Apical Position Research Articles

Open surgical exposure with apically positioning flap technique: A treatment for apically impacted maxillary incisors and canine

Introduction: Impacted teeth are a condition in which the teeth cannot erupt completely. The most effective method for treating labial impacted teeth is the apical flap position technique which maintains attached gingiva. This paper aims to show how the apical flap positioning technique works as a treatment for impacted maxillary incisors and canines. Case presentation: A 12-year-old girl came with her mother to the pediatric dentistry clinic at Universitas Airlangga with complaints of non-erupting upper front teeth. From the clinical examination, it was found that teeth 21,22,23 were impacted. The examination begins with anamnesis and clinical examination, followed by panoramic, cephalometric, occlusal, and CBCT. Case Management: Fixed orthodontic treatment is carried out to get a place for impacted teeth 21,22,23. Open surgery with an apically positioned flap technique is performed by making a flap to open the crown, minimizing the bone covering the enamel surface, and then restoring the flap by lifting and joining it with the attached gingiva so that it leaves half to two-thirds of the crown visible. In the H+7 control, removal of sutures, evaluation of treatment measures, and examination of the patient's condition and postoperative recovery were carried out. Fixed orthodontic treatment is still ongoing as of this writing. Conclusion: Open surgical exposure with the apical flap technique is a good technique to be used in cases of impacted maxillary incisors and canines.

Golgi polarity shift instructs dendritic refinement in the neonatal cortex by mediating NMDA receptor signaling

Dendritic refinement is a critical component of activity-dependent neuronal circuit maturation, through which individual neurons establish specific connectivity with their target axons. Here, we demonstrate that the developmental shift of Golgi polarity is a key process in dendritic refinement. During neonatal development, the Golgi apparatus in layer 4 spiny stellate (SS) neurons in the mouse barrel cortex lose their original apical positioning and acquire laterally polarized distributions. This lateral Golgi polarity, which is oriented toward the barrel center, peaks on postnatal days 5-7 (P5-P7) and disappears by P15, which aligns with the developmental time course of SS neuron dendritic refinement. Genetic ablation of N-methyl-D-aspartate (NMDA) receptors, key players in dendritic refinement, disturbs the lateral Golgi polarity. Golgi polarity manipulation disrupts the asymmetric dendritic projection pattern and the primary-whisker-specific response of SS neurons. Our results elucidate activity-dependent Golgi dynamics and their critical role in developmental neuronal circuit refinement.

Poly[[bis-[μ4-3-(2-carboxyl-atophen-yl)propionato]{N-[2-(pyridine-3-amido)-eth-yl]nicotinamide}-dicopper(II)] penta-hydrate

In the title compound, {[Cu2(C10H8O4)2(C14H14N4O2)]·5H2O}n, the CuII cations are coordinated in a square-pyramidal fashion, with four 3-(2-carb-oxy-phen-yl)propionate (cpp) carboxyl-ate O-atom donors in the basal plane, along with an N-atom donor from a N-[2-(pyridin-3-yl-amino)-eth-yl]nicotinamide (pen) ligand in the apical position. [Cu2(cpp)2]n coordination polymer layer motifs with embedded {Cu2(OCO)4} paddlewheel clusters are thereby constructed. These layer motifs are connected into a three-dimensional [Cu2(cpp)2(pen)]n coordination polymer network by tethering pen ligands. Treating the {Cu2(OCO)4 paddelwheel clusters as 6-connected nodes reveals an underlying cross-pillared self-penetrated rob network with 48668 topology. The water mol-ecules of crystallization are held to the coordination polymer network by N-H⋯O and O-H⋯O hydrogen-bonding patterns.

