One year of surgical mask testing at the University of Bologna labs: Lessons learned from data analysis.

The outbreak of SARS-CoV-2 pandemic highlighted the worldwide lack of surgical masks and personal protective equipment, which represent the main defense available against respiratory diseases as COVID-19. At the time, masks shortage was dramatic in Italy, the first European country seriously hit by the pandemic: aiming to address the emergency and to support the Italian industrial reconversion to the production of surgical masks, a multidisciplinary team of the University of Bologna organized a laboratory to test surgical masks according to European regulations. The group, driven by the expertise of chemical engineers, microbiologists, and occupational physicians, set-up the test lines to perform all the functional tests required. The laboratory started its activity on late March 2020, and as of the end of December of the same year 435 surgical mask prototypes were tested, with only 42 masks compliant to the European standard. From the analysis of the materials used, as well as of the production methods, it was found that a compliant surgical mask is most likely composed of three layers, a central meltblown filtration layer and two external spunbond comfort layers. An increase in the material thickness (grammage), or in the number of layers, does not improve the filtration efficiency, but leads to poor breathability, indicating that filtration depends not only on pure size exclusion, but other mechanisms are taking place (driven by electrostatic charge). The study critically reviewed the European standard procedures, identifying the weak aspects; among the others, the control of aerosol droplet size during the bacterial filtration test results to be crucial, since it can change the classification of a mask when its performance lies near to the limiting values of 95 or 98%.

Multidetector CT Dentascan evaluation of bone regeneration obtained with deproteinised bovine graft in residual cavity after mandibular cyst enucleation.

PURPOSE: This study compared spontaneous bone healing and regeneration obtained with deproteinised bovine graft in residual cavities after mandibular cyst enucleation using computed tomography (CT) Dentascan. MATERIALS AND METHODS: Eighty patients with a radiological diagnosis of mandibular cyst underwent surgical enucleation. Patients were divided into a control group (spontaneous healing, 40 patients) and a test group (deproteinised bovine graft, 40 patients). All patients underwent follow-up CT Dentascan 12 months after the procedure. For each residual cavity, apical-coronal and mesial-distal distance, average pixel intensity and volume were calculated and results compared between two groups using the t test. RESULTS: The control group showed mean volume, apical-coronal and mesial-distal distance of 703.2 ± 185.3 mm(3), 28.6 ± 9.4 mm and 25 ± 2.84 mm, respectively. In the test group, values were 738.2 ± 189.2 mm(3), 27.5 ± 3.6 mm and 25.3 ± 2.97 mm, respectively. There was no statistically significant difference between groups. Average pixel intensity was 1,102.8 ± 124.3 in the test group and 624.9 ± 133.3 in the control group, with a significant difference between groups (p<0.0001). CONCLUSIONS: The significantly higher average pixel intensity observed in the test group demonstrates the cavalue of treatment with biomaterials to obtain earlier bone regeneration.

How do biomaterials affect the biological activities and responses of cells? An in vitro study.

AIM: As part of regenerative bone surgery, according to the principles of tissue engineering and GBR, the use of biomaterials aims to restore bone deficiencies by restoring both functionality and original morphology of the bone tissue. Besides being biocompatible, biofunctional and reabsorbable, the ideal scaffolding should possess an osteoinductive geometry, which depends on many physical-chemical characteristics and, in particular, on a three-dimensional morphology and the placement of molecules, which would determine pore size and interconnection between them. The purpose of this study was, therefore, to carry out an analysis with a scanning electron microscope, in order to evaluate the effect of the diameter size of the scaffold pores on the bio-molecular interaction between osteoblast-like MG63 cells and four biomaterials with different pore sizes: polylactic-co-glycolic acid, deproteinized bovine bone, equine bone, demineralized bone matrix (DBM). METHODS: Through the observations made with SEM and X-ray microanalysis, it is possible to infer how the morphology, the proliferative ability, the modality of adhesion and the differentiation of MG63 cells are influenced in different ways by the porous structure of the various biomaterials used as a substrate for growth. RESULTS: From among all of the biomaterials examined, DBM represented the best substrate for growth; in fact, there would be a more intense and precocious adhesion of MG-63 cells. CONCLUSION: The strong osteoconductive effect observed in human DBM, seems to be related to the presence of the organic component, while the osteoinductive effect would be mainly attributed to the presence of BMPs.

Phlegmon of the face and neck: a case report.

Deep face and neck infections are potentially life threatening if they are not diagnosed in time and then treated quickly. This report describes a case of face and deep neck infection, associated with a semi-impacted and decayed wisdom tooth in a cardiopathic, immunosuppressed patient suffering from, diabetes, hypothyroidism, osteoporosis, breathlessness, chronic bronchitis, with oral, cutaneous and vaginal erythematous lichen, Cushing's Syndrome, penicillin allergy, subjected to past hypophysectomy. The swelling was, first of all, treated in urgency, with an intravenous antibiotic therapy and, immediately afterwards, the phlegmonous infiltration linked to the avulsion of the lower third molar was surgically drained. The patient was then treated with intravenous multiple antibiotics, with the aim of eradicating the predominating bacteria that was encountered in the microbiological culture test. A complete remission of the pathological picture was obtained .

