Immunogenicity and safety of a recombinant adenovirus type-5 COVID-19 vaccine in adults: Data from a randomised, double-blind, placebo-controlled, single-dose, phase 3 trial in Russia.

BACKGROUND: To determine the immunogenicity, efficacy, reactogenicity, and safety of a single dose of recombinant adenovirus type-5 vectored COVID-19 vaccine (Ad5-nCoV, 5 × 1010 viral particles per 0.5 mL dose), we conducted a single-dose, randomised, double-blind, placebo-controlled, parallel group (3:1 Ad5-nCoV:placebo), phase 3 trial (Prometheus). METHODS: From 11-September-2020 to 05-May-2021, across six sites in the Russian Federation, 496 participants were injected with either placebo or Ad5-nCoV expressing the full-length spike (S) protein from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). RESULTS: Seroconversion (the primary endpoint) rates of 78.5% (95% CI: 73.9; 82.6) against receptor binding domain (RBD), 90.6% (95% CI: 87.2; 93.4) against S protein and 59.0% (95% CI: 53.3; 64.6) seroconversion of neutralising antibodies against SARS-CoV-2 at 28 days post-vaccination were observed. Geometric mean titres (GMTs) were also elevated for antibodies against the RBD (405 [95% CI: 366; 449]) and S protein (677 [95% CI: 608; 753]) compared to the GMT of neutralising antibodies against SARS-CoV-2 (16.7 [95% CI: 15.3; 18.3]). Using an IFN-γ ELISpot assay after stimulating the cells with recombinant S protein ectodomain we showed that the Ad5-nCoV vaccine induced the most robust cellular immune response on Days 14 and 28. Up to Day 28, the primary and all secondary endpoints of the Ad5-nCoV vaccine were statistically significant compared with the placebo (р<0.001). Systemic reactions were reported in 113 of 496 (22.8%) participants (Ad5-nCoV, 26.9%; Placebo, 10.5%), and local reactions were reported in 108 (21.8%) participants (Ad5-nCoV, 28.5%; Placebo, 1.6%). These were generally mild and resolved within 7 days after vaccination. Of the six serious adverse events reported, none of the events were vaccine related. There were no deaths or premature withdrawals. CONCLUSION: A single-dose of Ad5-nCoV vaccine induced a marked specific humoral and cellular immune response with a favourable safety profile. TRIAL REGISTRATION: Trial registration: ClinicalTrials.gov: NCT04540419.

Final efficacy analysis, interim safety analysis, and immunogenicity of a single dose of recombinant novel coronavirus vaccine (adenovirus type 5 vector) in adults 18 years and older: an international, multicentre, randomised, double-blinded, placebo-controlled phase 3 trial.

