabetes mellitus.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymopathy and hemolytic anemia can be triggered by many drugs, by the ingestion of fava beans, and by metabolic imbalances. Nonetheless, only sporadic reports of hemolytic anemia due to G6PD deficiency in patients with type 1 diabetes mellitus (DM1) have been reported to date. We describe an 8 year-old Sicilian boy who suffered from hemolytic anemia some days after admission for DM1. On admission, acid-base equilibrium was normal but 4 days later he presented hemolytic anemia with G6PD deficiency, confirmed by personal and family history and laboratory evaluation. We suggest that the hemolytic crisis in this patient was triggered by the relative hypoglycemia that followed insulin administration. The interference of acidosis, infections, drugs, food or other triggering agents was excluded. This report demonstrates that hemolysis may represent a possible complication of DM treatment in patients with G6PD deficiency and we recommend careful clinical surveillance in these patients.

Clinical improvement and serum amino acid levels after mud-bath therapy.

Spa therapy is an ancient approach to degenerative diseases such as osteoarthritis, but until today this tradition has been predominantly empiric and intuitive and few studies have focused on the biological changes derived from this treatment. We assessed the clinical efficacy and variations in amino acid concentrations in serum samples from patients with knee osteoarthritis who underwent spa therapy and put forward an explanation of their role in clinical improvement. Thirty-one patients with knee osteoarthritis who underwent spa therapy underwent a clinical evaluation, and serum amino acid levels were assayed before and after a cycle of balneotherapy and mud-pack therapy. The thermal treatments were carried out in Sciacca. Analysis of the data showed a significant reduction in pain and improvement in joint motility. Serum concentrations of tryptophan, cysteine and citrulline were significantly higher than at baseline. No significant differences were observed in serum levels of the remaining free amino acids. The results of this study confirm the efficacy of spa therapy in the treatment of osteoarthritis. A possible role for changes in serum amino acid concentration is discussed.

Preliminary report: Amino acid profile in platelets of diabetic patients.

Platelet levels of 19 amino acids were measured in 20 outpatients with type 1 (age [mean +/- SE], 35.5 +/- 2.0 years) and 27 with type 2 (age, 58.4 +/- 1.4 years) diabetes, and 20 young (age 33.7 +/- 1.3 years) and 20 older (age 57.4 +/- 1.5 years) healthy volunteers. Platelet levels of most amino acids tended to be lower in patients with type 1 diabetes than in healthy controls. In particular, asparagine, glycine, taurine, alanine, valine, cysteine, leucine, phenylalanine, and lysine levels, expressed as nmol/10(8) platelets, were significantly lower. Only taurine significantly decreased in patients with type 2 diabetes, whereas threonine, alanine, and isoleucine increased.

Taurine and osmoregulation: platelet taurine content, uptake, and release in type 2 diabetic patients.

In this study, plasma and platelet taurine content and fluxes were determined in 38 type 2 diabetic patients and in 26 healthy control subjects. Taurine levels in diabetic patients were significantly lower than in control subjects both in plasma (32.1 v 48.6 micromol/L, P = .000) and platelets (148 v 183 nmol/mg protein, P = .043). Platelet taurine uptake in diabetic patients was significantly reduced (321.2 v 524.9 pmol total taurine 10(8) platelet(-1) min(-20), P = .000), whereas taurine release increased in comparison to healthy controls (38.7 v 29.5% of platelet 3H taurine at the start of incubation, P = .000). These results may reflect modified systems of taurine carriers or a compensatory mechanism in response to an increase of other organic osmolytes.

Age-related modifications in human unstimulated whole saliva: a biochemical study.

Human whole saliva contains a number of antimicrobial agents, and lysozyme, lactoferrin, secretory IgA and peroxidase are among the best known. Peroxidase catalyzes a reaction involved in the inhibition of bacterial growth and metabolism, and the prevention of hydrogen peroxide accumulation, thus protecting proteins from the action of oxygen and reactive oxygen species (ROS). To better understand the role played by the oxidative stress in the aging process, we studied the relationship between total protein content, peroxidase activity, malondialdehyde (MDA) and nitric oxide (NO) content of human unstimulated whole saliva in 169 healthy subjects subdivided into groups according to age. Our results show a significant decrease in peroxidase activity with age. Moreover, the increase in saliva lipid peroxide levels indicates an enhanced free radical production that may contribute to tissue damage. On the other hand, findings concerning human unstimulated whole saliva NO content showed a significant increase in elderly subjects, suggesting that an enhanced NO production might depend on a stimulation of leukocyte-inducible NO synthase (i-NOS) activity. Our results suggest that during aging the oral tissues may become more susceptible to environmental factors due to a modification in the balance between different antimicrobial agents.

Changes in the composition of human unstimulated whole saliva with age.

