Optimization approach for the mesialization of lower molars: a case report / Técnica para la optimización del movimiento de ortodoncia en la mesialización de molares inferiores: reporte de un caso

Abstract Premature molar loss results in inclination of teeth adjacent to the edentulous gap, uneven marginal ridges, posterior collapse of bite, and atrophy of the residual bone width. The orthodontic treatment aimed at closing post-extraction spaces is one possible treatment plan. However, in many cases this movement is compromised by the collapse of cortical plates and the decrease of the osseous corridor. Due to this problem, flexicorticotomy may be considered as an alternative in the mesialization of molars to improve residual bone width and to accelerate orthodontic movement. A 22-year-old female patient underwent extraction of the right mandibular first molar. A flexicorticotomy was performed to accelerate the mesial movement of teeth number 37 and 38, using a miniscrew for absolute anchorage. This technique helped mesialize teeth number 37 and 38, attaining a stable class I relationship, thus finding an orthodontic solution to a problem that was historically treated only prosthetically. In conclusion, this technique facilitates the mesial movement of molars, reaching treatment goals more effectively, and saving costs by avoiding further prosthetic treatment.

Resumen La pérdida prematura de molares trae como consecuencia inclinación mesial de los dientes adyacentes a la brecha edéntula, rebordes marginales desiguales, colapso posterior de la mordida y atresia en el ancho del hueso residual. El cierre de espacio con tratamiento ortodóncico es uno de los posibles tratamientos; sin embargo, en muchos casos ese movimiento se ve comprometido por el colapso de las tablas óseas y disminución del corredor óseo en el sitio postextracción. Debido a esta problemática, se ha propuesto el uso de la flexicorticotomía como coadyuvante en la mesialización de molares para mejorar el corridor óseo y acelerar el movimiento de ortodoncia. Se presenta una paciente de 22 años, quien acude a la consulta presentando ausencia de la UD 36. El plan de tratamiento a seguir consistió en flexicorticotomía para acelerar el desplazamiento de las UD 37 y 38 colocando un anclaje absoluto entre las UD 34 y 35. Dicho procedimiento se logró con una mecánica de mesialización con cadena elástica y anclaje absoluto. Se pudo mesializar las UD 37 y 38, manteniendo una relación clase I estable y encontrando una solución ortodóncica a un problema que anteriormente era tratado netamente de manera protésica. Se concluye que esta técnica mejora el movimiento de los molares hacia adelante y abre una nueva gama de posibilidades al permitir movimientos que anteriormente estaban limitados; además, permite cumplir objetivos de tratamientos de manera más efectiva, brindando una alternativa más eficiente y ahorrando costos al prescindir del tratamiento protésico.

Recurrent infection in the left thumb.

INTRODUCTION: Infections of the hand may be associated with lymphangitis and lymphadenitis. In most cases, bacterial infections are responsible but these may be also due to viral infections. MATERIAL AND METHODS: We describe a clinical case of a recurrent infection in the left thumb of a health male. Bacterial and viral cultures were performed. RESULTS: Herpes simplex virus (HSV) type 2 was isolated on viral culture and on direct fluorescent antibody testing; so, the final diagnosis was herpetic whitlow. CONCLUSIONS: Herpetic whitlow should be considered in cases of recurrent finger infections.

BK virus infection in human immunodeficiency virus-infected patients.

The aim of this study is to evaluate the prevalence of BK virus (BKV) infection in HIV-positive patients receiving highly active antiretroviral therapy (HAART) in our hospital. The presence of BKV was analysed in urine and plasma samples from 78 non-selected HIV-infected patients. Clinical data were recorded using a pre-established protocol. We used a nested PCR to amplify a specific region of the BKV T-large antigen. Positive samples were quantified using real-time PCR. Mean CD4 count in HIV-infected patients was 472 cells/mm3 and median HIV viral load was <50 copies/mL. BKV viraemia was detected in only 1 HIV-positive patient, but 57.7% (45 out of 78) had BKV viruria, which was more common in patients with CD4 counts>500 cells/mm3 (74.3% vs 25.7%; p=0.007). Viruria was present in 21.7% of healthy controls (5 out of 23 samples, p=0.02). All viral loads were low (<100 copies/mL), and we could not find any association between BKV infection and renal or neurological manifestations. We provide an update on the prevalence of BKV in HIV-infected patients treated with HAART. BKV viruria was more common in HIV-infected patients; however, no role for BKV has been demonstrated in this population.

