Relationship between rheumatoid arthritis and periodontitis

Background: Because of several similar features in the pathobiology of periodontitis and rheumatoid arthritis, in a previous study we proposed a possible relationship between the two diseases. Therefore, the aims of this study were to study a population of rheumatoid arthritis patients and determine the extent of their periodontal disease and correlate this with various indicators of rheumatoid arthritis. Methods: Sixty-five consecutive patients attending a rheumatology clinic were examined for their levels of periodontitis and rheumatoid arthritis. A control group consisted of age- and gender-matched individuals without rheumatoid arthritis. Specific measures for periodontitis included probing depths, attachment loss, bleeding scores, plague scores, and radiographic bone loss scores. Measures of rheumatoid arthritis included tender joint analysis, swollen joint analysis, pain index, physician's global assessment on a visual analogue scale, health assessment questionnaire, levels of C-reactive protein, and erythrocyte sedimentation rate. The relationship between periodontal bone loss and rheumatological findings as well as the relationship between bone loss in the rheumatoid arthritis and control groups were analyzed. Results: No differences were noted for the plaque and bleeding indices between the control and rheumatoid arthritis groups. The rheumatoid arthritis group did, however, have more missing teeth than the control group and a higher percentage of these subjects had deeper pocketing. When the percentage of bone loss was compared with various indicators of rheumatoid arthritis disease activity, it was found that swollen joints, health assessment questionnaire scores, levels of C-reactive protein, and erythrocyte sedimentation rate were the principal parameters which could be associated with periodontal bone loss. Conclusions: The results of this study provide further evidence of a significant association between periodontitis and rheumatoid arthritis. This association may be a reflection of a common underlying disregulation of the inflammatory response in these individuals.

Survival of Dental Implants in the Cleft Area-A Retrospective Study

Objective To evaluate the survival rate of dental implants placed in the cleft area Design Retrospective study Setting Hospital for Rehabilitation of Craniofacial Anomalies, Brazil Institutional Tertiary Healthcare Center Patients 120 patients who received dental implants in the grafted cleft area in the years 1999 to 2005 Interventions Clinical data were evaluated from the records of 120 patients according to the following criteria placement grafted, cleft area, and age at surgery, age at placement of dental implants, site and dimension of implants, interval between placement of implants and the last clinical follow-up, and interval between placement and removal or indication for removal of implants Main Outcome Measures Percentage of survival rate of implants Results Mean age at placement of the bone graft was 17 6 years and 21 years at placement of implants A total of 123 cleft areas received secondary bone graft and bone graft to install implants (regraft) The mean survival rate was 34 months since placement of the implant to the last clinical follow-up and 26 months since placement of the prosthesis Seven dental implants were removed The survival rate since placement to the last clinical follow-up was 94 3% Conclusion Rehabilitation of the cleft area with dental implants is a viable and secure alternative, with good prognosis

Hyperplastic polyposis - Association with colorectal cancer

Hyperplastic polyposis is a loosely defined syndrome initially thought not to confer a clinically important predisposition to colorectal cancer. The aim of the current study was to examine the clinical, histologic, and molecular features of a prospective series of cases meeting a strict definition of the condition. Twelve patients were identified, seven of whom had developed colorectal cancer. Most polyps were hyperplastic, but 11 patients also had polyps containing dysplasia as either serrated adenomas. mixed polyps, or traditional adenomas. The mean percentage of dysplastic polyps in patients with cancer was 35%, and in patients without cancer, 11%(p < 0.05). Microsatellite instability (MSI) was present in 3 of 47 hyperplastic polyps and two of right serrated adenomas. Kras was mutated in 8 of 47 hyperplastic polyps and two of eight serrated adenomas. No polyps showed loss of heterozygosity of chromosomes 5q, 1p, or 18q. Two of seven cancers showed a high level of MSI. It is concluded that hyperplastic polyposis is associated with a high risk of colorectal cancer. Hyperplastic polyps are the dominant type of polyp, but most cases have some dysplastic epithelium. A higher proportion of dysplastic polyps is associated with increased cancer risk. Clonal generic changes are observed in some hyperplastic polyps and serrated adenomas.

