The Replanting of a 1.1 from an Ectopic Position during the Course of Orthodontic Therapy: Follow-Up at 8 Years.

The case that is reported here describes the replanting of a 1.1 from an ectopic position during orthodontic therapy. The 9-year-old patient suffered from class 2 type malocclusion with the upper maxilla contracted, right-left posterior cross-bite. The clinical case presented the following details: in the upper incisor group, the 1.1 was overlapping the 1.2 and was distalised and completely vestibularised, whilst in the place of the 1.1, a 1.1 supernumerary persisted in occlusion. Following several medical investigations, such as OPT and, most importantly, TC cone beam investigation, the dangerous position of the dental element became clear. This did not present vestibular cortical bone but only gingival mucosa. Following these investigations, the difficulty in bringing the dental element into its natural position through orthodontic treatment became obvious since the natural position was without sufficient bone support. From this, it became obvious that surgery and replanting of the 1.1 immediately after the extraction of the supernumerary 1.1 was the only choice available.

Antisense Oligonucleotide: Basic Concepts and Therapeutic Application in Inflammatory Bowel Disease.

Several molecular technologies aimed at regulating gene expression that have been recently developed as a strategy to combat inflammatory and neoplastic diseases. Among these, antisense technology is a specific, rapid, and potentially high-throughput approach for inhibiting gene expression through recognition of cellular RNAs. Advances in the understanding of the molecular mechanisms that drive tissue damage in different inflammatory diseases, including Crohn's disease (CD) and ulcerative colitis (UC), the two major inflammatory bowel diseases (IBDs) in humans, have facilitated the identification of novel druggable targets and offered interesting therapeutic perspectives for the treatment of patients. This short review provides a comprehensive understanding of the basic concepts underlying the mechanism of action of the oligonucleotide therapeutics, and summarizes the available pre-clinical and clinical data for oligonucleotide-based therapy in IBD.

Neutrophil Extracellular Traps Sustain Inflammatory Signals in Ulcerative Colitis.

BACKGROUND AND AIMS: In ulcerative colitis [UC], mucosal damage occurs in areas that are infiltrated with neutrophils. The antimicrobial function of neutrophils relies in part on the formation of extracellular web-like structures, named neutrophil extracellular traps [NETs]. The formation and/or clearance of aberrant NETs have been associated with several immune diseases. Here we investigated the role of NETs in UC-related inflammation. METHODS: The expression of NET-associated proteins was evaluated in colonic biopsies of patients with Crohn's disease [CD], UC and in normal controls [NC] by Western blotting, immunofluorescence and immunohistochemistry. Colonic biopsies of UC patients were analysed before and after anti-tumour necrosis factor α [anti-TNF-α] treatment. The capacity of neutrophils to produce NETs upon activation was tested in vitro. UC lamina propria mononuclear cells [LPMCs] were cultured with NETs in the presence or absence of an extracellular signal-regulated kinase-1/2 [ERK1/2] inhibitor and inflammatory cytokine induction was assessed by real-time polymerase chain reaction and enzyme-linked immunosorbent assay. We also characterized the contribution of NETs in dextran sodium sulfate [DSS]-induced colitis. RESULTS: NET-associated proteins were over-expressed in inflamed colon of UC patients as compared to CD patients and NC. Circulating neutrophils of UC patients produced NETs in response to TNF-α stimulation, and reduced expression of NET-related proteins and diminished NET formation were seen in patients receiving successful treatment with anti-TNF-α. Treatment of UC LPMCs with NETs activated ERK1/2, thus enhancing TNF-α and interleukin-1ß [IL-1ß] production. NETs were induced in mice with DSS-colitis and in vivo inhibition of NET release attenuated colitis. CONCLUSIONS: Our data show that NET release occurs in UC and suggest a role for NETs in sustaining mucosal inflammation in this disorder.

Minimally invasive surgical management of impacted maxillary canines.

