Six-Month Follow-Up of Periodontal Condition in Rheumatoid Arthritis and Ankylosing Spondylitis Arthritis Patients Undergoing Anti-Tumour Necrosis Factor-α Therapy.

In our present study, we aimed to assess the effects of anti-TNF therapy on periodontal condition in a mixed cohort of patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Moreover, we wished to determine whether the baseline dental condition of these patients would affect response to biological therapy. A cohort of 24 arthritis patients was consecutively recruited before starting anti-TNFα therapy. After the dropout of six patients, we evaluated the dental status of 18 subjects at baseline and after 6 months of biological therapy. Clinical responder (R) and non-responder (NR) status was determined after 6 months of anti-TNF treatment. Plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), PPDmax, clinical attachment loss (CAL), and CALmax were determined. During the 6-month treatment period, six patients (3 RA and 3 AS) terminated the study prematurely as they did not respond to treatment (NR). Therefore, 18 patients were included in the full analysis. There were no major differences in PI, BOP, PPD, PPD max, CAL, and CALmax, among R and NR patients. TNF inhibition resulted in increased GI (0.65 ± 0.34 vs. 0.88 ± 0.30; p < 0.05), as well as decreased PPDmax (4 ± 1.94 vs. 2.72 ± 1.36; p < 0.05) and CALmax (5.22 ± 2.56 vs. 2.72 ± 1.36; p < 0.05) after 6 months. Eight patients had incomplete canal fillings or dead pulps and/or apical periodontitis; six in the R and two in the NR group. In our present study, anti-TNF therapy seemed to worsen the extent of gingival inflammation (GI); however our results also do not support the reduction of mean CPD and CAL as reported by others.

Hypercitrullination and anti-citrullinated protein antibodies in chronic apical periodontitis, a laboratory investigation. Does autoimmunity contribute to the pathogenesis?

AIM: The presence of Gram-negative anaerobic bacteria, in particular, Porphyromonas gingivalis (P. gingivalis) in periapical granulomas predicts the generation of citrullinated proteins in the lesion. Citrullination of proteins may lead to the formation of anti-citrullinated autoantibodies (ACPA-s) initiating the formation of an autoimmune loop which may contribute to the perpetuation of inflammatory reactions and tissue damage in chronic apical periodontitis. The objective of this study was to demonstrate the formation of citrullinated proteins in chronic apical periodontitis and whether they can act as autoantigens. METHODOLOGY: Twenty-five periapical granulomas (n = 25) were investigated in the study. Healthy periodontal tissue samples served as normal control tissue (n = 6). The peptidyl-citrulline level was determined with the dot blot method. ACPA levels were analysed using anti-citrullinated cyclic peptide (anti-CCP) EDIA kit. Differences between periapical granuloma and control samples were assessed using Mann-Whitney U tests. p Values <.05 were considered as statistically significant. RESULTS: Protein concentrations, peptidyl-citrulline levels and anti-CCP ratios were compared between periapical granuloma and healthy control groups. Multiple linear regression analysis revealed significant (p = .042) hypercitrullination in periapical granuloma samples. Moreover, there was a significant difference in the ACPA ratios between periapical granuloma (2.03 ± 0.30) and healthy control (0.63 ± 0.17) groups (p = .01). Seventeen of 25 periapical granuloma samples (17/25; 68%), whereas one out of six control samples (1/6; 17%) were shown to be positive for the presence of ACPA. CONCLUSIONS: This is the first study detecting the presence of citrullinated peptides and APCA in periapical granuloma, suggesting the contribution of autoimmune reactions in the pathogenesis and perpetuation of chronic apical periodontitis.

Comparative Analysis of Bond Strength Durability of 10-Methacryloyloxydecyl Dihydrogen Phosphate-Containing Adhesives on a Low-Viscosity Bulk-Fill Composite Surface.

