Sinorhizobium meliloti GR4 Produces Chromosomal- and pSymA-Encoded Type IVc Pili That Influence the Interaction with Alfalfa Plants.

Type IVc Pili (T4cP), also known as Tad or Flp pili, are long thin microbial filaments that are made up of small-sized pilins. These appendages serve different functions in bacteria, including attachment, biofilm formation, surface sensing, motility, and host colonization. Despite their relevant role in diverse microbial lifestyles, knowledge about T4cP in bacteria that establish symbiosis with legumes, collectively referred to as rhizobia, is still limited. Sinorhizobium meliloti contains two clusters of T4cP-related genes: flp-1 and flp-2, which are located on the chromosome and the pSymA megaplasmid, respectively. Bundle-forming pili associated with flp-1 are involved in the competitive nodulation of alfalfa plants, but the role of flp-2 remains elusive. In this work, we have performed a comprehensive bioinformatic analysis of T4cP genes in the highly competitive S. meliloti GR4 strain and investigated the role of its flp clusters in pilus biogenesis, motility, and in the interaction with alfalfa. Single and double flp-cluster mutants were constructed on the wild-type genetic background as well as in a flagellaless derivative strain. Our data demonstrate that both chromosomal and pSymA flp clusters are functional in pili biogenesis and contribute to surface translocation and nodule formation efficiency in GR4. In this strain, the presence of flp-1 in the absence of flp-2 reduces the competitiveness for nodule occupation.

Case report: Management of pediatric gigantism caused by the TADopathy, X-linked acrogigantism.

X-linked acrogigantism (X-LAG) is a rare form of pituitary gigantism that is associated with growth hormone (GH) and prolactin-secreting pituitary adenomas/pituitary neuroendocrine tumors (PitNETs) that develop in infancy. It is caused by a duplication on chromosome Xq26.3 that leads to the misexpression of the gene GPR101, a constitutively active stimulator of pituitary GH and prolactin secretion. GPR101 normally exists within its own topologically associating domain (TAD) and is insulated from surrounding regulatory elements. X-LAG is a TADopathy in which the duplication disrupts a conserved TAD border, leading to a neo-TAD in which ectopic enhancers drive GPR101 over-expression, thus causing gigantism. Here we trace the full diagnostic and therapeutic pathway of a female patient with X-LAG from 4C-seq studies demonstrating the neo-TAD through medical and surgical interventions and detailed tumor histopathology. The complex nature of treating young children with X-LAG is illustrated, including the achievement of hormonal control using a combination of neurosurgery and adult doses of first-generation somatostatin analogs.

Corrosion Behavior of 10 ppi TAD3D/5A05Al Composite in a Chloride Environment.

This study utilizes desalted and denitrated treated aluminum dross (TAD) as a raw material, along with kaolin and 10 ppi (pores per inch) polyurethane foam as a template. The slurry is converted into an aluminum dross green body with a three-dimensional network structure using the impregnation method. A three-dimensional network aluminum dross ceramic framework (TAD3D) is created at a sintering temperature of 1350 °C. The liquid 5A05 aluminum alloy at a temperature of 950 °C infiltrates into the voids of TAD3D through pressureless infiltration, resulting in TAD3D/5A05Al composite material with an interpenetrating phase composite (IPC) structure. The corrosion behavior of TAD3D/5A05 composite material in sodium chloride solution was examined using the salt spray test (NSS) method. The study shows that the pores of the TAD3D framework, produced by sintering aluminum dross as raw material, are approximately 10 ppi. The bonding between TAD3D and 5A05Al interfaces is dense, with strong interfacial adhesion. The NSS corrosion time ranged from 24 h to 360 h, during which the composite material underwent pitting corrosion, crevice corrosion and self-healing processes. Results from Potentiodynamic Polarization (PDP) and Electrochemical Impedance Spectroscopy (EIS) indicate that, as corrosion progresses, the Ecorr of TAD3D/5A05Al decreases from -0.718 V to -0.786 V, and Icorr decreases from 0.398 µA·cm-2 to 0.141 µA·cm-2. A dense oxide film forms on the surface of the composite material, increasing the anodic Tafel slope and decreasing the cathodic Tafel slope, thus slowing down the rates of cathodic and anodic reactions. Factors such as lower interface corrosion resistance or a relatively weak passivation film at the interface do not significantly diminish the corrosion resistance of TAD3D and 5A05Al. The corrosion resistance of the composite material initially decreases and then increases.

