Biomedical subjects
Publications and source records attributed to L Franchi.
An orthopedic appliance for the correction of skeletal Class III malocclusion in the primary dentition is described. The appliance consists of two resin splints with hooks for Class III elastic intraoral traction. Construction features and biomechanical aspects of the device are described along with the clinical evaluation of treatment effects in two case reports.
Orally active nonpeptide antagonists of endothelin (ET) receptors may prove beneficial in the treatment of cardiovascular and renal disease. The pharmacodynamics and pharmacokinetics of these drugs are not sufficiently known, and practical methods for their analysis have not been developed. We describe a simple, sensitive, and reproducible radioreceptor assay (RRA) for LU135252, a selective antagonist of the ETA receptor, using porcine aortic smooth muscle membranes as the acceptor and 125I-endothelin-1 as the ligand. With methanol extraction of plasma and urine samples, recovery of LU135252 ranged from 79% to 91% at 60-1000 nmol/L. The logit-log transformed calibration curves constructed with LU135252 added to plasma or to urine were linear (r = 0.993 +/- 0.005, n = 11) in the range from 18.7 to 2400 nmol/L. The detection limit with plasma- and urine-based calibration curves was 19 nmol/L. The interassay coefficient of variation was 12.6% at 70 nmol/L (n = 9) and 6.5% at 590 nmol/L (n = 9). Endothelin-1 did not interfere in the RRA at pathophysiologically and clinically relevant concentrations [up to 15 pmol/L (40 pg/ mL)]. When LU135252 was added to plasma, the signal was completely stable after storage for 1 week at 4 degrees C, although there was a modest loss of the signal after 24 h at room temperature. The practical performance of this RRA was then tested in plasma samples obtained from (a) rats after a single oral administration of LU135252, (b) from coronary-ligated rats chronically treated with LU135252, and (c) in plasma and urine samples obtained from dogs during intrarenal infusion of LU135252.
INTRODUCTION: US of some muscular components of the stomatognathic system (orbicularis oris and masseter muscles) has proved to provide important information about their morphologic features. The purpose of this study is to explore the US features of the perioral and masticatory muscles in patients affected with any type of malocclusion and to analyze the correlations between dento-skeletal characteristics and muscle changes. MATERIAL AND METHODS: We examined 26 untreated patients (10 men and 16 women); we measured their cephalometric parameters on lateral skull teleradiographs and then we measured with US both the masseter and orbicular muscles dimensions. The US images were acquired with 5 MHz and 7.5 MHz probes, measuring the masseter muscle with transversal and longitudinal scans, and the two parts of the orbicularis oris with longitudinal scans. The cephalometric measures were calculated with: angular parameters useful to determine the sagittal relationships, both angular and linear parameters to define the vertical relationships and angular measures that define the incisor position. We applied the Spearman test to assess if there was a relationship between the US dimensions of the orbicularis oris and the masseter, and the dento-skeletal characteristics of these 26 patients. RESULTS: Our results show that there is a strong correlation between mandibular morphology, the palatal plane, respectively, and the masseter length. There is a direct correlation with the masseter dimension for the palatal plane obliquity, and an inverse correlation for the mandibular morphology. The incisor position is influenced by the orbicular oris muscle dimension and by the asymmetric position of the superior and inferior incisors. CONCLUSIONS: This noninvasive diagnostic examination is a useful aid to the clinical examination of the muscles, especially in orthodontic diagnosis, together with MRI and CT, respectively more expensive and unhealthier.
The current study was undertaken to evaluate both maxillary and mandibular shape/size changes in children with Class III malocclusions, treated with a functional appliance (removable mandibular retractor). Nonconventional cephalometric methods (Bookstein's shape coordinate analysis, centroid size analysis, and tensor analysis) were applied to a maxillary triangle (T-FMN-A) and to a mandibular triangle (Co-Go-Pg). A group of 30 children with treated Class III malocclusions were compared with a matched group of 30 children with untreated Class III malocclusions. Treatment with the functional appliance produced a significantly increased growth of the maxilla, featuring a more downward and forward displacement of the region of point A and a significantly more upward and forward direction of condylar growth, leading to a "shrinkage" of total mandibular length. The biologic significance of some conventional cephalometric measurements used for the assessment of both maxillary and mandibular position and structure was tested.