PURPOSE: To compare the bond durability of adhesives with 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) to low-viscosity bulk-fill composite. MATERIALS AND METHODS: Four 10-MDP-containing adhesives (Tokuyama Bond Force II [TBF II], Tokuyama; Scotchbond Universal [SU], 3M Oral Care; Clearfil Universal Bond Quick [CL], Kuraray Noritake; and G-Premio Bond [GP], GC) and one 10-MDP-free adhesive (Heliobond [HB] Ivoclar Vivadent) as a control were applied to polished, air-abraded surfaces of randomly assigned SureFil SDR flow low-viscosity bulk-fill composite blocks. The application of the adhesives was followed by applying Tetric EvoCeram universal nanohybrid composite in layers. Each layered composite block was sliced into stick specimens with a hard-tissue microtome. Half of the groups were randomly selected and tested for microtensile bond strength (immediate group); the other groups were aged in a thermocyling machine for 5000 cycles, followed by testing microtensile bond strength (aged group). The adhesive interface was evaluated with scanning electron microscopy (SEM). Failure modes were observed using light microscopy. The results were evaluated with Levene's test, ANOVA, Welch's ANOVA, Tukey's test and the Z-test as appropriate (significance: p < 0.05). RESULTS: There was a significant difference in the bond strength between 10-MDP-containing adhesives and the 10-MDP-free adhesive in all groups. Aging significantly decreased the bond strength in all adhesive groups. There was no significant difference in the bond strength durability among the 10-MDP-containing adhesives. CONCLUSION: Application of 10-MDP-containing adhesives has an advantageous effect on the air-abraded SDR composite surface compared with 10-MDP-free adhesive. The composition of 10-MDP-containing adhesives did not influence the bond strength. Aging diminishes the bond strength durability of 10-MDP-containing adhesives.

Effects of different surface treatments and adhesive self-etch functional monomers on the repair of bulk fill composites: A randomised controlled study.

OBJECTIVE: To evaluate the effect of different adhesive protocols on the microtensile bond strength (µTBS) and integrity of the repaired bulk fill composite interface. METHODS: Two hundred and seventy composite blocks made of bulk fill composites of different viscosity were randomly assigned to 18 surface conditioning groups (n = 15/group). The universal adhesive systems used were Heliobond™, Tokuyama bond force II™ and Scotchbond Universal™. A nanohybrid resin composite was applied as the repair material. Negative and positive control groups were included. Stick shape specimens of each group were subjected to µTBS testing. Representative samples from all test groups were subjected to microscopic, profilometric and SEM examination to determine their mode of failure. The data were analysed statistically using two-way ANOVA test, Tukey's test and the independent t-test (α = 0.05). RESULTS: The mean µTBS of all test groups ranged between 28.5 and 46.8 MPa and varied with the type of adhesive system employed. Significantly highest µTBS values were obtained when Tokuyama bond force II™ and Scotchbond Universal™ adhesives were used (p < 0.01) which were comparable to the coherent strength of the bulk fill resin composite in the positive control groups (p > 0.05). The viscosity of the bulk fill composite did not significantly influence repair bond strength. The microscopy and SEM examination of the failed interfaces revealed a mixture of adhesive and cohesive failures. CONCLUSIONS: Under the tested conditions, significantly greater µTBS of repaired bulk fill composite was achieved when the substrate surface was treated with adhesive systems containing a functional monomer. CLINICAL SIGNIFICANCE: Eff ;ecting a repair of a bulk fill resin composite restoration with the application of a functional monomer containing adhesive system, such as Tokuyama Bond Force II™ or Scotchbond Universal™, would seem to enhance the interfacial bond strength and integrity of the repaired resin composite interface.

[Sterilization in dentistry. Limitations of elastic materials: a case presentation]. / Sterilizálási lehetoségek a fogászatban. Rugalmas anyagok csírátlanításának korlátai egy eset kapcsán.

In everyday dental practice, sterility is essential. Sterilizing different materials can require different methods. In the case of heat sensitive and elastic materials, most common techniques are not suitable because they need to be treated on lower temperature, not to lose their physical properties. For instance, if rubber dam is divested of elasticity, it is useless in restorative dentistry thereafter. Sterilizing rubber dam sheets is not a frequent process, but in certain cases it can be necessary. In such a situation, dentists have to choose between rare and hard-to-reach options. In our referral, we summarize the possibilities of sterilization, focusing on plasma sterilization and hydrogen-peroxide vapor sterilization. During the treatment of our presented case with a deep subgingival fracture line, affecting the crown and the root surface as well, we applied a rubber dam sheet, sterilized with hydrogen-peroxide vapor in order to use adhesive technique. Orv Hetil. 2020; 161(3): 110-115.

A randomised controlled study on the effects of different surface treatments and adhesive self-etch functional monomers on the immediate repair bond strength and integrity of the repaired resin composite interface.