Prolactin differentially modulates the macrophage activity of lactating rats: possible role of reproductive experience

Reproductive experience (i.e., pregnancy and lactation) induces physiological changes in mammals. We recently showed that a previous reproductive experience can modulate the activity of dopaminergic hypothalamic systems while decreasing serum prolactin (PRL) levels and oxidative burst activity in peritoneal macrophages. Dopamine receptor antagonists increase serum PRL levels, and both PRL and dopamine receptors might be involved in the modulation of macrophage activity, providing a means of communication between the nervous and immune systems. The present study evaluated the in vitro effects of PRL and the dopamine receptor 02 antagonist domperidone (DOMP) on the peritoneal activity of macrophages from primiparous and multiparous female rats during lactation. Oxidative bursts and phagocytosis in peritoneal macrophages were evaluated by flow cytometry. Primiparous and multiparous Wistar rats, during the period of lactation (i.e., days 5-7 after parturition) were used. Samples of peritoneal fluid from these rats were first incubated with PRL (10 and 100 nM) for different periods of time. The same procedure was repeated to evaluate the effects of DOMP (10 and 100 nM). Our results showed that macrophages from multiparous rats respond more effectively to in vitro incubation with PRL, especially with regard to oxidative bursts and the percentage of phagocytosis. Additionally, these effects were more pronounced after 30 min of incubation. These data suggest that reproductive experience is associated with a reduction in serum PRL levels, and cells in experienced female animals, including their macrophages, become more sensitive to the effects of PRL (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Craniocervical posture and hyoid bone position in children with mild and moderate asthma and mouth breathing

Introduction The objective of the present study was to assess the craniocervical posture and the positioning of the hyoid bone in children with asthma who are mouth breathers compared to non-asthma controls. Methods The study was conducted on 56 children, 28 of them with mild (n = 15) and moderate (n = 13) asthma (14 girls aged 10 79 +/- 1 31 years and 14 boys aged 9 79 +/- 1.12 years), matched for sex, height, weight and age with 28 non-asthma children who are not mouth breathers The sample size was calculated considering a confidence interval of 95% and a prevalence of 4% of asthma in Latin America. Eighteen variables were analyzed in two radiographs (latero-lateral teleradiography and lateral cervical spine radiography), both obtained with the head in a natural position The independent t-test was used to compare means values and the chi-square test to compare percentage values (p < 0 05) Intraclass correlation coefficient (ICC) was used to verify reliability. Results. The Craniovertebral Angle (CVA) was found to be significantly smaller in asthma than in control children (106.38 +/- 766 vs. 111 21 +/- 7.40. p = 0 02) and the frequency of asthma children with an absent or inverted hyoid triangle was found to be significantly higher compared to non-asthma children (36% vs 7%, p = 0.0001). The values of the inclination angles of the superior cervical spine in relation to the horizontal plane were significantly higher in moderate than in mild asthma children (CVT/Hor 85 10 +/- 725 vs. 90 92 +/- 6.69, p = 0 04 and C1/Hor. 80 93 +/- 5.56 vs 85 00 +/- 4 20, p = 0 04) Conclusions These findings revealed that asthma children presented higher head extension and a higher frequency of changes in hyoid bone position compared to non-asthma children and that greater the asthma severity greater the extension of the upper cervical spine. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Analysis of enamel microbiopsies in shed primary teeth by Scanning Electron Microscopy (SEM) and Polarizing Microscopy (PM)

