Efficiency of Lasers and a Desensitizer Agent on Dentin Hypersensitivity Treatment: A Clinical Study.

AIM: The aim of this clinical study was to determine and compare the efficiency of the glutaraldehyde-containing agent (GCA), Nd:YAG, Er,Cr:YSGG lasers, and the combination of them on the dentin hypersensitivity (DH) treatment. SUBJECTS AND METHODS: This study was performed with the participation of 17 healthy adult patients having 100 teeth with DH; the patients were randomly divided into five groups according to the treatment protocol: (1) application of GCA on sensitive teeth, (2) Nd:YAG laser (1 W/cm2, 10 Hz) irradiation on sensitive teeth, (3) application of GCA on sensitive teeth and then Nd:YAG laser irradiation, (4) Er,Cr:YSGG laser (0.25 W/cm2, 20 Hz) irradiation on sensitive teeth, (5) application of GCA on sensitive teeth and then Er,Cr:YSGG laser irradiation. Sensitivity levels were assessed by the Yeaple probe on the buccal surfaces of the teeth at a force setting of 10 g. Measurements were performed for 30 min, after 7, 90, and 180 days of the therapy to assess the effects of desensitization. The evaluations were analyzed using the one-way analysis of variance and repeated measurement test (P < 0.05). RESULTS: After sessions, DH was significantly reduced in all groups at each measurement point. The Er,Cr:YSGG laser with or without GCA application were the most effective ones in DH treatment (P < 0.05). Comparison of the treatment regimens demonstrated that the scores achieved with the Yeaple probe were not significantly higher for the Nd:YAG laser groups than the GCA alone group. CONCLUSIONS: This clinical study shows that the Er,Cr:YSGG laser have promising potential for the treatment of DH.

Evaluation of different treatment protocols for dentin hypersensitivity: an 18-month randomized clinical trial.

This randomized and longitudinal in vivo study aimed to assess different protocols for the treatment of dentin hypersensitivity with low-power laser (with different doses), high-power laser, and a desensitizing agent, for a period of 12 and 18 months. The lesions from 32 patients (117 lesions), who were submitted to the inclusion and exclusion criteria, were divided into nine groups (n = 13): G1: Gluma Desensitizer (Heraeus Kulzer), G2: low-power laser with low dose (three points of irradiation in vestibular portion and an apical point 30 mW, 10 J/cm2, 9 s per point with the wavelength of 810 nm, with three sessions with an interval of 72 h), G3: low-power laser with high dose (one point in the cervical area, and one apical point 100 mW, 40 J/cm2, 11 s per point with the wavelength of 810 nm in three sessions with an interval of 72 h), G4: low-power laser with low dose + Gluma Desensitizer, G5: low-power laser with high dose + Gluma Desensitizer, G6: Nd:YAG laser (Power Laser™ ST6, Research® in contact 1.0 W, 10 Hz and 100 mJ, ≈85 J/cm2, with the wavelength of 1064 nm), G7: Nd:YAG laser + Gluma Desensitizer, G8: low-power laser with low dose + Nd:YAG laser, and G9: low-power laser with high dose + Nd:YAG laser. The level of sensitivity of each volunteer was assessed by visual analog scale of pain (VAS) with the aid of air from the triple syringe and exploration probe, 12 and 18 months after treatment. All analyses were performed separately for air and probe stimulus. The level of significance was considered for values of p < 0.05. After statistical analysis, all treatments were shown to be effective in reducing dentinal hypersensitivity, and the results were considered not statistically different from those at 12 months. Therefore, until the 18-month evaluation, it could be said that no statistical differences were observed in the sensitivity levels for all treatments.