Implementation of the Targeted Axillary Dissection Procedure in Clinically Node-Positive Breast Cancer: A Retrospective Analysis.

BACKGROUND: The targeted axillary dissection (TAD) procedure is used in clinically positive lymph node (cN+) breast cancer to assess whether pathological complete response (pCR) is achieved after neoadjuvant systemic therapy (NST) to decide on de-escalation of axillary lymph node dissection (ALND). In this study, we review the implementation of the TAD procedure in a large regional breast cancer center. METHODS: All TAD procedures between 2016 and 2022 were reviewed. The TAD procedure consists of marking pre-NST the largest suspected metastatic lymph node(s) using a radioactive I-125 seed. During surgery, the marked node was excised together with a sentinel node procedure. Axillary therapy (ALND, axillary radiotherapy, or nothing) recommendations were based on the amount of suspected positive axillary lymph nodes (ALNs < 4 or ≥ 4) pre-NST and if pCR was achieved after NST. RESULTS: A total of 312 TAD procedures were successfully performed in 309 patients. In 134 (43%) cases, pCR of the TAD lymph nodes were achieved. Per treatment protocol, 43 cases (14%) did not receive any axillary treatment, 218 cases (70%) received adjuvant axillary radiotherapy, and 51 cases (16%) underwent an ALND. During a median follow-up of 2.8 years, 46 patients (14%) developed recurrence, of which 11 patients (3.5%) had axillary recurrence. CONCLUSIONS: Introduction of the TAD procedure has resulted in a reduction of 84% of previously indicated ALNDs. Moreover, 18% of cases did not receive adjuvant axillary radiotherapy. These data show that implementation of de-escalation axillary treatment with the TAD procedure appeared to be successful.

Structural basis for the preservation of a subset of topologically associating domains in interphase chromosomes upon cohesin depletion.

Compartment formation in interphase chromosomes is a result of spatial segregation between euchromatin and heterochromatin on a few megabase pairs (Mbp) scale. On the sub-Mbp scales, topologically associating domains (TADs) appear as interacting domains along the diagonal in the ensemble averaged Hi-C contact map. Hi-C experiments showed that most of the TADs vanish upon deleting cohesin, while the compartment structure is maintained, and perhaps even enhanced. However, closer inspection of the data reveals that a non-negligible fraction of TADs is preserved (P-TADs) after cohesin loss. Imaging experiments show that, at the single-cell level, TAD-like structures are present even without cohesin. To provide a structural basis for these findings, we first used polymer simulations to show that certain TADs with epigenetic switches across their boundaries survive after depletion of loops. More importantly, the three-dimensional structures show that many of the P-TADs have sharp physical boundaries. Informed by the simulations, we analyzed the Hi-C maps (with and without cohesin) in mouse liver and human colorectal carcinoma cell lines, which affirmed that epigenetic switches and physical boundaries (calculated using the predicted 3D structures using the data-driven HIPPS method that uses Hi-C as the input) explain the origin of the P-TADs. Single-cell structures display TAD-like features in the absence of cohesin that are remarkably similar to the findings in imaging experiments. Some P-TADs, with physical boundaries, are relevant to the retention of enhancer-promoter/promoter-promoter interactions. Overall, our study shows that preservation of a subset of TADs upon removing cohesin is a robust phenomenon that is valid across multiple cell lines.

Correlation between cephalic screw positioning of Standard Gamma 3 Nail for intertrochanteric fractures and cut-out incidence.

