Publications by authors named "Nadia Lunardi"

17 Publications

  • Page 1 of 1

Surgery, Anesthesia and Intensive Care Environment Induce Delirium-Like Behaviors and Impairment of Synaptic Function-Related Gene Expression in Aged Mice.

Front Aging Neurosci 2020 25;12:542421. Epub 2020 Sep 25.

Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA, United States.

Objective: To establish a clinically relevant mouse model of perioperative delirium.

Methods: Aged C57BL/6J mice were tested at baseline in the Y-maze novel arm preference, buried food, simple discrimination task of the attentional set-shifting test, and open field tests. They were subsequently randomized to insult (anesthesia, surgery, and Intensive Care Unit environment) or control group. Insult-exposed mice received laparotomy under sevoflurane anesthesia, propofol sedation and exposure to intermittent lights, sounds and cage shaking. Controls did not receive anesthesia, surgery, or intensive care environment. All mice were tested in the Y-maze novel arm preference, buried food, attentional, and open field tests at the end of intensive care environment (0 h) and every 6 h up to 24 h. Mouse hippocampi were collected at 24 h for gene expression analyses.

Results: Surgery, anesthesia and Intensive Care environment decreased the entries in the Y-maze novel arm at 0 h ( = 0.001), 6 h ( < 0.001), 18 h ( = 0.002), and 24 h ( = 0.029). Insult exposure increased the latency to find a buried cereal reward at 18 h ( = 0.035) and 24 h ( = 0.027), and increased the trials to criterion in the reverse compound discrimination ( = 0.013) and extradimensional shift ( < 0.001) tasks of the attentional test. The overall incidence of delirium was 72% in A/S/I mice. Messenger RNA levels of synuclein alpha (-3.785 fold change relative to controls), Neurotrophic Receptor Tyrosine Kinase1 (-2.267), and syntaxin1a (-1.498) were decreased in the hippocampus of mice 24 h after insult exposure. Protein levels of syntaxin 1a ( = 0.012), Neurotrophic Receptor Tyrosine Kinase1 ( = 0.039), synuclein alpha ( = 0.017), phosphorylated synuclein alpha ( = 0.008), synaptophysin ( = 0.002), postsynaptic density protein 95 ( = 0.003), and microtubule-associated protein 2 ( = 0.013) were also decreased, relative to controls.

Conclusion: Surgery, anesthesia and Intensive Care environment impaired mouse behaviors that depend on attention, memory, and thought organization. The changes were acute in onset and fluctuating in time. Mice with delirium exhibited decreased expression of key synaptic function-related genes. The behavioral changes induced by anesthesia, surgery, and Intensive Care environment in aged mice are consistent with the clinical features of human delirium, and support the use of this animal model for future mechanistic studies of perioperative delirium.
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http://dx.doi.org/10.3389/fnagi.2020.542421DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544741PMC
September 2020

Two Sides of the Same Coin: Addressing Racial and Gender Disparities Among Physicians and the Impact on the Community They Serve.

Anesthesiol Clin 2020 Jun 1;38(2):369-377. Epub 2020 Apr 1.

University of Utah School of Medicine, 30 North 1900 East, Room 3C444 SOM, Salt Lake City, UT 84132, USA.

The influence of historical cultural norms is evident when analyzing the physician demographics in the United States. To this day, there exists a paucity in diversity as it pertains to gender balance and ethnicity. This phenomenon is particularly concerning when studies support the notion that race and gender concordance are associated with improved outcomes. The literature presented in this article identifies potential targets for interventions on how to attract, train, and retain minority physicians.
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http://dx.doi.org/10.1016/j.anclin.2020.01.001DOI Listing
June 2020

The Flaw of Medicine: Addressing Racial and Gender Disparities in Critical Care.

Anesthesiol Clin 2020 Jun 1;38(2):357-368. Epub 2020 Apr 1.

University of Utah School of Medicine, 30 North 1900 East, Room 3C444 SOM, Salt Lake City, UT 84132, USA.

The age of modern medicine has ushered in remarkable advances and with them increased longevity of life. The questions are, however: Has everyone benefited from these developments equally? and Do all lives truly matter? The presence of gender and racial health disparities indicates that there is work still left to be done. The first target of intervention may well be the medical establishment itself. The literature presented in this article identifies potential targets for interventions and future areas of exploration.
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http://dx.doi.org/10.1016/j.anclin.2020.01.011DOI Listing
June 2020

Preparation of Newborn Rat Brain Tissue for Ultrastructural Morphometric Analysis of Synaptic Vesicle Distribution at Nerve Terminals.