Crystal structure of poly[(aceto-nitrile-κN)(μ3-7-{[bis-(pyridin-2-ylmeth-yl)amino]-meth-yl}-8-hy-droxy-quinoline-5-sulfonato-κ4N,O:O':O'')sodium

In the title compound, [Na(C22H19N4O4S)(CH3CN)]n, the NaI atom adopts a distorted square-pyramidal coordination geometry, formed by one N and one O atom of the qunolinol moiety in the ligand, two O atoms of sulfonate moieties of two adjacent ligands and the N atom of the coordinated aceto-nitrile solvent. The NaI atom is located well above the mean basal plane of the square-based pyramid. The apical position is occupied by a sulfonate O atom of a neighboring ligand. Three N atoms of the bis-(pyridin-2-ylmeth-yl)amine moiety in the ligand are not coordinated by the sodium atom. The mol-ecule forms an intra-molecular bifurcated O-H⋯[N(tertiary amine),N(pyridine)] hydrogen bond, generating S(6) and S(5) rings. In the crystal, four mol-ecules are linked by four Na-O(sulfonato) bridged coordination bonds, forming a supra-molecular centrosymmetric tetra-mer unit comprising an eight-membered ring, and generating a two-dimensional network sheet. The mol-ecules of different sheets form inter-molecular C-H⋯O hydrogen bonds, and thereby a three-dimensional network structure.

Is there a relationship between Haller Index and cardiopulmonary function in children with pectus excavatum?

This study aims to systematically examine the cardiopulmonary functions in children with pectus excavatum and to compare the obtained findings with the Haller Index. Between September 2017 and June 2018, medical records of a total of 31 patients (27 males, 4 females; mean age: 14.8±2.0 years; range, 9 to 18 years) with pectus excavatum were retrospectively analyzed. The patients were divided into Group 1 (<2.5), Group 2 (2.5 to 3.19), and Group 3 (>3.2) according to the Haller Index. All groups were systematically evaluated based on pulmonary function tests and echocardiography. Forced vital capacity, forced expiratory volume in 1 second, and the forced expiratory volume in 1 second/ forced vital capacity ratio were calculated. Left ventricular enddiastolic diameter, ejection fraction, mitral valve prolapses, and right ventricular cavity in the apical four-chamber position were evaluated with echocardiography. Of the patients, 19.4% were in Group 1, 38.7% in Group 2, and 41.9% in Group 3. The mean Haller Index value was 3.09±0.64. According to pulmonary function test results, 16.1% of the patients had restrictive disease and 6.5% had obstructive disease. There was a negative correlation between the index and forced expiratory volume in 1 second and forced vital capacity, and there was a statistically significant decrease in these values, as the Haller Index increased (p<0.017). There was a significant difference in the ejection fraction among the groups (p<0.001) and, as the Haller Index increased, ejection fraction statistically significantly decreased. Our study results show a negative correlation between the severity of pectus excavatum and pulmonary dysfunction and, as the severity increases, left ventricular function may be affected by the deformity. As a result, there seems to be a significant relationship between the severity of the deformity and cardiopulmonary functions.

Acute performance of stylet driven leads for left bundle branch area pacing: a comparison with lumenless leads

