Cytokines and VEGF induction in orthodontic movement in animal models.

Orthodontics is a branch of dentistry that aims at the resolution of dental malocclusions. The specialist carries out the treatment using intraoral or extraoral orthodontic appliances that require forces of a given load level to obtain a tooth movement in a certain direction in dental arches. Orthodontic tooth movement is dependent on efficient remodeling of periodontal ligament and alveolar bone, correlated with several biological and mechanical responses of the tissues surrounding the teeth. A periodontal ligament placed under pressure will result in bone resorption whereas a periodontal ligament under tension results in bone formation. In the primary stage of the application of orthodontic forces, an acute inflammation occurs in periodontium. Several proinflammatory cytokines are produced by immune-competent cells migrating by means of dilated capillaries. In this paper we summarize, also through the utilization of animal models, the role of some of these molecules, namely, interleukin-1ß and vascular endothelial growth factor, that are some proliferation markers of osteoclasts and osteoblasts, and the macrophage colony stimulating factor.

Social determinants of the increasing caesarean section rate in Italy.

AIM: Consistent modifications of socio-economic factors may represent crucial non-clinical determinants for the rising rate of caesarean section among primiparae. This increasing trend has been reported in many countries and its relationship with social modifications is widely accepted, though poorly supported by published data. METHODS: Population-based social and economic data were analyzed between two study periods 30 years apart (1971 vs 2001). RESULTS: The number of births dropped dramatically within the study period (about -40%). Italian women tend to delay childbearing (25.1 vs 28.8 years of age at first delivery) to pursue a career and a later marriage and motherhood lead to a contraction of the number of members of the family. Older mothers are at higher risk of caesarean (treble over 40 years of age), especially those with high career position. Health expenditures increased significantly between 1971 and 2001. A progressive contraction of the number of women in reproductive age is expected in the next 50 years in Italy. CONCLUSION: Many determinants are involved in the choice of a caesarean section and most of these are not strictly medical. The rapidly mounting number of legal claims may indeed lead to defensive practices. Given these data, a reduction of caesarean section rate seems unlikely to be achieved at present.