J Vis Exp 2019 06 7(148). Epub 2019 Jun 7.

Department of Anesthesiology, University of Virginia Health System;

Our laboratory and many others have exploited the high resolving power of transmission electron microscopy to study the morphology and spatial organization of synaptic vesicles. In order to obtain high-quality electron micrographs that can yield the degree of morphological detail necessary for quantitative analysis of pre-synaptic vesicle distribution, optimal specimen preparation is critical. Chemical fixation is the first step in the process of specimen preparation, and of utmost importance to preserve fine ultrastructure. Vascular fixation with a glutaraldehyde-formaldehyde solution, followed by treatment of vibratome-sectioned specimens with osmium tetroxide, stabilizes the maximum number of molecules, especially proteins and lipids, and results in superior conservation of ultrastructure. Tissue is then processed with counterstaining, sequential dehydration and resin-embedding. En bloc staining with uranyl acetate (i.e., staining of vibratome-sectioned tissue before resin embedding) enhances endogenous contrast and stabilizes cell components against extraction during specimen processing. Contrast can be further increased by applying uranyl acetate as a post-stain on ultrathin sections. Double-staining of ultrathin sections with lead citrate after uranyl acetate treatment also improves image resolution, by intensifying electron-opacity of nucleic acid-containing structures through selective binding of lead to uranyl acetate. Transmission electron microscopy is a powerful tool for characterization of the morphological details of synaptic vesicles and quantification of their size and spatial organization in the terminal bouton. However, because it uses fixed tissue, transmission electron microscopy can only provide indirect information regarding living or evolving processes. Therefore, other techniques should be considered when the main objective is to study dynamic or functional aspects of synaptic vesicle trafficking and exocytosis.
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http://dx.doi.org/10.3791/59694DOI Listing
June 2019

Neonatal anesthesia impairs synapsin 1 and synaptotagmin 1, two key regulators of synaptic vesicle docking and fusion.

Neuroreport 2019 05;30(8):544-549

Department of Anesthesiology, University of Virginia Health System.

Early exposure to anesthetics may interfere with synaptic development and lead to cognitive deficits. We previously demonstrated a decrease in vesicles docked at and within 100 nm from the presynaptic membrane in hippocampal nerve terminals of neonatal rats after anesthesia. Hence, we designed this study to assess the effects of neonatal anesthesia on synapsin 1 (Syn1) and synaptotagmin 1 (Syt1), two key regulators of vesicle docking and fusion. To test the link between changes in Syn1 and Syt1 and behavioral deficits observed after neonatal anesthesia, we also assessed retention memory and fear conditioning in adolescent rats after neonatal anesthesia. Pups received a combination of clinical anesthetics, then Syn1 and Syt1 mRNA and protein expression were determined at the peak (postnatal day 8, P8), part-way through (P12) and end of synaptogenesis (P24) in the CA1-subiculum by qPCR and western blotting. Anesthesia decreased Syn1 and Syt1 mRNA expression at P8 (P<0.01 and <0.001) and P12 (P=0.001 and 0.017), but not P24 (P=0.538 and 0.671), and impaired Syn1, p-Syn1, and Syt1 protein levels at P8 (P=0.038, 0.041, and 0.004, respectively), P12 (P<0.001, P=0.001, and P<0.0001), and P24 (P=0.025, 0.031, and 0.001). Anesthetic-challenged rats displayed deficient long-term retention memory (P=0.019) and hippocampus-dependent fear conditioning (P<0.001). These results suggest that anesthetics alter Syn1 and Syt1 during synapse assembly and maturation, raising the possibility that anesthetic interference with Syn1 and Syt1 could initiate changes in synaptic function that contribute to the cognitive deficits observed after neonatal anesthesia.
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http://dx.doi.org/10.1097/WNR.0000000000001235DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510243PMC
May 2019

Disruption of Rapid Eye Movement Sleep Homeostasis in Adolescent Rats after Neonatal Anesthesia.