Abstract Funding Acknowledgements Type of funding sources: None. Background Lumen-less leads (LLL) and stylet driven leads (SDL) are currently used for left bundle branch area pacing (LBBAP). We sought to evaluate the acute performance of SDL during LBBAP in comparison with LLL. Methods This is an observational retrospective study including consecutive patients undergoing LBBAP at our institution.Acute lead performance was evaluated including implant success rate,electrical parameters,ECG characteristics and lead related complications (intraprocedure LBBAP lead dislodgment after having being penetrated into the septum in an stable position needing lead repositioning, septal perforation, coronary venous fistula, development of complete AV block not previously present and LBBAP lead damage during implant).Conduction system capture criteria were assessed before patient discharge during asynchronous ventricular pacing. Ventricular lead position within the septum was evaluated using paced QRS axis, fluoroscopic orthogonal views and post-procedure TTE, and classified as basal,mid or apical septum. Results 451 consecutive LBBAP implants were included, 333 using LLL and 118 using SDL. LBBAP acute success was significantly higher with LLL (91.6% for LLL vs 79.7% for SDL,p=0.001).Among patients with successful LBBAP,LBB capture criteria were achieved in 53.2% for LLL vs 36.4% for SDL,while left ventricular septal pacing (LVSP) was achieved in 39% vs 44.1%,respectively (p&amp;lt;0.0001). A basal lead position was more frequently obtained with LLL (19.8% for LLL vs 13.3% for SDL),while SDL were more frequently located at mid to apical septal positions (86.7% for SDL vs 80.1% for LLL, p=0.003).Paced ECG axis was inferior in 43.9% of LLL vs 28.9% of SDL and superior in 24.5% vs 42.1%, respectively,p=0.001.Intraprocedure lead dislodgment occurred in 9.3% of SDL vs 2.1% of LLL,p=0.001.In 5 cases of SDL (4.2%),lead damage occurred during lead implant needing lead replacement due to helix entrapment or malfunction with no such cases registered among LLL patients.Acute LBBAP lead-related complications were significantly higher for SDL vs LLL (29.1% vs 12.6%, respectively, p&amp;lt;0.0001,table 1),none of them needing additional interventions.Among patients with LBBAP criteria at the end of the procedure,34 (7.5%) experienced loss of r prime wave in V1 with paced QRS widening before hospital discharge,more frequently in patients with SDL (17.8% vs. 9.4%, respectively,p&amp;lt;0.0001) indicative of lead microdislodgment. Conclusions In our experience,acute lead performance is different between LLL and SDL.LBBAP implant success rate is significantly higher with LLL with higher percentage of patients with LBB capture criteria in comparison with SDL.SDL are associated with a more mid to apical and inferior lead position in the septum.A significantly higher rate of lead related complications during the implant procedure as well as higher rates of acute microdislodgment after implantation were also seen in SDL,none of them needing acute re-intervention.

Unexpected coordination mode for a phenol/pyridine-containing tripodal ligand towards copper(II) ions: Solid state, solution and DFT Studies

Reaction between the tripodal ligand HBPAMFF, namely, 3-[N,N-(2-pyridylmethyl)(2-hydroxybenzyl)aminomethyl]-5-methylsalicylaldehyde, and stoichiometric amounts of CuCl2·2H2O afforded a turquoise mononuclear complex (1), which crystallizes in the monoclinic system, space group P 21/c. The pentacoordinated copper site adopts a slightly distorted square pyramidal geometry with the apical position occupied by a phenolic oxygen. A combined experimental-theoretical analysis of the mid-infrared absorptions of 1 confirmed that both phenol groups present in HBPAMFF remain fully protonated upon complexation. Still in the solid state, X-band EPR spectroscopy showed a three g-values rhombic spectrum without a hyperfine unfolding. Solution studies were performed in acetonitrile (MeCN), in which the chloride ions remain mostly coordinated to copper, and dimethylsulfoxide (DMSO), with the replacement of a chloride ion by a solvent molecule in the coordination sphere of copper. Electronic spectroscopy and frozen solution EPR also confirm the different nature of the species present in MeCN and DMSO. This work shines a light on some structural aspects regarding metal compounds of phenol-containing ligands, such as HBPAMFF, and their mono- and binucleating derivatives.

Targeting heparan sulfate-protein interactions with oligosaccharides and monoclonal antibodies.

Heparan sulfate-binding proteins (HSBPs) are structurally diverse extracellular and membrane attached proteins that interact with HS under normal physiological conditions. Interactions with HS offer an additional level of control over the localization and function of HSBPs, which enables them to behave in a more refined manner. Because all cell signaling events start at the cell membrane, and cell-cell communication relies on translocation of soluble factors across the extracellular matrix, HS occupies an apical position in cellular signal transduction by interacting with hundreds of growth factors, cytokines, chemokines, enzymes, enzyme inhibitors, receptors and adhesion molecules. These extracellular and membrane proteins can play important roles in physiological and pathological conditions. For most HS-binding proteins, the interaction with HS represents an essential element in regulating their normal physiological functions. Such dependence on HS suggests that manipulating HS-protein interactions could be explored as a therapeutic strategy to selectively antagonize/activate HS-binding proteins. In this review, we will discuss current understanding of the diverse nature of HS-HSBP interactions, and the latest advancements in targeting the HS-binding site of HSBPs using structurally-defined HS oligosaccharides and monoclonal antibodies.