The aims of this study were 1) to verify how close to the theoretically presumed areas are the areas of enamel microbiopsies carried out in vivo or in exfoliated teeth; 2) to test whether the etching solution penetrates beyond the tape borders: 3) to test whether the etching solution demineralizes the enamel in depth. 24 shed upper primary central incisors were randomly divided into two groups: the Rehydrated Teeth Group and the Dry Teeth Group. An enamel microbiopsy was performed, and the enamel microbiopsies were then analyzed by Scanning Electron Microscopy (SEMI) and Polarizing Microscopy (PM). Quantitative birefringence measurements were performed. The ""true"" etched area was determined by measuring the etched enamel using the NIH Image analysis program. Enamel birefringence was compared using the paired t test. There was a statistically significant difference when the etched areas in the Rehydrated teeth were compared with those of the Dry teeth (p = 0.04). The etched areas varied from -11.6% to 73.5% of the presumed area in the Rehydrated teeth, and from 6.6% to 61.3% in the Dry teeth. The mean percentage of variation in each group could be used as a correction factor for the etched area. Analysis of PM pictures shows no evidence of in-depth enamel demineralization by the etching solution. No statistically significant differences in enamel birefringence were observed between values underneath and outside the microbiopsy area in the same tooth, showing that no mineral loss occurred below the enamel superficial layer. Our data showed no evidence of in-depth enamel demineralization by the etching solution used in the enamel microbiopsy proposed for primary enamel. This study also showed a variation in the measured diameter of the enamel microbiopsy in nineteen teeth out of twenty four, indicating that in most cases the etching solution penetrated beyond the tape borders. (C) 2009 Elsevier B.V. All rights reserved.

Flat-Oval Root Canal Preparation with Self-Adjusting File Instrument: A Micro-Computed Tomography Study

Introduction: The aim of this study was to evaluate the root canal preparation in flat-oval canals treated with either rotary or self-adjusting file (SAF) by using micro-tomography analysis. Methods: Forty mandibular incisors were scanned before and after root canal instrumentation with rotary instruments (n = 20) or SAF (n = 20). Changes in canal volume, surface area, and cross-sectional geometry were compared with preoperative values. Data were compared by independent sample t test and chi(2) test between groups and paired sample t test within the group (alpha = 0.05). Results: Overall, area, perimeter, roundness, and major and minor diameters revealed no statistical difference between groups (P > .05). In the coronal third, percentage of prepared root canal walls and mean increases of volume and area were significantly higher with SAF (92.0%, 1.44 +/- 0.49 mm(3), 0.40 +/- 0.14 mm(2), respectively) than rotary instrumentation (62.0%, 0.81 +/- 0.45 mm(3), 0.23 +/- 0.15 mm2, respectively) (P < .05). SAF removed dentin layer from all around the canal, whereas rotary instrumentation showed substantial untouched areas. Conclusions: In the coronal third, mean increases of area and volume of the canal as well as the percentage of prepared walls were significantly higher with SAF than with rotary instrumentation. By using SAF instruments, flat-oval canals were homogenously and circumferentially prepared. The size of the SAF preparation in the apical third of the canal was equivalent to those prepared with #40 rotary file with a 0.02 taper. (J Endod 2011;37:1002-1007)

Histological evaluation of the effectiveness of increased apical enlargement for cleaning the apical third of curved canals

P>Objective To evaluate the influence of apical size on cleaning of the apical third of curved canals prepared with rotary instruments. Methodology Forty-four mesiobuccal canals of maxillary molars teeth were instrumented to different apical sizes (30, 0.02; 35, 0.02; 40, 0.02; 45, 0.02) using a crown-down technique. After canal preparation, the apical thirds of the roots were submitted to histological processing and examination. The specimens were analysed at 40x magnification and the images were submitted to morphometric analysis with an integration grid to evaluate the percentage of debris and uninstrumented root canal walls. The action of the instruments on the root canal walls was assessed based on the surface regularity, abrupt change on the continuity of root canal walls, and partial or total pre-dentine removal. The results were statistically compared using one-way anova with post hoc Tukey test. Pearson`s correlation was performed to identify potential correlations between values. Results The percentage of uninstrumented root canal dentine was higher when apical enlargement was performed with instruments 30, 0.02 taper (55.64 +/- 4.62%) and 35, 0.02 taper (49.03 +/- 5.70%) than with instruments 40, 0.02 taper (38.08 +/- 10.44%) and 45, 0.02 taper (32.65 +/- 8.51%) (P < 0.05). More debris were observed when apical enlargement was performed with instruments 30, 0.02 taper (34.62 +/- 9.49%) and 35, 0.02 taper (25.33 +/- 7.37%) (P < 0.05). There was a significant correlation between the amount of remaining debris and the perimeter of uninstrumented root canal dentine (r = 0.9130, P < 0.001). Conclusion No apical enlargement size allowed the root canal walls to be prepared completely. Apical third cleanliness could be predicted by instrument diameter.

