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Purpose: Chemokines and their receptors play a crucial role in the development of atherosclerosis. CCR5 is considered to be crucial to monocyte recruitment during development of atherosclerosis. CCR5, known as a co‐receptor of HIV‐1, is the target of the approved CCR5 antagonist maraviroc (MVC). Therefore we investigated whether MVC reduces inflammation and atherosclerosis in a rodent model of dyslipidemia (ApoE‐/‐mice) treated or not with Ritonavir (RTV). Methods: Two‐month‐old mice (8 per group): wild type, ApoE‐/‐ plus vehicle; ApoE‐/‐ plus RTV; ApoE‐/‐ plus RTV in combination with MVC. Nine‐month‐old mice (13 per group): wild type; Apo E‐/‐ + vehicle; and Apo E‐/‐ + MVC. Animals were sacrificed after 3 months treatments and plasma, aortas and epididymal fat were collected. Areas of aortas plaque were measured. Immunohistochemistry was performed to evaluate macrophages infiltration, and protein levels of cytokines/chemokines (i.e. ICAM, PAI, VCAM, IL‐10, IL‐17, MCP1, Rantes, TNFα, INFγ) were evaluated in aorta lysates. Summary of results: RTV enhances the plaque areas percentage in two month old ApoE‐/‐ mice and is significantly reduced by MVC. The ritonavir‐enhanced Mac3 expression on plaques is also reduced by MVC. Treatment with MVC lowers aortic concentration of cytokines/chemokines and plasmatic level of CRP that are increased by RTV. Ritonavir, enhancing mRNA expression of IL‐6, Rantes and Mip1α, induces lipoatrophy in epididymal fat; MVC revertes this lipoatrophy and reduces mRNA levels of these cytokines‐chemokines. Moreover, in ApoE‐/‐ mice 9 months old, MVC significantly reduces the percentage of plaque areas (from 16.6±3.35% to 7.13±1.44%) (en‐face coloration), lowers aortic MAC3 staining and reduces the aortic concentration of cytokines/chemokines. Conclusions: In a dyslipidemic rodent model the CCR5 inhibitor Maraviroc significantly reduces the percentage of aortic plaque areas, aortic inflammation and lipoatrophy of the epididymal fat. Therefore, the current use of CCR5 antagonists to treat HIV infection, a condition associated with an increased occurrence of cardiovascular disease, should also be exploited to determine any beneficial cardiovascular effects [1,2]., References Mencarelli A, Cipriani S, Renga B, Francisci D, Palladino G, Distrutti E, et al. The bile acid sensor FXR protects against dyslipidemia and aortic plaques development induced by the [...]

Background: Various modifications of the laterally sliding flap have been proposed to reduce the risk of gingival recession at the donor tooth site, but the reported root coverage predictability was quite low. The goal of the present study was to evaluate the effectiveness with respect to root coverage of a modified surgical approach of the laterally moved flap procedure for the treatment of an isolated type of recession defect. Methods: One hundred and twenty (120) isolated gingival recessions (Miller Class I or II) with specific features of the keratinized tissue lateral to the defects were treated with a new approach to the laterally moved flap. The main surgical modifications consisted of the coronal advancement of the laterally moved flap and the different thickness during flap elevation. Clinical evaluation was made 1 year after the surgery. Results: At the 1-year examination, 97% of the root surface was covered with soft tissue and 96 defects (80%) showed complete root coverage. A statistical and clinically significant increase of keratinized tissue was observed. These favorable results were accomplished with no change in the position of gingival margin or in the height of gingival tissue at the donor tooth/site. Conclusions: The laterally moved, coronally advanced surgical technique was very effective in treating isolated gingival recessions. It combined the esthetic and root coverage advantages of the coronally advanced flap with the increase in gingival thickness and keratinized tissue associated with the laterally moved flap. The ideal gingival conditions must be present lateral to an isolated recession defect in order to render the proposed surgical technique an highly effective and predictable root coverage surgical procedure. [ABSTRACT FROM AUTHOR]

Background: Various clinical studies have demonstrated that applying commercially available enamel matrix proteins (EMP) on the instrumented root surface during access flap surgery promotes clinically significant gains of clinical attachment and bone in intrabony defects. The aim of the present controlled clinical trial was to evaluate the adjunctive effect of filling the intrabony lesion with bovine porous bone mineral (BPBM) to a simplified papilla preservation (SPP) flap and EMP surgical procedure. Methods: Sixty deep interproximal intrabony lesions in 60 patients with chronic periodontitis were treated with the SPP flap and EMP. In the 30 test defects, the intrabony component was filled with BPBM particles previously reconstituted with the EMP gel. A stringent infection control program was adopted for 1 year. The clinical and radiographical reevaluation was made 1 year after surgery. Results: Both techniques resulted in clinically and statistically significant improvements between baseline and 1 year, in terms of clinical attachment level (CAL) gain, probing depth (PD) reduction, and radiographic bone fill; however, the BPBM test treatment showed statistically significantly greater CAL (5.6 ± 1.1 versus 4.9 ± 1.0) and radiographic bone (DEPTH) level gains (5.3 ± 1.1 versus 4.3 ± 1.5), and less increase in gingival recession (0.4 plusmn; 0.6 versus 0.9 ± 0.5) than the control surgical procedure. Conclusion: The present study data supported the hypothesis that the adjunctive use of BPBM in grafting intrabony defects has the ability to improve clinical and radiographical outcomes achievable with EMP alone. [ABSTRACT FROM AUTHOR]

A response by G. Zuchelli et al. to a letter to the editor about their article "Laterally Moved, Coronally Advanced Flap: A Modified Surgical Approach for Isolated Recession-Type Defects" in a 2004 issue is presented.