Bone regeneration: in vitro evaluation of the behaviour of osteoblast-like MG63 cells placed in contact with polylactic-co-glycolic acid, deproteinized bovine bone and demineralized freeze-dried bone allograft.

Insufficient bone density of the alveolar crests, caused by loss of the dental elements, sometimes impedes the primary stability of an integrated bone implant. The techniques of bone regeneration allow to obtain a sufficient quantity of alveolar bone to permit the implant rehabilitation of the edentulous crests. Today several grafting materials are available and they have different characteristics, according to their structure, which influence the different behaviour of the grafting materials to the bone and the implant surface. The aim of this study is to evaluate the interaction between a human osteosarcoma MG63 cell line and three different biomaterials: polylactic-co-glycolic acid (PLAGA), deproteinized bovine bone and demineralised freeze-dried bone allograft (DFDBA). From this study a different behaviour emerges of the osteoblast-like MG63 cells in relation to the sublayer on which these cells were placed in culture. The results of the study, in fact, demonstrate that the most osteoconductive material of the three analysed is the DFDBA, followed by DPBB. On the contrary, the PLGA, because of its roughness, does not seem to represent a valid support for cell growth, and does not encourage any morphologic modification in tumor cells. Furthermore, deproteinized bovine bone shows a differentiating effect which could lead to hypothesise an osteoconductive capacity of this biomaterial. Further studies should be carried out with the aim of explaining the results obtained.

Mandibular osteomyelitis due to Pseudomonas aeruginosa. Case report.

Osteomyelitis is a relatively frequent bacterial infection of the jaw bones. This report describes a case of mandibular osteomyelitis in a surgical site after enucleation of a follicular cyst and extraction of the associated tooth. This case is unusual because maxillary osteomyelitis generally results from polymicrobial infection. In our patient, however, laboratory analysis identified Pseudomonas aeruginosa as the etiologic agent, an opportunistic pathogen normally found on moist surfaces and vegetation. Notorious for its antibiotic multiresistance, P. aeruginosa is increasingly recognized as a serious problem in hospitalized patients. Isolation of the responsible microbe permitted specific antibiotic treatment with a 10-day course of ciprofloxacin (250 mg/12 h), which fully cleared the infection.

Dental implants with locking taper connection versus screwed connection: microbiologic and scanning electron microscope study.

The aim of this study is to carry out an analysis of the Fixture-Abutment Interfaces (FAI), comparing different connection systems, to evaluate the role of geometric discrepancy, which is present between the abutment and the fixture, in favoring the permeability to bacterial colonization. Two types of commercially available FAI were studied, 16 screwed FAI (Sweden-Martina Italia) (4 of Ø 3.8 mm diameter, 4 of Ø 4.7 mm diameter, 4 of Ø 5.7 mm diameter and 4 of Ø 6.7 mm diameter) and 4 FAI (Bicon) (Ø 3.5mm diameter). The assays were carried out in vitro, placing the different dental implants in contact with broth culture of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Streptococcus pyogenes to test the infiltration inside the FAI. Furthermore, scanning electron microscope (SEM) analysis was carried out to evaluate the gap at the fixture-abutment interface. In all the locking taper FAI and in the screwed FAI with a diameter of 3.8 mm there was no trace of bacterial infiltration of the species examined. In the screwed FAI with a diameter of 4.7 mm, 5.7 mm and 6.7 mm there was an increasing level of bacterial infiltration in relationship to the diameter. Therefore, this paper shows that there exists an important correlation between the diameter of the screwed implant and the permeability to microbic infiltration that is directly proportional to the diameter of the implant.

Antimicrobial susceptibility and beta-lactamase production of anaerobic and aerobic bacteria isolated from pus specimens from orofacial infections.

Most suppurative orofacial infections are polymicrobial. Information regarding the antimicrobial susceptibility of the microorganisms involved can be useful in the choice of an effective antibiotic therapy. In this study we determined the antimicrobial susceptibility of a total 235 anaerobic and aerobic bacteria recently isolated from pus specimens of orofacial infections. All the viridans streptococci were susceptible to penicillin, cefotaxime, cefoxitin, imipenem and levofloxacin. Imipenem and levofloxacin were active against 100% of the anaerobic Gram-positive organisms isolated. Among the anaerobic Gram-negative rods beta-lactamase production was detected in all species except Campylobacter rectus. Amoxicillin-clavulanate, cefoxitin, imipenem and metronidazole were active against all the isolates of anaerobic Gram-negative species. Isolates resistant to erythromycin were found in all the species tested, however, resistance to clindamycin was only detected in Porphyromonas gingivalis and Bacteroides ureolyticus. Isolates resistant to levofloxacin were detected in P. gingivalis and Prevotella sp.