The aim of this study was to evaluate changes in the concentration of certain components of human unstimulated whole saliva during aging, in order to better understand the role played by aging in oral health. In particular, we studied total protein concentration, alpha-amylase activity, sialic acid content and calcium and phosphorus concentrations in 100 healthy subjects of both genders, aged between 10 and 80 years, who were subdivided into four groups according to their age: 10-25 years, 26-40 years, 41-65 years, and 66-80 years. Other than sialic acid, the concentrations of the components studied were not affected by age. There was a significant negative correlation between sialic acid content and age. Our data indicate the presence of a decreased submandibular/sublingual function with aging, thus suggesting the possibility of a concomitant reduction in the modulating action of unstimulated whole saliva on the oral flora.

[Dentinogenesis imperfecta. Scanning electron microscopic study and microanalysis]. / Dentinogenesi imperfetta. Studio al microscopio elettronico a scansione e microanalisi.

BACKGROUND: Dentinogenesis imperfecta (DI) is an inherited dentine defect which affects both the primary and secondary dentitions. Shields et al. in 1973 suggested a classification of DI within three types: type I, associated with osteogenesis imperfecta (OI), type II and type III. Although the varying clinical, radiographic and histological findings in DI have been described in detail, an available method for closer examination of the abnormal dentine matrix, electron microscopy, has seldom been used. Scanning and transmission electron microscopy studies can help to understand the pathogenesis of the different types of heritable dentine defects and the diagnosis and classification of these diseases. The aim of the present study was to evaluate a case of DI using scanning electron microscopy and microanalysis. METHODS: Dentine was obtained from tooth samples from a fourteen-year-old boy affected by DI and from third molars extracted for therapeutic reasons used as controls. Samples were observed with a scanning electron microscope, scanning electron micrographs were evaluated with an image analysis program and specimens were finally observed with a scanning electron microscope equipped for micro-analysis. RESULTS AND CONCLUSIONS: The results obtained showed that the total number of dentinal tubules was significantly reduced and the presence of a dentine mineralization defect in the patient affected by DI, in comparison to the controls.

Biochemical modifications of human whole saliva induced by pregnancy.

OBJECTIVE: To assess human unstimulated whole saliva components during pregnancy, to determine the relation, if any, between pregnancy and oral health, particularly total protein concentration, alpha-amylase activity, sialic acid content and calcium and phosphate concentrations were evaluated. DESIGN: Cross-sectional study. PARTICIPANTS: Forty-five healthy primigravid women; 15 nonpregnant women acted as controls. RESULTS: 1. A higher total protein content at 10 and 21 weeks of gestation with respect to the controls and to pregnant women at 40 weeks; 2. a higher alpha-amylase activity at 10 and 21 weeks of gestation compared with the controls and to pregnant women at 40 weeks; 3. an increased sialic acid content at 21 and 40 weeks; 4. decreased calcium and phosphorus concentrations at 21 and 40 weeks of gestation. CONCLUSIONS: Pregnancy modifies saliva composition. This could play a pivotal role in the incidence of pregnancy-induced dental caries.

Polyamines are involved in retinoic acid-mediated induction of tissue transglutaminase in human peripheral blood monocytes.

The differentiation of human peripheral blood monocytes (HPBM) into macrophages, when cultured in vitro, has been associated with an increase in the expression of tissue transglutaminase (TGc). Retinoic acid (RA) addition to 5-day-old cultured monocytes, 36 h later induced about 5-folds increase of TGc content. The preliminary exposure of cultured monocytes to alpha-difluoromethylornithine (DFMO) significantly reduced TGc induction caused by RA. DFMO alone does not induce significant changes in the time-course of TGc activity. In cultured monocytes exposed to DFMO, putrescine and spermidine, but not spermine were significantly depleted. The supplementation of putrescine (1 mM) or spermidine (0.5 mM) to culture medium reversed the inhibiting effect of DFMO on RA-mediated induction of TGc. However, the addition of polyamines in the absence of RA or DFMO did not mimic the induction of TGc by RA. We conclude that TGc induction by RA during in vitro maturation of monocytes to macrophages may be modulated by polyamine availability.

Excess of taurine supplementation in rat: effects on GABA-related amino acids in developing nervous tissues.

The effects of taurine supplementation on GABA-related amino acid homeostasis in developing nervous tissues of suckling rats were studied. In the first two weeks of postnatal growth, cerebral cortex and cerebellum appear more accessible to taurine supplementation in comparison to retina; in addition, different changes in excitatory/inhibitory amino acids were observed. After the 5th day of life, in the retina and cerebellum of taurine-supplemented pups a decrease in GABA levels was found; in contrast, in cerebral cortex GABA content significantly increased throughout 20 days of postnatal growth. In all nervous tissues studied (except for cerebellum) glutamine concentration increased at the 5th day; then in cerebellum and in retina, but not in cerebral cortex, a significant decrease until the 20th day occurred. Furthermore, in cerebellum and retina taurine supplementation decreased glutamate levels, in comparison to controls, at the 10th and until the 20th day of postnatal life, respectively, whereas in cerebral cortex an increase in glutamate level was observed only at the 5th day. In conclusion, taurine supplementation, in excess to the usual amount from the mother's milk, affected the glutamate compartments in various cell types. The changes in GABA-related amino acid concentrations in cerebral cortex, cerebellum, and retina may depend on the different pattern of the metabolic processes at different maturative stages.