BACKGROUND: The Ad5-nCoV vaccine is a single-dose adenovirus type 5 (Ad5) vectored vaccine expressing the SARS-CoV-2 spike protein that was well-tolerated and immunogenic in phase 1 and 2 studies. In this study, we report results on the final efficacy and interim safety analyses of the phase 3 trial. METHODS: This double-blind, randomised, international, placebo-controlled, endpoint-case driven, phase 3, clinical trial enrolled adults aged 18 years older at study centres in Argentina, Chile, Mexico, Pakistan, and Russia. Participants were eligible for the study if they had no unstable or severe underlying medical or psychiatric conditions; had no history of a laboratory-confirmed SARS-CoV-2 infection; were not pregnant or breastfeeding; and had no previous receipt of an adenovirus-vectored, coronavirus, or SARS-CoV-2 vaccine. After informed consent was obtained, 25 mL of whole blood was withdrawn from all eligible participants who were randomised in a 1:1 ratio to receive a single intramuscular dose of 0·5 mL placebo or a 0·5 mL dose of 5 × 1010 viral particle (vp)/mL Ad5-nCoV vaccine; study staff and participants were blinded to treatment allocation. All participants were contacted weekly by email, telephone, or text message to self-report any symptoms of COVID-19 illness, and laboratory testing for SARS-CoV-2 was done for all participants with any symptoms. The primary efficacy objective evaluated Ad5-nCoV in preventing symptomatic, PCR-confirmed COVID-19 infection occurring at least 28 days after vaccination in all participants who were at least 28 days postvaccination on Jan 15, 2021. The primary safety objective evaluated the incidence of any serious adverse events or medically attended adverse events postvaccination in all participants who received a study injection. This trial is closed for enrolment and is registered with ClinicalTrials.gov (NCT04526990). FINDINGS: Study enrolment began on Sept 22, 2020, in Pakistan, Nov 6, 2020, in Mexico, Dec 2, 2020, in Russia and Chile, and Dec 17, 2020, in Argentina; 150 endpoint cases were reached on Jan 15, 2021, triggering the final primary efficacy analysis. One dose of Ad5-nCoV showed a 57·5% (95% CI 39·7-70·0, p=0·0026) efficacy against symptomatic, PCR-confirmed, COVID-19 infection at 28 days or more postvaccination (21 250 participants; 45 days median duration of follow-up [IQR 36-58]). In the primary safety analysis undertaken at the time of the efficacy analysis (36 717 participants), there was no significant difference in the incidence of serious adverse events (14 [0·1%] of 18 363 Ad5-nCoV recipients and 10 [0·1%] of 18 354 placebo recipients, p=0·54) or medically attended adverse events (442 [2·4%] of 18 363 Ad5-nCoV recipients and 411 [2·2%] of 18 354 placebo recipients, p=0·30) between the Ad5-nCoV or placebo groups, or any serious adverse events considered related to the study product (none in both Ad5-nCoV and placebo recipients). In the extended safety cohort, 1004 (63·5%) of 1582 of Ad5-nCoV recipients and 729 (46·4%) of 1572 placebo recipients reported a solicited systemic adverse event (p<0·0001), of which headache was the most common (699 [44%] of Ad5-nCoV recipients and 481 [30·6%] of placebo recipients; p<0·0001). 971 (61·3%) of 1584 Ad5-nCoV recipients and 314 (20·0%) of 1573 placebo recipients reported an injection-site adverse event (p<0·0001), of which pain at the injection site was the most frequent; reported by 939 (59%) Ad5-nCoV recipients and 303 (19%) placebo recipients. INTERPRETATION: One dose of Ad5-nCoV is efficacious and safe in healthy adults aged 18 years and older. FUNDING: CanSino Biologics and the Beijing Institute of Biotechnology.

Fenótipo Periodontal: uma Visão Clínica e Atual / Periodontal Phenotype: a Clinical and Current View

Um dos elementos essenciais para alcançar a estética do sorriso é o fenótipo e o contorno gengival que, com suas arquiteturas, in- fluenciam no tamanho das coroas dentais. O termo "fenótipo periodontal" foi padronizado no Workshop Mundial para a Classificação das Doenças e Condições Periodontais e Peri-Implantares de 2017, porém esse tema já havia sido abordado outras vezes, com outras nomenclaturas. A avaliação dos diferentes fenótipos periodontais é fundamental, pois nos dão informações relacionadas às características dos tecidos periodontais e às formas dentárias, além de tornar o tratamento mais previsível, podendo evitar problemas como: trau- ma, inflamação e outras complicações clínicas e cirúrgicas. O objetivo desta revisão de literatura é fazer uma pesquisa a respeito do tema fenótipo periodontal por meio dos artigos mais relevantes entre o período de 2017 a 2021, evidenciando sua classificação, prevalência e formas de diagnóstico. Existem várias formas de diagnosticar o fenótipo periodontal, sendo a transparência do sulco gengival por meio da sonda milimetrada a preconizada pelo Workshop Mundial. Podemos observar uma prevalência do fenótipo fino pelo gênero feminino, e o fenótipo espesso pelo gênero masculino. Ainda faltam mais evidências científicas para o correto relacionamento do fenótipo periodontal com outros fatores como idade, tabagismo, hábitos de higiene, alimentação e má oclusão.