Safety of immunotherapy with glutaraldehyde modified allergen extracts in children and adults

BACKGROUND: Glutaraldehyde-modified natural allergen extracts show significant reduction in the IgE-binding capacity and proteolytic activity. This allows the administration of higher doses in a shorter period of time, and to mix different allergen extracts. OBJECTIVE: Evaluate the safety of different concentrations and mixtures of glutaraldehyde-modified allergen extracts in a large group of paediatric and adult patients undergoing specific immunotherapy treatment. MATERIALS AND METHODS: 1855 patients (1156 adults and 699 children), suffering from rhinoconjunctivitis and/or asthma, participated in an observational multicentre cohort study, to evaluate the safety of immunotherapy using vaccines containing modified allergen extracts. Patients were monosensitised, or polysensitised, and received a therapeutic vaccine containing polymerised allergen extracts adsorbed onto aluminium hydroxide. Safety was assessed by recording all side reactions related to immunotherapy. RESULTS: The clinically relevant local reactions totalled 120, (90 immediate and 30 delayed) (1.02% of injections). Of them, 31 (0.26% of injections) occurred in children (26 immediate and 5 delayed) and 89 (0.76% of injections) in adults (64 immediate and 25 delayed). There were 38 systemic reactions. Eleven reactions were immediate (9 of grade 1 and 2 of grade 2) and 27 delayed (22 of grade 1 and 5 of grade 2). There were seven grade 2 systemic reactions (0.06% of the injections). No differences (P>0.05) in the number of reactions were observed between adults and children and between treatments were found in systemic reactions. All systemic reactions were mild and resolved spontaneously without the need of medication. CONCLUSION: Specific immunotherapy using natural modified allergen vaccines is safe to treat allergic patients, even at higher doses and in mixtures of unrelated allergen extracts. The percentage of adverse reactions detected is lower than those reported in the literature with native unmodified allergen extracts

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Actualización sobre el tratamiento de las verrugas vulgares en los niños / Treatment of Warts in Children: An Update

Las verrugas víricas son una de las infecciones cutáneas más frecuentes en los niños. Aunque existen múltiples opciones de tratamiento, no hay ningún tratamiento que garantice una total eficacia con una única sesión terapéutica. En la edad pediátrica el tratamiento es particularmente complicado, no solo porque algunos métodos son mal tolerados, sino también porque a menudo las expectativas de los padres respecto a la eficacia del tratamiento son poco realistas. Este artículo proporciona una actualización sobre las diferentes terapias antiverrugas, particularmente enfocado a los pacientes pediátricos, excluyendo el tratamiento de las verrugas de la mucosa oral y anogenital

Warts are among the most common skin infections in children. Although numerous treatment options are available, none are completely effective in a single session. Treatment is particularly complicated in children, not only because certain treatments are poorly tolerated, but also because parents frequently have unrealistic expectations. In this article, we offer an update on the treatments available for warts, focusing specifically on pediatric patients. We do not discuss treatments for oral and anogenital warts

In vitro and in vivo evaluation of the effectiveness of three dentin desensitizing treatment regimens.

PURPOSE: To evaluate the in vitro and in vivo effects of three treatment regimens on dentin permeability and reduction of dentin hypersensitivity (DH). METHODS: The desensitization treatments were: Gluma Desensitizer PowerGel (GLU), MS Coat One (MSC), and dentin burnishing with fiber-resin burs (STB). A split-chamber device was used to determine the permeability of dentin slices cut from human molars in vitro. Fluid flow through dentin was recorded with a photochemical method after EDTA cleaning, albumin soaking and desensitization treatment (n = 10). 61 study participants with three severely hypersensitive teeth each were enrolled. Sensitivity was determined with an air stimulus before, immediately after treatment, and after 1, 3 and 6 months, using a verbal rating scale. RESULTS: From the 61 study participants enrolled, 52 completed the trial. Permeability at baseline and after albumin soaking was not significantly different. All treatments produced reduced fluid flow through dentin (P > 0.05). All treatments reduced DH significantly (no or moderate sensitivity). Statistical results revealed significant differences among the treatments (P = 0.03). Mann-Whitney comparisons showed GLU, STB < MSC.