Anesthesiology 2019 06;130(6):981-994

From the Department of Anesthesiology (N.L., N.A., C.K., Z.Z.) Department of Neurology (H.P.G.), University of Virginia Health System, Charlottesville, Virginia School of Medicine (R.S.) Department of Pharmacology and Neuroscience Graduate Program (K.A.S.) Department of Pharmacology (M.P.B.), University of Virginia, Charlottesville, Virginia.

Background: Previous studies suggest that rapid eye movement sleep rebound and disruption of rapid eye movement sleep architecture occur during the first 24 h after general anesthesia with volatile anesthetics in adult rats. However, it is unknown whether rapid eye movement sleep alterations persist beyond the anesthetic recovery phase in neonatal rats. This study tested the hypothesis that rapid eye movement sleep disturbances would be present in adolescent rats treated with anesthesia on postnatal day 7.

Methods: Forty-four neonatal rats were randomly allocated to treatment with anesthesia consisting of midazolam, nitrous oxide, and isoflurane or control conditions for 2 h or 6 h. Electroencephalographic and electromyographic electrodes were implanted and recordings obtained between postnatal days 26 and 34. The primary outcome was time spent in rapid eye movement sleep. Data were analyzed using two-tailed unpaired t tests and two-way repeated measures analysis of variance.

Results: Rats treated with midazolam, nitrous oxide, and isoflurane exhibited a significant increase in rapid eye movement sleep three weeks later when compared with control rats, regardless of whether they were treated for 2 h (174.0 ± 7.2 min in anesthetized, 108.6 ± 5.3 in controls, P < 0.0001) or 6 h (151.6 ± 9.9 min in anesthetized, 108.8 ± 7.1 in controls, P = 0.002).

Conclusions: Treatment with midazolam, nitrous oxide, and isoflurane on postnatal day 7 increases rapid eye movement sleep three weeks later in rats.
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http://dx.doi.org/10.1097/ALN.0000000000002660DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520183PMC
June 2019

Effective and Safe Use of Glucocorticosteroids for Rescue of Late ARDS.

Case Rep Crit Care 2017 26;2017:6740532. Epub 2017 Feb 26.

Anesthesiology, University of Virginia Health System, Charlottesville, VA, USA.

We describe a case of severe refractory hypoxemia requiring prolonged extra corporeal membrane oxygenation (ECMO) support in a case of postpartum acute respiratory distress syndrome (ARDS). The clinical course was marked by persistently poor lung compliance and several complications of ECMO, that is, significant hemolysis, hemothorax, and intracranial bleeding. We report marked improvement of lung mechanics and respiratory function, leading to accelerated separation from ECMO, following rescue administration of low dose methylprednisolone 24 days after the onset of ARDS. Corticosteroid treatment was safe and well tolerated. In contrast with the conclusions of the 2006 ARDS Network trial, our report establishes a case in support of the use of low dose methylprednisolone as a safe and effective rescue treatment option in selected subsets of patients with nonresolving ARDS.
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http://dx.doi.org/10.1155/2017/6740532DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346401PMC
February 2017

Evaluation of Torsional Strength, Design, and Stress Distribution of Different Brands of Orthodontic Mini-Implants.

J Craniofac Surg 2015 Jul;26(5):1717-8

Department of Orthodontics School of Dentistry, Araraquara, University Center (UNIARA), Araraquara, SP, Brazil Department of Surgery, School of Dentistry, Araraquara University Center (UNIARA), Araraquara, SP, Brazil Universidade Estadual Paulista, Araçatuba Dental School Department of Surgery and Integrated Clinic, São Paulo, Brazil.

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http://dx.doi.org/10.1097/SCS.0000000000001771DOI Listing
July 2015

Early Exposure to General Anesthesia with Isoflurane Downregulates Inhibitory Synaptic Neurotransmission in the Rat Thalamus.

Mol Neurobiol 2015 Oct 6;52(2):952-8. Epub 2015 Jun 6.

Department of Anesthesiology, University of Virginia School of Medicine, PO 800710, Charlottesville, VA, 22908-0710, USA.