Effect of 980-nanometer diode laser on root canal permeability after dentin treatment with different chemical solutions

This study evaluated the effect of 980-nm diode laser at different parameters on root canal dentin permeability associated with different irrigants. Seventy-five canines were sectioned at 15 mm from the apex, prepared mechanically up to #40 .02 instrument, and irrigated with 2 mL distilled water. Final irrigation (10 mL) was used as follows: (1) distilled water; (2) 1% NaOCl; (3) 17% ethylenediaminetetraacetic acid + a cationic surfactant cetyltrimethylammonium bromide (EDTAC). Laser was applied at 1.5 or 3.0 W as either continuous wave or pulsed wave (100 Hz). The teeth were then processed histochemically, the percentage of copper ion penetration into the dentin of the canal walls was counted, and the data were analyzed statistically with the Tukey-Kramer test (alpha < .01). When laser was associated with water, an increase in permeability was found, whereas permeability decreased when associated with EDTAC. Dentin permeability after laser irradiation was directly dependent on the solution used for final irrigation.

Influence of Filling Materials on the Bonding Interface of Thin-walled Roots Reinforced with Resin and Quartz Fiber Posts

Introduction: A common complication during the restoration of severely destroyed teeth is the loss of coronal root dentine. The aim of this study was to evaluate the influence of different sealers on the bonding interface of weakened roots reinforced with resin and fiber posts. Methods: Sixty extracted maxillary canines were used. The crowns were removed, and the thickness of root dentine was reduced in the experimental (n = 40) and positive control (n = 10) groups. The specimens of experimental group were assigned to four subgroups (n = 10) according to the filling material: gutta-percha + Grossmann`s sealer, gutta-percha + AH Plus (Dentsply De Trey Gmbh, Konstanz, Germany), gutta-percha + Epiphany (Pentron Clinical Technologies, Wallingford, CT), and Resilon (Resilon Research LLC, Madison, CT) + Epiphany. In the negative control group (n = 10), canals were not filled. After post space preparation, the roots were restored with composite resin light-activated through a translucent fiber post. After 24 hours, specimens were transversally sectioned into 1-mm-thick slices. Push-out test and scanning electron microscopic (SEM) analyses of different regions were performed. Data from push-out test were analyzed by using Tukey post hoc multiple comparison tests. The percentage of failure type was calculated. Data from SEM analysis were compared by Friedman and Kruskal-Wallis tests (alpha = 0.05). Results: The mean bond strength was significantly higher in the negative control group as compared with the other groups (P < .05). In all groups, the most frequent type of failure was adhesive. Overall, apical and middle regions presented a lower density of resin tags than the coronal region (P < .05). Conclusions: The push-out bond strength was not affected by sealer or region. The canal region affected significantly the resin tag morphology and density at the bonding interface. (J Endod 2011;37:531-537)

Influence of shaft design on the shaping ability of 3 nickel-titanium rotary systems by means of spiral computerized tomography

Objective. To evaluate the influence of shaft design on the shaping ability of 3 rotary nickel-titanium (NiTi) systems. Study design. Sixty curved mesial canals of mandibular molars were used. Specimens were scanned by spiral tomography before and after canal preparation using ProTaper, ProFile, and ProSystem GT rotary instruments. One-millimeter-thick slices were scanned from the apical end point to the pulp chamber. The cross-sectional images from the slices taken earlier and after canal preparation at the apical, coronal, and midroot levels were compared. Results. The mean working time was 137.22 +/- 5.15 s. Mean transportation, mean centering ratio, and percentage of area increase were 0.022 +/- 0.131 mm, 0.21 +/- 0.11, and 76.90 +/- 42.27%, respectively, with no statistical differences (P > .05). Conclusions. All instruments were able to shape curved mesial canals in mandibular molars to size 30 without significant errors. The differences in shaft designs seemed not to affect their shaping capabilities.