INTRODUCTION: Lateral fractures of proximal femur are the most frequent fractures in elderly people. Internal fixation using medullary nails is the gold standard of treatment (Gamma 3 nail is the most implanted device) due to reduced incidence of complications than other devices. We report our experience in treating this kind of fractures with Gamma 3 nail, between January 2015 and December 2021. METHODS: We performed a retrospective cohort study of patients treated in our orthopaedic department; level of clinical care is III: 559 patients (431 females and 128 males, with an average age of 85.3 years) with lateral femoral neck fracture. All patients were surgically treated with Gamma 3 standard nail (SGN). We evaluated preliminary X-rays to classify fractures, according to AO-OTA classification and post-operative X-ray to verify cephalic screw position site, according to areas described by Cleveland in 1959: we measured tip-to-apex distance (TAD) and tip-to-apex calcar referred distance (CalTAD). Finally Chang reduction quality criteria (CRQC) for fracture reduction of trochanteric fractures were determined using preoperative or postoperative Antero-Posterior (AP) and lateral radiographs in a Picture Archiving and Communication System (PACS). Incidence of cut-out was evaluated in relation with these parameters. Patients were divided into 2 groups: first group had cephalic screw in optimal positions (5-8-9), the other group had cephalic screw in other positions. RESULTS: In 328 patients (58.7%) screw was in positions 5-8-9, in 231 patients (41.2%) screw was in not-optimal position. Median TAD was 19.1 ± 7.0 mm (range = 0.0-50.5); in 463 patients (82.8%) TAD was ≤ 25 mm. Median CalTAD was 21.4 ± 4.7 mm (range = 5.7-39.2); in 105 patients (79.4%) CalTAD was ≤ 25 mm. Cut-out was observed in 8 cases (1.43%). Multivariate analysis showed a significant correlation (p < 0,05) between incidence of cut-out and fracture type 31A2 and with TAD values >25 mm. Cephalic screw position did not influence incidence of cut-out. DISCUSSION: In order to obtain fracture healing with a low risk of failure, in particular cut-out, it is necessary to obtain good reduction of fracture and optimal lag screw position in order to achieve a TAD inferior to 25 mm.

Genetic Insights into Biofilm Formation by a Pathogenic Strain of Vibrio harveyi.

The Vibrio genus includes bacteria widely distributed in aquatic habitats and the infections caused by these bacteria can affect a wide range of hosts. They are able to adhere to numerous surfaces, which can result in biofilm formation that helps maintain them in the environment. The involvement of the biofilm lifestyle in the virulence of Vibrio pathogens of aquatic organisms remains to be investigated. Vibrio harveyi ORM4 is a pathogen responsible for an outbreak in European abalone Haliotis tuberculata populations. In the present study, we used a dynamic biofilm culture technique coupled with laser scanning microscopy to characterize the biofilm formed by V. harveyi ORM4. We furthermore used RNA-seq analysis to examine the global changes in gene expression in biofilm cells compared to planktonic bacteria, and to identify biofilm- and virulence-related genes showing altered expression. A total of 1565 genes were differentially expressed, including genes associated with motility, polysaccharide synthesis, and quorum sensing. The up-regulation of 18 genes associated with the synthesis of the type III secretion system suggests that this virulence factor is induced in V. harveyi ORM4 biofilms, providing indirect evidence of a relationship between biofilm and virulence.

ZNF143 deletion alters enhancer/promoter looping and CTCF/cohesin geometry.

The transcription factor ZNF143 contains a central domain of seven zinc fingers in a tandem array and is involved in 3D genome construction. However, the mechanism by which ZNF143 functions in chromatin looping remains unclear. Here, we show that ZNF143 directionally recognizes a diverse range of genomic sites directly within enhancers and promoters and is required for chromatin looping between these sites. In addition, ZNF143 is located between CTCF and cohesin at numerous CTCF sites, and ZNF143 removal narrows the space between CTCF and cohesin. Moreover, genetic deletion of ZNF143, in conjunction with acute CTCF degradation, reveals that ZNF143 and CTCF collaborate to regulate higher-order topological chromatin organization. Finally, CTCF depletion enlarges direct ZNF143 chromatin looping. Thus, ZNF143 is recruited by CTCF to the CTCF sites to regulate CTCF/cohesin configuration and TAD (topologically associating domain) formation, whereas directional recognition of genomic DNA motifs directly by ZNF143 itself regulates promoter activity via chromatin looping.

Topologically associating domains define the impact of de novo promoter variants on autism spectrum disorder risk.