Chronic hyperbaric oxygen therapy causes only minor ultrastructural changes in the human nasal epithelium

Hyperbaric oxygen (HBO) therapy is becoming increasingly popular in the treatment of several pathologies, namely in vascular diseases. It is generally considered to be innocuous, with few restrictions. Thus, patients subjected to HBO therapy breath saturated oxygen at an elevated pressure. Since the respiratory mucosa comes into contact with this altered inhaled air, we decided to use light and electron microscopy to investigate whether chronic HBO therapy causes significant changes in the nasal mucosa. For this, we obtained biopsies of the anterior portion of the lower nasal turbinate from two groups of 9 individuals under direct visual inspection. The first group had a diagnosis of tinnitus and was subjected to 15 sessions of 100 min-long HBO treatments, and the latter group comprised healthy volunteers not subjected to HBO therapy. The samples were processed for light and electron microscopy. We found that the turbinate mucosa of the HBO-treated group showed a moderate infiltration by leukocytes and an increase in the thickness of the epithelial basement membrane. By transmission electron microscopy (TEM), we observed that only a minority of the nasal epithelial cells presented alterations due to the HBO treatment; these alterations were focal and restricted to cilia. We conclude that chronic HBO treatment induces only minor alterations in the nasal mucosa and that these are likely to be reversible when treatment is discontinued (AU)

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Evaluation of the effects of a new drug candidate (GEMSP) in a chronic EAE model.

Chronic Experimental Autoimmune Encephalomyelitis (EAE) was induced in rats to evaluate a new drug candidate (GEMSP) for the treatment of multiple sclerosis. This work is a part of preclinical studies on GEMSP, which is made up of fatty acids, vitamins and amino acids or their derivatives; all these compounds were linked to Poly-L-Lysine. In order to evaluate the effects of GEMSP, animals were divided into three experimental groups: 1) EAE rats treated with GEMSP; 2) EAE rats treated with NaCl; and 3) non-EAE rats. Using immunocytochemical techniques with a pan-leukocyte marker (anti-CD 45), differential leukocyte infiltration was compared in the central nervous systems of the different experimental groups. Antibodies directed against a component of GEMSP, the conjugated methionine, were used in all three groups. We found that: 1) GEMSP was effective in abolishing EAE. The crises and clinical scores were completely abolished in the animals of the first group, but not in the animals belonging to the second group; 2) the degree of leukocyte infiltration varied, depending on the different EAE stages, but was not related to the clinical score; and 3) after using anti-conjugated methionine antibodies, we observed immunoreactivity only in the motoneurons of the ventral horn of the spinal cord in the animals of the first group. This immunoreactivity was not found in the animals of the second or third groups. No methionine immunoreactivity was found in the brain. Our results suggest that GEMSP may be a potential drug candidate against the pathogenic processes involved in multiple sclerosis, inhibiting EAE episodes and brain leukocyte infiltration. Our results also show that one component of GEMSP, the methionine compound, is stored inside motoneurons. The possible physiological actions of GEMSP on spinal cord motoneurons are discussed.

Dentine-bonded resin composite (Retroplast) for root-end filling: a prospective clinical and radiographic study with a mean follow-up period of 8 years.

AIM: To evaluate treatment outcome after using a resin composite (Retroplast, RP) in combination with a dentine-bonding agent (GLUMA) as root-end filling material after 1 year as well as after more than 5 years (final examination). Also, the influence of various pre-, intra- and postoperative factors on the treatment outcome was studied. METHODOLOGY: All patients (87) undergoing root-end resection consecutively treated by root-end filling with RP on an incisor, canine, pre-molar, or first molar (87 teeth, 118 roots) were initially enrolled in the study. RP was applied on the entire resected surface that was prepared to a slightly concave shape and after conditioning with EDTA and GLUMA. The treatment outcome involving subjective, clinical and radiographic parameters was evaluated after 1 year and at the final examination. A total of 27 patients (36 roots) were excluded from the study because of unavailability of follow-up (19) and extraction of the operated tooth for reasons other than failed surgery (8). Consequently, 60 patients (82 roots) were included in the final material. The mean follow-up period at the final examination was 8 years (range: 6.5-9 years). RESULTS: The radiographic evaluation at the final examination revealed that 77%, 5%, 7% and 11% of the treated roots were characterized by complete, incomplete, uncertain and unsatisfactory healing, respectively. A total of 95% of the roots classified as completely healed at the 1-year control were also completely healed at the final examination. Two roots (5%) showing complete healing at the 1-year control revealed unsatisfactory healing at the final examination because of displaced or lost RP-filling. Moreover, 60% of the roots with uncertain healing at the 1-year control demonstrated complete or incomplete healing at the final examination. The classification according to subjective, clinical and radiographic parameters revealed that 78% of the teeth were characterized by a successful treatment outcome at the final examination. Evaluation of the influence of various pre-, intra- and postoperative factors on the treatment outcome revealed that the radiographic classification at the final examination was exclusively influenced by the radiographic classification at the 1-year control (P < 0.001). CONCLUSIONS: The present long-term study indicates that RP can be used for root-end filling with a successful treatment outcome.

