Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate Added to Milk, Chewing Gum, and Candy on Dental Caries: A Systematic Review.

Casein is one of the most studied proteins with activity against dental caries. In particular, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has shown promising remineralizing properties. In vivo evidence on the anticaries potential of CPP-ACP added to foodstuffs is elusive, nonetheless. Hence, this systematic review aimed at determining whether the use of CPP-ACP added to foodstuffs has a remineralizing or inhibitory action on dental demineralization either in vivo or in situ. The review protocol followed the PRISMA-P criteria and was registered in PROSPERO. PubMed, Scopus, and Web of Science databases were searched using predefined criteria, based on the PICO question: Is there an effect on dental caries upon adding CPP-ACP to milk, chewing gums, or candies? No year or language limits were applied. Article selection and data extraction were carried out independently by 2 investigators. Two hundred ten titles were examined, 23 were selected for full-text review, and 16 studies were included (2 in vivo and 14 in situ). CPP-ACP was added to candy in 2 studies, to milk in 2 studies, and to chewing gum in 12 studies. The main outcomes included enamel remineralization and activity against dental biofilm. The overall quality of the evidence was classified as moderate. The available evidence suggests that CPP-ACP added to milk, chewing gum, or candy has a potential remineralizing activity on tooth enamel, with some additional antibacterial activity on the dental biofilm. Further clinical studies are needed to verify if this effect is clinically significant in reducing the caries lesion incidence or to revert the demineralizing process.

Molecular signatures of extracellular vesicles in oral fluids of periodontitis patients.

OBJECTIVE: To characterize extracellular vesicles (EVs) in gingival crevicular fluid (GCF) and saliva samples from healthy/gingivitis and periodontitis patients and correlate them with clinical inflammatory periodontal parameters. MATERIAL AND METHOD: An exploratory study, including 86 subjects, was conducted. Clinical and periodontal data were recorded, and oral fluid samples were obtained. EVs were precipitated by ExoQuick-TC™ and characterized by nanoparticle tracking (NanoSight™), Western blot (WB), transmission electron microscopy (TEM), and ELISA analysis. RESULTS: TEM showed nanoparticles morphologically compatible with EVs, and WB analysis revealed bands of specific EV markers (CD9, TSG101, and Alix) in both oral fluids of periodontitis and healthy/gingivitis subjects. The total concentration of EVs in GCF was increased in periodontitis patients compared to healthy/gingivitis subjects (p = .017). However, we did not observe differences in the EV concentration of saliva samples (p = .190). The size of GCF-EVs was 144.2 nm in periodontitis and 160.35 nm in healthy/gingivitis patients (p = .038). The CD63 exosome marker was increased in GCF of periodontitis patients (p = .00001). The total concentration of EVs in GCF was correlated with bleeding on probing (rho = 0.63, p = .002), periodontal probing depth (rho = 0.56, p = .009), and clinical attachment level (rho = 0.48, p = .030). CONCLUSION: Periodontitis patients have an increased concentration of EVs in GCF, and their role in periodontitis should be clarified.

SOX10 regulates an alternative promoter at the Charcot-Marie-Tooth disease locus MTMR2.

Schwann cells are the myelinating glia of the peripheral nervous system and dysfunction of these cells causes motor and sensory peripheral neuropathy. The transcription factor SOX10 is critical for Schwann cell development and maintenance, and many SOX10 target genes encode proteins required for Schwann cell function. Loss-of-function mutations in the gene encoding myotubularin-related protein 2 (MTMR2) cause Charcot-Marie-Tooth disease type 4B1 (CMT4B1), a severe demyelinating peripheral neuropathy characterized by myelin outfoldings along peripheral nerves. Previous reports indicate that MTMR2 is ubiquitously expressed making it unclear how loss of this gene causes a Schwann cell-specific phenotype. To address this, we performed computational and functional analyses at MTMR2 to identify transcriptional regulatory elements important for Schwann cell expression. Through these efforts, we identified an alternative, SOX10-responsive promoter at MTMR2 that displays strong regulatory activity in immortalized rat Schwann (S16) cells. This promoter directs transcription of a previously unidentified MTMR2 transcript that is enriched in mouse Schwann cells compared to immortalized mouse motor neurons (MN-1), and is predicted to encode an N-terminally truncated protein isoform. The expression of the endogenous transcript is induced in a heterologous cell line by ectopically expressing SOX10, and is nearly ablated in Schwann cells by impairing SOX10 function. Intriguingly, overexpressing the two MTMR2 protein isoforms in HeLa cells revealed that both localize to nuclear puncta and the shorter isoform displays higher nuclear localization compared to the longer isoform. Combined, our data warrant further investigation of the truncated MTMR2 protein isoform in Schwann cells and in CMT4B1 pathogenesis.