Association between left ventricular lead position and intrinsic QRS morphology with regard to clinical outcome in cardiac resynchronization therapy for heart failure.

Left ventricular (LV) lead position may be an important factor for delivering effective cardiac resynchronization therapy (CRT). We therefore aimed to evaluate the effects of LV lead position, stratified by native QRS morphology, regarding the clinical outcome. A total of 1295 CRT-implanted patients were retrospectively evaluated. LV lead position was classified as lateral, anterior, inferior, or apical, and was determined using the left and right anterior oblique X-ray views. Kaplan Meier and Cox regression were performed to evaluate the effects on all-cause mortality and heart failure hospitalization, and the potential interaction between LV lead position and native ECG morphologies. A total of 1295 patients were included. Patients were aged 69 ± 7 years, 20% were female, 46% received a CRT-Pacemaker (vs. CRT-Defibrillator), mean LVEF was 25% ± 7%, and median follow-up was 3.3 years [IQR 1.6-5-7 years]. Eight hundred and eighty-two patients (68%) had a lateral LV lead location, 207 (16%) anterior, 155 (12%) apical, and 51 (4%) inferior. Patients with lateral LV lead position had larger QRS reduction (-13 ± 27 ms vs. -3 ± 24 ms, p < .001). Non-lateral lead location was associated with a higher risk for all-cause mortality (HR 1.34 [1.09-1.67], p = .007) and heart failure hospitalization (HR 1.25 [1.03-1.52], p = .03). This association was strongest for patients with native left or right bundle branch block, and not significant for patients with prior paced QRS or nonspecific intraventricular conduction delay. In patients treated with CRT, non-lateral LV lead positions (including apical, anterior, and inferior positions) were associated with worse clinical outcome and less reduction of QRS duration. This association was strongest for patients with native LBBB or RBBB.

Evaluation of root position during orthodontic treatment via multiple intraoral scans with automated registration technology

This study aimed to introduce a method for dynamically monitoring root position with intraoral scans using automated crown registration and root segmentation with artificial intelligence technology and to evaluate its accuracy using a novel semiautomatic root apical distance measurement procedure. The sample consisted of 412 teeth from 16 patients whose intraoral scans and cone-beam computed tomography (CBCT) were obtained before and after treatment. Crowns from intraoral scans and roots segmented from CBCT with artificial intelligence technology before treatment were registered, integrated, and divided into individual teeth. With an automated registration program, the virtual root was constructed by crown registration before and after treatment. The distance deviation of the root position at the apex between the virtual root and the actual root, which served as a control, was measured and decomposed into the distance deviation in the mesiodistal and buccolingual directions. The shell deviation of crown registration between CBCT and oral scan before treatment was 0.19 ± 0.04 mm and 0.22 ± 0.04 mm in the maxilla and mandible, respectively. The apical root position distance deviations were 0.27 ± 0.12 mm in the maxilla and 0.31 ± 0.11 mm in the mandible. There was no significant difference between root position in mesiodistal and buccolingual directions. Applying automated crown registration and root segmentation with artificial intelligence technology in this study improved the accuracy and efficiency of monitoring root position. In addition, the innovative semiautomatic distance measurement procedure can more precisely distinguish the root position discrepancy.

