Angela Pia Cazzolla

Down-regulated expression of transforming growth factor beta 1 mRNA in endometrial carcinoma

Transforming growth factor beta1 (TGF-beta1) is a potent modulator of cell proliferation in vitro, and recent studies have demonstrated its overexpression in several different tumours; nevertheless, the molecular mechanisms of TGF-beta1 action on cell growth and differentiation have not been fully elucidated. To clarify the role of TGF-beta and its receptor in human endometrial proliferation and differentiation, TGF-beta1 expression at both the mRNA and protein levels has been evaluated by using Northern blotting and immunohistochemistry, in both normal (atrophic, proliferative and secretory) and neoplastic (adenocarcinoma) endometrial samples. This study demonstrates that TGF-beta1 mRNA expression is dramatically reduced in endometrial carcinomas with respect to non-neoplastic tissues, whereas the immunohistochemical expression of TGF-beta1 is enhanced in the epithelial component of endometrial carcinomas compared with non-neoplastic tissues. These data suggest that TGF-beta1 acts as a paracrine regulator of endometrial cell proliferation and that it may contribute to the carcinogenic mechanisms of endometrial carcinoma.

Dentinogenesis imperfecta in children with osteogenesis imperfecta: a clinical and ultrastructural study

AIM The aim of this study was to assess the correlation between osteogenesis imperfecta (OI) and dentinogenesis imperfecta (DI) from both a clinical and histological point of view, particularly clarifying the structural and ultrastructural dentine changes. DESIGN Sixteen children (6-12 years aged) with diagnosis of OI were examined for dental alterations referable to DI. For each patient, the OI type (I, III, or IV) was recorded. Extracted or normally exfoliated primary teeth were subjected to a histological examination (to both optical microscopy and confocal laser-scanning microscopy). RESULTS A total of ten patients had abnormal discolourations referable to DI: four patients were affected by OI type I, three patients by OI type III, and three patients by OI type IV. The discolourations, yellow/brown or opalescent grey, could not be related to the different types of OI. Histological exam of primary teeth showed severe pathological change in the dentin, structured into four different layers. A collagen defect due to odontoblast dysfunction was theorized to be on the base of the histological changes. CONCLUSIONS There is no correlation between the type of OI and the type of discolouration. The underlying dentinal defect seems to be related to an odontoblast dysfunction.

Changes in pharyngeal aerobic microflora in oral breathers after palatal rapid expansion

BackgroundThe purpose of this study was to investigate in oral breathing children the qualitative and quantitative effects on aerobic and facultatively anaerobic oropharyngeal microflora of respiratory function improved by rapid palatal expansion (RPE).MethodsIn an open clinical trial, we studied 50 oral breathers, aged 8 to 14 years and suffering from both maxillary constriction and posterior cross-bite. At baseline, patients were examined by a single otorhinolaryngologist (ENT), confirming nasal obstruction in all subjects by posterior rhino-manometric test. Patients were evaluated three times by oropharyngeal swabs:1) at baseline (T = 0); 2) after palatal spreading out (T = 1); and 3) at the end of RPE treatment (T = 2). With regard to the microbiological aspect, the most common and potentially pathogenic oral microrganisms (i.e. Streptococcus pyogenes, Diplococcus pneumoniae, Staphylococcus aureus, Haemophilus spp, Branhamella catarrhalis, Klebsiella pneumoniae, Candida albicans) were specifically detected in proper culture plates, isolated colonies were identified by means of biochemical tests and counted by calibrated loop. The data were analyzed by means of the following tests: Chi-square test, Fishers exact test and Wilcoxons test.ResultsAfter the use of RME there was a statistically significant decrease of Staphylococcus aureus stock at CFU/mLat T1(P = 0.0005; Z = -3,455 by Wilcoxon Rank test) and T2 (P < 0.0001; Z = -4,512 by Wilcoxon Rank test) vs T0. No significant changes were found for the other examined microrganisms.ConclusionOur data suggest that RPE therapy in oral breathers may strongly reduce the pathogenic aerobic and facultatively anaerobic microflora in the oral pharynx after a normalization of the upper airways function, and may reduce the risk of respiratory infections.