Influence of Narrow Titanium Dental Implant Diameter on Fatigue Behavior: A Comparison between Unitary and Splinted Implants.

Background: Scientific literature lacks strong support for using narrow diameter implants (NDI) in high masticatory force areas, especially in molars. Implant splinting in cases of multiple missing teeth reduces lateral forces, improves force distribution, and minimizes stress on implants. However, no studies have evaluated the fatigue load resistance of unitary or splinted implants. Methods: This in vitro study compares five groups of new metal alloy implants, including unitary and splinted implants with varying diameters. Mechanical characterization was assessed using a BIONIX 370 testing machine (MTS, Minneapolis, MN, USA) according to ISO 14801. For each of the five study sample groups, (n = 5) specimens underwent monotonic uniaxial compression at break testing and (n = 15) cyclic loading to determine the maximum force (Fmax) and the fatigue life (LF) values. Scanning electron microscopy (SEM) was employed for the fractographic analysis of the fractured samples. Results: The Fmax values for unitary samples ranged from 196 N to 246 N, whereas the two-splinted samples displayed significantly higher values, ranging from 2439 N to 3796 N. Similarly, the LF values for unitary samples ranged from 118 N to 230 N, while the two-splinted samples exhibited notably higher values, ranging from 488 N to 759 N. Conclusions: The observed resistance difference between sample groups in terms of Fmax and LF may be due to variations in effective cross-sectional area, determined by implant diameter and number. Additionally, this disparity may indicate a potential stiffening effect resulting from the splinting process. These findings have significant implications for dental clinical practice, suggesting the potential use of splinted sets of small-sized NDI as replacements for posterior dentition (premolars and molars) in cases of alveolar bone ridge deficiencies.

An exploratory study of the effect of age and gender on face scanning during affect recognition in immersive virtual reality.

A person with impaired emotion recognition is not able to correctly identify facial expressions represented by other individuals. The aim of the present study is to assess eyes gaze and facial emotion recognition in a healthy population using dynamic avatars in immersive virtual reality (IVR). For the first time, the viewing of each area of interest of the face in IVR is studied by gender and age. This work in healthy people is conducted to assess the future usefulness of IVR in patients with deficits in the recognition of facial expressions. Seventy-four healthy volunteers participated in the study. The materials used were a laptop computer, a game controller, and a head-mounted display. Dynamic virtual faces randomly representing the six basic emotions plus neutral expression were used as stimuli. After the virtual human represented an emotion, a response panel was displayed with the seven possible options. Besides storing the hits and misses, the software program internally divided the faces into different areas of interest (AOIs) and recorded how long participants looked at each AOI. As regards the overall accuracy of the participants' responses, hits decreased from the youngest to the middle-aged and older adults. Also, all three groups spent the highest percentage of time looking at the eyes, but younger adults had the highest percentage. It is also noteworthy that attention to the face compared to the background decreased with age. Moreover, the hits between women and men were remarkably similar and, in fact, there were no statistically significant differences between them. In general, men paid more attention to the eyes than women, but women paid more attention to the forehead and mouth. In contrast to previous work, our study indicates that there are no differences between men and women in facial emotion recognition. Moreover, in line with previous work, the percentage of face viewing time for younger adults is higher than for older adults. However, contrary to earlier studies, older adults look more at the eyes than at the mouth.Consistent with other studies, the eyes are the AOI with the highest percentage of viewing time. For men the most viewed AOI is the eyes for all emotions in both hits and misses. Women look more at the eyes for all emotions, except for joy, fear, and anger on hits. On misses, they look more into the eyes for almost all emotions except surprise and fear.

Anterior maxillary and mandibular biotype: relationship between gingival thickness and width with respect to underlying bone thickness.