The aim of this study was to select a model of cephalometric and occlusal predictive variables for the results of early treatment of Class III malocclusion, due to mandibular protrusion in the deciduous dentition. Lateral cephalograms and dental casts of 45 subjects (22 boys and 23 girls) with Class III malocclusion in the deciduous dentition were analyzed at the start of treatment (mean age 5.57 +/- 0.85 years). The patients were treated with a functional appliance (removable mandibular retractor). All subjects were reevaluated after a mean period of 9.54 +/- 2.28 years comprising active treatment plus retention. At this time, the sample was divided into two groups according to occlusal criteria: successful group (23 subjects) and unsuccessful group (22 subjects). Stepwise variable selection on the measurements at the time of first observation identified three predictive variables; the inclination of the condylar axis in relation to the stable basicranial line (CondAx-SBL), the inclination of the nasal line to the mandibular line (NL-ML), and the transverse width of the mandibular arch measured at the first deciduous molars. Discriminant analysis assigned a classificative power of 95.55% to the predictive model. On the basis of the equation generated by the multivariate statistical method, outcome of early treatment for each new case with Class III malocclusion in the deciduous dentition can be accordingly predicted. The important role of both vertical and transverse relationships in Class III prognosis was emphasized.
A group of 25 untreated subjects with Class II malocclusion in the deciduous dentition (featuring the concomitant presence of distal step, Class II deciduous canine relationship, and excessive overjet) was compared with a control group of 22 untreated subjects with ideal occlusion (flush terminal plane, Class I deciduous canine relationship, minimal overbite, and overjet) at the same dentitional stage. The subjects were monitored during a 2 1/2-year period in the transition from the deciduous to the mixed dentition, during which time no orthodontic treatment was provided. Occlusal analysis of the Class II group in the deciduous dentition revealed an average interarch transverse discrepancy due to a narrow maxillary arch relative to the mandible. All occlusal Class II features were maintained or became exaggerated during the transition to the mixed dentition. The skeletal pattern of Class II malocclusion in the deciduous dentition typically was characterized by significant mandibular skeletal retrusion and mandibular size deficiency. During the period examined, cephalometric changes consisted of significantly greater maxillary growth increments and smaller increments in mandibular dimensions in the Class II sample. Moreover, a greater downward and backward inclination of the condylar axis relative to the mandibular line, with consequent smaller decrements in the gonial angle, were found in the Class II group, an indication of posterior morphogenetic rotation of the mandible in patients with Class II malocclusion occurring during the period examined. The results of this study indicate that the clinical signs of Class II malocclusion are evident in the deciduous dentition and persist into the mixed dentition. Whereas treatment to correct the Class II problem can be initiated in all three planes of space (e.g., RME, extraoral traction, functional jaw orthopedics), other factors such as patient cooperation and management must also be taken into consideration before early treatment is started.
The purpose of the present study was to analyse the position of the glenoid fossa in subjects with different sagittal and vertical skeletal features. A cephalometric study was carried out on a sample of 180 subjects (90 males and 90 females, aged 7-12 years) who were combined to form three groups (60 subjects each) according to skeletal sagittal relationships and three groups (60 subjects each) according to skeletal vertical relationships. Cephalometric analysis comprised both sagittal and vertical measurements for the assessment of the position of the glenoid fossa in relation to surrounding skeletal structures. As for sagittal measurements, TMJ position was more posterior in skeletal Class II when compared with skeletal Class III. In the vertical plane, the position of the glenoid fossa relative to basicranial structures was more caudal in low angle subjects when compared with subjects with normal or high angle vertical relationships. Both basicranial structures and the posterior nasal spine may be used as reference structures for the assessment of vertical position of the glenoid fossa in diagnosis and treatment planning.
Posterior transverse interarch discrepancy (PTID), measured as the difference between the maxillary and mandibular intermolar widths, was investigated in a sample of 60 Class II, Division 1 subjects during the mixed dentition phase. Two main groups were detected: Class II group 1 (30 subjects) with PTID and Class II group 2 (30 subjects) without PTID. A sample of 30 Class I subjects in the mixed dentition phase was used as a control group. In Class II group 1, PTID was found to be due to a significantly narrower maxillary arch. The craniofacial skeletal features of both Class II groups and of the Class I group were assessed. The Class II group with PTID showed mandibular retrusion associated with a posteriorly displaced mandible of normal size (functional mandibular retrusion). The Class II group without PTID had mandibular retrusion due to a micrognathic mandible (anatomic mandibular retrusion). The relevance of these findings for treatment planning in Class II, Division 1 malocclusion in the mixed dentition was stressed.