Actividad in vivo del mentol frente a larvas l3 de Anisakis tipo I / In vivo larvicidal activity of menthol against Anisakis type I

Se ha estudiado la actividad larvicida in vivo de mentol, principal componente del aceite esencial de Mentha pipperita, frente a larvas de Anisakis tipo I aisladas del hospedador Micromesistius poutassou (bacaladilla), adquiridas en diversas pescaderías de la ciudad de Granada. Los resultados obtenidos en el ensayo muestran que en el grupo tratado con mentol no se apreciaron lesiones en el aparato digestivo, mientras que en el grupo control estas lesiones fueron observadas en el 93’3% de los animales de experimentación. En este mismo grupo se encontraron larvas que habían perforado la pared gástrica, localizándose libres en la cavidad corporal(AU)

We have studied the in vivo larvicidal activity of menthol, the main component of the essential oil of Mentha pipperita, against Anisakis type I larvae isolated from the host Micromesistius poutassou(blue whiting), acquired in several fishmongers in the city of Granada. The in vivo test results showed no gastric wall lesions in the group treated with menthol, while in the control group, 93.3% of infected rats showed those lesions. In the same control group were found larvae that had drilled the gastric wall, located free in the abdominal cavity(AU)

Olfactory bulbectomy induced oxidative and cell damage in rat: protective effect of melatonin.

In this study we analyzed the effects of melatonin (Mel, 1 mg/kg ip) on behavioral changes as well as cell and oxidative damage prompted by bilaterally olfactory bulbectomy. Olfactory bulbectomy caused an increase in lipid peroxidation products and caspase-3, whereas it prompted a decrease of reduced glutathione (GSH) content and antioxidative enzymes activities. Additionally, olfactory bulbectomy induced behavioral changes characterized by the enhancement of immobility time in the forced swim test and hyperactivity in the open field test. All these changes were normalized by treatment of Mel (14 days). Our data show that Mel has a beneficial neuropsychiatric action against oxidative stress, cell damage and behavior alterations.

Neuroprotective effect of carvedilol and melatonin on 3-nitropropionic acid-induced neurotoxicity in neuroblastoma

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In neurodegenerative diseases, progressive oxidative stress is a major event that precedes neuronal death. Oxidative stress is characterized by an imbalance between oxidants and antioxidants. This imbalance induced oxidative molecular and cell damage, reducing cellular viability. 3-Nitropropionic acid (3NP) causes oxidative stress and other molecular and cellular changes similar to those observed in neurons of patients with Huntington’s disease. Since carvedilol and melatonin act as free-radical scavengers, this study examined the effect of carvedilol (10−5 M) and melatonin (10−5 M) on oxidative and cell damage induced by 3NP in N1E-115 neuroblastoma cells. Carvedilol and melatonin prevented the increases in lipid peroxidation and total LDH activity, as well as the depletion of reduced glutathione (GSH) and the reduction of antioxidative enzymes activities in N1E-115 cells incubated with 100 mM 3NP. All these carvedilol and melatonin effects were more intense when the drugs were added before rather than after inducing the damage by 3NP. These results also provided evidence supporting the hypothesis that carvedilol and melatonin can be useful for treating neurodegenerative diseases, such as Huntington’s disease (AU)

Effect of melatonin on myocardial oxidative stress induced by experimental obstructive jaundice.