PURPOSE: : Periodontal biotype is considered to be a significant factor related to successful dental treatments. The purpose of this study was to determine the relationship between gingival thickness (GT) and width with respect to the underlying bone thickness in the maxillary and mandibular anterior sextant. MATERIALS AND METHODS: : Overall, 180 anterior teeth within healthy patients were assessed. GT and buccal bone thickness (BT) were measured at 3 locations: crestal/gingival margin, tooth apex, and a midpoint between the 2. In addition, the apicoincisal gingival width (GW) was recorded. Clinical and cone beam CT measurements were compared and correlated. RESULTS: : No statistically significant relations were observed between GT and BT measures at any of the 3 positions. The mean GT at crestal mid and apical position for the maxillary teeth was 1.01 (±0.58) mm, 1.06 (±0.48) mm, and 0.83 (±0.47) mm, respectively, and the corresponding mean BT was 1.24 (±0.90) mm, 0.81 (±0.33) mm, and 2.78 (±1.62) mm, respectively. The GW is directly related (R = 0.007; P < 0.05) to the crestal BT. CONCLUSION: : In this study, the GT is not linked to the BT. However, the GW seems to be associated with the crestal BT.

Can an ultrathin strut stent design and a polymer free, proendothelializing probucol matrix coating improve early strut healing? The FRIENDLY-OCT trial. An intra-patient randomized study with OCT, evaluating early strut coverage of a novel probucol coated polymer-free and ultra-thin strut sirolimus-eluting stent compared to a biodegradable polymer sirolimus-eluting stent.

BACKGROUND: incomplete strut coverage determines the risk of stent thrombosis in the first months after stent implantation. AIMS: To evaluate the potential better early healing of a novel probucol coated polymer free ultra-thin strut sirolimus eluting stent (PF-SES). [Clinical trial unique identifier: NCT02785237]. METHODS: Patients with two (angiographically similar) lesions with clinical indication for PCI were enrolled. The investigated stent was compared to a thin strut, bioresorbable polymer, sirolimus eluting stent (BP-SES). Every patient received both stents, one in each lesion, assigned in a randomized sequence. OCT was systematically performed at 3 months. Primary end point was the difference in the proportion of covered struts at 3 months (defined as ≥20 µm of tissue coverage). Secondary end points included differences in percentage of uncovered struts (0 µm coverage), mean strut coverage thickness, and malapposed struts' coverage proportion. Major adverse cardiac events (cardiac death, myocardial infarction, target lesion revascularization, and definite or probable stent thrombosis) at 12 months were also evaluated. RESULTS: 70 patients were included. At 3 months, a consistent and significantly higher strut coverage rate (≥20 µm) was observed in PF-SES as compared to BP-SES, both for well apposed (87.3% versus 79.1%, p < 0.001) and malapposed struts (50.4% vs 37.8%, p 0.00). Uncoverage rate (0 µm) was also significantly lower for the PF-SES (3.1% vs 5.3%, p < 0.001). There were no differences in clinical endpoints. CONCLUSION: The probucol coated non-polymeric ultra-thin strut sirolimus eluting stent showed a significantly better early strut coverage at 3 months.

Saliva levels of Abeta1-42 as potential biomarker of Alzheimer's disease: a pilot study.

BACKGROUND: Simple, non-invasive tests for early detection of degenerative dementia by use of biomarkers are urgently required. However, up to the present, no validated extracerebral diagnostic markers for the early diagnosis of Alzheimer disease (AD) are available. The clinical diagnosis of probable AD is made with around 90% accuracy using modern clinical, neuropsychological and imaging methods. A biochemical marker that would support the clinical diagnosis and distinguish AD from other causes of dementia would therefore be of great value as a screening test. A total of 126 samples were obtained from subjects with AD, and age-sex-matched controls. Additionally, 51 Parkinson's disease (PD) patients were used as an example of another neurodegenerative disorder. We analyzed saliva and plasma levels of ß amyloid (Aß) using a highly sensitive ELISA kit. RESULTS: We found a small but statistically significant increase in saliva Aß42 levels in mild AD patients. In addition, there were not differences in saliva concentration of Aß42 between patients with PD and healthy controls. Saliva Aß40 expression was unchanged within all the studied sample. The association between saliva Aß42 levels and AD was independent of established risk factors, including age or Apo E, but was dependent on sex and functional capacity. CONCLUSIONS: We suggest that saliva Aß42 levels could be considered a potential peripheral marker of AD and help discrimination from other types of neurodegenerative disorders. We propose a new and promising biomarker for early AD.

Enhanced CXCL1 production and angiogenesis in adenosine-mediated lung disease.