One of the essential elements to achieving smile esthetics is the phenotype and gingival contour, which with their architecture influence the size of dental crowns. The term "periodontal phenotype" was standardized in the 2017 World Workshop on the Classification of Periodontal and Peri- Implant Diseases and Conditions. However, much has been said about the topic, with other nomenclatures. Evaluating different periodontal phenotypes is essential, as they provide us with information related to the characteristics of periodontal tissues and dental forms. In addition to making the treatment more predictable, it can avoid problems such as trauma, inflammation, and other clinical and surgical complications. The purpose of this literature review is to research the topic, periodontal phenotype, through the most relevant articles between the period 2017 to 2021, showing its classification, prevalence, and forms of diagnosis. There are several ways to diagnose the periodontal phenotype, and the one recommended by the World Workshop is the transparency of the gingival sulcus using the millimeter probe. We can observe a prevalence of the thin phenotype for the female gender, whereas the thick phenotype is prevalent for the male gender. There is still a lack of scientific evidence for the correct relationship of the periodontal phenotype with other factors such as age, smoking, hygiene habits, diet and, malocclusion

Utilização do Conceito Digital Smile Design na Odontologia Restauradora / Concept Using Digital Smile Desing in Dentistry Restorative

Due to the advancement of digital dentistry, the Digital Smile Design (DSD) technique has been gaining credibility on the part of professionals and patients. The planning of aesthetic and functional restorative treatments becomes more predictable with its use. This case report presents a patient with aesthetic complaint of the size and shape of her anterior teeth, associated with great gingival exposure. Photographs were important assistants in the planning of dental intervention. These were used for facial analysis, drawings of guidelines and more suitable dental forms. A software called Keynote was used, capable of managing photos, creating measurements, straight and curved lines, facilitating the planning of a new dental proportion. At the end of this process, the patient can observe, through the help of photographs, the new smile that was built virtually. That way, it became easier for her to accept the treatment plan, allowing her to make a test of her new smile with the mock-up.

Devido ao avanço da Odontologia digital, a técnica Digital Smile Design (DSD) vem ganhando credibilidade por parte dos profissionais e pacientes. O planejamento de tratamentos restauradores estéticos e funcionais torna-se mais previsível com sua utilização. Este relato de caso apresenta uma paciente com queixa estética do tamanho e forma dos seus dentes anteriores, associada a grande exposição gengival. Fotografias foram auxiliares importantes no planejamento da intervenção odontológica. Estas serviram para análises faciais, desenhos de linhas de orientação e de formas dentárias mais adequadas. Utilizou-se um software chamado Keynote, capaz de gerenciar fotos, criar medidas, linhas retas e curvas, facilitando o planejamento de uma nova proporção dental. Ao término deste processo a paciente pode observar, pelo auxílio das fotografias, o novo sorriso que foi construído virtualmente. Desta forma, tornou-se mais fácil, por parte dela, a aceitação do plano de tratamento, possibilitando que a mesma faça uma prova do seu novo sorriso com a realização do mock- up.

NOVA CLASSIFICAÇÃO DAS PERIODONTITES ADAPTADO DO RELATÓRIO DE CONSENSO DO 2017 WORLD WORKSHOP ON THE CLASSIFICATION OF PERIODONTAL AND PERI-IMPLANT DISEASES AND CONDITIONS / NEW CLASSIFICATION OF PERIODONTITIS ADAPTED FROM THE 2017 WORLD WORKSHOP ON THE CLASSIFICATION OF PERIODONTAL AND PERI-IMPLANT DISEASES AND CONDITIONS CONSENSUS REPORT

Em novembro de 2017, ocorreu nos Estados Unidos um evento conjunto da Academia Americana de Periodontia e da Federação Europeia de Periodontia. Este evento teve como objetivo discutir pontos não resolvidos da classificação periodontal de 1999, o que culminou com uma nova classificação das doenças periodontais. Modificações importantes foram estabelecidas, principalmente no que tange às periodontites. Assim, este texto em língua portuguesa visa atualizar os dentistas e estudantes de Odontologia sobre a nova classificação das periodontites, com base na publicação no relatório de consenso do 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions em junho de 2018. A nova classificação abrange todas as doenças e condições periodontais e peri-implantares, incluindo a definição de saúde periodontal, a reorganização das doenças e condições gengivais não induzidas por placa, a inclusão de doenças e condições sistêmicas que afetam o tecido periodontal de suporte, as bases para o tratamento de retração gengival, a substituição de termos periodontais e a introdução de uma nova classificação para doenças e condições peri-implantares. Como pode ser observado, não seria possível detalhar todos estes aspectos da nova classificação, assim, este artigo apresenta somente a nova classificação referente às periodontites.