To evaluate the effects of a functional appliance (removable mandibular retractor) on the craniofacial skeleton in children with Class II malocclusions, a longitudinal cephalometric study was performed. A sample of 30 children with treated Class III malocclusions (18 boys, 12 girls, mean age at the first observation 5.64 +/- 1.01 years, mean age at the second observation 8.43 +/- 1.73 years) was compared to a sample of 30 children with untreated Class III malocclusions (13 boys, 17 girls, mean age at first observation 6.06 +/- 1.14 years, mean age at the second observation 8.45 +/- 1.79 years) used as controls. The treated group matched the control group as to sex, age at the first observation, age at the second observation, observation period, Class III occlusal signs, and also as to angular craniofacial dimensions at the first observation. A cephalometric analysis based on a stable basicranial reference system was applied. The main significant findings in the treated group were an anterior morphogenetic rotation of the mandible as a result of an upward-forward direction of condylar growth, a more vertical orientation of the ramus, and a reduced gonial angle; reduced mandibular protrusion and total length; increased maxillary protrusion; increased maxillary dentoalveolar protrusion and reduced mandibular dentoalveolar protrusion. No significant changes in the vertical craniofacial relationships and in cranial base angulation were observed. The role of an early correction of Class III occlusal relationship in the establishment of a more favorable craniofacial growth pattern was discussed.
This study provides norms for the evaluation of individual skeletal patterns in subjects with full deciduous dentition. The method is based on the associations among correlated craniofacial measurements (S-N-A, S-N-B, NL-NSL, ML-NSL, N-S-Ba). The results are given in a graphical box-like form (floating norms). An easy practical procedure allows identification of either individual harmonious craniofacial features or anomalous deviations from the individual norm. The use of cephalometric floating norms in the deciduous dentition phase is strongly recommended for early diagnosis and treatment planning.
Eruption anomalies of the maxillary permanent cuspid on the cleft side was analyzed in a sample of 77 children with mono- and bi-lateral cleft lip/palate. The main findings were: 1) The permanent cuspid showed an initial mesial position in relation to the root of its primary predecessor in a relatively high number of cases. Nearly all those cuspids that showed an anomalous position (mesial or distal) in relation to the corresponding primary teeth at the time of the first observation erupted in malposition (palatally in the cleft area, mesially or distally to the primary cuspids). 2) In most cases presenting a mesially positioned permanent cuspid at the time of first observation, the permanent later incisor was congenitally missing, microdontic or in a mesial position in relation to the cleft. 3) Distally positioned permanent cuspids were always associated with a supernumerary lateral incisor. 4) A congenitally missing lateral incisor could represent a predisposing factor to a mesial position of the permanent cuspid. An early radiographic evaluation of the position of the permanent cuspid was suggested especially in those children presenting a congenitally missing lateral incisor.
A superimposition study on mandibular stable structures was performed to evaluate changes in mandibular rotation and in the direction of condylar growth induced by early treatment of Class III malocclusion by a functional appliance (removable mandibular retractor). A sample of 18 children with treated Class III malocclusions, mean age at the first observation (immediately before the beginning of treatment) 5.47 +/- 1.14 years, mean age at the second observation 8 +/- 1.29 years, mean observation period 2.5 +/- 0.9 years, was compared with a control group of 18 children with untreated Class III malocclusions, mean age at the first observation 5.72 +/- 1.11 years, mean age at the second observation 7.86 +/- 1.44 years, mean observation period 2.27 +/- 0.92 years. No statistically significant difference between the two groups was recorded for positional (total) rotation of the mandible. A significant upward-forward direction of condylar growth was assessed in the treated group (p < 0.001). This therapeutically induced change in growth direction of the mandibular condyle was considered a skeletal sign of anterior morphogenetic rotation of the mandible, i.e., a mechanism compensating for excessive mandibular growth.
Three fragments of the upper jaw of an Etruscan adolescent of the 6th century B.C. discovered at the necropolis of Cancellone 1 (Magliano in Tuscany, Grosseto, Italy) were examined. A triad of associated dental anomalies was found: congenitally missing second premolars, "peg-shaped" permanent lateral incisors, and ectopic (palatal) eruption of a permanent canine. These findings provided the opportunity to discuss etiopathogenetic aspects of the associations among different types of tooth abnormalities.