Condylar Position Indicator and T-Scan system II in clinical evaluation of temporomandibular intracapsular disease

INTRODUCTION The pathogenesis of temporomandibular joint intracapsular disease (TMJI) is multifactorial and its diagnosis is not easy. In this work authors show two types of clinical analysis: the Condylar Position Indicator (CPI) and T-Scan 2 system. MATERIAL AND METHODS Twenty patients (mean age of 24.5 years) with TMJI problem and 10 healthy matched subjects (mean age: 25.4 years) were selected. Analysis of TMJI was performed on each patient by means of Condylar Position Indicator (CPI) and T-Scan System II tests. RESULTS Eight patients presented vertical symmetrical condylar distraction greater than healthy subjects (P-value<0.001). T-Scan showed a difference of Percentage of Force (POF) not greater than 5%. Seven patients showed sagittal shift greater than healthy subject (P-value<0.001). T-Scan records showed a difference of POF greater than 5%. Five non-healthy subjects presented sagittal, vertical, transverse shift greater than healthy subjects (P-value<0.001). T-Scan records show a difference of POF greater than 5%. CONCLUSION In this work authors present a new method of analysis. CPI indicates discrepancy of the condyle position in CO from CR and T-Scan allows the operator to study all teeth contacts and occlusal forces taking place during dynamic jaw movement.

Síndrome de Rendu-Osler-Weber o Telangiectasia Hemorrágica Hereditaria (HHT): Descripción de dos casos y revisión de la literatura

El sindrome de Rendu-Osler-Weber, tambien conocido como Telangiectasia Hemorragica Hereditaria, es un desorden vascular cuya prevalencia se estima que afecta a uno de cada 5-8.000 individuos. Se trata de una alteracion vascular displasica multisistemica de caracter autosomico dominante, asociada a dos genes, HHT1 y HHT2, que determinan mutaciones en el gen endoglina (ENG), localizado en el cromosoma 9, y por mutaciones en el gen ALK1, localizado en el cromosoma 12. El 95% de los afectados presentan epitaxis recurrentes, con edad media de comienzo a los 12 anos e incremento progresivo del sangrado nasal en frecuencia y severidad. Generalmente se presenta asociado a malformaciones arteriovenosas pulmonares y/o multiples telangiectasias en sistema gastrointestinal, manos, cara, cavidad oral y afectacion de otras visceras. El diagnostico inicial de HHT continua basandose en la presencia de signos clinicos compatibles junto con la historia familiar. Para el diagnostico molecular es necesario secuenciar las regiones codificantes cormpletas de los genes ALK1 y ENG. El test genetico no es positivo en el 100% de los pacientes con diagnostico clinico de HHT, siendo posible no encontrar en un mismo grupo familiar la mutacion comun. Se revisa la literatura y se presentan dos casos con manifestaciones orales en lengua y labio inferior, sin otras lesiones sistemicas asociadas, tratada en nuestro departamento por problemas odontologicos

Hyperphosphatemic Familial Tumoral Calcinosis: Odontostomatologic Management and Pathological Features

Patient: Male, 9 Final Diagnosis: Hyperphosphatemic familial tumoral calcinosis Symptoms: — Medication: — Clinical Procedure: Ortopantomography Specialty: Dentistry Objective: Rare disease Background: Hyperphosphatemic familial tumoral calcinosis (HFTC) is to a rare autosomal recessive disorder characterized by cutaneous and sub-cutaneous calcified masses, usually adjacent to large joints. The aim of the current study was to report on the clinico-pathological features of a patient with HFCT, with emphasis on alterations in the jawbones and teeth and the subsequent therapeutic interventions. Case Report: A 13-year-old male patient with HFTC diagnosis came to our attention for dental anomalies and maxillary and mandibular hypoplasia. OPT highlighted multiple impacted teeth, short and bulbous teeth, and pulp chamber and canal obliterations. Lateral cephalometric radiograms pointed out retrusion of both jaws, skeletal class II malocclusion, and deep-bite. He underwent orthopedic, orthodontic, conservative, and surgical treatments, allowing the correction of maxillo-facial and dental abnormalities and dysmorphisms without adverse effects. The surgical samples were sent for conventional and confocal laser scanning microscope (CLSM) histopathological examination, which highlighted several metaplastic micro- and macro-calcifications in the soft tissues, and typical islands of homogenous, non-tubular, dentino-osteoid calcified structures in dentinal tissues. Conclusions: The management of maxillo-facial abnormalities in patients affected by HFTC is very difficult and, requires a combined therapeutic approach. To date, very few indications have been published in the literature.

