Effect of an alcoholic diet on dental caries and on Streptococcus of the mutans group: Study in rats

The objective of this study was to evaluate the effects of an alcohol diet on Streptococcus of the mutans group and on dental caries in the oral cavity of rats. Forty animals were divided into 3 groups according to the following liquid diets: 20% ethanol solution (Alcohol Group, AG), 27% sucrose solution (Isocaloric Group, IG), and water (Control Group, CG). After 56 days, samples were collected and plated on Mitis Salivarius Bacitracin agar to assess the number of colony forming units (CFU/mL) of Streptococcus of the mutans group. The animals were sacrificed and the jaws were removed in order to assess the occurrence of dental caries on the smooth and occlusal surfaces using stereomicroscopy. The data were submitted to ANOVA and Tukey test. The average numbers of CFU/mL (10 3) were: 8.17 (AG), 9.78 (IG), and 5.63 (CG). There was no significant difference among the groups for the occurrence of occlusal caries. Regarding smooth surface caries, in the upper jaw, the caries number in the IG (1.58) was similar to that in the AG (2.06) and in the CG (1.14), and the number of caries in the AG was higher than in the CG; in the lower jaw there was significant difference among the 3 groups: AG (1.14), IG (2.00) and CG (0.43). The diets with the alcohol and sucrose solutions presented a tendency of increasing the colonization by Streptococcus of the mutans group and of increasing the occurrence of smooth surface dental caries in rat molars when compared to the control diet.

Influence of the power level of an ultra-sonic system on dental cavity preparation

The aim of this study was to evaluate the shape of dental cavities made with the CVDentus® system using different ultrasound power levels. One standard cavity was made on the buccal aspect of 15 bovine incisors with a CVDentus® cylindrical bur (82142). The sample was divided into three groups: G1 - ultrasound with power II; G2 - ultrasound with power III; and G3 - ultrasound with power IV. A standardizing device was used to obtain standardized preparations and ultrasound was applied during one minute in each dental preparation. The cavities were sectioned in the middle, allowing observation of the cavity's profile with a magnifying glass, and width and depth measurement using the Leica Qwin program. The Kruskal-Wallis (p < 0.05) and Dunn statistical analyses demonstrated differences between the dental cavity shapes when powers III and IV were used. However, the cavities that were made with power III presented dimensions similar to those of the bur used for preparation. We concluded that the power recommended by the manufacturer (III) is the most adequate for use with the CVDentus® system.

Excision of an atypical case of palatal bone exostosis: a case report.

Bone exostosis has long been described in the literature, appearing in most cases as a torus palatinus or mandibularis. These two variations are relatively common and affect approximately 30% of the world's population. Incidence is even higher when human skulls are examined post mortem, indicating that in some cases the exostosis is small and cannot be seen under the soft tissue. Removal of an exostosis is usually associated with the construction of a prothesis, but in rare cases such as the present, the lesion enlarges enough to affect speech and feeding. Few studies have reported the removal of such a large exostosis, and all were conducted in a hospital environment. In this case, complete removal was successfully conducted in an ambulatory clinic under local anesthesia.

Visual evaluation of color stability after accelerated aging of pigmented and nonpigmented silicones to be used in facial prostheses

Objectives: The objective of this study was to evaluate by a visual method of comparison the color stability of nonpigmented and pigmented facial silicones after accelerated aging. Materials and Methods: Two kinds of silicones were used in this study; one specifically formulated for facial prostheses and the other an acetic silicone for industrial use. Twenty-four trial bodies were made for each silicone. These were divided into colorless and intrinsically pigmented groups: ceramic, make-up, and iron oxide. The groups were submitted to accelerated aging for nonmetallic materials. An initial reading and subsequent readings were made at 163, 351, 692, and 1000 hours using a visual method of comparison. The values were annotated in a spreadsheet by two observers, according to scores elaborated for this study. Results: All groups presented color stability in the visual method. According to the results obtained and analyzed in this study, we can conclude that both silicones, Silastic 732 RTV and Silastic MDX 4-4210, behaved similarly, they can therefore be indicated for use in maxillofacial prosthesis. The time factor of aging influenced negatively, independently of the pigmentation, or lack of it, and of silicones and no group had visually noticeable alterations in any of the accelerated aging time, independently of the addition or not of pigments.

Implant removal by means of an expansion of the alveolar bony crest: Report of a clinical technique

Aim: To describe the adaptation of the Edentulous Ridge Expansion (E.R.E.) technique for implant removal. Material and Methods: The E.R.E. technique for the removal of failed implants is described in detail. A clinical case is also reported. In a patient carrying a full arch removable prosthesis in the upper jaw, sustained by two bars, two out of five implants were found to be fractured. Bucco-lingual partial-thickness flaps were used to access the fractured implants. The implants were subsequently removed applying the E.R.E. technique. Two recipient sites were prepared in the same position, using bone expanders, and two new implants were installed. Results: After 4 months of healing, the implants were integrated and a new bar was fabricated, and the old prosthesis readapted. Conclusion: The ERE technique may be successfully applied for the removal of failed implants, and the immediate or delayed reinstallation of new implants. © 2012 John Wiley & Sons A/S.