Whole-genome sequencing (WGS) studies of autism spectrum disorder (ASD) have demonstrated the roles of rare promoter de novo variants (DNVs). However, most promoter DNVs in ASD are not located immediately upstream of known ASD genes. In this study analyzing WGS data of 5,044 ASD probands, 4,095 unaffected siblings, and their parents, we show that promoter DNVs within topologically associating domains (TADs) containing ASD genes are significantly and specifically associated with ASD. An analysis considering TADs as functional units identified specific TADs enriched for promoter DNVs in ASD and indicated that common variants in these regions also confer ASD heritability. Experimental validation using human induced pluripotent stem cells (iPSCs) showed that likely deleterious promoter DNVs in ASD can influence multiple genes within the same TAD, resulting in overall dysregulation of ASD-associated genes. These results highlight the importance of TADs and gene-regulatory mechanisms in better understanding the genetic architecture of ASD.

Chromatin remodeling analysis reveals the RdDM pathway responds to low-phosphorus stress in maize.

Chromatin in eukaryotes folds into a complex three-dimensional (3D) structure that is essential for controlling gene expression and cellular function and is dynamically regulated in biological processes. Studies on plant phosphorus signaling have concentrated on single genes and gene interactions. It is critical to expand the existing signaling pathway in terms of its 3D structure. In this study, low-Pi treatment led to greater chromatin volume. Furthermore, low-Pi stress increased the insulation score and the number of TAD-like domains, but the effects on the A/B compartment were not obvious. The methylation levels of target sites (hereafter as RdDM levels) peaked at specific TAD-like boundaries, whereas RdDM peak levels at conserved TAD-like boundaries shifted and decreased sharply. The distribution pattern of RdDM sites originating from the Helitron transposons matched that of genome-wide RdDM sites near TAD-like boundaries. RdDM pathway genes were upregulated in the middle or early stages and downregulated in the later stages under low-Pi conditions. The RdDM pathway mutant ddm1a showed increased tolerance to low-Pi stress, with shortened and thickened roots contributing to higher Pi uptake from the shallow soil layer. ChIP-seq results revealed that ZmDDM1A could bind to Pi- and root development-related genes. Strong associations were found between interacting genes in significantly different chromatin-interaction regions and root traits. These findings not only expand the mechanisms by which plants respond to low-Pi stress through the RdDM pathway but also offer a crucial framework for the analysis of biological issues using 3D genomics.

Interactions of Chromatin with the Nuclear Lamina and Nuclear Pore Complexes.

Heterochromatin and euchromatin form different spatial compartments in the interphase nucleus, with heterochromatin being localized mainly at the nuclear periphery. The mechanisms responsible for peripheral localization of heterochromatin are still not fully understood. The nuclear lamina and nuclear pore complexes were obvious candidates for the role of heterochromatin binders. This review is focused on recent studies showing that heterochromatin interactions with the nuclear lamina and nuclear pore complexes maintain its peripheral localization. Differences in chromatin interactions with the nuclear envelope in cell populations and in individual cells are also discussed.

Supramolecular Polymer Network based on Electrophilic Substitution (ES) Adduct of Furan-Triazolinedione.

Polymers with furan functionality have been the subject of extensive research on developing sustainable materials applying a limited number of dynamic covalent approaches. Herein, we introduce a facile, dynamic non-covalent approach to make a furan polymer readily accessible for self-healing applications based on its electrophilic substitution (ES) with a commercially available 1,2,4-triazoline-3,5-dione (TAD) derivative, 4-phenyl-TAD (PTAD). A tailor-made furan polymer, poly(furfuryl methacrylate) (PFMA), considering it an initial illustrative example, was rapidly ES modified with PTAD to produce furfuryl-tagged triazolidine that subsequently associated via inter-molecular hydrogen (H-) bonding to produce a thermally reversible supramolecular polymer network under ambient conditions. The H-bonded network was experimentally quantified via ATR-IR analysis and theoretically rationalized via the density functional theory (DFT) study using smaller organic model compounds analogous to the macromolecular system. Thermoreversible feature of the H-bonded triazolidine-derived supramolecular polymer network enabled the solution reprocessing and self-healing of the polymer material.