AIM: Combined surgical-orthodontic treatment of impacted maxillary canines has developed significantly in the last few years, regarding management of both hard and soft tissues and forces of traction. The aim of this report is to describe a combined surgical-orthodontic approach used to treat an impacted maxillary canine and to value the functional and esthetic results after 5 years of followup. MATERIALS AND METHODS: A 13-year-old boy had been seen by surgeons in the Operative Unit of Orthodontics of Policlinico Tor Vergata in Rome. Radiographic images showed intraosseous impaction of teeth 1.3 and 2.3 in a late mixed dentition, and the patient was scheduled for the combined surgical-orthodontic treatment. RESULTS: After the five-year follow-up, the patient had a good occlusal stability. The maxillary canine that had been orthodontically repositioned showed an adequate width of attached gingiva, which was well keratinized, and the margin of free gingiva that followed the course of the cement-enamel junction. Bleeding was absent on probing, the periodontal pocket depth was < 4 mm, and there was no radiographically evident bone loss. CONCLUSIONS: The combined surgical-orthodontic technique used in this case (closed eruption towards the center of the alveolar ridge associated with conservative periodontal surgery, the adhesive technique, and controlled orthodontic traction) simulates physiological tooth eruption and results in proper alignment with good periodontal results. It should be considered as the treatment of choice for impacted teeth whose eruption is not precluded by the position of the tooth and/or the presence of ankyloses. KEY WORDS: Mucoperiosteal flap, Surgical tecnique.

Histological evaluation of a biomimetic material in bone regeneration after one year from graft.

AIM: The use of substitute materials is one of the solutions used in periodontology for the reconstruction of intrabony defects. Advances in scientific research gave rise to a new generation of biomaterials of synthetic origin stoichiometrically unstable and therefore really absorbable. Our research is directed precisely towards a biomaterial synthesis, Engipore® (Finceramica, Faenza, Italy) which is a bone substitute of the latest hydroxyapatite-based generation, that possesses chemical and morphological properties similar to those of natural bone in the treatment of infrabony periodontal defects. Aim of this study was to evaluate the efficacy of Engipore® in the treatment of intrabony periodontal defects. METHODS: The study was conducted on 100 parodontopatics patients, which had gingival pockets of at least infrabonies 8/10 mm. The histological evaluation was performed with samples after one year from the graft. RESULTS: The histological samples collected after one year showed an abundant new bone formation, with mature lamellar bone tissue surrounding the residual particles of Engipore® that appear completely osteointegrated. The surrounding connective tissue shows no signs of inflammation. CONCLUSIONS: The results obtained in our research demonstrated that, after a proper selection of patients and lesions, and applying an adequate surgical technique, this type of biomaterial in the treatment of periodontal defects acts in an optimal manner as a filler inducing the formation of new bone as evidenced by histological examinations.

IL-21 as a therapeutic target in inflammatory disorders.

INTRODUCTION: IL-21, a cytokine produced by activated CD4(+) cells, activated natural killer T cells and T helper cells in the germinal centers, is involved in the control of the function of both immune and parenchymal cells. AREAS COVERED: IL-21 is overproduced in many chronic inflammatory disorders, including inflammatory bowel diseases, psoriasis, rheumatoid arthritis, type I diabetes and systemic lupus erythematosus, and studies in experimental models indicate that IL-21 plays an important role in sustaining tissue-damaging immune responses in such pathologies. However, genetic deficiency of IL-21 associates with inflammatory bowel diseases and blockade of IL-21 in the early phases exacerbates the disease progression in some models of rheumatoid arthritis and systemic lupus erythematosus, thus suggesting a dual role of IL-21 in the control of immune-mediated diseases. IL-21 can exert additional protective functions for the host as it promotes cytotoxic responses against tumors and viruses. EXPERT OPINION: We here review the available data on the role of IL-21 in chronic inflammatory diseases and discuss the therapeutic benefit of IL-21 inhibitors in such diseases as well as the potential risks of such treatments.

An overview of the role of innate lymphoid cells in gut infections and inflammation.

Innate lymphoid cells (ILCs) are a group of hematopoietic cells devoid of antigen receptors that have important functions in lymphoid organogenesis, in the defense against extracellular pathogens, and in the maintenance of the epithelial barrier. Three distinct groups of ILCs have been identified on the basis of phenotypic and functional criteria and termed ILCs1, ILCs2, and ILCs3. Specifically, ILCs1 express the transcription factor T-bet and secrete T helper type-1- (Th1-) related cytokines, ILCs2 are dependent on the transcription factor RORα and express Gata-3 and the chemokine receptor homologous molecule (CRTH2) and produce Th2-related cytokines, and ILCs3 express the transcription factor RORγt and synthesize interleukin- (IL-) 17, IL-22, and, under specific stimuli, interferon-γ. ILCs represent a relatively small population in the gut, but accumulating evidence suggests that these cells could play a decisive role in orchestrating both protective and detrimental immune responses. In this review, we will summarize the present knowledge on the distribution of ILCs in the intestinal mucosa, with particular focus on their role in the control of both infections and effector cytokine response in immune-mediated pathologies.