Recent evidence supports the idea that common general anesthetics (GAs) such as isoflurane (Iso) and nitrous oxide (N2O; laughing gas) are neurotoxic and may harm the developing mammalian brain, including the thalamus; however, to date very little is known about how developmental exposure to GAs may affect synaptic transmission in the thalamus which, in turn, controls the function of thalamocortical circuitry. To address this issue we used in vitro patch-clamp recordings of evoked inhibitory postsynaptic currents (eIPSCs) from intact neurons of the nucleus reticularis thalami (nRT) in brain slices from rat pups (postnatal age P10-P18) exposed at age of P7 to clinically relevant GA combinations of Iso and N2O. We found that rats exposed to a combination of 0.75 % Iso and 75 % N2O display lasting reduction in the amplitude and faster decays of eIPSCs. Exposure to sub-anesthetic concentrations of 75 % N2O alone or 0.75 % Iso alone at P7 did not affect the amplitude of eIPSCs; however, Iso alone, but not N2O, significantly accelerated decay of eIPSCs. Anesthesia with 1.5 % Iso alone decreased amplitudes, caused faster decay and decreased the paired-pulse ratio of eIPSCs. We conclude that anesthesia at P7 with Iso alone or in combination with N2O causes plasticity of eIPSCs in nRT neurons by both presynaptic and postsynaptic mechanisms. We hypothesize that changes in inhibitory synaptic transmission in the thalamus induced by GAs may contribute to altered neuronal excitability and consequently abnormal thalamocortical oscillations later in life.
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http://dx.doi.org/10.1007/s12035-015-9247-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558348PMC
October 2015

Hyperexcitability of rat thalamocortical networks after exposure to general anesthesia during brain development.

J Neurosci 2015 Jan;35(4):1481-92

Department of Anesthesiology, Neuroscience Graduate Program, Neuroscience,

Prevailing literature supports the idea that common general anesthetics (GAs) cause long-term cognitive changes and neurodegeneration in the developing mammalian brain, especially in the thalamus. However, the possible role of GAs in modifying ion channels that control neuronal excitability has not been taken into consideration. Here we show that rats exposed to GAs at postnatal day 7 display a lasting reduction in inhibitory synaptic transmission, an increase in excitatory synaptic transmission, and concomitant increase in the amplitude of T-type calcium currents (T-currents) in neurons of the nucleus reticularis thalami (nRT). Collectively, this plasticity of ionic currents leads to increased action potential firing in vitro and increased strength of pharmacologically induced spike and wave discharges in vivo. Selective blockade of T-currents reversed neuronal hyperexcitability in vitro and in vivo. We conclude that drugs that regulate thalamic excitability may improve the safety of GAs used during early brain development.
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http://dx.doi.org/10.1523/JNEUROSCI.4883-13.2015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4308595PMC
January 2015

Spectrophotometric evaluation of dental bleaching under orthodontic bracket in enamel and dentin.

J Clin Exp Dent 2014 Oct 1;6(4):e321-6. Epub 2014 Oct 1.

Assistent Professor. Prostetic Department, School of Dentistry, State University of Campinas UNICAMP, Piracicaba, Brazil.

Unlabelled: Aware of the diffusion capacity of bleaching in the dental tissues, many orthodontists are subjecting their patients to dental bleaching during orthodontic treatment for esthetic purposes or to anticipate the exchange of esthetic restorations after the orthodontic treatment. For this purpose specific products have been developed in pre-loaded whitening trays designed to fit over and around brackets and wires, with clinical efficacy proven.

Objective: The objective of this study was to evaluate, through spectrophotometric reflectance, the effectiveness of dental bleaching under orthodontic bracket.

Material And Methods: Thirty-two bovine incisors crown blocks of 8 mm x 8 mm height lengths were used. Staining of tooth blocks with black tea was performed for six days. They were distributed randomly into 4 groups (1-home bleaching with bracket, 2- home bleaching without bracket, 3- office bleaching with bracket, 4 office bleaching without bracket). The color evaluation was performed (CIE L * a * b *) using color reflectance spectrophotometer. Metal brackets were bonded in groups 1 and 3. The groups 1 and 2 samples were subjected to the carbamide peroxide at 15%, 4 hours daily for 21 days. Groups 3 and 4 were subjected to 3 in-office bleaching treatment sessions, hydrogen peroxide 38%. After removal of the brackets, the second color evaluation was performed in tooth block, difference between the area under the bracket and around it, and after 7 days to verified color stability. Data analysis was performed using the paired t-test and two-way variance analysis and Tukey's.

Results: The home bleaching technique proved to be more effective compared to the office bleaching. There was a significant difference between the margin and center color values of the specimens that were subjected to bracket bonding.