In November 2017, a joined meeting between the American Academy of Periodontology and the European Federation of Periodontology was held in United States. This meeting had the aim to discuss non-solved issues regarding 1999 periodontal classification, which culminated with a new periodontal classification. Important changes were established, mainly in reference to different forms of periodontitis. Thus, the current paper aims to update dentists and dental students on the new classification of periodontitis, based on the consensus report of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions published in June 2018. The new classification covers all periodontal and peri-implant diseases and conditions, including the periodontal health definition, the re-organization of gingival diseases and conditions non-induced by plaque, the inclusion of systemic diseases and conditions that affect the support periodontal tissue, the basis for gingival retraction treatment, the replacement of periodontal terms, and the introduction of a new classification for peri-implant diseases and conditions. As can be observed, it would be impossible to detail all aspects of the new classification, thus, this paper presents only the periodontitis new classification.

Author Correction: Genome-wide association and HLA fine-mapping studies identify risk loci and genetic pathways underlying allergic rhinitis.

In the version of this article initially published, in Fig. 3, the y-axis numbering did not match the log scale indicated in the axis label. The error has been corrected in the HTML and PDF version of the article.

Genome-wide association and HLA fine-mapping studies identify risk loci and genetic pathways underlying allergic rhinitis.

Allergic rhinitis is the most common clinical presentation of allergy, affecting 400 million people worldwide, with increasing incidence in westernized countries1,2. To elucidate the genetic architecture and understand the underlying disease mechanisms, we carried out a meta-analysis of allergic rhinitis in 59,762 cases and 152,358 controls of European ancestry and identified a total of 41 risk loci for allergic rhinitis, including 20 loci not previously associated with allergic rhinitis, which were confirmed in a replication phase of 60,720 cases and 618,527 controls. Functional annotation implicated genes involved in various immune pathways, and fine mapping of the HLA region suggested amino acid variants important for antigen binding. We further performed genome-wide association study (GWAS) analyses of allergic sensitization against inhalant allergens and nonallergic rhinitis, which suggested shared genetic mechanisms across rhinitis-related traits. Future studies of the identified loci and genes might identify novel targets for treatment and prevention of allergic rhinitis.

A pathway-based association study reveals variants from Wnt signalling genes contributing to asthma susceptibility.

BACKGROUND: Genetic susceptibility to asthma is currently linked to a handful of genes which have a limited ability to predict the overall disease risk, suggesting the existence of many other genes involved in disease development. Accumulated evidence from association studies in genes related by biological pathways could reveal novel asthma genes. OBJECTIVE: To reveal novel asthma susceptibility genes by means of a pathway-based association study. METHODS: Based on summary data from a previous a genomewide association study (GWAS) of asthma, we first identified significant biological pathways using a gene-set enrichment analysis. We then mapped all tested single nucleotide polymorphisms (SNPs) on the genes contributing to significant pathways and prioritized those with a disproportionate number of nominal significant associations for further studies. For those prioritized genes, association studies were performed for selected SNPs in independent case-control samples (n = 1765) using logistic regression models, and results were meta-analysed with those from the GWAS. RESULTS: Two biological processes were significantly enriched: the cytokine-cytokine receptor interaction (P = 0.002) and the Wnt signalling (P = 0.012). From the 417 genes interacting in these two pathways, 10 showed an excess of nominal associations, including a known asthma susceptibility locus (encoding SMAD family member 3) and other novel candidate genes. From the latter, association studies of 14 selected SNPs evidenced replication in a locus near the frizzled class receptor 6 (FZD6) gene (P = 9.90 × 10-4 ), which had a consistent direction of effects with the GWAS findings (meta-analysed odds ratio = 1.49; P = 5.87 × 10-6 ) and was in high linkage disequilibrium with expression quantitative trait loci in lung tissues. CONCLUSIONS AND CLINICAL RELEVANCE: This study revealed the importance of two biological pathways in asthma pathogenesis and identified a novel susceptibility locus near Wnt signalling genes.

Effect of interim cement application on bond strength between resin cements and dentin: Immediate and delayed dentin sealing.