Survival analysis of temporary anchorage devices: A retrospective analysis in a Nigerian orthodontic patient population.

OBJECTIVES: Temporary anchorage devices (TADs) are skeletal anchorage devices. They are minimally invasive and placed by the orthodontist to prevent unwanted tooth movement. This study evaluated the survival rate of orthodontic TADs at 6 months. This study also assessed the effect of age, gender, side, site, dental arch of placement, and length of the TADs on its survival rate. MATERIALS AND METHODS: Ethical approval was obtained from the Health Research Ethics Committee of the hospital. The study sample comprised orthodontic patients who required the placement of TADs during treatment at a private dental facility in Lagos. Data for the study were obtained from the case files of the study subjects and included the subjects' age, gender, date of placement of the TADs, the site, side and arch of placement, the length of the TADs, and the survival rate of 6 months after placement. RESULTS: We reviewed 90 placed TADs and observed a survival rate of 88.9%. Most TAD failures occurred in the first month of placement (p = 001). There was no observable statistically significant effect of all other variables assessed (age, gender, arch, site, side, or implant length) on the survival rate of the TADs. CONCLUSIONS: The survival rate of TADs was high. Most TAD failures significantly occurred within one month of placement. There was no significant association between all other clinical variables and orthodontic mini-implant survival.

Insertion of orthodontic temporary anchorage devices with free gingival grafting for phenotype modification of the peri-implant mucosa.

Background: Mini Implants are widely used in contemporary orthodontics, they provide skeletal anchorage even in non-compliant patients, facilitate orthodontic tooth movement, are easy to place and are relatively inexpensive. Their failure is multifactorial, and the quality of the soft tissue can present a risk limitation for the insertion of TADS. Orthodontic Mini Implants inserted in keratinized gingiva present fewer tissue-related complications and higher survival rate, than those inserted in non-keratinized mucosa. The purpose of this report is to present and describe this novel technique to modify and enhance the peri-implant mucosa of Orthodontic Mini Implants inserted in nonkeratinized gingiva. Methods: A free gingival graft was harvested from the palate in combination with a buccal recipient site preparation in the alveolar mucosa and a TAD insertion procedure. Results: After twenty-one days of healing, graft integration was observed. One hundred and eighty days after insertion and twelve weeks of loading, none to mild signs of clinical inflammation were documented, and the patient reported no pain or discomfort. Conclusion: Within the limitations of this report, free gingival grafting for phenotype modification of the peri-implant mucosa, can benefit patients who need insertion of orthodontic mini-implants in non-keratinized mucosa for orthodontic tooth movement.

Human aortic smooth muscle cell regulation by METTL3 via upregulation of m6A NOTCH1 modification and inhibition of NOTCH1.

Background: Thoracic aortic dissection (TAD) is a very serious vascular condition that requires immediate treatment. Phenotypic conversion of human aortic smooth muscle cells (HASMCs) has been reported to be a causal factor for TAD development. Genetic variations affecting RNA modification may play a functional role in TAD. In this study, we aimed to explore the potential role of the methyltransferase like 3 (METTL3) and notch homolog 1 (NOTCH1) N6-methyladenosine (m6A) modification mechanisms in HASMCs. Methods: HASMCs were cultured. METTL3 was knocked down and overexpressed. Then, both METTL3 and NOTCH1 were simultaneously knocked down in HASMCs. HASMC proliferation was determined using Cell Counting Kit-8 (CCK-8). METTL3, NOTCH1, α-smooth muscle actin (α-SMA), smooth muscle protein 22-alpha (SM22α), and calponin expressions were monitored with quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting. An m6A dot blot assay was used to examine the m6A modification levels. The NOTCH1 3' untranslated region (3'UTR) m6A modification was analyzed using SRAMP and RMBase v. 2.0. A methylated RNA immunoprecipitation (MeRIP) assay was used to evaluate the METTL3 overexpression effect on m6A modification of NOTCH1 messenger RNA (mRNA). A dual-luciferase assay was used to investigate the effect of METTL3 binding of the NOTCH1 mRNA m6A modification site. YTH domain family 2 (YTHDF2)-RNA immunoprecipitation (RIP) was used to detect the change in YTHDF2's ability to bind to NOTCH1 mRNA after METTL3 overexpression. Results: Overexpression of METTL3 inhibited α-SMA, SM22α, calponin, and NOTCH1 expressions and promoted HASMC proliferation. Knocking down METTL3 had the opposite effect. The cointerference of the METTL3 and NOTCH1 results suggested that METTL3 regulated NOTCH1, contributing to HASMC phenotypic changes. The MeRIP assay showed that the m6A modification of NOTCH1 mRNA increased after METTL3 overexpression. The dual-luciferase assay indicated that the NOTCH1 mRNA m6A modification site and METTL3 overexpression promoted NOTCH1 mRNA degradation. YTHDF2-RIP further demonstrated that the binding ability of YTHDF2 and NOTCH1 mRNA was enhanced after METTL3 overexpression. Conclusions: METTL3 regulated the phenotypic changes of HASMC by upregulating m6A modification of NOTCH1 and inhibiting NOTCH1.

