In vitro study of the orthodontic mini-implants influence on the growth of human osteoblasts.

This study aimed to assess the in vitro biocompatibility of titanium (Ti) alloy orthodontic mini-implants by correlating human osteoblasts (HOb) response with chemical composition and surface morphology of mini-implants. HOb were cultivated with or without custom-made and commercial mini-implants, discs and filings. The surface morphology and chemical composition of the implants were assessed under the scanning electron microscopy (SEM) with energy-dispersive X-ray (EDX) microanalysis system. Cell viability, adhesion and proliferation were analyzed by optical microscopy and flow cytometry. 3-(4,5-Dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) reduction and lactate dehydrogenase (LDH) release tests were used to assess the cytotoxicity of discs and filings-treated culture medium. Shape, adhesion, and multiplication of HOb were not significantly altered by the presence of mini-implants, discs or filings in culture, even though Ti alloy may exert in vitro a low cytotoxic effect on HOb adhered to discs. Morphology analysis by SEM demonstrated that custom-made mini-implants' surface differs from that of commercial mini-screws in terms of surface finish and roughness, whilst EDX analysis showed largely similar percentages of Ti, aluminum and vanadium for the two types of implants. No major differences were noticed regarding the effect exerted in vitro on HOb by the investigated implants. The new mini-implants have a convenient in vitro cytotoxicity profile on HOb.

Anesthetic Management of a Down Syndrome Patient with Subocclusive Syndrome.

The present study aims to describe the anesthetic management of a patient with Down syndrome in connection to the degree of difficulty in orotracheal intubation and the associated risks of general anesthesia. The established diagnosis was subocclusive syndrome, requiring an emergent surgical intervention. Preoperatively, the patient was stabilized, and secondly, a series of clinical and paraclinical investigations were carried out in order to assess the best management of the anesthetic procedure. Risk factors were identified, including ischemic heart disease, grade II obesity, hyperglycemia, patient's old age and marked mental retardation. The results of examinations that were carried out showed that the degree of difficulty of orotracheal intubation was low. Finally, the preoperative assessment indicated that the most appropriate approach for this patient was to perform a general anesthesia with endotracheal intubation. However, special care was given to the anesthetic and postoperative condition of the patient in order to lower the possible complications of the surgical intervention.

Endotracheal Intubation in a Down Syndrome Adult Undergoing Cataract Surgery - a Multidisciplinary Approach.

The present case report aims to describe and discuss the approach for the management of difficult endotracheal intubation in an adult with Down syndrome undergoing cataract surgery. A 26-year-old female with Down syndrome and a validated diagnosis of cataract requiring surgery was examined in order to assess the degree of difficulty of endotracheal intubation. Patients with Down syndrome have characteristic craniofacial abnormalities which require a thorough pre-operative assessment to anticipate and prepare for a difficult endotracheal intubation. Before the surgery, a series of clinical and paraclinical examinations were conducted. Although cataract surgery generally requires loco-regional anesthesia, in our case it was performed under general anesthesia. Indicators of potentially difficult intubation were macroglossia, prognathism, short neck, limited degree of head extension and obesity. The pre-operative examinations, which revealed a high degree of endotracheal intubation, allowed the anesthetist to achieve a better peri- and intra-operative management of the patient.