Streptococcus dentisani inhibits the growth of Candida albicans and Candida glabrata: in vitro assay.

BACKGROUND: Probiotic bacteria inhibit aggregation, biofilm formation, and dimorphism of Candida spp. However, the effects of a new probiotic, Streptococcus dentisani, on the growth of Candida albicans and Candida glabrata biofilms are unknown. OBJECTIVE: To determine the effect of S. dentisani on the different phases of C. albicans and C. glabrata biofilm development. METHODS: Growth quantification and ultrastructural analyses were performed on biofilms of C. albicans ATCC 90028, C. glabrata ATCC 2001, and clinical isolates of C. albicans from oral candidiasis (CA-C1), caries (CA-CR1), and periodontal pocket (CA-P1) treated with cell suspensions of S. dentisani CECT 7746. Cell viability was determined by quantifying colony-forming units (CFU/mL). The ultrastructural analyses were done with atomic force microscopy. RESULTS: S. dentisani induced a significant reduction (p < 0.05) of CFU/mL of immature and mature biofilm in all strains of C. albicans and C. glabrata. Microscopic analysis revealed that S. dentisani reduced C. albicans density in mixed biofilm. The fungus-bacteria interaction affected cell membrane integrity in yeast. CONCLUSION: For the first time, our data elucidate the antifungal effect of S. dentisani on the development of C. albicans and C. glabrata biofilms, supporting its usefulness as a niche-specific probiotic to prevent and treat oral dysbiosis.

The efficacy of hypnosis compared with the tell/show/do technique for the reduction of anxiety/pain in children undergoing pulpotomies: a randomized controlled trial.

Anxiety/pain is a combined experience that can hinder dental treatment in children and lead to the development of negative behaviours in any form of surgical treatment. Hypnosis is a suitable option with which to reduce anxiety and pain during dental treatment. In this study, we aimed to evaluate the efficacy of hypnosis compared to the tell/show/do technique for the reduction of anxiety and pain as measured by Face, Legs, Activity, Crying, Consolability (FLACC) scale in children undergoing pulpotomies. We performed a randomized and controlled clinical trial involving 60 children aged 5 to 7 years without previous dental experiences but with clinical and radiographic indications for pulpotomy in the primary mandibular right or left first or second molar. The children were divided into two groups: a control group (treated by conventional behaviour management techniques) and an experimental group (treated by hypnosis). The FLACC scale was used to evaluate anxiety/pain during preoperative, transoperative and postoperative pulpotomy treatment; we also analysed variations in heart rate and skin conductance. The trial was registered at ClinicalTrials.gov (NCT03739346). Statistical analysis was performed in R Studio version 1.2.1335. The FLACC scale was significantly lower in the experimental group (p = 0.022) throughout the entire treatment duration. In addition, heart rate and global skin conductance were both significantly lower in the experimental group when measured at different times (p = 0.005 and p = 0.032, respectively). When compared to conventional behavioural management techniques, the FLACC scale demonstrated that hypnosis was associated with significant reductions in heart rate, skin conductance and anxiety/pain throughout the entire duration of treatment. decreases anxiety/pain during the entire operative procedure. There was clear improvements in anxiety and pain control in patients receiving hypnotic therapy.

Increased IL-12p70 and IL-8 Produced by Monocytes in Response to Streptococcus spp. and Actinomyces spp. Causals of Endodontic Primary Infections.

We sought to evaluate the effect of endodontic-causative microorganisms of primary infections on mononuclear cells such as CD14+, CD4+, CD8+, CD19+ and Tregs Foxp3+. Facultative anaerobic microorganisms were isolated from radicular conducts and peripheral blood samples, which were taken from patients with primary infections. Cellular cultures were performed with peripheral blood mononuclear cells (PBMC) with and without Actinomyces spp. and Streptococcus spp. during 48, 72, and 96 h of contact in culture (concentration 5 × 105 cells/well) in a round plate bound with 48 wells. Later, PBMC was collected for analysis by flow cytometry, with the monoclonal antibodies αCD14, αCD4, αCD8, αCD19 and αFoxp3, and acquired using an FACSCanto II cytometer. The supernatant of cellular cultures was analyzed for the quantification of inflammatory cytokines. Data analysis was performed in FlowJo v10.8.2 and FCAPArray software, and statistical analysis was performed using GraphPad v5.0. software. We observed an increase in the percentage of CD14+ cells in patients at different hours of cellular culture in the presence of both Actinomyces spp. and Streptococcus spp. microorganisms, compared to healthy controls. This study demonstrates the role played by the innate immune system in the pathogeny of endodontic primary infections, explaining the effects that generate the more common microorganisms in this oral pathology.