Immunotherapy with depigmented glutaraldehyde-polymerized extracts: changes in quality of life.

BACKGROUND: Immunotherapy (IT) with modified allergens reduces allergic rhinitis (AR) symptoms and medications requirements. Improvement of quality of life (QOL) is a key point in the treatment of AR. The aim of this study was to provide evidence of changes related to the patient's QOL (well-being) induced by a modified (depigmented glutaraldehyde-polymerized) therapeutic vaccine and of its safety. MATERIAL AND METHODS: Fifty-three patients with a well-documented clinical history of seasonal AR sensitized to Dactylis glomerata and Olea europaea pollens were included in a randomized clinical trial. Twenty-five patients (Group-A) received a mixture of D. glomerata and O. europaea pollen extracts and 28 patients received placebo (group-C). Any adverse event was recorded and graded in accordance with EAACI guidelines. RQLQ was recorded before the treatment (pollen season 2000) and after 1 year of treatment (pollen season 2001). Dose-response skin prick test with each allergen extract was conducted at baseline and at the end of the study. RESULTS: Each patient received 17 injections during this period. All patients completed the trial and no systemic adverse reactions were recorded. Symptom scores (P<0.001) and medication requirements (P<0.001) were significantly reduced in the IT group during the pollen season. This patient group also experienced greater and statistically significant improvement in overall RQLQ score and in five of the seven domains, all of them surpassing the threshold of 'minimal important difference' of 0.5 points. CONCLUSIONS: Results of this study provided evidence that IT with depigmented, glutaraldehyde-modified allergen extracts was well-tolerated and added beneficial effects to AR treatment in pollen allergic patients eliciting an improvement in QOL enough to justify a change in the patient's treatment.

Allergen-specific IgE in circulating immune complexes in patients with inhalant allergy undergoing specific immunotherapy.

Specific immunotherapy (SIT) has been used worldwide since it was introduced near the beginning of this century. Although this mode of therapy has been known for over 80 years, its mechanism of action is still not definitely clear. The problem of the presence of allergen-specific IgE in IgE-containing circulating immune complexes of patients with inhalant allergy has been mentioned in the literature. However, there are no data concerning specific immunotherapy. The aim of our study was to evaluate the influence of SIT in patients with inhalant allergy on allergen-specific IgE in serum and in IgE circulating immune complexes. A total of 112 subjects with allergic rhinitis (57 with grass pollen allergy and 55 sensitive to house dust mites Dermatophagoides pteronyssinus) were included in the study. SIT was administered to 29 patients suffering from pollinosis and 27 patients sensitive to house dust mites. The remaining patients were treated with an H2-receptor antagonist only. The decrease of allergen-specific IgE concentration in IgE circulating immune complexes was parallel to the analogous changes in the serum only in the patients with pollinosis. Immunotherapy of house dust mite-sensitive patients caused a much slower decrease of allergen-specific IgE in circulating immune complexes than in serum. The binding index of allergen-specific IgE in circulating immune complexes increased during the course of the treatment. No significant associations were found between the immunological indices studied and clinical score of the disease activity.

Experimental gluing of lung parenchyma in rats.