PO-03-009 3830 LEAD TIP POSITION ON COMPUTED TOMOGRAPHY AND ELECTROPHYSIOLOGIC OUTCOMES IN LEFT BUNDLE BRANCH AREA PACING

Prior studies have evaluated the impact of lead tip distance from the LV blood pool on pacing parameters during left bundle branch area pacing (LBBAP). Few studies to date have evaluated lead tip angulation within the interventricular septum (IVS) in relation to pacing morphology on surface 12-lead ECG. To establish the observed lead tip trajectories within the interventricular septum encountered during LBBAP. Patients who underwent LBBAP implantation between 02/2019-07/2022 were retrospectively analyzed. Patients who underwent computed tomography (CT) of the chest or thorax post-implantation for any indication were included for analysis. Lead distance from the mitral annulus, lead tip distance from LV blood pool (DEBP), lead tip angle of incidence (AOI), and post-implantation electrocardiographic and pacing parameters were analyzed (Figure 1a). 38 pts were identified, out of whom 37 pts had CT images available for analysis. In the 20 pts with contrast enhanced imaging, DEBP was 2.1±1.8mm. Average observed AOI was 10.9±20.6 degrees in the axial plane (long axis; Figure 1b) and 12.4±22.2 degrees in the saggital plane (short axis; Figure 1c). Lead impedance at time of implant did not correlate strongly with axial or sagittal angle of incidence (R2=0.01 and 0.03 respectively) or with distance from LV endocardial blood pool (R2=0.04). The most commonly encountered lead insertion locations included the mid-septal (22, 59.5%), basal septal (4, 10.8%), and mid antero-septal (3, 8.1%) positions (Figure 1d). Average lead tip distance from the AV annulus was 36.6±8.2mm. Mean paced QRSd for the basal, mid, and apical cohorts were 122.5±8.1ms, 118.5±10.7ms, and 120±15.9ms, respectively. Left ventricular activation time in lead V6 numerically decreased for more apical positions, with basal, mid and apical values of 84.4±11.9ms, 73.9±10.6ms, and 69.5±6.0ms, respectively. Lead threshold, impedance, and sensed R waves were stable at time of 2 year follow-up. No analyzed patients underwent lead revision. Multiple lead tip orientations are observed in relation to the IVS during successful LBBAP. More apical lead tip positioning may result in numerically lower LVAT values, despite similar overall QRS duration.

Effect of lead nitrate, administered on the histology of kidney of Cyprinus carpio (Common carp)

Acute toxicity (96 h LC50) of lead nitratel was analyzed in the Cyprinus carpio in static bio-assay over a 96-h exposure period using probit method. The aim of this study was to assess the effect of lead nitrate, administered on the histology of kidney of Cyprinus carpio. Fish were exposed to sub-lethal concentration of lead nitrate (5 and 10 ppm) over a period of 15, 30, 60 and 90 days. In this study, various groups with one control and experimental each of 10 fingerlings of common carp were used. Investigations pertaining to the histopathological sections have shown high degree of pathological lesions observed with the passage of time. Study showed dermal necrosis, disintegration of parietal layer of glomerulus, disorganization of proximal tubule with pycnotic nuclei and excessive increase in hematopoietic tissue that spread over large area. The nuclei of renal tubules were hyperchromatic and in several cells were displaced to an apical position, Exposure of fish to lead nitrate for showed increased disintegration of glomerulus, increase in Bowman’s space of glomeruli, vacuolated proximal tubules, enlarged basement membranes of proximal and distal tubule and increased hematopoietic tissue. The results of the present study clearly indicate that chronic exposure to lead nitrate caused adverse effects on the kidney of Cyprinus carpio and also the quality of water.

Toxoplasma gondii HOOK-FTS-HIP Complex is Critical for Secretory Organelle Discharge during Motility, Invasion, and Egress.