OBJECTIVE: melatonin has been demonstrated to have active antioxidant properties in different tissues during experimental cholestasis. The aim of this research was to study myocardial oxidative stress on obstructive jaundice, and to analyze the effect of melatonin on myocardial oxidative lesions. MATERIAL AND METHODS: we achieved cholestasis by ligature and sectioning of the main bile duct. Melatonin was administered intraperitoneally (500 microg/kg/day). We measured malondialdehyde (MDA), reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) and glutathione peroxydase (GPx) antioxidant enzyme levels in the heart tissue. RESULTS: obstructive cholestasis increased MDA and decreased GSH as well as all antioxidant enzymes. Melatonin administration significantly decreased MDA values, and increased GSH and antioxidant enzymes on the icteric animal myocardium. CONCLUSIONS: melatonin treatment prevents oxidative stress in the cardiac tissue as induced by experimental cholestasis.

Effect of melatonin on myocardial oxidative stress induced by experimental obstructive jaundice

Objective: melatonin has been demonstrated to have activeantioxidant properties in different tissues during experimentalcholestasis. The aim of this research was to study myocardial oxidativestress on obstructive jaundice, and to analyze the effect ofmelatonin on myocardial oxidative lesions.Material and methods: we achieved cholestasis by ligatureand sectioning of the main bile duct. Melatonin was administeredintraperitoneally (500 ìg/kg/day). We measured malondialdehyde(MDA), reduced glutathione (GSH), catalase (CAT), superoxidedismutase (SOD) and glutathione peroxydase (GPx) antioxidantenzyme levels in the heart tissue.Results: obstructive cholestasis increased MDA and decreasedGSH as well as all antioxidant enzymes. Melatonin administrationsignificantly decreased MDA values, and increased GSH and antioxidantenzymes on the icteric animal myocardium.Conclusions: melatonin treatment prevents oxidative stressin the cardiac tissue as induced by experimental cholestasis(AU)

Effects of magnetic stimulation on oxidative stress and skeletal muscle regeneration induced by mepivacaine in rat.

We investigated the effect of magnetic field stimulation (MS) on oxidative damage and skeletal muscle injury prompted by mepivacaine injection in the anterior tibial muscle of Wistar rats. The effects of mepivacaine and MS on oxidative stress were evaluated by lipid peroxidation, GSH levels and catalase activity. Muscle regeneration was analyzed by haematoxylin-eosin stained, NADH-TR histochemical reaction, desmin immunostaining as well as by morphometric parameters such as fibers density and fiber area were evaluated. Our data revealed that mepivacaine induced oxidative stress, that MS prevents the harmful effects induced by mepivacaine and that it facilitates the regeneration process of skeletal muscle. In conclusion, the results show the ability of MS to modify skeletal muscle response to mepivacaine.

Neuroprotective effect of carvedilol and melatonin on 3-nitropropionic acid-induced neurotoxicity in neuroblastoma.

In neurodegenerative diseases, progressive oxidative stress is a major event that precedes neuronal death. Oxidative stress is characterized by an imbalance between oxidants and antioxidants. This imbalance induced oxidative molecular and cell damage, reducing cellular viability. 3-Nitropropionic acid (3NP) causes oxidative stress and other molecular and cellular changes similar to those observed in neurons of patients with Huntington's disease. Since carvedilol and melatonin act as free-radical scavengers, this study examined the effect of carvedilol (10(-5) M) and melatonin (10(-5) M) on oxidative and cell damage induced by 3NP in N1E-115 neuroblastoma cells. Carvedilol and melatonin prevented the increases in lipid peroxidation and total LDH activity, as well as the depletion of reduced glutathione (GSH) and the reduction of antioxidative enzymes activities in N1E-115 cells incubated with 100 mM 3NP. All these carvedilol and melatonin effects were more intense when the drugs were added before rather than after inducing the damage by 3NP. These results also provided evidence supporting the hypothesis that carvedilol and melatonin can be useful for treating neurodegenerative diseases, such as Huntington's disease.

Fat overload aggravates oxidative stress in patients with the metabolic syndrome.