Gelatin-resorcinol-dialdehyde adhesive has been developed from a gelatin-resorcinol-formaldehyde adhesive by replacing the formaldehyde with two less histotoxic dialdehydes, ethandial and pentandial. The aim of the present study was to evaluate the usefulness of this modified composition in gluing defects in lung parenchyma. In 40 male Wistar rats a standardized lung incision 1.0 cm in length and 0.8 cm in depth were closed by application of gelatin-resorcinol-dialdehyde adhesive. For macroscopic and microscopic examination 4 animals were sacrificed on each of postoperative days 2, 7, and 14 and 14 animals on each of postoperative days 28 and 120. Macroscopic examination revealed a tight closure of the parenchymal defects in all postoperative stages. Initially by an adhesive layer and later on by granulation tissue and scar tissue respectively. On microscopic examination an inflammatory tissue response with polymorphonuclear neutrophils and macrophages predominating was found 2 days postoperatively. After 7 days multinucleated giant cells appeared. On postoperative day 14 the tissue response presented a distinct granulomatous character with multinucleated giant cells persisting. After 28 days remnants of adhesive surrounded by granulation tissue were detectable. On postoperative day 120 the adhesive had been completely resorbed and the parenchymal defect was replaced by fibrous scar tissue. The gelatin-resorcinol-adhesive proved effective in tight closure of lung parenchyma in rats. The adhesive is resorbed completely and does not interfere with parenchymal healing.

[Effect of immunotherapy on selected immunologic indices in children with pollinosis]. / Wplyw odczulania swoistego na wybrane wskazniki immunologiczne u dzieci z pylkowica.

The study was carried out on 15 children with pollinosis. The children were treated with "Pollinex-Bencard" before the pollen season. We looked for changes of serum IgE levels and percentages of T (CD3) cells and their subsets CD4, CD8. After immunotherapy we observed a significant decrease of CD3, CD4 and CD8 cells, whereas no statistical difference was observed in the CD4/CD8 ratio. Three months after immunotherapy, serum IgE levels were significantly elevated, while after 9 months, markedly decreased.

[Spontaneous histamine release by basophils and bronchial hyperreactivity in patients with hay fever]. / Spontaniczne uwalnianie histaminy z bazofilów oraz nadreaktywnosc oskrzeli u chorych na pylkowice.

Basophil spontaneous histamine release test was performed in seventeen patients suffered from seasonal allergic rhinitis before, 2 weeks after immunotherapy and during pollen season. During pollen season at the same day non-specific bronchial hyperreactivity to histamine was estimated. Values of spontaneous basophil histamine release before immunotherapy were not different from control group but significantly increased after immunotherapy and during pollen season. There was no correlation between degree of nonspecific bronchial hyperreactivity and values of spontaneous histamine release from basophils.

Clinical effects of specific immunotheraphy in children with atopic dermatitis.

The clinical results of specific immunotheraphy using Pollinex, Catalet, or Alavac S-HDM vaccines in 22 patients with atopic dermatitis are presented. The immunotheraphy in children with allergy to Dermatophagoides lasted for about 3 years and in children allergic to pollen grass antigens 3 pollen seasons. In the group of children submitted to specific immunotheraphy with Dermatophagoides antigens very good and good results after 3 years of treatment were observed in 75% of patients. In the patients treated with grass pollen antigens Catalet or Pollinex very good and good results were noted in 83% and 80% patients respectively. Our investigation showed, that specific immunotheraphy should be taken into consideration in the treatment of atopic dermatitis in carefully selected cases of children allergic to both grass pollen and Dermatophagoides allergens.

[Characteristics of hay fever during pollen season with regard to the influence of specific immunotherapy. I. Clinical course and biochemical changes in nasal lavage]. / Przebieg pylkowicy w sezonie pylenia z uwzglednieniem wplywu swoistej immunoterapii. Czesc I: Przebieg kliniczny i zmiany biochemiczne w wydzielinie z nosa.

Nasal lavage is a useful tool for monitoring of inflammatory process in pollinosis. In 27 patients with pollen allergy the nasal lavage was performed before, during and after pollen season. The concentration of total protein, albumin and lysozyme were determined in obtained fluid. In one group Pollinex (Bencard) was applied before pollen season, and in the second one--placebo in similar injections. The concentrations of total protein in nasal lavage fluid was significantly lower after the pollen season in both analyzed groups. On the other hand, the concentrations of albumin and lysozyme were increased during pollen season relatively to values before and after the season. In patients treated with Pollinex observed values after the season were lower than in placebo group.