Members of the Apicomplexa phylum possess specialized secretory organelles that discharge, apically and in a timely regulated manner, key factors implicated in parasite motility, host cell invasion, egress and subversion of host cellular functions. The mechanisms regulating trafficking and apical docking of these secretory organelles are only partially elucidated. Here, we characterized two conserved endosomal trafficking regulators known to promote vesicle transport and/or fusion, HOOK and Fused Toes (FTS), in the context of organelle discharge in Toxoplasma gondii. TgHOOK and TgFTS form a complex with a coccidian-specific partner, named HOOK interacting partner (HIP). TgHOOK displays an apically enriched vesicular pattern and concentrates at the parasite apical tip where it colocalizes with TgFTS and TgHIP. Functional investigations revealed that TgHOOK is dispensable but fitness conferring. The protein regulates the apical positioning and secretion of micronemes and contributes to egress, motility, host cell attachment, and invasion. Conditional depletion of TgFTS or TgHIP impacted on the same processes but led to more severe phenotypes. This study provides evidence of endosomal trafficking regulators involved in the apical exocytosis of micronemes and possibly as a consequence or directly on the discharge of the rhoptries. IMPORTANCE Toxoplasma gondii affects between 30 and 80% of the human population, poses a life-threatening risk to immunocompromised individuals, and is a cause of abortion and birth defects following congenital transmission. T. gondii belongs to the phylum of Apicomplexa characterized by a set of unique apical secretory organelles called the micronemes and rhoptries. Upon host cell recognition, this obligatory intracellular parasite secretes specific effectors contained in micronemes and rhoptries to promote parasite invasion of host cells and subsequent persistence. Here, we identified novel T. gondii endosomal trafficking regulators and demonstrated that they regulate microneme organelle apical positioning and exocytosis, thereby strongly contributing to host cell invasion and parasite virulence.

Evaluation of cuspid cortical anchorage with different sagittal patterns using cone-beam computed tomography: a retrospective study

BackgroundNo studies have focused on cortical anchorage resistance in cuspids, this study aimed to characterize the cortical anchorage according to sagittal skeletal classes using cone-beam computed tomography (CBCT).MethodsCBCT images of 104 men and 104 women were divided into skeletal class I, II, and III malocclusion groups. Skeletal and dental evaluations were performed on the sagittal and axial cross-sections. One-way analysis of variance followed by least significant difference post-hoc tests was used for group differences. Multiple linear regression was performed to evaluate the relationship between influential factors and cuspid cortical anchorage.ResultsAll cuspids were close to the labial bone cortex in different sagittal skeletal patterns and had different inclinations. There was a significant difference in the apical root position of cuspids in the alveolar bone; however, no significant difference in the middle or cervical portions of the root was found between different sagittal facial patterns. The middle of the cuspid root was embedded to the greatest extent in the labial bone cortex, with no significant difference between the sagittal patterns. For all sagittal patterns, 6.03 ± 4.41° (men) and 6.08 ± 4.45° (women) may be appropriate root control angles to keep maxillary cuspids’ roots detached from the labial bone cortex.ConclusionsComparison of skeletal class I, II, and III malocclusion patients showed that dental compensation alleviated sagittal skeletal discrepancies in the cuspid positions of all patients, regardless of the malocclusion class. Detailed treatment procedures and clear treatment boundaries of cuspids with different skeletal patterns can improve the treatment time, periodontal bone remodeling, and post-treatment long-term stability. Future studies on cuspids with different dentofacial patterns and considering cuspid morphology and periodontal condition may provide more evidence for clinical treatment.

Higher expression of Th1/Th2‐related cytokines in the intestine of Wistar rats with ligature‐induced periodontitis

