Randomized Trial to Test a Chemo-Mechanical Antiplaque Regimen as Adjunct to Periodontal Therapy.

BACKGROUND: The control of dental biofilm regrowth after nonsurgical periodontal therapy is associated with better clinical outcomes. However, many patients have difficulty achieving optimal plaque control. Subjects with diabetes, in which immune and wound-healing responses are typically impaired, may benefit from intensive antiplaque control regimens after scaling and root planing (SRP). OBJECTIVES: This study aimed to evaluate the effects of an intensive, at-home, chemical, and mechanical antiplaque regimen as an adjunct to SRP for the treatment of moderate to severe periodontitis. A secondary objective was to compare responses in subjects with type 2 diabetes and nondiabetics. METHODS: This was a 6-mo, single-center, parallel-group, randomized trial. The test group received SRP and oral hygiene instructions, and subjects were instructed to use a 0.12% chlorhexidine gluconate mouthrinse twice a day for 3 mo and utilize rubber interproximal bristle cleaners twice a day for 6 mo. The control group received SRP and oral hygiene instructions. The main outcome was change in mean probing depth (PD) from baseline to 6 mo. Secondary outcomes included change in sites with deep PDs, mean clinical attachment level, bleeding on probing, plaque index, hemoglobin A1C, fasting blood glucose, C-reactive protein, and taste assessment. This study was registered at ClinicalTrials.gov as NCT04830969. RESULTS: In total, 114 subjects were randomized to either treatment. Eighty-six subjects completed the trial with no missing visits. Neither an intention-to-treat nor a per-protocol analysis showed statistically significant differences between treatment groups in mean PD at 6 mo. In a subgroup analysis, subjects with diabetes in the test group showed a statistically significant greater reduction in mean PD at 6 mo when compared to subjects with diabetes receiving the control treatment (Δ = 0.15, P = 0.04), while there were no differences within nondiabetics (Δ = 0.02, P = 0.75). CONCLUSION: Outcomes in subjects with diabetes may be improved by chemo-mechanical antiplaque measures after nonsurgical periodontal therapy. KNOWLEDGE TRANSFER STATEMENT: This study suggests diabetic subjects may benefit from an intensive, at-home, chemical, and mechanical antiplaque regimen to improve nonsurgical periodontal therapy outcomes.

Percutaneous surgery of allux valgus: risks and limitation in our experience.

AIM OF THE STUDY: The Reverdin-Isham percutaneous osteotomy is indicated in the treatment of mild to moderate hallux valgus. The aim of this study is to evaluate the technique itself after a relevant experience. METHODS: From January 2010 to January 2012 we have done 213 percutaneous osteotomy. The patients were evaluated clinically and with imaging after a minimum 5 months and a maximum 2 years follow up. For the clinical evaluation it was used the American Orthopaedic Foot and Ankle Society score. RESULTS: The mean postoperatory clinical score was 90 points in front of the mean 45 preoperatory points. The technique was well accepted by the patients because of the minimal invasivity, the poor post operatory pain and the immediate functional recovery even with poor radiological results. These imaging results pose dubts on the lenght of the clinical results and pose the necessity of particular technical choiches and strict indication limits. CONCLUSION: The results we have obtained with the Reverdin- Isham percutaneous osteotomy have confirmed that this procedure is a valid alternative to other open techniques. However this is a not simple technique, requires the respect of the indications, a steep and long learning curve and the necessity of a greater follow up.

Effect of serotonin and nicotine on the growth of a human small cell lung cancer xenograft.

Small cell lung cancer (SCLC) cells express cholinergic nicotinic receptors on their membranes, and the stimulatory effect on cell growth of nicotine has been described in cell cultures. We investigated three SCLC cell lines, all showing high levels of fluorescence intensity when labeled with FITC alpha-bungarotoxin in most cells. From one of these cell lines, NCI-N592 a tumor line in athymic nude mice was established. Nude mice were subcutaneously grafted on the same day with tumor fragments and with Alzet osmotic minipumps (200 microliters, 14 days of infusion) infused with serotonin or nicotine to investigate their effects on tumor growth. Two dose levels of each compound were used, namely 20 and 200 micrograms/day. In mice treated with 200 micrograms serotonin, tumors took a shorter time than those of untreated controls to reach 50 mg in volume, meaning that the first steps of tumor growth were faster. In contrast, a delay in tumor appearance was observed in mice treated with low-dose serotonin. No differences were found in tumor growth in the groups of mice treated with nicotine. When the treatment was delivered to already established and vascularized tumors (around 100 mm3), no effect on tumor growth was achieved by serotonin or nicotine. Therefore, in the experimental conditions used in the study, the stimulatory effect of nicotine on an SCLC tumor was not demonstrated.

Myositis ossificans circumscripta with spontaneous healing of a cortical cyst.

We report a case of myositis ossificans circumscripta with an initial periosteal reaction and subsequent development of a cyst in the underlying cortex. All the roentgenographic abnormalities resolved spontaneously and permanently. The unusual course may have been due to formation of a subperiosteal hematoma at the time of development of the soft tissue ossification.