Angiogenesis is a feature of chronic lung diseases such as asthma and pulmonary fibrosis; however, the pathways controlling pathological angiogenesis during lung disease are not completely understood. Adenosine is a signaling molecule that has been implicated in the exacerbation of chronic lung disease and in the regulation of angiogenesis; however, the relationship between these factors has not been investigated. The current study utilized adenosine deaminase (ADA)-deficient mice to determine whether chronic elevations in adenosine in vivo result in pulmonary angiogenesis. Results demonstrate substantial angiogenesis in the tracheas of ADA-deficient mice in association with adenosine elevations. ADA replacement enzyme therapy resulted in a lowering of adenosine levels and reversal of tracheal angiogenesis, indicating that the increases in vessel number are dependent on adenosine elevations. Levels of the angiogenic chemokine CXCL1 (mouse functional homologue of human IL-8) were found to be elevated in an adenosine-dependent manner in the lungs of ADA-deficient mice. Neutralization of CXCL1 and its receptor, CXCR2, resulted in the inhibition of angiogenic activity, which suggests that CXCL1 signaling through the CXCR2 receptor mediated the observed increases in angiogenesis. Our findings suggest that adenosine plays an important role, via CXCL1, in the induction of pulmonary angiogenesis.

Severe immune thrombocytopaenia in a patient taking benznidazole for chronic Chagas disease.

Chagas disease is a parasitic disease that mostly affects Latin American countries, but it has currently become a worldwide epidemic due to migration. Both drugs marketed for its treatment (benznidazole and nifurtimox) are associated with a high rate of adverse reactions. Benznidazole is preferred initially because of its more favourable toxicity profile and perceived greater efficacy. Hypersensitivity dermatological reactions, gastrointestinal and neurological disturbances represent the most common drug-related adverse events. General symptoms such as fever, arthralgia, myalgia or bone marrow depression (leucopaenia) are seen less frequently. We describe the case of a 33-year-old woman with chronic Chagas disease who presented with acute gingival bleeding and severe thrombocytopaenia, probably related to benznidazole treatment. Temporal association with drug initiation and recovery after treatment withdrawal were demonstrated. Clinicians should be aware of the possible association between immune thrombocytopaenia and benznidazole, even though the pathogenesis remains unclear at present.

Efficacy of Adjunctive Er, Cr:YSGG Laser Application Following Scaling and Root Planing in Periodontally Diseased Patients.

The application of laser as a monotherapy has been shown to reduce probing pocket depths and increase clinical attachment levels after treatment of patients suffering from chronic periodontitis. Its controversial use as an adjunct to scaling and root planing (SRP) is discussed. The present study aimed to evaluate the efficacy of adjunctive Er, Cr:YSGG laser application following conventional SRP. A total of 30 patients with chronic periodontitis were enrolled in the study. The quadrants of each patient were allocated to either SRP or SRP + laser. A total of 3,654 sites with pocket depths ≥ 4 mm were treated and evaluated at 6 weeks and 6 months postoperatively with respect to attachment gain. Both therapies resulted in improved probing pocket depths and clinical attachment levels. The adjunctive application of Er, Cr:YSGG laser following SRP did not improve probing pocket depth or attachment level compared with SRP alone.

Prevalencia y factores pronósticos de caries dental en la población de 15 a 19 años / Prevalence and prognostic factors of dental caries in population aged 15 to 19

Introducción: las edades entre 15 y 19 años es una etapa en la que se pueden consolidar actitudes y comportamientos saludables como los de prevención de la caries dental. Objetivos: identificar la prevalencia de caries dental y los factores pronósticos que conducen a la enfermedad en los adolescentes de 15 a 19 años de los consultorios 8 y 25 del Área de Salud Julián Grimau en el año 2012. Método: se realizó una investigación descriptiva. El universo fue de 120 adolescentes, residentes en el área que atienden los consultorios. Se exploraron variables de estado de salud bucal, características socioeconómicas, prácticas nocivas a la salud, y daños a la salud. La información se resumió en frecuencias absolutas y por cientos. Se aplicó la prueba estadística de independencia para identificar la asociación entre la presencia de caries dental y las variables estudiadas con un nivel de significación de 0,05. Para la identificación de los factores pronósticos, la muestra se dividió en dos grupos, los casos fueron los adolescentes con caries y los controles, los que no la tenían; se utilizó la regresión logística paso a paso y mediante el estadígrafo de Wald con una significación de 0,05 se agregaron las variables al modelo. Resultados: la caries dental estuvo presente en la tercera parte de los adolescentes. Los afectados presentaron más frecuentemente historia anterior de caries, placa dentobacteriana, uso de aparatos de ortodoncia, enfermedad periodontal, incorrecta calidad del cepillado, consumo de alimentos cariogénicos, condiciones inadecuadas de la vivienda; la ocupación de los adolescentes y de los padres respondía a menos remuneración. Los factores pronósticos de caries fueron: la historia anterior de caries dental, la enfermedad gingival, el consumo de alimentos cariogénicos, el apiñamiento y la ocupación de la madre. Conclusiones: la presencia de caries estuvo relacionada con prácticas nocivas a la salud y aspectos socioeconómicos y clínicos que a su vez son factores pronósticos para la aparición de una nueva afección dentaria de este tipo(AU)