Bone substitutes in oral surgery.

Osseous defects pose a clinical challenge the operator can meet with the aid of techniques that promote bone tissue regeneration. The current gold standard is autologous bone harvested from intra- and extraoral donor sites; however, autologous bone grafting requires two surgical sites (donor and recipient), resulting in greater morbidity and prolonged operating times, particularly for extraoral sites, with greater discomfort for the patient. Such disadvantages can be overcome with the use of bone substitute materials. There is a notable variety of so-called intelligent biomaterials that can modulate bone response in regeneration. Based on origin, bone substitute materials are classified as allogenic, heterologous and alloplastic materials. The first refer to bone from same-species donors, the second are obtained through processing of bone from different species, while alloplastic materials are synthetic composites. Besides different resorption rates, they possess different chemical and structural characteristics that influence the stimulation or support of bone regeneration. In daily clinical practice, before selecting from the wide variety of biomaterials, a wise step is to analyze and compare the clinical and histological results obtained with these materials. This article examines the clinical applications and osteoconductive and/or osteoinductive properties of some currently available biomaterials.

Local delivery of antimicrobial drugs in the treatment of chronic adult periodontitis.

AIM: The aim of this study was to evaluate the clinical and microbiologic results of local delivery of adjunctive antimicrobials in the treatment and management of patients with periodontitis. METHODS: The study population included 33 patients (age range, 37-49 years), with chronic adult periodontitis. Eleven of 33 received local treatment with 10% doxycycline injected directly into the periodontal pocket; 11 received local treatment with a chlorhexidine-based gel (1.5%) in situ; 11 received mechanical treatment with scaling and root planing. The crevicular fluid of the doxycycline-treated group was analyzed using high performance liquid chromatography over a period of 1 month. RESULTS: In the 11 patients treated with an antibiotic we observed a reduction in attachment loss and a reduction in probing depth of 1.4 mm; in the 11 chlorhexidine-treated patients we observed a reduction in attachment loss and a reduction in probing depth of 0.9 mm; in the remaining 11 patients the reduction in attachment loss and probing depth was less than those measured in the other two treatment groups. CONCLUSIONS: Our results suggest that direct delivery of antimicrobial agents to the infection site may be a useful adjunctive to conventional periodontal treatment.

Gingival overgrowth in renal transplant recipients induced by pharmacological treatment. Review of the literature.

Patients who undergo a renal transplant also require a pharmacological immunosuppressor therapy with cyclosporine (CsA) as well as anti-hypertensive calcium channel-blockers (CCBs); the former suppresses interferon and interleukin-2 production thus interfering with T cell cell-mediated activity, while the latter are used in order to counteract the nephrotoxicity of CsA which causes the local release, of thromboxane A2 with vascular vasoconstriction in the kidney. The use of both these drugs, particularly if used in association, leads to the onset of a clinical picture of variable entity, characterized mainly by a hypertrophy originating usually at the level of interdental papillae, and more pronounced in the anterior maxillary areas and the vestibular surfaces of the teeth, in a more or less symptomatic manner. The therapy is above all preventive, with an appropriate oral hygiene program, both professionally as well as at home, and with the use of substitutive drugs that do not present such side effects.

Implant surface and osseointegration.

Oral rehabilitation by means of osteointegrated implants is gaining more and more importance, in particular due to the improved characteristics of the fixture: among these, the superficial microscopical morphology plays a role of primary importance, since it can influence the evolution of the osteointegrative process. Therefore, this led to many surface treatments which can improve the quality and the speed of formation of the bony tissue. The aim of this paper is a review of the literature on this topic in order to find out which processes of characterization of the surface implant are now available and which results can be obtained.

The use of r-hFSH in treatment of idiopathic male factor infertility before ICSI.

OBJECTIVE: To evaluate the efficacy of pre-treatment of idiopathic oligozoospermic patients with r-hFSH to improve the clinical results of ICSI. PATIENTS AND METHODS: 82 infertile couples due to male factor who attended our center were included in the study. Thirty-six were randomized to the treatment group (group A) and forty-six to the control group (group B). The male partners in group A were treated with recombinant human FSH (r-hFSH; Gonal F®) 150 IU subcutaneously three times a week for a 3-months period. The control group (group B) did not receive any treatment. After the treatment couples of both groups underwent a cycle of ICSI. RESULTS: The fertilization rate was comparable in both groups. However, in the treatment group (group A), the clinical pregnancy rate was significantly higher (42%) compared to the control group (group B) (20%) (p < 0.02). Also, the implantation rate was significantly higher in treatment group (26%) compared to the control (15%) (p < 0.04). Miscarriage rate was lower (15.7%) in the treatment group than in the control (43.7%), and this difference was statistically significant (p < 0.05). CONCLUSIONS: Treatment of idiopathic male factor infertility with r-hFSH before ICSI improves clinical pregnancy rate, increases implantation rate and decreases the early pregnancy loss.