STATEMENT OF PROBLEM: Despite the advances in materials and techniques, adhesion to dentin is challenging because of the complex composition of dentin's mineral, organic, and fluid phases. PURPOSE: The purpose of this in vitro study was to evaluate the bond strength of 2 different resin cements (conventional and self-adhesive) with or without previous dentin sealing and the effect of interim cement. MATERIAL AND METHODS: Forty-five molars were embedded into acrylic resin blocks and a flat dentin surface was exposed. Twenty teeth (n=5 per group) were treated with the conventional resin cement associated with etch-and-rinse or self-etch adhesive approaches, applied before (immediate dentin sealing) or after (delayed dentin sealing) the application/removal of interim cement. Another 25 teeth (n=5, per group) were treated with self-adhesive resin cement with (self-etch mode [immediate dentin sealing or delayed dentin sealing]) or without adhesive application. Furthermore, in the self-adhesive resin cement group, the application of polyacrylic acid for dentin etching before cementation was evaluated. Composite resin blocks were cemented onto flat, treated dentin surfaces, and the assemblies were sectioned into bar-shaped specimens for microtensile bond strength testing. The data were subjected to 1-way ANOVA followed by the post-hoc Tukey test (α=.05). The failure patterns were classified as cohesive, adhesive, or mixed. RESULTS: The application of adhesive before interim cement (immediate dental sealing) promoted the highest values of bond strength for both resin cements (P<.001). For self-adhesive resin cement, polyacrylic acid-enhanced bond strength after the application of interim cement. CONCLUSIONS: The application of dental adhesive immediately after tooth preparation (immediate dentin sealing) and before the use of an interim cement promoted the highest values of bond strength to dentin with the resin cements tested.

Periodontal Conditions in Human Immunodeficiency Virus-Positive Patients Under Highly Active Antiretroviral Therapy From a Metropolitan Area of Rio De Janeiro.

BACKGROUND: The aim of this study is to evaluate the periodontal status and the presence of opportunistic oral lesions in human immunodeficiency virus-positive (HIV+) patients under highly active antiretroviral therapy (HAART) and their association with cluster of differentiation (CD)4+ and CD4+ nadir T-cell counts and viral load levels. METHODS: Clinical periodontal parameters and the presence of opportunistic oral lesions along with records of CD4+ counts and viral load levels were evaluated in 29 individuals (16 females; mean age: 42.7 years) with previous serologic diagnosis of HIV, from the acquired immunodeficiency syndrome program of the Health Center of Duque de Caxias, Rio de Janeiro, Brazil. RESULTS: All individuals presented gingivitis or periodontitis. A higher non-significant prevalence of periodontitis was found in smokers (93.8%) compared with non-smokers (76.9%). A significant weak positive correlation was observed between CD4+ counts and missing teeth (ρ = 0.380, P <0.05), CD4+ nadir and periodontal diagnosis (ρ = 0.418, P <0.005), and CD4+ nadir and moderate probing depth (PD) (ρ = 0.424, P <0.05). When only non-smokers were analyzed, a significant moderate positive association was found between viral load and moderate clinical attachment level (CAL) (ρ = 0.638, P <0.05), CD4+ nadir and diagnosis (ρ = 0.586, P <0.05), and CD4+ nadir and moderate CAL (ρ = 0.680, P <0.05). Analysis considering only smokers found no correlations between serologic parameters and demographic or clinical parameters. CONCLUSIONS: The current investigation demonstrates that HIV+ individuals under HAART presents a high prevalence of mild to moderate periodontal disease. Viral load levels, CD4+ nadir, and CD4+ counts may present a weak to moderate correlation to the number of missing teeth, periodontal diagnosis, moderate PD, and moderate CAL, which may also reflect some effect of these systemic conditions on the periodontal status.

Next Generation Vaccine Biomarkers workshop October 30-31, 2014--Ottawa, Canada.

Vaccine biomarkers are critical to many aspects of vaccine development and licensure, including bridging findings in pre-clinical studies to clinical studies, predicting potential adverse events, and predicting vaccine efficacy. Despite advances in our understanding of various biological pathways, and advances in systems analyses of the immune response, there remains much to learn about qualitative and quantitative aspects of the human host response to vaccination. To stimulate discussion and identify opportunities for collaborative ways to advance the field of vaccine biomarkers, A Next Generation Vaccine Biomarker workshop was held in Ottawa. The two day workshop, sponsored by the National Research Council Canada, Canadian Institutes of Health Research, Public Health Agency of Canada, Pfizer, and Medicago, brought together stakeholders from Canadian and international industry, government and academia. The workshop was grouped in themes, covering vaccine biomarker challenges in the pre-clinical and clinical spaces, veterinary vaccines, regulatory challenges, and development of biomarkers for adjuvants and cancer vaccines. The use of case studies allowed participants to identify the needs and gaps requiring innovation. The workshop concluded with a discussion on opportunities for vaccine biomarker discovery, the Canadian context, and approaches for moving forward. This article provides a synopsis of these discussions and identifies steps forward for advancing vaccine biomarker research in Canada.