Antimicrobial activity and surface properties of an acrylic resin containing a biocide polymer

Objective: To evaluate the antimicrobial activity and surface properties of an acrylic resin containing the biocide polymer poly (2-tert-butylaminoethyl) methacrylate (PTBAEMA). Background: Several approaches have been proposed to prevent oral infections, including the incorporation of antimicrobial agents to acrylic resins. Materials and methods: Specimens of an acrylic resin (Lucitone 550) were divided into two groups: 0% (control) and 10% PTBAEMA. Antimicrobial activity was assessed by adherence assay of one of the microorganisms, Staphylococcus aureus, Streptococcus mutans and Candida albicans. Surface topography was characterised by atomic force microscopy and wettability properties determined by contact angle measurements. Results: Data of viable cells (log (CFU + 1)/ml) for S. aureus (control: 7.9 ± 0.8; 10%: 3.8 ± 3.3) and S. mutans (control: 7.5 ± 0.7; 10%: 5.1 ± 2.7) showed a significant decrease with 10% of PTBAEMA (Mann-Whitney, p < 0.05). For C. albicans (control: 6.6 ± 0.2; 10%: 6.6 ± 0.4), there was no significant difference between control and 10% of PTBAEMA (Kruskal-Wallis, p > 0.05). Incorporating 10% PTBAEMA increased surface roughness and decreased contact angles. Conclusion: Incorporating 10% PTBAEMA into acrylic resins increases wettability and roughness of acrylic resin surface; and decreases the adhesion of S. mutans and S. aureus on acrylic surface, but did not exhibit antimicrobial effect against C. albicans. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

In Vivo study of an intracanal dressing of calcium hydroxide/chlorhexidine in necrotic primary teeth

AIM:To evaluate the clinical and radiographic success of endodontic treatment in human primary teeth with necrotic pulp with and without radiographically visible furcal/periapical lesion treated with a calcium hydroxide (CH) and chlorhexidine (CHX) intracanal dressing. The tested hypothesis was that there is no difference in the clinical and radiographic success in primary teeth medicated with CH pastes prepared with polyethylene glycol (PEG) or CHX.METHODS:Thirty-two teeth with necrotic pulp were used in this randomized clinical study: 12 without and 20 with lesion. Canals were prepared and medicated with CH pastes with polyethylene glycol (CH/PEG) (n=16) or 2% CHX gel (CH/CHX) (n=16). Definitive filling was done after 30 days. The teeth were clinically and radiographically examined during 12 months to determine the success of the endodontic therapy. Data from clinical and radiographic examination of the initial condition and 12 months after treatment were compared using the Z test (α = 0.05).RESULTS:There was no significant difference (p>0.05) in the success rate of teeth with and without lesion medicated with CH/PEG or CH/CHX. No significant difference (p>0.05) was found between the pastes regardless of the presence of lesion.CONCLUSIONS:Combination of CHX and CH was not more effective than the CH/PEG paste, as similar clinical and radiographic success rate was observed in teeth medicated with either type of intracanal dressing.

In Vitro Regulation of CCL3 and CXCL12 by Bacterial By-products Is Dependent on Site of Origin of Human Oral Fibroblasts

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The impact of the addition of iodoform on the physicochemical properties of an epoxy-based endodontic sealer

Due to the low radiopacity of Sealer 26, iodoform is frequently empirically added to this sealer. Thus, the interference of this procedure with the physicochemical properties of Sealer 26 must be evaluated. Objective: This study evaluated the influence of the addition of iodoform on setting time, flow, solubility, pH, and calcium release of an epoxy-based sealer. Material and Methods: The control group was pure Sealer 26, and the experimental groups were Sealer 26 added with 1.1 g, 0.55 g or 0.275 g of iodoform. Setting time evaluation was performed in accordance with the ASTM C266-03 speciflcation. The analysis of flow and solubility was in accordance with the ISO 6876-2001 speciflcation. For the evaluation of pH and calcium ion release, polyethylene tubes were filled with the materials and immersed in flasks with 10 ml of deionized water. After 24 h, 7, 14, 21, 28, and 45 days pH was measured. In 45 days, the calcium released was evaluated with an atomic absorption spectrophotometer. Results: The addition of iodoform increased setting time in comparison with pure sealer (P < 0.05). As for flow, solubility, and calcium release, the mixtures presented results similar to pure sealer (p > 0.05). In the 24 h period, the mixture with 1.1 g and 0.55 g of iodoform showed lower pH than pure sealer and than sealer added with 0.275 g of iodoform (P < 0.05). Conclusions: The iodoform added to Sealer 26 interferes with its setting time and solubility properties. Further studies are needed to address the clinical signiflcance of this interference.