Chromosome-level organization of the regulatory genome in the Drosophila nervous system.

Previous studies have identified topologically associating domains (TADs) as basic units of genome organization. We present evidence of a previously unreported level of genome folding, where distant TAD pairs, megabases apart, interact to form meta-domains. Within meta-domains, gene promoters and structural intergenic elements present in distant TADs are specifically paired. The associated genes encode neuronal determinants, including those engaged in axonal guidance and adhesion. These long-range associations occur in a large fraction of neurons but support transcription in only a subset of neurons. Meta-domains are formed by diverse transcription factors that are able to pair over long and flexible distances. We present evidence that two such factors, GAF and CTCF, play direct roles in this process. The relative simplicity of higher-order meta-domain interactions in Drosophila, compared with those previously described in mammals, allowed the demonstration that genomes can fold into highly specialized cell-type-specific scaffolds that enable megabase-scale regulatory associations.

Acclimatizing waste activated sludge in a thermophilic anaerobic fixed-bed biofilm reactor to maximize biogas production for food waste treatment at high organic loading rates.

Thermophilic anaerobic digestion (TAD) provides a promising solution for sustainable high-strength waste treatment due to its enhanced methane-rich biogas recovery. However, high organic loading rates (OLR) exceeding 3.0 kgCOD/m3/day and short hydraulic retention times (HRT) below 10 days pose challenges in waste-to-energy conversion during TAD, stemming from volatile fatty acids (VFAs) accumulation and methanogenesis failure. In this study, we implemented a stepwise strategy for acclimatizing waste activated sludge (WAS) in a thermophilic anaerobic fixed-bed biofilm reactor (TA-FBBR) to optimize methanogen populations, thereby enhancing waste-to-energy efficiencies under elevated OLRs in food waste treatment. Results showed that following stepwise acclimatization, the TA-FBBR achieved stable methane production of approximately 5.8 L/L-reactor/day at an ultrahigh OLR of ∼20 kgCOD/m3/day and ∼15 kgVS/m3/day at 6-day HRT in food waste treatment. The average methane yield reached 0.45 m3/kgCODremoval, attaining the theoretical production in TAD. Moreover, VFA concentrations were stabilized below 1000 mg/L at the ultrahigh OLR under 6-day HRT, while maintaining an acetate/propionate ratio of > 1.8 and a VFA/TAK ratio of < 0.3 serving as effective indicators of system stability and methane yield potential. The microbial community analysis revealed that the WAS acclimatization strategy fostered the microbial diversity and abundance of Methanothermobacter and Methanosarcina. Methanosarcina in the biofilm were observed to be twice as abundant as Methanothermobacter, indicating a potential preference for biofilm existence among methanogens. The findings demonstrated an effective strategy, specifically the stepwise acclimatization of WAS in a thermophilic fixed-bed biofilm reactor, to enhance the food waste treatment performance at high OLRs, contributing valuable mechanistic and technical insights for future sustainable high-strength waste management.

Can computer-guided surgery help orthodontics in miniscrew insertion and corticotomies? A narrative review.