Tratamento de doença peri-implantar e regeneração óssea guiada associada a osso autógeno: relato de caso / Treatment of peri-implantitis and guided bone regeneration associated with autogenous bone: a case report

Os implantes osseointegráveis foram incorporados como importantes aliados para o tratamento reabilitador, servindo de forma bastante satisfatória quer em tratamentos unitários ou em reabilitações mais extensas. Entretanto, algumas situações adversas à saúde podem acontecer, como, por exemplo, a peri-implantite, que é uma doença infecciosa semelhante à periodontite crônica, que afeta os tecidos peri-implantares, cujo tratamento visa a restauração funcional e estética, restabelecendo a condição de saúde. A maioria dos tratamentos busca a redução da carga bacteriana do ambiente da bolsa peri-implantar por meio da descontaminação dasuperfície do implante, seguida ou não da tentativa de regenerar osso. Vários protocolos de tratamento já foram sugeridos, porém, ainda se sabe pouco se essas terapias são capazes de devolver a osseointegração dos implantes. Objetivo: o objetivo desse relato de caso foi apresentar alguns aspectos da doença peri-implantar, com ênfase em seu tratamento, apresentando os resultados favoráveis da correção da perda de suporte por meio de enxerto ósseo autógeno associado a regeneração óssea guiada, podendo resultar em um alto índice de ganho ósseo e completo recobrimentodos implantes.

Dental implants have been considered important allies in the rehabilitation treatment of lost teeth, either in single-unit cases or in more complex rehabilitations. However, adverse outcomes may occur, for instance, peri-implantitis, which is an infectious disease similar to chronic periodontitis, affecting peri-implant tissues of which treatment aims at restoring health, as well as function and esthetics. Most treatments focus on reducing the microbiological burden of the peri-implant environment pocket by decontaminating the implant surface. In many cases, treatment of infection is followed by bone regeneration with fairly good results. Several treatment protocols have been suggested, however, little is yet known whether these therapies are able to lead to new osseointegration of implants. Objective: The aim of this case report was to show some aspects of peri-implantitis with emphasis on its treatment, and to show the outcomes of associating autogenous bone graft with guided bone regeneration. Our results reveal that the association between both techniques might result in high bone gain rates and complete implant cover.

Canadian Adjuvant Initiative Workshop, March 26-27, 2013--Ottawa, Canada.

Novel adjuvants hold the promise for developing effective modern subunit vaccines capable of appropriately modulating the immune response against challenging diseases such as those caused by chronic and/or intracellular pathogens and cancer. Over the past decade there has been intensive research into discovering new adjuvants, however, their translation into routine clinical use is lagging. To stimulate discussion and identify opportunities for networking and collaboration among various stakeholders, a Canadian Adjuvant Initiative Workshop was held in Ottawa. Sponsored by the National Research Council Canada, Canadian Institutes of Health Research and the Vaccine Industry Committee, a two day workshop was held that brought together key Canadian and international stakeholders in adjuvant research from industry, academia and government. To discover innovation gaps and unmet needs, the presentations covered a board range of topics in adjuvant development; criteria for selection of lead adjuvant candidates from an industry perspective, discovery research across Canada, bioprocessing needs and challenges, veterinary vaccines, Canadian vaccine trial capabilities, the Canadian regulatory framework and WHO formulation laboratory experience. The workshop concluded with a discussion on the opportunity to create a Canadian Adjuvant Development Network. This report details the key discussion points and steps forward identified for facilitating adjuvant development research in Canada.

Challenges and opportunities for bacterial vaccine development in the 21(st) century.

With the convergence of modern technology in genomics, proteomics, carbohydrate, protein and lipid biochemistry as well as decades of experience in vaccine development and delivery of immunization programs, the Global Vaccine Action Plan has declared 2011 to 2020 as 'The Decade of Vaccines'. This review focuses on bacterial vaccines and summarises the current state of vaccinology in bacteriology and looks forward to the potential of how the newer technologies can impact our knowledge of bacterial diseases and their control through vaccine development. The major breakthroughs in the last couple of decades include low cost high throughput genomics, proteomics, cellular immunology and the delicate network of immune-cytokines, bioinformatics, immune-informatics, and disease modelling. Together, these newer developments can provide a real impact on our understanding of infectious diseases and their control by vaccination.