The effect of final irrigation on the penetrability of an epoxy resin-based sealer into dentinal tubules: a confocal microscopy study

Introduction The aim of this study was to compare the effect of QMix, BioPure MTAD, 17 % EDTA, and saline on the penetrability of a resin-based sealer into dentinal tubules using a confocal laser scanning microscope (CLSM) and to describe the cleaning of root canal walls by SEM. Methods Eighty distobuccal roots from upper molars were selected and randomly divided into four groups (n=20) before root canal preparation according to the solution used in the final rinse protocol (FRP): QG (QMix), MG (BioPure MTAD), EG (17 % EDTA), and CG (control group: saline). Ten roots of each group were prepared for SEM, and images (×2000) from the canal walls were acquired. The remaining canals were filled with a single gutta-percha cone and AH Plus with 0.1 % Rhodamine B. The specimens were horizontally sectioned at 4 mm from the apex, and the slices were analyzed in CLSM (×10). Sealer penetration was analyzed with Adobe Photoshop software. Results QG and EG presented similar amounts of sealer penetration (P>.05). MG and CG presented the lowest penetrability values (P<.05). The best results for smear layer removal of the apical third of the root canal were achieved by the QG and EG groups when compared with MG and CG (P<.05). Conclusions Seventeen percent EDTA and QMix promoted sealer penetration superior to that achieved by BioPure MTAD and saline. Clinical relevance Despite studies have not confirmed the relationship between sealing ability of endodontic sealers and their penetration in dentinal tubules, sealer penetration assumes importance, since endodontic sealers, unlike guttapercha, are able to penetrate in dentinal tubules, isthmus, and accessory canals, filling the root canal system.

Primary cutaneous histoplasmosis developed in the penis of an immunocompetent patient

A 70-year-old male presenting a 3-month history of genital painless erythematous nodules in the balanopreputial sulcus was referred to our service. Histopathological exam presented a chronic dermatitis with epithelioid granulomas and Grocott staining revealed numerous fungal structures with a suggestive morphology of Histoplasma sp. Cultures evidenced Histoplasma capsulatum var. capsulatum. Treatment with oral itraconazole led to complete remission of lesions.

Acetaminophen as an Oral Toxicant for Nile Monitor Lizards (Varanus niloticus) and Burmese Pythons (Python molurus bivittatus)

Context. Invasive species are a growing global problem. Biological invasions can result in numerous harmful impacts on local ecologies, and non-native herpetofauna are frequently ignored. Nile monitor lizards (Varanus niloticus) and Burmese pythons (Python molurus bivittatus, recently reassessed as Python bivittatus bivittatus), have become established in southern Florida. Both are large, semi-aquatic predators that pose serious threats to a variety of threatened and endangered species, as well as to the unique ecology of the area. Aims. Acetaminophen (CAS#103-90-2), a lethal oral toxicant for the invasive brown treesnake (Boiga irregularis) on Guam, was investigated as a possible toxicant in juvenile Burmese pythons and Nile monitors. Methods. Dead neonatal mouse (DNM) baits containing 0, 10, 20, or 40 mg acetaminophen were force-fed to Nile monitors, whereas DNM containing doses of 0, 20, 40, or 80 mg were freely consumed by Burmese pythons. Subjects were frequently observed post-treatment for general condition and position, with special attention paid to activity (if any), behaviour, respiration, bleeding, emesis, ataxia, and mortality. Key results. In Nile monitors, acetaminophen doses of 10, 20, or 40 mg resulted in 0, 50 and 100% mortality, respectively. In Burmese pythons, doses of 20, 40, or 80 mg resulted in 14.3, 85.7 and 100% mortality, respectively. No mortality was observed in control individuals of either species. A negative correlation between dosage (mg kg–1) and time-to-death was observed in both species. Dosages ranging from 522 to 2438 mg kg–1 and 263 to 703 mg kg–1 were uniformly lethal to monitors and pythons, respectively. Neither species exhibited signs of pain or discomfort following acetaminophen treatment. Conclusions. Acetaminophen is an effective toxicant in juvenile Nile monitors and Burmese pythons. Further investigation into acetaminophen toxicity in adults of these species is merited. Implications. Although further investigation into adult lethal dosages and strategies to optimize bait deployment while minimizing secondary hazards is required, acetaminophen may have a role to play in the control of these invasive species in Florida.