2 × 4 appliance in the mixed dentition stage: a scoping review of the evidence.

A great emphasis is currently given to the early correction of malocclusions to prevent further complications if left untreated. Interceptive orthodontics not only simplifies but also eliminates the need for later procedures. The 2 × 4 appliance is an orthodontic treatment modality applied during the mixed dentition period, particularly for malpositioned permanent upper incisors. This scoping review was aimed to examine the breadth and depth of the published literature on this clinical topic, as well as knowledge gaps, about this fixed appliance during mixed dentition, for the correction of incipient anterior malocclusions (incisor crowdings, midline diastemas, or crossbites). PubMed, Cochrane Library, Google Scholar, Dentistry & Oral Sciences Source, and two grey literature databases were explored; under a structured PICO question (Patient, Intervention, Comparison, Outcome) and eligibility criteria, for relevant clinical trials, observational studies, and case reports/series (in English or Spanish), using different searching terms. Titles and abstracts were screened. Full-text articles were critically reviewed for bias risk and a data charting table was constructed. 161 references were identified, after which 115 titles remained after removing duplicates. After the abstract screening, 18 potential full-text articles were reviewed. Finally, 16 studies were included, according to the performed critical appraisal. The 2 × 4 appliance is suitable for mixed dentition patients with mild or severe malocclusions, particularly when removable appliance usage is a critical problem.

Clinical interventions for caries management through minimal intervention procedures in young children: an updated evidence-based review.

This review aimed to summarize the preventive, non-restorative and restorative minimal intervention dentistry (MID) interventions for managing dental caries during the primary dentition stage, after selecting the highest quality evidence. A comprehensive literature search for relevant studies was performed in PubMed (MEDLINE), Embase, Cochrane Library and Google Scholar, published between 2007 and 2022. Only clinical randomized controlled trials, clinical guidelines with literature review, systematic reviews and meta-analyses conducted in the primary dentition were included. One hundred fifty-three MID-associated references were found, and 63 of them were considered for the present review. Of these, 24 were clinical randomized controlled trials, 21 were systematic reviews, 3 umbrella reviews and 11 practice guidelines with a literature review. The retrieved evidence was divided into (and discussed) three general caries management strategies: (i) carious lesion diagnosis and individual risk assessment; (ii) preventive measurements and non-cavitated lesions management; and (iii) cavitated lesions management. MID is an attractive alternative management that promotes prevention rather than intervention to achieve a long-lasting oral health in young children through easy and cost-benefit preventive, non-invasive, minimally invasive or conservative invasive restorative measures. This philosophy of management is suitable for treating young children, considered friendlier and less anxiety-provoking than traditional methods.

Effect of 4-Allyl-1-hydroxy-2-methoxybenzene (eugenol) in the expression of genes involved in cellular cycle and apoptotic process in dental pulp fibroblasts.

OBJECTIVE: This study sought to evaluate the effect of eugenol on the cell morphology and expression of genes involved in the apoptotic process in human dental pulp fibroblasts (hDPFs) from deciduous teeth. MATERIALS AND METHODS: hDPFs were cultured with 4 concentrations of eugenol (0.06 nM, 0.6 nM, 6 nM, 12 nM) and compared with a control group. After a 72 h incubation period, the cytotoxic effect on cell morphology by optical microscopy and gene expression by RT-PCR were evaluated. RESULTS: At 0.06 nM and 0.6 nM eugenol concentrations, vacuolisation of the cytoplasm was observed with atypical granulation of the hDPFs, and, at 6 nM and 12 nM cytoplasmic extensions disappeared almost completely. Casp-3, Casp-9, and telomerase genes were not expressed at the concentrations evaluated nor in the control group. The relative expression responses of Bcl-2 and TGF-ß genes were overexpressed at the 4 concentrations. MAKP's 0.06 nM (p < .001), 0.6 nM (p < .05) and 12 nM (p < .05) and Cyclin 1 at 12 nM showed significant difference versus the control group (p < .05). CONCLUSION: Eugenol is capable of causing morphological changes in hDPFs in a dose-dependent manner, higher concentrations may promote overexpression of apoptotic genes.