BACKGROUND: Patients with the metabolic syndrome have greater levels of oxidative stress. However, as the response of markers of this stress to a fat overload is unknown, we evaluated certain markers of oxidative stress in these patients. MATERIAL AND METHODS: The study population comprised 93 subjects (70 men and 23 women): 13 healthy people (controls) with a mean age of 48.81 +/- 9.01 years and 80 patients with the metabolic syndrome (mean age, 43.25 +/- 11.55 years), according to the Adult Treatment Panel III criteria. All the participants were given a 60 g fat overload (Supracal). Three hours later the following biomarkers of oxidative stress were measured: lipid peroxidation products, protein carbonyl groups, reduced glutathione, glutathione peroxidase (GSH-Px), catalase, superoxide dismutase, glutathione reductase (GSH-Road) and glutathione S-transferase. The levels of oxidized glutathione (GSSG) were calculated. RESULTS: Compared with the controls, the patients showed greater baseline oxidative stress, higher levels of lipid peroxidation products and oxidized glutathione, and lower levels of reduced glutathione, glutathione peroxidase activity, glutathione reductase and glutathione transferase. This stress was more intense after the subjects received a fat overload, more so in the patients who experienced a greater reduction in GSHpx and GSHrd antioxidant activity and a greater increase in the levels of carbonylated proteins and lipoperoxides than the controls. CONCLUSIONS: Patients with the metabolic syndrome have greater oxidative stress than healthy people. The variation in markers of this stress after a fat overload was even more pronounced in the patients.

The effect of infliximab on oxidative stress in chronic inflammatory joint disease.

OBJECTIVE: To evaluate infliximab effect on oxidative stress in active chronic inflammatory joint disease. PATIENTS AND METHODS: The study population comprised 12 patients: five with ankylosing spondylitis, five with rheumatoid arthritis and two with psoriatic arthritis. At the time of the study all patients were divided into two groups: (i) seven active patients and (ii) five inactive patients according to the accepted criteria that define activity of disease for each of the diseases. C-reactive protein and erythrocyte sedimentation rate were measured. Patient's Global Assessment of the Disease (PGA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for ankylosing spondylitis patients and Disease Activity Score (DAS 28) for rheumatoid arthritis patients) were used for assessment of disease activity. Patients with active chronic inflammatory joint disease were introduced into the infliximab therapy programme. RESULTS: Infliximab effects were evaluated after 6 weeks of treatment as changes in the quantity of lipid peroxidation products, protein carbonyl groups, reduced glutathione content, glutathione peroxidase, catalase and superoxide dismutase. CONCLUSIONS: Our results revealed that: (i) infliximab has antioxidative properties, (ii) chronic inflammatory joint patients show high levels of oxidative injury, and (iii) oxidative stress is more intense in active disease group than in the inactive disease group.

Effect of catecholestrogen administration during adriamycin-induced cardiomyopathy in ovariectomized rat.

The therapeutical beneficial effect of estrogen-derived metabolites or catecholestrogens is controversial. These molecules are produced during estrogen therapy based on 17-beta-estradiol treatment. The metabolization of 17-beta-estradiol is carried out in brain, kidney or liver, and triggers different products such as 2- and 4- hydroxyestradiol (2OH and 4OH). These products have shown antioxidant properties against oxidative stress (OS) in several experimental models. Different noxious side effects related to those metabolites have also been observed upon estrogen therapy. In this sense, catecholestrogens seem to be implicated in tumoral and mutagenic process after long treatment with estrogens substitutive therapy. In our study, we have verified that 2OH and 4OH have antioxidant and cardioprotective effects against adriamycin (AD)-induced cardiomyopathy in ovariectomized (OVX) rats. Catecholestrogens diminished the lipid peroxides and carbonyl protein (CO) content, and different enzymes related to cell injury (creatinine kinase, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase) in cardiac tissue from OVX-, AD-, and OVX+AD-treated rats. All these changes were correlated to a recovery on reduced glutathione (GSH), glutathione peroxidase (GPx), superoxide dismutase (SOD) and catalase (CAT) in heart tissue. The present study showed that 2OH and 4OH reduced all the parameters related to OS, antioxidant depletion and cardiac injury in OVX rats treated or not with AD.