This study aimed to investigate the impact of ligature-induced periodontitis (LIP) on histopathological and immunological outcomes in the colon of Wistar rats. It has been repeatedly shown that inflammatory bowel disease (IBD) patients are at higher risk of developing periodontitis and presenting worse oral health than non-IBD patients. However, whether the chronic inflammatory process around teeth contributes to the pathophysiology of IBD needs to be further explored. Thirteen Wistar rats were allocated into LIP (n = 7) and controls (n = 6). Half of the colon was processed for histopathological analyses and immunohistochemical (CD45); the other half was homogenized for immunological analyses. Periodontal destruction was confirmed by measuring the distance from the cementum-enamel junction to the mandible's apical position of the mesial interproximal bone. The immunological analyses were performed with the Bio-Plex Th1/Th2 assay. There was a significantly higher interproximal bone loss in LIP compared to controls. The LIP group showed a moderate infiltrate of inflammatory cells, predominantly mononucleated cells in the intestinal tissues. There was significantly higher expression of GM-CSF, IFN-γ, IL-1α, IL-1β, IL-2, IL-4, IL-5, IL-10, IL-12 (p70), IL-13, and TNF-α in the intestinal tissues of LIP group compared to controls. Ligature-induced periodontitis was associated with an overexpression of Th1/Th2-related cytokines in the colon of Wistar rats.

Synthesis and Reactivity of an Anti-van't Hoff/Le Bel Compound with a Planar Tetracoordinate Silicon(II) Atom.

For a long time, planar tetracoordinate carbon (ptC) represented an exotic coordination mode in organic and organometallic chemistry, but it is now a useful synthetic building block. In contrast, realization of planar tetracoordinate silicon (ptSi), a heavier analogue of ptC, is still challenging. Herein we report the successful synthesis and unusual reactivity of the first ptSi species of divalent silicon present in 3, supported by the chelating bis(N-heterocyclic silylene)bipyridine ligand, 2,2'-{[(4-tBuPh)C(NtBu)]2SiNMe}2(C5N)2, 1]. The compound resulted from direct reaction of 1 with Idipp-SiI2 [Idipp = 1,3-bis(2,6-diisopropylphenyl)imidazol-2-ylidene]. Alternatively, it can also be synthesized by a two-electron reduction of the corresponding Si(IV) precursor 2 with 2 molar equiv of KC10H8. Density functional theory calculations show that the lone pair at the ptSi(II) resides almost completely in its 3pz orbital, very different from known four-coordinate silylenes. Oxidative addition of MeI to the ptSi(II) atom affords the corresponding pentacoordinate Si(IV) compound 4, with the methyl group located in an apical position. Remarkably, the reaction of 2 with [CuOtBu] leads to the regeneration of the bis(silylene) arms via Si-Si bond scission and induces the Si(II) → Si(IV) oxidation of the central Si(II) atom and concomitant two-electron reduction of the bipyridine moiety to form the neutral bis(silylene)silyl Cu(I) complex 5.

Multidisciplinary approach to restore esthetics and function in a young patient with three consecutive impacted teeth: a case report with 18-month follow-up.

This case report describes the orthodontic treatment of an 11-year-old patient with three maxillary impacted teeth on the right side. Cone-beam computed tomography showed that these teeth were close together, with the lateral incisor in a lower position, followed by the central incisor, and the canine in a more apical position. Treatment included applying traction to these teeth. A transpalatal arch was used as an anchorage device, and surgical exposure of the lateral incisor was performed for traction with an elastic chain toward the hook welded to the 0.017 × 0.025-inch steel segmented arch. Subsequently, the central incisor was surgically exposed, elastic chains were used, along with a 0.016-inch steel arch with a box loop for correcting the tooth position. The canine spontaneously began to erupt, and a 0.017 × 0.025-inch TMA segmented arch with boot loop was used to control rotation and torque of the canine during its distalization. Once these three teeth were in the arch, treatment was finished in the usual manner. For esthetic improvement, gingivoplasty was performed in the maxillary arch. Eighteen-month follow-up showed that orthodontic treatment allowed preservation of the natural teeth, the contour of gingival support, and avoidance of prosthetic rehabilitation, reestablishing the patient's esthetics and function, with satisfactory stability.