The Effect of Coating Patterns with Spinel-Based Investment on the Castability and Porosity of Titanium Cast into Three Phosphate-Bonded Investments

Purpose: This study evaluated the effect of pattern coating with spinel-based investment Rematitan Ultra (RU) on the castability and internal porosity of commercially pure (CP) titanium invested into phosphate-bonded investments. The apparent porosity of the investment was also measured. Materials and Methods: Square patterns (15 x 15 x 0.3 mm(3)) were either coated with RU, or not and invested into the phosphate-bonded investments: Rematitan Plus (RP), Rema Exakt (RE), Castorit Super C (CA), and RU (control group). The castings were made in an Ar-arc vacuum-pressure machine. The castability area (mm(2)) was measured by an image-analysis system (n = 10). For internal porosity, the casting (12 x 12 x 2 mm(3)) was studied by the X-ray method, and the projected porous area percentage was measured by an image-analysis system (n = 10). The apparent porosity of the investment (n = 10) was measured in accordance with the ASTM C373-88 standard. Results: Analysis of variance (One-way ANOVA) of castability was significant, and the Tukey test indicated that RU had the highest mean but the investing technique with coating increased the castability for all phosphate-bonded investments. The analysis of the internal porosity of the cast by the nonparametric test demonstrated that the RP, RE, and CA with coating and RP without coating did not differ from the control group (RU), while the CA and RE casts without coating were more porous. The one-way ANOVA of apparent porosity of the investment was significant, and the Tukey test showed that the means of RU (36.10%) and CA (37.22%) were higher than those of RP (25.91%) and RE (26.02%). Conclusion: Pattern coating with spinel-based material prior to phosphate-bonded investments can influence the castability and the internal porosity of CP Ti.

Variations in cone photoreceptor abundance and the visual ecology of birds

The relative abundance and topographical distribution of retinal cone photoreceptors was measured in 19 bird species to identify possible correlations between photoreceptor complement and visual ecology. In contrast to previous studies, all five types of cone photoreceptor were distinguished, using bright field and epifluorescent light microscopy, in four retinal quadrants. Land birds tended to show either posterior dorsal to anterior ventral or anterior dorsal to posterior ventral gradients in cone photoreceptor distribution, fundus coloration and oil droplet pigmentation across the retina. Marine birds tended to show dorsal to ventral gradients instead. Statistical analyses showed that the proportions of the different cone types varied significantly across the retinae of all species investigated. Cluster analysis was performed on the data to identify groups or clusters of species on the basis of their oil droplet complement. Using the absolute percentages of each oil droplet type in each quadrant for the analysis produced clusters that tended to reflect phylogenetic relatedness between species rather than similarities in their visual ecology. Repeating the analysis after subtracting the mean percentage of a given oil droplet type across the whole retina (the 'eye mean') from the percentage of that oil droplet type in each quadrant, i.e. to give a measure of the variation about the mean, resulted in clusters that reflected diet, feeding behaviour and habitat to a greater extent than phylogeny.

Resting energy expenditure of children attending a rehabilitation programme following head injury

Statement of purpose: Increased resting energy expenditure following head injury is well documented, but whether this increase extends into rehabilitation and whether this is affected by changes in body composition have not been studied. The aim of this study was to determine whether children attending a rehabilitation program following head injury had altered energy expenditure and body composition. Methods: Measurements of resting energy expenditure by indirect calorimetry were performed in 21 head injured children (mean age 10.2±3.8 years). Measurement of body composition was performed using total body potassium. Results: Measured resting energy expenditure values were widely distributed, ranging from 52.3-156.4% of predicted values, yet the mean percentage predicted using Schofield weight, Schofield weight and height and World Health Organization predictive equations were 97.5%, 97.4% and 98.6%, respectively. Mean percentage of expected total body potassium for weight, height and age for head injured children were 85.1 ± 15.5%, 89.1 ± 14.1% and 86.9 ± 15.9%, thus all showed significant depletion. Conclusions: During rehabilitation, using predictive equations to estimate resting energy expenditure in this group revealed a small bias on average but very large bias at the individual level. Head injured children had altered resting energy expenditure and body composition.