Assessment of inter- and intra-operator cephalometric tracings on cone beam CT radiographs: comparison of the precision of the cone beam CT versus the latero-lateral radiograph tracing.

BACKGROUND: In this study we aimed at quantifying the possible errors which may occur when assessing specific reference planes and linear derivants on cephalometric radiographs traced manually and digitally. Furthermore, we have compared the precision of the tracings according to both the two- and three-dimensional (2D and 3D respectively) techniques and between clinicians. FINDINGS: We have obtained via cone beam computed tomography (CBCT) archive of the orthodontics department of the University of Milan 20 cone beam CT radiographs from which we have obtained 20 latero-lateral radiographs. Five independent clinicians referred to as A, B, C, D, E have been randomly selected to trace both radiographs maintaining the same working and lighting conditions to minimize the possibility of operator- and environment-dependent errors from occurring. The results have been statistically assessed by Student's t test. The comparison of the data gathered from the tracings in 2D and 3D shows that certain measurements have statistically significant differences. Particularly, the difference in the measurements of the sagittal dimension of the mandible and the anterior and posterior nasal spines has resulted to be statistically significant. The results of the intra-operator comparison proved that the 3D technique is extremely precise. CONCLUSION: Our study determines that the 3D technique allows to obtain more precise results and with several advantages when compared to the conventional technique such as a true representation of the anatomical structures, less risk of errors occurring due to clinician skills and absence of overlapping anatomical structures.

Congenital macroglossia: surgical and orthodontic management.

OBJECTIVES: A case of congenital macroglossia is reported. The most important sign of macroglossia is tongue protrusion through the lips. Tongue protrusion might influence skeletal growth and can cause anterior open bite, proclination of upper and lower incisors and development of diastemas. MATERIALS AND METHODS: A 4 year-old female patient was diagnosed with congenital macroglossia. Parents referred an abnormal tongue dimension since birth and the development of a progressive anterior open bite. The treatment of macroglossia included tongue reduction by partial glossectomy. She was seen regularly and at the age of eight years old a lingual frenectomy was performed and an orthodontic treatment was planned. RESULTS: At the end of the orthodontic treatment a Class I occlusion was obtained with correct overbite and overjet values. CONCLUSIONS: Early interception of macroglossia and surgical reduction in combination with orthodontic treatment can be seen as preventive measures to avoid the tongue influence on the development of malocclusions.

Alternative Pathways of Cancer Cell Death by Rottlerin: Apoptosis versus Autophagy.

Since the ability of cancer cells to evade apoptosis often limits the efficacy of radiotherapy and chemotherapy, autophagy is emerging as an alternative target to promote cell death. Therefore, we wondered whether Rottlerin, a natural polyphenolic compound with antiproliferative effects in several cell types, can induce cell death in MCF-7 breast cancer cells. The MCF-7 cell line is a good model of chemo/radio resistance, being both apoptosis and autophagy resistant, due to deletion of caspase 3 gene, high expression of the antiapoptotic protein Bcl-2, and low expression of the autophagic Beclin-1 protein. The contribution of autophagy and apoptosis to the cytotoxic effects of Rottlerin was examined by light, fluorescence, and electron microscopic examination and by western blotting analysis of apoptotic and autophagic markers. By comparing caspases-3-deficient (MCF-7(3def)) and caspases-3-transfected MCF-7 cells (MCF-7(3trans)), we found that Rottlerin induced a noncanonical, Bcl-2-, Beclin 1-, Akt-, and ERK-independent autophagic death in the former- and the caspases-mediated apoptosis in the latter, in not starved conditions and in the absence of any other treatment. These findings suggest that Rottlerin could be cytotoxic for different cancer cell types, both apoptosis competent and apoptosis resistant.