Aerosolized furosemide has been shown to prevent the worsening of different variables in pulmonary function testing, following exercise or bronchial provocation with numerous agents. To investigate if aerosolized furosemide has a bronchodilator effect, we performed two prospective, randomized, placebo-controlled, double-blinded and crossover studies of four aerosol regimens in children with mild chronic asthma. In a pilot study examining three different doses of furosemide in 11 children, the dose of 1.0 mg/kg resulted in a mean maximum increase of 30.0 +/- 6.8% in forced expiratory flow between 25 and 75% vital capacity (FEF25-75), compared with a 3.1 +/- 6.8% increase after aerosolized normal saline. The effect was observed after 10 minutes with a mean percent change of 17.7 +/- 1.7% from baseline, that persisted to 30 minutes (19.3 +/- 3.7%) and was significantly greater than that seen following aerosolized placebo (1.4 +/- 2.9% and 0.7 +/- 3.4%, respectively; P < 0.05). We then compared the effect of furosemide with that of aerosolized albuterol (0.15 mg/kg) in 18 patients. There was no statistically significant difference in the improvement observed in forced expiratory volume in 1 second (FEV1) for albuterol (15.0 +/- 2.7%) compared with furosemide (12.1 +/- 2.9%) or in FEF25-75 (42.9 +/- 9.0% versus 26.3 +/- 6.7%). The addition of albuterol to furosemide resulted in a 17.2 +/- 5.9% increase in FEV1 and a 51.1 +/- 13.9% increase in FEF25-75. Our results indicate that aerosolized furosemide has a bronchodilator effect in children with mild stable asthma.
The craniofacial morphology of Class III children with a full deciduous dentition was investigated by means of a cephalometric and correlation study. A group of 69 Class III subjects was compared to a group of 60 Class I subjects during the phase of the primary dentition. Each group was then divided into three age subgroups (4, 5, and 6 years) and a comparison was also performed between Class III and Class I subgroups. According to the results, early signs of Class III skeletal disharmony are present during the deciduous dentition phase. A larger mandibular body length (P < 0.001), a greater value for the ratio between the extent of the anterior cranial base and the mandibular body length (P < 0.001), and a forward positioning of the mandible (< P0.01 < 0.001) were consistently found in Class III children at the ages of 4, 5, and 6 years. A correlation analysis between all the cephalometric measurements in the Class III and Class I groups was then carried out, and the significance of the differences between correlation coefficients of the two groups was calculated. A distinctive Class III pattern of non-topographical associations between anterior cranial base and mandibular measurements could be detected.
The authors present their initial experience in the US Study of the foetal hip. Focusing on difficulties found and the possible advantages. The US foetal hip study shows that it is most likely to obtain qualitative morphologic data rather than quantitative that are interesting in case of occasional identification remark during US.
The case of an adolescent male with short stature and partial growth hormone deficiency who developed a slipped capital femoral epiphysis during the treatment with recombinant growth hormone is reported in this paper. Our patient started GH therapy with recombinant growth hormone at the dose of 15 U/m2/week administered subcutaneously three times a week. After 6 months of GH therapy there was a satisfactory response to the therapy and his growth velocity improved significantly. Unfortunately the patient had pain of the left hip which was exacerbated by walking. The diagnosis of slipped capital femoral epiphysis was confirmed radiographically and treated surgically with internal fixation of the epiphysis with the use of Moore's pins. Treatment with GH was discontinued. After one year there was the complete resolution of the disease and the adolescent was able to return at his usual way of life. Slipped capital femoral epiphysis is a disease in which the anatomic relationship between the femoral head and neck changes by disruption of the epiphyseal plate. This condition can occur only before the epiphyseal plate closes. Patients vary in age from newborn infant to teenager, nevertheless slipped capital femoral epiphysis is probably the most common hip disease during adolescence, and is often associated with endocrine imbalance including growth hormone deficiency. The aetiology of slipped capital femoral epiphysis is still unknown although many theories have been proposed.(ABSTRACT TRUNCATED AT 250 WORDS)
By means of a review of the most recent literature, the authors report on "state of the art" about etiology and pathogenesis of cleft palate. Epithelial-mesenchymal interactions regulating growth and orientation of palatal shelves, as well as teratogenic effects on such ultrastructural development control by endogenous and exogenous substances, are described.