Targeted disruption of the murine CCK1 receptor gene reduces intestinal lipid-induced feedback inhibition of gastric function

Cholecystokinin (CCK), acting at CCK1 receptors (CCK1Rs) on intestinal vagal afferent terminals, has been implicated in the control of gastrointestinal function and food intake. Using CCK1R(-/-) mice, we tested the hypothesis that lipid-induced activation of the vagal afferent pathway and intestinal feedback of gastric function is CCK1R dependent. In anesthetized CCK1R(+/+) ("wild type") mice, meal-stimulated gastric acid secretion was inhibited by intestinal lipid infusion; this was abolished in CCK1R(-/-) mice. Gastric emptying of whole egg, measured by nuclear scintigraphy in awake mice, was significantly faster in CCK1R(-/-) than CCK1R(+/+) mice. Gastric emptying of chow was significantly slowed in response to administration of CCK-8 (22 pmol) in CCK1R(+/+) but not CCK1R(-/-) mice. Activation of the vagal afferent pathway was measured by immunohistochemical localization of Fos protein in the nucleus of the solitary tract (NTS; a region where vagal afferents terminate). CCK-8 (22 pmol ip) increased neuronal Fos expression in the NTS of fasted CCK1R(+/+) mice; CCK-induced Fos expression was reduced by 97% in CCK1R(-/-) compared with CCK1R(+/+) mice. Intralipid (0.2 ml of 20% Intralipid and 0.04 g lipid), but not saline, gavage increased Fos expression in the NTS of fasted CCK1R(+/+) mice; lipid-induced Fos expression was decreased by 47% in CCK1R(-/-) compared with CCK1R(+/+)mice. We conclude that intestinal lipid activates the vagal afferent pathway, decreases gastric acid secretion, and delays gastric emptying via a CCK1R-dependent mechanism. Thus, despite a relatively normal phenotype, intestinal feedback in response to lipid is severely impaired in these mice.

Improvements of facial profile and smile aesthetic using temporary anchorage devices and botulinum toxin: a case report

The severe gummy smile and a skeletal class II profile pose challenges in treatment. This case report outlines an effective alternative for addressing these problems in a patient with skeletal class II division 2, class II molar relationship, retroclination of upper incisors, and lip protrusion. Treatment objectives included normalizing the overjet and overbite, improving the gummy smile, and establishing a satisfactory occlusion. A three-dimensional simulation was performed to consult with the patient, assess possible results, and predict treatment biomechanics. The treatment involved the use of two zygomatic and one inter-radicular temporary anchorage devices, along with botulinum toxin. After the 2-year follow-up, a satisfactory dental occlusion, aesthetic improvement, and adequate function were achieved. This approach offers a viable alternative to orthognathic surgery for adults with skeletal class II malocclusion and a severe gummy smile due to hypermobile lip.

Management of a severe skeletal open bite case using temporary anchorage devices and multiloop edgewise arch wire technique

The primary cause of complex AOB malocclusion is typically a combination of dental, skeletal, functional, and habitual factors. Open bite correction is a challenging treatment due to its complexity and the requirement for long-term stability, therefore, multidisciplinary treatment is often the best option for achieving stable esthetic outcomes.

A multidisciplinary approach to managing severe gummy smile using 3D simulation and digital surgical guide: a case report

A smile that reveals >4 mm of gum tissue is called a gummy smile (GS), offering negative impacts on people's self-confidence and aesthetic appearance. The treatment for GS should be planned according to underlying causes such as altered passive eruption of teeth, dentoalveolar extrusion, vertical maxillary excess, and short or hyperactive lip muscles. In this case report, a patient with severe GS received orthodontic and gingivoplasty treatment, aided by digital tools such as 3D simulation, smile design, and 3D printed guides. The treatment yielded remarkable and satisfactory results, without the need for extensive surgery. Our findings suggest that gingivoplasty is a minimally invasive, time- and cost-effective alternative to more extensive procedures for correcting severe gum recession.

Class II Correction and Crowding Treatment Using In-House Direct Printed Clear Aligners: A Literature Review and Case Report

Clear aligner therapy has significantly improved orthodontic treatment by offering patients a more aesthetically pleasing option compared to traditional braces. This literature review and case report specifically focus on the effectiveness of directly printed clear aligners in treating Class II malocclusions and crowding. Class II malocclusions are characterized by excessive overjet, which often results from skeletal or dental discrepancies between the upper and lower jaws. Crowding refers to the lack of space for teeth within the dental arch, leading to misalignment and potential functional issues. The review and case report highlight the increasing importance of directly printed clear aligners in modern orthodontics and provide clinicians with a valuable tool to effectively address complex malocclusions and crowding while also meeting patient needs for discretion and comfort. Further research is necessary to validate the long-term stability and outcomes of directly printed clear aligner therapy in various orthodontic cases. A detailed case report demonstrates the successful treatment of a patient with Class II malocclusion and mild crowding using directly printed clear aligners. Treatment outcomes include improvements in dental alignment, occlusion, and facial aesthetics, showcasing the effectiveness of this innovative approach.

Multidisciplinary Treatment With Adjunctive Orthodontics, Surgical Crown Lengthening, and Esthetic Rehabilitation

Anterior spacing caused by missing upper lateral incisors and edge-to-edge position in the front teeth can negatively affect the appearance of a person's smile, leading to mental and social distress. A 29-year-old woman approached with the issue of edge-to-edge anterior occlusion, upper and lower spacing, missing lateral teeth, and improper occlusion. The treatment plan involved an interdisciplinary approach with orthodontics, implants, periodontics, and prosthodontics. After orthodontic treatment, third molar extraction and two buccal shelf mini screws were recommended to distalize the lower posterior teeth and retract the lower incisors using a power chain. Gingivoplasty and veneer restorations were performed on teeth 14-24 to improve the patient's smile aesthetics. The interdisciplinary approach used in this case involved fixed orthodontics, periodontal surgery, and prosthodontics to manage and improve the patient's smile and facial appearance.