A clinical study of the piezosurgery, high-speed contra-angle handpiece, and the combined application of both for extraction of embedded supernumerary teeth

ObjectivesTo compare the effectiveness of three methods: high-speed contra-angle handpiece (HSCAH), piezosurgery, and combined in the extraction of different locations and types of embedded supernumerary teeth.MethodsSixty cases with different locations and different types of embedded supernumerary teeth were randomly divided into three groups for extraction by HSCAH, piezosurgery, and the combination of both, and the intraoperative and postoperative conditions of the three groups were compared and analyzed.ResultsIn the extraction of embedded supernumerary teeth in the inverted, horizontal, and root tip positions, the piezosurgery group required significantly longer operative time and reduced intraoperative bleeding compared with the HSCAH and the piezosurgery combined with the HSCAH; it could effectively relieve postoperative pain and facial swelling. In the extraction of oblique, orthodontic, middle, and crown segments of embedded supernumerary teeth, the use of a piezosurgery combined with an HSCAH can effectively reduce the operative time, while the factors of bleeding, postoperative pain, and facial swelling not statistically significant when compared with a piezosurgery. Compared with the HSCAH and combined piezosurgery, piezosurgery can significantly reduce the fear of patients.ConclusionPiezosurgery is effective in extracting embedded supernumerary teeth in inverted, horizontal, and apical positions, effectively reducing intraoperative and postoperative trauma and shortening the time required for healing. The piezosurgery combined with an HSCAH can effectively reduce intraoperative and postoperative trauma when extracting embedded supernumerary teeth in oblique, orthodontic, middle, and crown positions. piezosurgery is a technique suitable for the treatment of patients with fear.

Apical or Septal Right Ventricular Location in Patients Receiving Defibrillation Leads: A Systematic Review and Meta-Analysis.

This study reviews the published data comparing the efficacy and safety of apical and septal right ventricle defibrillator lead positioning at 1-year follow-up. Systemic research on Medline (PubMed), ClinicalTrials.gov, and Embase was performed using the keywords "septal defibrillation," "apical defibrillation," "site defibrillation," and "defibrillation lead placement," including implantable cardioverter-defibrillator and cardiac resynchronization therapy devices. Comparisons between apical and septal position were performed regarding R-wave amplitude, pacing threshold at a pulse width of 0.5 ms, pacing and shock lead impedance, suboptimal lead performance, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter, readmissions due to heart failure and mortality rates. A total of 5 studies comprising 1438 patients were included in the analysis. Mean age was 64.5 years, 76.9% were male, with a median LVEF of 27.8%, ischemic etiology in 51.1%, and a mean follow-up period of 26.5 months. The apical lead placement was performed in 743 patients and septal lead placement in 690 patients. Comparing the 2 placement sites, no significant differences were found regarding R-wave amplitude, lead impedance, suboptimal lead performance, LVEF, left ventricular end-diastolic diameter, and mortality rate at 1-year follow-up. Pacing threshold values favored septal defibrillator lead placement (P = 0.003), as well as shock impedance (P = 0.009) and readmissions due to heart failure (P = 0.02). Among patients receiving a defibrillator lead, only pacing threshold, shock lead impedance, and readmission due to heart failure showed results favoring septal lead placement. Therefore, generally, the right ventricle lead placement does not appear to be of major importance.

Np(V) azide complexes with electroneutral N-donor ligands

Abstract Two new Np(V) azide complexes with electroneutral N-donor ligands of terpyridine derivatives have been synthesized and structurally characterized: [(NpO2)(Cl-Terpy)(N3)(H2O)] (1) and a centrosymmetric dimer [(NpO2)(EtO-Terpy)(N3)]2·2CH3OH (2). The coordination polyhedra of Np atoms in compounds are pentagonal bipyramids with “yl” oxygen atoms in apical positions. The equatorial plane of the bipyramid in complex 1 is formed by: a nitrogen atom from an anion, three nitrogen atoms from an electroneutral Cl-Terpy ligand and an oxygen atom of a water molecule. The equatorial plane of bipyramids in dimer 2 is formed by five nitrogen atoms: two atoms from two anions [N3]− and three atoms from EtO-Terpy. In compound 1, the anion [N3]− acts as a monodentate ligand, and in compound 2, the anion [N3]− is a bidentate-bridging ligand.