Prenatal detection and postnatal management of an intranasal glioma

Nasal gliomas are rare benign congenital midline tumors composed of heterotopic neuroglial tissue. They have potential for intracranial extension through a bony defect in the skull base. Neuroimaging is essential for identifying nasal lesions and for determining their exact location and any possible intracranial extension. Computed tomography is often the initial imaging study obtained because it provides good visualization of the bony landmarks of the skull base; it is not, however, well suited for soft tissue imaging. Magnetic resonance imaging has better soft tissue resolution and may be the best initial study in patients seen early in life because the anterior skull base consists of an unossified cartilage and may falsely appear as if there is a bony dehiscence on computed tomography. A frontal craniotomy approach is recommended if intracranial extension is identified, followed by a transnasal endoscopic approach for intranasal glioma. A case is presented of a huge fetal facial mass that was shown by ultrasound that protruded through the left nostril at 33 weeks of gestation. Computed tomography of the neonate suggested a transethmoidal encephalocele. Magnetic resonance imaging showed a huge mass occupying the nasopharynx and the nasal cavity and protruding externally to the face but ruled out bony discontinuity in the skull base and, therefore, any intracranial connection. The infant underwent an endoscopic resection of the mass via oral and nasal routes and pathologic examination revealed intranasal glioma. (C) 2012 Elsevier Inc. All rights reserved.

Parental reports of the oral health-related quality of life of children with cerebral palsy

Background: The severity of physical and mental impairments and oral problems, as well as socioeconomic factors, may have an impact on quality of life of children with cerebral palsy (CP). The aim of this research was to assess the impact of impairments and oral health conditions, adjusted by socioeconomic factors, on the Oral Health-Related Quality of Life (OHRQoL) of children with CP using their parents as proxies. Methods: Sixty children, between 6-14 years of age were selected. Their parents answered a children's OHRQoL instrument (5 domains) which combines the Parental-Caregivers Perception Questionnaire (P-CPQ) and Family Impact Scale (FIS). The severity of dental caries, type of CP, communication ability, gross motor function, seizures and socioeconomic conditions were assessed. Results: Considering the total score of the OHRQoL instrument, only the reduction of communication ability and dental caries severity had a negative impact on the OHRQoL (p < 0.05). Considering each domain of the instrument, the severity of the type of CP and its reduction of communication ability showed a negative impact on oral symptoms and functional limitations domains (p < 0.05). Seizures have a negative impact on oral symptoms domain (p = 0.006). The multivariate fitted model showed that the severity of dental caries, communication ability and low family income were negatively associated with the impact on OHRQoL (p = 0.001). Conclusions: The severity of dental caries, communication ability, and family income are conditions strongly associated with a negative impact on OHRQoL of children with CP.

Sorafenib in Combination With Capecitabine: An Oral Regimen for Patients With HER2-Negative Locally Advanced or Metastatic Breast Cancer

Purpose Sorafenib is a multikinase inhibitor with antiangiogenic/antiproliferative activity. A randomized, double-blind, placebo-controlled phase IIB trial assessed sorafenib with capecitabine for locally advanced or metastatic human epidermal growth factor receptor 2 (HER2) -negative breast cancer. Patients and Methods Patients were randomly assigned to first-or second-line capecitabine 1,000 mg/m(2) orally twice a day for days 1 to 14 of every 21-day cycle with sorafenib 400 mg orally twice a day or placebo. The primary end point was progression-free survival (PFS). Results In total, 229 patients were enrolled. The addition of sorafenib to capecitabine resulted in a significant improvement in PFS versus placebo (median, 6.4 v 4.1 months; hazard ratio [HR], 0.58; 95% CI, 0.41 to 0.81; P = .001) with sorafenib favored across subgroups, including first-line (HR, 0.50; 95% CI, 0.30 to 0.82) and second-line (HR, 0.65; 95% CI, 0.41 to 1.04) treatment. There was no significant improvement for overall survival (median, 22.2 v 20.9 months; HR, 0.86; 95% CI, 0.61 to 1.23; P = .42) and overall response (38% v 31%; P = .25). Toxicities (sorafenib v placebo) of any grade included rash (22% v 8%), diarrhea (58% v 30%), mucosal inflammation (33% v 21%), neutropenia (13% v 4%), hypertension (18% v 12%), and hand-foot skin reaction/hand-foot syndrome (HFSR/HFS; 90% v 66%); grade 3 to 4 toxicities were comparable between treatment arms except HFSR/HFS (44% v 14%). Reasons for discontinuation in the sorafenib and placebo arms included disease progression (63% v 82%, respectively), adverse events (20% v 9%, respectively), and death (0% v 1%, respectively). Conclusion Addition of sorafenib to capecitabine improved PFS in patients with HER2-negative advanced breast cancer. The dose of sorafenib used in this trial resulted in unacceptable toxicity for many patients. A phase III confirmatory trial has been initiated with a reduced sorafenib dose.