[Course of hay fever during the pollen season with respect to the effect of specific immunotherapy. II. Cytologic changes and chemotactic activity in nasal lavage]. / Przebieg pylkowicy w sezonie pylenia z uwzglednieniem wplywu immunoterapii swoistej Czesc II: Zmiany cytologiczne i aktywnosc chemotaktyczna w wydzielinie z nosa.

The cytological changes and chemotactic activity in nasal lavage fluid were observed in 27 patients with pollen allergy. In one group of patients Pollinex was administered, but in the second--only placebo. Total cell count in nasal secretions was increased after pollen season. The significant increase of eosinophils and metachromatic cells was observed during the season in comparison with the time before and after it. No seasonal dynamic was documented in chemotactic activity of neutrophils in the nasal lavage fluid. Applied immunotherapy gave a some protection on evaluated parameters and observed symptoms.

Role of complement inhibition in topical therapy of muco-cutaneous herpes simplex virus infections.

A complement-inhibiting formulation with anti-inflammatory activity due to suppression of both the classical and alternative pathways of complement activation is presented for local treatment of muco-cutaneous lesions produced by Herpes simplex virus, types 1 and 2. The drug contains glutaraldehyde, a strong inhibitor of the complement system, dimethylsulphoxyde, used as a vector modifying the barrier properties of the skin and 1,2-propylene glycol, a delipidating agent which increases the adhesiveness of the watery solutions to the skin surface. It proved to be devoid of adverse effects for normal skin of animal and humans, and produced rapid disappearance of herpetic neuralgia and accelerates the remission of local symptoms. The mechanism of action seems to be associated with the inhibition of local anaphylatoxin release (C3a and C5a) which are responsible for the acute evolution of the lesions produced by viruses of the Zoster-Varicella group and with a quick lethal effect on the parasitized cells which are selectively eliminated without affecting the adjoining normal cells of the host.

Linear monitoring of patients sensitive to Olea and grass pollens treated with immunotherapy based on glutaraldehyde-modified (allergoid) extracts.

Extracts modified with glutaraldehyde (allergoid) have been offered to allergologists for immunotherapy in the last few years as supposedly clinically effective agents that diminish undesirable side-effects (allergenicity vs. immunogenicity). In order to acquire experience in the use of this therapeutic resource, we monitored a group of patients with pollinosis sensitive to Olea, grass pollens or both, who suffered from seasonal rhinoconjunctivitis (SRC) or rhinoconjunctivitis and seasonal asthma (RCSA) and were administered allergoid treatments standardized in biological units (HEP). The patients were monitored by determination of specific IgE and IgG4, endpoint prick tests and conjunctival provocation tests (CPT) with two types of antigen: Lolium perenne and Olea europaea. Measurements were made at baseline (T1), when the maximal tolerated dose had been given (T2) and 1 year after the treatment was started (T3). According to our results, this type of extract is tolerated quite well and causes no alterations in specific IgG4 or IgE levels. On the other hand, it features significantly decreased allergen-specific skin reactivity and increased response thresholds to the CPT (p < 0.01). A high correlation between skin and conjunctival provocation tests was observed at some stages (r = 0.79, p < 0.01).

Evaluation of the desensitizing effect of Gluma Dentin Bond on teeth prepared for complete-coverage restorations.

This clinical trial assessed the ability of Gluma Dentin Bond to inhibit dentinal sensitivity in teeth prepared to receive complete cast restorations. Twenty patients provided 76 teeth for the study. Following tooth preparation, dentinal surfaces were coated with either sterile water (control) or two 30-second applications of Gluma Dentin Bond (test) on either intact or removed smear layers. Patients were recalled after 14 days for a test of sensitivity of the prepared dentin to compressed air, osmotic stimulus (saturated CaCl2 solution), and tactile stimulation via a scratch test under controlled loads. A significantly lower number of teeth responded to the test stimuli for both Gluma groups when compared to the controls (P less than .01). No difference was noted between teeth with smear layers intact or removed prior to treatment with Gluma.