Aesthetic rehabilitation for anterior teeth of dental fluorosis with direct composite veneers.

Intrinsic discoloration can be formed due to many reasons, and by clinical evaluation and history from the patient, the exact cause of the discoloration can be known and one of the reasons that can make the intrinsic discoloration is the high level of fluoride intake. Two siblings had come to the Department of Restorative Dentistry clinics; they had the same compliance which is severe dental fluorosis, caries, and malocclusion of their teeth. What is interesting and worrying is that some patients with severe dental fluorosis show higher levels of caries, which can be explained as the enamel becoming porous with severe fluorosis. The possible treatment options were discussed with the patients. According to their financial concern and their desire to get their teeth done as soon as possible, the use of direct composite veneer for the treatment of anterior teeth was decided. Long-term clinical trials are required to assess the efficacy of various treatment options for fluorosis of different severity.

The effect of pregabalin and ibuprofen combination for pain after third molar surgery.

AIM: The objective of this study was to compare the efficacy of different doses of pregabalin and intravenous ibuprofen with regard to pain management and analgesic consumption after third molar surgery. MATERIALS AND METHODS: Ninety patients who had been scheduled for third molar surgery were assigned to four different treatment groups. The inclusion criteria consisted of the presence of fully or partially bony retentive asymptomatic mandibular third molars. These groups are included the following: (Group 1) premedicated with oral placebo and intravenous (IV) placebo, (Group 2) premedicated with oral placebo and 400-mg IV Ibuprofen, (Group 3) premedicated with 75-mg oral pregabalin and 400-mg IV ibuprofen, and (Group 4) premedicated with 150-mg oral pregabalin and 400 mg IV ibuprofen. Postoperative pain was assessed with visual analog scale (VAS) every hour for the first 12 hs following the surgery. Pain was then assessed at different time intervals during 7 days following the surgery. Kruskal-Wallis tests were used to compare the four groups in terms of VAS pain scores, analgesic consumption, and first rescue analgesic request time after the surgery. RESULTS: At the end of the study, the results of 80 patients (20 patients per group) were analyzed. The group 4 had lower pain intensity compared with other groups at various time intervals. This difference is statistically significant in between the first 3-10 h (first day) and single-time intervals in second, third, fifth, and sixth postoperative days. Postoperative analgesic consumption was not statistically different between the groups. The first rescue analgesic request time after surgery was different between the pregabalin combination groups and group 2. No significant difference in the side effects was observed. CONCLUSION: These findings suggest that preoperative coadministration of 150-mg pregabalin and IV ibuprofen may be useful in improving pain control after third molar surgery.

Diagnostic role of ultrasound elastography on lymph node metastases in patients with head and neck cancer.

INTRODUCTION: Ultrasonography is the easiest non-invasive method to diagnose lymph node metastases in patients with head and neck cancer. However, since CT scans are often preferred in the evaluation of primary tumours of these patients, information about lymphatic metastases may also available in these patients. Therefore, ultrasound is not routinely employed in the evaluation of these patients. However, elastography technique, a recent development in ultrasound technology, could make use of ultrasonography in these patients even more widespread, even though it is still not widely used today. OBJECTIVES: The aim of this study was to evaluate the role of sonographic elastography in the diagnosis of lymph node metastasis of head and neck cancer. METHODS: Twenty-three patients diagnosed with head and neck cancer and scheduled for surgical treatment including neck dissection were included in the study. All patients underwent neck examination by palpation, ultrasound elastography and computerized tomography with contrast. To compare the diagnostic performance of palpation, ultrasound elastography and computerized tomography, the findings of each examination method were compared with the histopathological examination results of neck specimens. RESULTS: 15 (65.2%) patients had a primary tumour in the larynx; 7 (30.4%) in the oral cavity; and 1 (4.3%) in the parotid. 7 (30.4%) out of 23 patients underwent bilateral neck dissection. In total, 30 neck dissections were hereby taken into account during study. Ultrasound elastography showed higher accuracy (83.3%) and higher sensitivity (82.4%) than palpation and computerized tomography, but the specificity of ultrasound elastography was lower (84.6%) than palpation and computerized tomography. CONCLUSIONS: Ultrasound elastography is helpful for the diagnosis of lymph node metastases in patients with head and neck cancer. Due to its non-invasive character, it can be used safety in combination with other radiological techniques to support or improve their diagnostic performance.

Behaviour of Toxoplasma gondii RH Ankara strain tachyzoites during continuous production in various cell lines.

Toxoplasma gondii is an obligate intracellular protozoan parasite. The objective of the present study was to examine the behaviour of Toxoplasma gondii RH Ankara strain tachyzoites in a cell culture environment. The study represents the first step in determining whether T. gondii RH Ankara strain tachyzoites, grown in cell culture, are of sufficient quality to allow cessation of in vivo tachyzoite production for diagnostic assays. In the present study, T. gondii RH Ankara strain tachyzoites were continuously produced in myeloma X63.Ag8.653, HeLa, Hep-2, and Vero cell cultures for 2 months. The average size of the tachyzoites was 3 x 5.7 microm prior to the first inoculation but after continuous production, a marked decrease was noted in average tachyzoite size. The smallest tachyzoite size, was 1 x 2.1 microm after 2 months, in myeloma cell cultures even though the yield of tachyzoites increased. With other cell cultures, tachyzoite yields were not as high as myeloma cell culture although decrease in size was less. The smallest decrease in tachyzoite size, averaging 2 x 3.8 microm after 2 months, was observed in tachyzoites produced in HeLa cell cultures. A virulence assay in small groups of BALB/c mice, using tachyzoites derived from cell cultures, was also conducted. The preliminary results of the virulence assay suggest that as the size of the tachyzoites decreased, the virulence in mice decreased. Future research will focus on the effect of the size of cell culture-derived T. gondii RH Ankara strain tachyzoites on the virulence, protein expression, and the reliability of diagnostic assays. Ultimately, the behaviour of tachyzoites from various T. gondii strains will be observed in cell culture to determine if size is altered.