Uso da coroa clínica dentária natural como material restaurador para a prótese sobreimplante / Natural tooth crowns as definitive materials for single-tooth implant-supported prosthesis

Este trabalho teve como objetivo apresentar um caso clínico onde se utilizou implante osseointegrável e como restauração (provisória e definitiva) foi reaproveitada a coroa do incisivo central superior (hígido), extraído devido à fratura radicular. Previamente à execução do caso, solicitou-se uma tomografia computadorizada para confirmação da fratura. A exodontia foi realizada de forma menos traumática possível e o alvéolo foi instrumentado com abordagem palatina para instalação do implante. Um torque de 60 Ncm foi alcançado garantindo estabilidade primária do implante, permitindo a provisionalizacão imediata com o próprio incisivo da paciente. Cuidados foram tomados com os ajustes oclusais para se evitar contatos em MIH e durante as excursões mandibulares. Após seis meses de osseointegração, pôde-se observar excelente resposta dos tecidos moles ao redor da restauração e qualidade estética incomparável, graças à utilização do próprio elemento extraído. Desta forma, o trabalho definitivo foi concluído reaproveitando a face vestibular do mesmo incisivo central utilizado na fase provisória.

This paper aims to present a clinical report in which the upper central incisor´s natural crown (extracted due to root fracture) was used as a provisional and restorative material for an implant-supported prosthesis. Tooth fracture was confirmed by CT scanning. After, tooth extraction was performed and the alveolar socket received a “palatine approach” for the implant placement. After a 60 Ncm torque being reached, immediate provisionalization was made with the patient’s own incisor. The oclusal adjustments were done carefully in order to avoid any contact in maximum occlusion and during all mandibular excursions. After 6 months, the soft tissues showed excellent response around the restoration and a unique aesthetic quality. Thus, the “definitive” work was completed with the reuse of the buccal aspect of the same central incisor in provisional stage

Safety and immunogenicity of a fully liquid vaccine containing five-component pertussis-diphtheria-tetanus-inactivated poliomyelitis-Haemophilus influenzae type b conjugate vaccines administered at two, four, six and 18 months of age.

OBJECTIVE: The safety, immunogenicity and lot consistency of a fully liquid, five-component acellular pertussis combination vaccine, comprised of diphteria, tetanus and acellular pertussis, inactivated polio vaccine, Haemophilus influenzae type b (DTaP-IPV-Hib [Pediacel, sanofi pasteur, Canada]) were assessed and compared with that of Hib vaccine reconstituted with the five-component acellular pertussis combination vaccine (DTaP-IPV//Hib, Pentacel [sanofi pasteur, Canada]). METHODS: Infants were recruited at vaccine study centres in Montreal, Quebec; Simon Fraser Health Region, British Columbia, and southern Alberta after the protocol had been approved by the relevant institutional ethics committees. Written informed consent was obtained from the parents or guardians of all subjects. At two months of age, the infants were randomly assigned to receive one of three consecutive production lots of DTaP-IPV-Hib by intramuscular injection. Reactions to vaccinations were assessed by parental observation and through telephone interviews conducted by study nurses. Blood samples were obtained at two, six, seven, 18 and 19 months of age for measurement of antibodies to vaccine antigens. RESULTS: Most injection site and systemic reactions were mild or moderate, and of brief duration. All infants were protected against tetanus, diphtheria and all three polio serotypes after both primary and booster vaccinations. Antibody responses to pertussis antigens were similar to those observed in Swedish infants, in whom the five-component vaccine was shown to be 85% effective. Proportions of infants with antipolyribosylribitol phosphate antibody of 0.15 mug/mL or greater and 1.0 mug/mL or greater, were 97.9% and 88.9%, respectively, following primary immunization, and 100% and 99% following booster vaccination. Safety and immunogenicity results with both reconstituted and fully liquid combination vaccines were comparable. CONCLUSIONS: The fully liquid combination vaccine was comparable in terms of safety and immunogenicity with the reconstituted combination vaccine.