Interactions at the outside faces of calix

Attractive pi-pi interactions between two of the four outside cavity faces of 1,3-bis-pyridylmethylcalix[4]arene (1) and both faces of 1,4-diiodotetrafluorobenzene (2a) form infinite one-dimensional non-covalent ribbons where the two modules alternate. These ribbons are cross-linked by electron donor-acceptor interactions between picolyl nitrogen atoms of calixarene 1 in one chain and iodine atoms of perfluoroarene 2a in another chain and the two-dimensional supramolecular network 3a is formed. A similar behaviour is also shown by 1,4-dibromotetrafluorobenzene (2b). The halogen bonding and the attractive pi-pi interactions occur in directions which are nearly orthogonal each other. Diiodotetrafluorobenzene, being involved in both these interactions, appears to be a particularly interesting tecton. The ability of electron-poor arenes to elicit the exo-receptor potential of calixarene module by connecting their outside faces through pi-pi interactions may be developed as a new and general binding protocol in calixarene self-assembly processes.

Efficacy of corticosteroid therapy on cerebral gummas: risks and implications.

Complete resolution of a cerebral gumma can take place after massive corticosteroid treatment. Such a result in patients not known as syphilitic can be misleading and hamper the identification of the true nature of the lesion.

Use of new adjuvants in an emergency vaccine against foot-and-mouth disease virus: evaluation of conferred immunity.

The ability of an emergency adjuvanted FMDV vaccine to elicit early protective immune response in mice was examined. We studied the efficacy of several adjuvants to induce such protection. The aqueous IMS1313 plus inactivated FMDV induce a higher protective immune response than the vaccine with inactivated virus alone at seven days post vaccination (dpv). Mice vaccinated with this formula showed higher lymphoproliferative index values and higher IL-2, IL-4 and IFNgamma levels than the controls.

[Isolated jejunal angiomatosis. A rare cause of intestinal hemorrhage]. / Angiomatosi digiunale isolata. Una causa rara di emorragia intestinale.

The Authors report a case of solitary small bowel angiodysplasia and emphasise the rarity of this site. The importance of angiography is stressed in terms of its fundamental role in the diagnostic process and in its ability to evaluate not only the site but the extension of this type of lesion, thus enabling a surgical approach to be defined.

X-ray evaluation of interferential femoral screw positioning in ACL reconstruction.

In a total of 27 patients the authors performed reconstruction of the anterior cruciate ligament using the mid third of the free patellar tendon (bone-tendon-bone), stabilized with two interferential wires, using a mini-arthrotomic half-tunnel in-out method. X-ray examination in two orthogonal views allows for an evaluation of the orientation of the femoral screw in relation to the joint plane and the diaphyseal axis, and its relationship with the bone graft, thus obtaining useful information on its anchoring. The method used is that reported by Lemos et al. (1993). The results obtained agree with those reported by the American author and substantiate the reliability of the method.

[Augmentation of the maxillary sinus by Le Fort osteotomy in endosseous implantology. A clinical case report]. / Riempimento del seno mascellare previa osteotomia Le Fort I in implantologia endossea. Presentazione di un caso clinico.

The authors present a case of sinus floor elevation using Le Fort I osteotomy. They underline that, owing to its peculiarities, this type of intervention is indicated, in their opinion, for sinus floor elevation when both the vertical dimension and possible skeletal discrepancies require modification. They briefly describe the indications, peculiarities and contraindications.

[Conservative treatment of upper anterior dental discrepancy during orthodontic therapy]. / Trattamento conservativo delle discrepanze dento-dentali anteriori superiori in corso di terapia ortognatodontica.

The orthodontic therapeutic sequence used in cases with dento-dental discrepancy for reduced mesiodistal size and congenital absent lateral upper incisors, is described. The importance of correct conoid tooth replacement in the programmed space between the other teeth and its restorative treatment in order to obtain the best biomechanical control is stressed. The contemporaneous presence of the form and volume anomaly of the 12th and the missing 22nd due to agenesia demanded an interdisciplinary approach. For the restoration of the conoid tooth the authors used a microhybrid composite for the alloy properties with the grain size of the inorganic particles. In fact this type of composite responds well to mechanical stress and has a high shining capacity and good aesthetical rendering. Meanwhile the temporary dental prothesis solution of the 22nd in this case has suggested the application of the artificial element on the superior Hawley holding plaque.