Effect of red wine on oxidative stress and hypercholesterolemia induced by feeding a high-cholesterol diet in rat.

The effect of red wine on oxidative stress and hypercholesterolemia induced by feeding a high-cholesterol diet (supplemented with 1.65% of cholesterol (w/w) for 4 weeks) to female Wistar rats was examined. When red wine was simultaneously supplemented to high-cholesterol diet, total cholesterol, triglycerides, atherogenic index and lipid peroxidation products significantly decreased compared with the high-cholesterol diet alone, while GSH content and antioxidative enzymes activities were enhanced. In the hypercholesterolemic rat the excretion of fecal bile acids, as well as their plasma and hepatic concentrations were increased significantly. Administration of red wine enhanced these values, indicating an increase in the cholesterol degradation. These results suggest that red wine may have a protective effect against oxidative stress, hypercholesterolemia and atherogenic index induced by high-cholesterol diet.

Effect of melatonin on the oxidative stress in N1E-115 cells is not mediated by mt1 receptors.

To explore if protective effect of melatonin on oxidative stress induced by okadaic acid, an inhibitor of protein phosphatases PP1 and PP2A, is mediated by membrane receptors subtype mt1, we used an in vitro model with N1E-115 neuroblastoma cells. We demonstrated that exposure of cells to 50 nM okadaic acid for 2 h induces a reduction in the activity of antioxidative enzymes, and an increase of lipid peroxidation products, while melatonin prevents the effect of okadaic acid. On the other hand, the presence of luzindole, 20 min before adding melatonin, did not cause changes on the effect of the melatonin on oxidative stress. These results seem to indicate that protective effect of melatonin is not mediated by mt1 receptors.

Effect of melatonin on hyperlipidemic nephropathy under constant light exposure.

Studies have shown anti-hyperlipidemic actions of melatonin, with pharmacological doses inducing changes in cholesterol levels. This study was designed to evaluate the effect of melatonin on adriamycin-induced (25mg/kg b.w., i.p.) hyperlipidemia under constant light exposure. Melatonin was injected i.p. (1,000 microg/kg b.w./day). Triglycerides, total cholesterol, high-density lipoprotein cholesterol, light-density lipoprotein cholesterol, non-proteic nitrogen compounds (urea and creatinine levels), total protein in serum, proteins eliminated in the urine and melatonin levels in serum and kidney were determined. Results show a decrease in melatonin levels induced by both adriamycin and constant light. Likewise, adriamycin induced significant increases in triglycerides, total cholesterol and light-density lipoprotein cholesterol, and lowered high-density lipoprotein cholesterol levels. Constant light exposure also prompted an increase in LDL-c levels and a decrease in HDL-c values, and intensified the effects of adriamycin on these two lipoproteins. All changes induced by adriamycin and constant light were reverted toward normality by melatonin administration.

A Mediterranean and a high-carbohydrate diet improve glucose metabolism in healthy young persons.