Conclusions: The bracket bond presence affected the effectiveness of both the home and office bleaching treatments. Key words:Tooth bleaching, spectrophotometry, orthodontics.
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http://dx.doi.org/10.4317/jced.51168DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4282895PMC
October 2014

General Anesthesia Causes Long-term Impairment of Mitochondrial Morphogenesis and Synaptic Transmission in Developing Rat Brain.

Anesthesiology 2011 Nov;115(5):992-1002

Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA.

Background: Clinically used general anesthetics, alone or in combination, are damaging to the developing mammalian brain. In addition to causing widespread apoptotic neurodegeneration in vulnerable brain regions, exposure to general anesthesia at the peak of synaptogenesis causes learning and memory deficiencies later in life. In vivo rodent studies have suggested that activation of the intrinsic (mitochondria-dependent) apoptotic pathway is the earliest warning sign of neuronal damage, suggesting that a disturbance in mitochondrial integrity and function could be the earliest triggering events.

Methods: Because proper and timely mitochondrial morphogenesis is critical for brain development, the authors examined the long-term effects of a commonly used anesthesia combination (isoflurane, nitrous oxide, and midazolam) on the regional distribution, ultrastructural properties, and electron transport chain function of mitochondria, as well as synaptic neurotransmission, in the subiculum of rat pups.

Results: This anesthesia, administered at the peak of synaptogenesis, causes protracted injury to mitochondria, including significant enlargement of mitochondria (more than 30%, P < 0.05), impairment of their structural integrity, an approximately 28% increase in their complex IV activity (P < 0.05), and a twofold decrease in their regional distribution in presynaptic neuronal profiles (P < 0.05), where their presence is important for the normal development and functioning of synapses. Consequently, the authors showed that impaired mitochondrial morphogenesis is accompanied by heightened autophagic activity, decrease in mitochondrial density (approximately 27%, P < 0.05), and long-lasting disturbances in inhibitory synaptic neurotransmission. The interrelation of these phenomena remains to be established.

Conclusion: Developing mitochondria are exquisitely vulnerable to general anesthesia and may be important early target of anesthesia-induced developmental neurodegeneration.
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http://dx.doi.org/10.1097/ALN.0b013e3182303a63DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3203321PMC
November 2011

Occurrence of skeletal malocclusions in Brazilian patients with dentofacial deformities.

Braz Dent J 2011 ;22(4):340-5

UNIARA - University Center of Araraquara, Araraquara, SP, Brazil.

In this study, a survey was conducted on the occurrence of skeletal malocclusions presented by patients of the Center for Research and Treatment of Buccofacial Deformities (CEDEFACE) in the city of Araraquara, SP, Brazil. The clinical charts of 381 patients with dentoskeletal deformities, who underwent combined orthodontic-surgical treatment in the period between 2000 and 2006, were reviewed. After sample selection (convenience method), based on the data of the pre- and post-surgical documentation, the number of patients was reduced to 171. For classification of the survey, the anteroposterior discrepancy (Class I, II and III), race, age, gender, absence or presence of asymmetry, vertical maxillary excess and maxillary biprotrusion were considered, in addition to determining in which bony base the surgical procedure was performed. Patients' documentations were analyzed by one examiner previously calibrated by repetition of the process until the method was considered adequate (intraclass correlation coefficient > 0.94). Patients' mean age was 23.59 (SD 6.93) years, the majority (102 patients) were women, and Caucasians (160 patients). Class III malocclusion was the most prevalent (81 patients). Asymmetry, vertical maxillary excess and biprotrusion were present in 54, 33, and 7 patients, respectively. The majority of surgeries for correction of dentoskeletal deformities were combined, involving the maxilla and mandible. In conclusion, Class III was the most prevalent skeletal deformity and Class I was the least prevalent; in general, the prevalence of skeletal deformities was higher in women; in the majority of patients with skeletal malocclusions there was a combination of maxillary and mandibular problems, which interferes directly in the decision regarding the most adequate treatment plan, and a higher incidence of asymmetry was observed in skeletal Class III; vertical excess occurred in a similar manner in Class II and III and there was a low incidence of biprotrusion among the malocclusions evaluated.
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http://dx.doi.org/10.1590/s0103-64402011000400014DOI Listing
December 2011

Isoflurane impairs immature astroglia development in vitro: the role of actin cytoskeleton.