Orthodontics has considerably increased the use of technology combined with surgery as a tool to improve dental movements in terms of predictability, acceleration of movement, and fewer side effects. To achieve these goals miniscrews and corticotomy were introduced. The digital workflow permits an increase in the accuracy of surgical and orthodontic setups. The tool that transfers the information is the CAD/CAM (Computer-Aided Design/ Computer-Aided Manufacturing) template. The aim of this review is to illustrate the use of computer-guided surgery in orthodontics regarding miniscrews and piezocision. The search strategy was a combination of Medical Subject Headings (Mesh) and free text words for PubMed. A total of 27 articles were included in this review: 16 concerned miniscrews and 11 concerned corticotomy. The current need for faster treatments, the improved systems of anchorage, and the evolution of imaging technologies require operators to be knowledgeable of the digital workflow. CAD/CAM templates allow greater precision and predictability of miniscrew insertion even if in the hands of less experienced clinicians and permit a better orientation and depth of the cortical incision. In conclusion, digital planning makes surgery faster and easier and allows for the identification and correction of any potential problem before the procedure.

Abordaje terapéutico del colapso transversal del maxilar superior con microimplantes (TAD´s) / Therapeutic approach of transverse maxillary collapse with microimplants (TAD's)

Introducción. La atresia o estrechez del maxilar superior es una patología de origen multifactorial que genera un colapso transversal, el mismo e implica la carencia de espacio necesario para la disposición correcta de las piezas dentales. Objetivo. El presente artículo está enmarcado en una revisión narrativa de la literatura, con el objetivo de describir el abordaje terapéutico del colapso transversal del maxilar superior con microimplantes (TAD´s), determinando los efectos esqueléticos y dentoalveolares en el maxilar superior, así como las ventajas y desventajas del tratamiento. Método. La búsqueda de artículos se realizó a través de mediante las plataformas de: Scielo, PubMed, Google Académico y Medline. Se seleccionaron 21 artículos cuyos textos completos fueron descargados para examinarlos a detalle y verificar que cumplieran con todos los criterios de inclusión, de los cuales se obtuvieron 16 artículos para elaborar esta revisión narrativa. Conclusiones. El abordaje terapéutico del colapso transversal se produce por medio de la expansión rápida del maxilar (ERM) o disyunción maxilar, en pacientes jóvenes en crecimiento; y en los pacientes adultos se suele emplear un tratamiento con técnica MARPE con microimplantes (TAD´s). El principal efecto esquelético es la apertura de la sutura maxilar que varía de 2 a 10 mm, muchos autores coinciden en que el manejo del colapso transversal del maxilar superior con microimplantes no genera efectos dentoalveolares negativos, al contrario, tiene ventajas biomecánicas debido al anclaje con el hueso, reduciendo el riesgo de movimiento dentales indeseados y permitiendo un control del crecimiento vertical.

Introduction. The atresia or narrowness of the upper jaw is a pathology of multifactorial origin that generates a transverse collapse, it implies the lack of space necessary for the correct arrangement of the dental pieces. Objective. This article is framed in a narrative review of the literature, with the aim of describing the therapeutic approach of transverse maxillary collapse with microimplants (TAD's), determining the skeletal and dentoalveolar effects in the maxilla, as well as the advantages and disadvantages of treatment. Method. The search for articles was carried out through the following platforms: Scielo, PubMed, Google Scholar and Medline. 21 articles whose full texts were downloaded were selected to examine them in detail and verify that they met all the inclusion criteria, of which 18 articles were obtained to prepare this narrative review. Conclusions. The therapeutic approach to transverse collapse occurs through rapid maxillary expansion (RME) or maxillary disjunction, in young growing patients; and in adult patients, treatment with the MARPE technique with microimplants (TAD's) is usually used. The main skeletal effect is the opening of the maxillary suture, which varies from 2 to 10 mm. Many authors agree that the management of the transverse collapse of the maxilla with microimplants does not generate negative dentoalveolar effects, on the contrary, it has biomechanical advantages due to the anchorage with the bone, reducing the risk of unwanted dental movement and allowing control of vertical growth.