Introduction: ages between 15 and 19 years is a stage in which attitudes and healthy behaviors such as the prevention of dental caries can be consolidated. Objectives: identify the prevalence of dental caries and the prognostic factors leading to disease in adolescents aged 15 to 19 assisted at medical practices 8 and 25 in Julian Grimau Health Area during 2012. Method: a descriptive research was conducted. The universe was 120 adolescents, residing in the health areas of these two medical practices. Variables were explored such as oral health status, socio-economic characteristics, harmful health practices, and health damage. Data is summarized in absolute frequencies and percentages. Statistical independence test was applied to identify the association between the presence of dental caries and these variables with a significance level of 0.05. For identifying of prognostic factors, the sample was divided into two groups: cases (teenagers with cavities) and controls (those who did not have). The stepwise logistic regression was used and variables to the model were added through Wald statistic with 0.05 significance. Results: the third of adolescents had caries. Those affected presented more frequently previous history of caries, presence of plaque, use of braces, periodontal disease, improper brushing, cariogenic food consumption, inadequate housing conditions and the occupation of adolescents and their parents responded to low income salary. The caries prognostic factors were previous history of caries, the presence of gum disease, cariogenic foods, crowding and their mother´s occupation. Conclusions: the presence of caries was associated with harmful health practices and socio-economic and clinical aspects, which in turn forecasts the emergence of a new dental condition of such factors(AU)

Evaluación de la transportación y ensanchamiento "in vitro" del sistema Pro-taper / In vitro evaluation of the transportation and enlargement of the Pro-taper system

Considerando la llegada de nuevos sistemas rotatorios de instrumentación de níquel-titanio en endodoncia que prometen mejoras significativas, se propone un análisis de la eficacia del sistema Pro-taper en cuanto a la posibilidad de transportación y capacidad de ensanchamiento. El presente estudio comparó la técnica a tres diferentes tiempos de permenencia en el tercio apical (1, 2 y 3 segundos), equiparándola con la de fuerzas balanceadas. En cuanto al cambio en el radio de la curvatura y el ensanchamiento por tercios antes y después de la instrumentación, se toman los resultados en dos vistas. lateral y frontal (tridimensionalidad). El análisis final demuestra que Pro-taper permite instrumentar el conducto sin modificar sustancialmente la curvatura; como se demuestra en el análisis de varianza, con un rango de confianza de >0.025. Respecto al ensanchamiento del tercio apical, los resultados prueban que el tiempo de permanencia afecta significativamente la amplitud promedio del conducto, el menor se logra con Pro-taper a 1 seg. El comportamiento sigue el mismo patrón en ambas vistas, lo que señala la capacidad de corte tridimensional uniforme en ambas técnicas. Los otros dos tercios (cervical y medio) no presentan cambios a dos y tres segundos, pero reflejaron menor ensanchamiento que el control.

Hernioplastía inguinal: estudio comparativo de diferentes técnicas quirúrgicas / Inguinal herniplasty: comparative study of different surgical techniques

El presente trabajo tiene como objetivo conocer la experiencia del Hospital San Juan de Dios en relación a las diferentes técnicas quirúrgicas utilizadas en la reparación de la hernia inguinal, evaluando sus complicaciones y ventajas. Se realizó un estudio descriptivo entre técnicas clásicas abiertas, técnica libre de tensión utilizando prótesis de polipropileno (Lichtenstein) y técnica laparoscópica transabdominal pre-peritoneal (TAPP). Se intervinieron 208 hernias en 170 pacientes (38 bilaterales) de las cuales 104 corresponden a técnicas abiertas clásicas (Bassini, Mc Vay y Shouldice), 73 a técnicas de Lichtenstein y 31 a técnica laparoscópica TAPP. Se operaron indistintamente pacientes primarios y recidivas. Se evaluaron resultados de acuerdo a dolor postoperatorio, utilizando escala de categoría numérica (0 a 10), tipo de anestesia, alta quirúrgica, reintegro laboral y complicaciones de cada una de las diferentes técnicas