J Neuropathol Exp Neurol 2011 Apr;70(4):281-91

Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA.

General anesthetics, either alone or in combination, can be detrimental to the developing mammalian brain and induce extensive apoptotic degeneration of immature neurons when they are administered at the peak of synaptogenesis. Because neuron development and normal functions depend on the integrity of astroglia, we sought to determine whether general anesthesia also causes disturbances in the early development of astroglia. Using isoflurane, an inhaled anesthetic that is highly toxic to immature neurons, we studied primary astroglia cultures, focusing on very early development (Day-In-Vitro 4 treatment). Exposure to 3% isoflurane for 24 hours delayed morphological differentiation and impaired the growth of immature astrocytes. The timing of delayed astroglia maturation and growth coincided with a major disturbance in actin cytoskeleton sculpting that was manifest as impaired actin stress fiber formation and cytoskeletal organization and downregulation of the focal adhesion protein, paxillin. Isoflurane-induced actin cytoskeletal changes were accompanied by a significant decrease in protein levels of the endogenous GTPase RhoA that regulates the phosphorylation of myosin light chain protein, suggesting that isoflurane-induced impairment in glial growth and morphological development is, in part, mediated by the RhoA/myosin light chain protein signaling pathway.
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http://dx.doi.org/10.1097/NEN.0b013e31821284e9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063859PMC
April 2011

Cephalometric evaluation of surgical mandibular advancement.

Braz Oral Res 2010 Apr-Jun;24(2):189-96

Department of Orthodontics, Hermínio Ometto University Center, Araras University, Araras, SP, Brazil.

The treatment of Class II adult individuals with mandibular deficiency has been the combination of orthodontic treatment and orthognathic surgery. Therefore, a study was conducted in which cephalometric analysis was used to evaluate the influence of dentoalveolar decompensation in Class II patients submitted to orthodontic and surgical treatment for mandibular advancement, by bilateral osteotomy of the mandibular ramus. A sample of 15 leukoderma adult female patients were selected and three cephalometric radiographs of each patient, taken before the orthodontic treatment, before surgery and after at least 6 months postoperatively, were analyzed in a total of 45 roentgenograms. The tracings were made by the manual method and the points were digitalized using software. The results showed that values of SNB increased from 75.6 to 78.6 degrees. The measures BNP and PGNP were reduced from -12.7 to -7.7 mm and -12.7 to -6.6 mm, respectively. For ANB there was a reduction of 3.23 degrees (from 8.1 degrees to 4.9 degrees). Likewise, the values of AOBO were diminished by 6.3 mm (from 7.6 to 1.3 mm), and in the values of OJ there was a reduction of 5.7 mm (from 9 to 3.3 mm). It was concluded that the pre-surgical orthodontic treatment promoted minimal and variable dental and skeletal changes in the final result. The surgical treatment caused significant skeletal changes, especially in the measurements related to the mandible (SNB, BNP, PGNP and SNPM) or indirectly to it (ANB, AOBO and OJ).
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http://dx.doi.org/10.1590/s1806-83242010000200011DOI Listing
December 2010

Comparative cephalometric study between nasal and predominantly mouth breathers.

Braz J Otorhinolaryngol 2006 Jan-Feb;72(1):72-81

Aim: To evaluate the possible correlation between the respiratory pattern in determining the craniofacial dimensions, using as baseline the Tweed-Merrifields cephalometric analysis, added to angle SN-GoGn and to Y axis angle.

Methodology: The selected sample to this study comprised 50 teleradiographies taken in lateral and natural positions of the head in young female patients at the age of 9 to 12 years, presenting mean age of 10 years and 5 months and Class 1 malocclusion. After diagnosis of respiratory pattern, the sample was divided into two groups: control group, 25 teleradiographies of nasal breathers in lateral and natural positions of the head; experimental group, 25 teleradiographies of predominantly mouth breathers in lateral and natural positions of the head.

Results: The results were submitted to descriptive analysis (mean and standard deviation), test F and "t" Student test with significance level of 5%. There was no significant difference between the group with nasal breathing and the group with predominantly mouth breathing for any of the studied variables.
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http://dx.doi.org/10.1016/s1808-8694(15)30037-9DOI Listing
March 2007