Orthopedic‐orthodontic treatment of the patient with Turner's syndrome: Review of the literature and case report

AIMS Turner syndrome (TS) patients have phenotypical variable presentations and they are more susceptible to endocrine, auto-immune, and structural anomalies. Typical clinical characteristics are short stature and premature ovarian insufficiency. Patients with TS show a typical cranial-facial morphology with bi-maxillary bi-retrusion, high-arched palate, micrognathia, and class II malocclusion. Aim of our study is to present the orthopedic-orthodontic treatment approach of a young TS patient and data of stability after 7 years. METHODS AND RESULTS A careful analysis of anamnestic data was performed. After extraoral and intraoral examination, cephalometric measurements and examination of models, appropriate orthopedic-orthodontic appliances were positioned in order to correct skeletal alterations due to primary pathology as much as possible. Consistent improvements were observed after the treatment. Clinical and radiographic follow-up at 7 years showed a net improvement of head posture and stability of the occlusal results. CONCLUSIONS An early diagnosis and appropriate orthopedic-orthodontic intervention allow to simplify the management of TS patients and provide satisfactory and stable results.

Primary hyperoxaluria: Orthodontic management in a pediatric patient: A case report

AIMS The aim of this study is to report the case of the orthodontic treatment in a patient affected by primary hyperoxaluria type 1 and subjected to a combinate liver-kidney transplant. METHODS AND RESULTS The 9-year patient was admitted to our department for the presence of facial dysmorphism. The patient was affected by primary hyperoxaluria type 1 and has undergone a combined liver-kidney transplantation. At the time of the visit, he was in treatment with immunosuppressive drugs and received a corticosteroid and an antibiotic therapy monthly. An intraoral and extraoral examination, as well as radiographic and model analysis, was performed in order to define an accurate diagnosis and a proper rehabilitation planning. An orthopedic-orthodontic treatment was performed and satisfactory final results obtained. A laser gingivectomy was also realized for eliminate the gengival hyperplasia probably induced by cyclosporine assumption. Both skeletal and dental relationships were improved by the treatment, reaching a good dental arches alignment. CONCLUSION An early diagnosis, as well as a multidisciplinary approach, is very important in patients with rare diseases. An appropriate treatment allowed us to achieve acceptable results and improve the patient quality of life.

Non-surgical Treatment of Condylar Fracture in an 11-Year-Old Patient: a Case Report

ABSTRACT Background Mandibular condylar fractures commonly occur after trauma and account for 25 to 35% of all mandibular fractures; its appropriate therapy still remains a point of controversy in children. The purpose of this paper is to describe the treatment of an 11-years-old male patient affected by neck-condylar fracture as result of trauma in evolutive age. Methods No surgical treatment was performed. A functional therapy was applied with a jaw splint. A closed treatment for mandibular condyle fractures was preferred because the amount of condylar displacement wasn’t considerable. Results The early treatment with functional therapy generated a functional adaptation of the condyle in the glenoid fossa and a normal mandibular function. After a 12-month follow-up the fracture resolution and an optimal condylar position were recorded. Conclusions The current case report and literature review showed that non-surgical therapy of neck-condylar fracture in a child with lower resin splint can restore mandibular movements and aesthetics. Facial growth after one year treatment resulted normal. A conservative treatment may be appropriate for children in selected cases with minimally displaced condyle.

Improvements in Obstructive Sleep Apnea Syndrome (OSAs) in Patient with Treacher Collins Syndrome (TCs): A Multidisciplinary Approach.

Introduction : The aim of this work is to present the improvements of a proper management of OSAs in a patient with TCs through a multidisciplinary approach with Oral-Maxillofacial team. Obstructive Sleep Apnea syndrome (OSAs) is characterized by upper airway obstruction during sleep and an increase airflow resistance mainly at the level of oropharynx, resulting in reduced pulmonary ventilation and hypoxia. Results and Discussion : Computed tomography shows an improvement in axial and sagittal section of the Minimal Cross Sectional Areas of the pharyngeal airway. The Cephalometric analysis showed an increased of SNA, MP-H, Go-Gn/H and a decrease of SNB, ANB, PAS, AHI. The different modifications of the LeFort I osteotomy have been proved to diminish the nasal airway resistance. Conclusions :Five years after surgery, the patient has a stable clinical result with a good aesthetic and a harmonious facial balance. He does not suffer from snoring, daytime somnolence or fatigue and has not required the use of c-PAP since surgery.