OBJECTIVES: To evaluate the effects of different surface conditioning methods on the immediate repair bond strength and integrity of the repaired composite interface. METHODS: One hundred and five resin composite blocks made of a nanohybrid resin composite were randomly assigned to one of the following surface conditioning groups (n = 15/group): Group 1: Gluma Self Etch™ adhesive system, Group 2: Tokuyama Bond Force II™ adhesive system, Group 3: non-roughened and non-conditioned surfaces, Group 4: sandblasting and Gluma Self Etch™, Group 5: sandblasting and Tokuyama Bond Force II™, Group 6: sandblasting only. A positive control group was also used. Resin composite identical to the substrate was applied and the repaired specimens were subjected to shear bond strength (SBS) testing. Representative samples from all groups were subjected to scanning electron microscopy and surface profilometry to determine their mode of failure. The data were analysed statistically using Analysis of Variance (ANOVA) and two independent sample t-test (α = 0.05). RESULTS: The mean SBS of all test groups ranged between 1.92 and 5.40 MPa and varied with the degree of composite surface roughness and the type of adhesive system employed. Significantly highest SBS values (5.40 ± 0.36 MPa) were obtained in Group 5 (p = 0.017) which were comparable to the coherent strength of the resin composite in the positive control group (p > 0.05). CONCLUSIONS: Under the tested conditions, significantly greater SBS of repaired resin composite was achieved when the substrate surface was conditioned by sandblasting followed by the application of the Tokuyama Bond Force II™ adhesive system. CLINICAL SIGNIFICANCE: Effecting a repair of a nanohybrid composite restoration with sandblasting and the application of TBF II would seem to enhance the interfacial bond strength and integrity of the repaired resin composite interface. Clinical trials are necessary to determine the usefulness of this technique.

[Possible correlations between periodontitis and chronic obstructive pulmonary disease. Review of the literature]. / A fogágybetegség és a krónikus obstruktív tüdobetegség (COPD) lehetséges összefüggései. Irodalmi áttekintés.

Chronic obstructive pulmonary disease (COPD) is a complex, multifactorial inflammatory disease of the airways and the pulmonary parenchyme, caused by infection, air pollution and particles. 4-7% of the adult population is involved. COPD is the 4th-6th common cause of death throughout the world. The main aetiological factor is smoking. Bacteria, such as bacteria from the oral cavity, could play a keyrole in the progression of the disease. Epidemiologic studies have noted a relationship between poor oral hygiene or periodontal bone loss and chronic obstructive pulmonary disease. The prevalence and mortality of the disease is increasing worldwide, the treatment is expensive, the efficiency of the present pharmacotherapy is poor, so the importance of prevention should be increasing. Patients with chronic obstructive pulmonary disease (COPD) are prone to frequent exacerbations which are a significant cause of morbidity and mortality. This review is a short summary of studies about the possible relationship between periodontitis and COPD.

[Correlations between dental-oral infections and cardiovascular disease]. / A fogeredetû gyulladásos kórképek és a cardiovascularis megbetegedések összefüggései.

The potential role of periodontal disease, gingivitis and other dental infections as a possible chronic source of infection and inflammation represents a continuous challenge to the host organism. The high number of oral pathogens, lipopolysaccharides and soluble mediators are related to the pathogenesis of local inflammation and the initiation of systemic inflammation process, which may impair systemic health. In the last decades, studies suggested that there could be a connection between the local oral infections and several systemic conditions such as diabetes, cardiovascular disease, low birth weight and chronic obstructive pulmonary disease. Cardiovascular disease is the number one cause of death in the last century. The primary contributing factor in the majority of cardiovascular diseases is atherosclerosis. The role of infection is believed to provide a critical inflammatory stimulus that contributes to atherogenesis. The present review is a short summary of studies of the last years about the possible pathogenic role of local oral infections as a contributing factor in the initiation and progression of cardiovascular disease.

[Periodontal disease and general health--literature review]. / A fogágybetegségek és az általános szervi megbetegedések összefüggése--összefoglaló referátum.

Periodontal disease is a significant cause of alveolar bone resorption resulting ultimately in the loss of teeth. Inflammation of the periodontal tissues is initiated by bacteria of the oral micro-flora. Invading micro-organisms stimulate both protective and destructive inflammatory-immune responses involving cytokine release syndrome, chemokines, arachidonic acid metabolites, reactive oxygen and nitrogen intermediates, and matrix melloproteinases. The local infection may affect general health in two ways. First, transient bacteremia from the oral focus may result in metastatic infection in remote organs of susceptible hosts, such as bacterial endocarditis in patients with congenital or acquired heart diseases. Second, lipopolysaccharide and inflammatory mediators are not only involved in local tissue destruction but have the potential to modulate the course of cardiovascular, chronic obstructive lung and autoimmune diseases, diabetes mellitus and preterm birth. Epidemiologic observations, awaiting further verification by controlled prospective trials, underline the impact of oral health on general well-doing.