AIMS/HYPOTHESIS: Insulin resistance usually precedes the diagnosis of Type II (non-insulin-dependent) diabetes mellitus. However, in most patients, the clinical expression of the disease could be prevented by dietary and lifestyle changes. We investigated the effects of a diet enriched in monounsaturated fatty acids (Mediterranean diet) and a low fat, high-carbohydrate diet on in vivo and in vitro glucose metabolism in 59 young subjects (30 men and 29 women). METHODS: We carried out an intervention dietary study with a saturated fat phase and two randomized-crossover dietary periods: a high-carbohydrate diet and a Mediterranean diet for 28 days each. We analysed the plasma lipoproteins fractions, free fatty acids, insulin sensitivity and glucose uptake in isolated monocytes at the end of the three dietary periods. RESULTS: In comparison to the saturated fat diet, the CHO and Mediterranean diets induced a decrease of LDL-cholesterol (p < 0.001) and HDL-cholesterol (p < 0.001). Steady-state plasma glucose decreased (p = 0.023) and basal and insulin-stimulated 2-deoxiglucose uptake in peripheral monocytes increased in both diets (CHO and Mediterranean), (p = 0.007) indicating an improvement in insulin sensitivity. Fasting free fatty acids plasma values were correlated positively with steady state plasma glucose (r = 0.45; p < 0.0001). In addition, there was an inverse correlation between the mean glucose of the steady state plasma glucose period and logarithmic values of basal (r = -0.34; p = 0.003) and insulin stimulated glucose uptake in monocytes (r = -0.32; p = 0.006). CONCLUSION/INTERPRETATION: Isocaloric substitution of carbohydrates and monounsaturated fatty acids for saturated fatty acids improved insulin sensitivity in vivo and in vitro, with an increase in glucose disposal. Both diets are an adequate alternatives for improving glucose metabolism in healthy young men and women.

Melatonin versus vitamin E as protective treatment against oxidative stress after extra-hepatic bile duct ligation in rats.

The aims of the present study were first to compare the effects of melatonin and vitamin E on the cholestasis syndrome and their protective effect on liver injury, and second, to evaluate the activity of antioxidant enzymes after treatment with these antioxidant drugs. Cholestasis was achieved in adult male Wistar rats by double ligature and section of the extra-hepatic biliary duct. Hepatic and plasma oxidative stress markers were evaluated by changes in the amount of lipid peroxides, measured as malondialdehyde (MDA) and reduced glutathione (GSH) in plasma and homogenates of hepatic tissue. Serum bilirubin, alkaline phosphatase (AP), and gamma-glutamyl-transpeptidase (GGT) were used to evaluate the severity of cholestasis, and serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were used to evaluate the hepatic injury. Both vitamin E and melatonin were administrated 1 day before and 7 days after bile duct ligation. Acute ligation of the bile duct was accompanied by a significant increased in MDA and a decrease in GSH levels in both plasma and liver, as well as a significant reduction in antioxidant enzymes activities. The overall analysis of both treatments showed that melatonin (500 microg/kg daily) offered significantly better protection against cholestasis and a superior protective effect on hepatic injury than did vitamin E (15 mg/kg daily). Although vitamin E treatment resulted in a reduction of parameters of oxidative stress, the results were significantly better after a much lower daily dose of melatonin. Moreover, melatonin treatment was associated with a significant recovery of antioxidative enzymes. In conclusion, the present paper demonstrates a correlation between the intensity of biliary tract obstruction and increased free radical generation, as well as a direct correlation between the level of oxidative stress and the biochemical markers of liver injury. Melatonin (at a much lower dose than vitamin E) was much more efficient than vitamin E in reducing the negative parameters of cholestasis, the degree of oxidative stress and provided a significantly greater hepatoprotective effect against the liver injury secondary to the acute ligation of the biliary duct.

Melatonin protects against renal oxidative stress after obstructive jaundice in rats.

The goals of this study were to analyze the renal oxidative status in experimental biliary obstruction and to evaluate the impact of melatonin on renal oxidative stress. Cholestasis was done by double ligature and section of the extra-hepatic biliary duct. Melatonin was injected i.p. (500 microg/kg/day). Malondialdehyde, reduced glutathione, catalase, superoxide dismutase, glutathione reductase, glutathione peroxidase and glutathione transferase were determined in the renal tissue. After biliary obstruction, an increase in malondialdehyde (P<0.0001) and a fall in reduced glutathione (P<0.0001) were seen. Moreover, the scavenger enzyme activity had significantly diminished. After melatonin administration, the malondialdehyde fell significantly (P<0.0001), whereas reduced glutathione showed an important increase (P<0.0001) compared with the ligated bile duct group. Experimental bile duct obstruction was associated to an increase of renal oxidative stress. Treatment with melatonin decreased the renal lipid peroxidation, and both the reduced glutathione as well as the scavenger enzyme activity recovered.