Effect of tricalcium silicate cements in gene expression of COL1A1, MAPK's, and NF-kB, and cell adhesion in primary teeth' pulp fibroblasts.

Tricalcium silicate cements (TSCs) regulate gene expression and cell responses from dental tissues surrounding the repair site. The study aimed to evaluate the gene expression levels of Collagen Type I Alpha 1 Chain (COL1A1), Mitogen-Activated Protein Kinases (MAPK's), Nuclear Factor-Kappa B (NF-κB), cell adhesion, and morphology of human dental pulp fibroblasts (hDPFs) from primary teeth treated with eluates obtained from Mineral Trioxide Aggregate (MTA) and Biodentine. hDPFs were treated with eluates from Biodentine and MTA (2.5 mg/mL in culture medium). The control group was a culture without the eluates. Gene expressions of COL1A1, MAPK's, and NF-κB were evaluated using Polymerase Chain Reaction (PCR) and cell adhesion by immunocytochemistry for Vinculin and Integrin ß1 expression. Gene expression of MAPK's and NF-κB in hDPFs with the eluates from MTA and Biodentine showed no significant difference versus the control group (p > 0.05), but COL1A1 exhibited a significant difference (p < 0.05). The expression of COL1A1, MAPK's, and NF-κB was lower in cultures with MTA and Biodentine eluates regarding the control group, with no significant difference between MTA and Biodentine (p > 0.05). After 72 h of incubation, the hDPFs cultured with MTA and Biodentine eluates showed an elongated morphology; after 7 d, a loss or/and reduction of the cytoplasmic processes, and smaller nuclei were observed. Vinculin and Integrin ß1 were expressed in hDPFs treated with MTA and Biodentine eluates. MTA and Biodentine did not inhibit or generate a significant difference in the expression levels of COL1A1, MAPK's, and NF-κB in hDPFs.

Assessment of Pediatricians' Knowledge, Practices, and Attitudes on Oral Health/Care in Children in the Last Decade: A Systematic Scoping Review and Critical Reflection.

Pediatricians are primary health care professionals who supervise the growth and development and treat infants and children during the first years of life. Thus, they should possess knowledge regarding oral health care, to provide anticipatory guidance, as well as dental education to parents in order to make appropriate clinical decisions. For many years, several surveys have been performed worldwide to assess the pediatricians' knowledge, awareness, and experience regarding oral health care and prevention. This work aimed to scope the existing literature and summarize the most relevant evidence about knowledge, practices, and attitudes on oral health/care among pediatricians worldwide. PubMed, Cochrane Library, Google Scholar, and Dentistry & Oral Sciences Source were explored. Under a structured PCC question and eligibility criteria, for relevant clinical trials and observational studies, published during the last decade. Titles and abstracts were screened. Full-text articles were critically reviewed for bias risk and a data charting table was constructed. A total of 44 references were initially identified, and 37 titles remained for abstract screening after removing duplicates; then, 27 potential full-text articles were carefully reviewed. Finally, 25 relevant and most informative studies were included. The selected studies were conducted in India, Lebanon, Saudi Arabia, and Paraguay, Europe, Australia, Qatar, Iran, Turkey, United Arab Emirates, Nigeria, Brazil, Chile, Germany, Taiwan, Canada, and the USA. Through included surveys, researchers have reported different levels of knowledge, practice involvement, and attitude on children's oral health among pediatricians. In general, unsatisfactory knowledge of oral health was reported. The main impediments for a better professional involvement or practice include inappropriate education, poor auto-confidence, and lack of time. So, it has been suggested that some oral health training or clinical guidelines should be included in the current medical curricula.

Synthesis of a PVA drug delivery system for controlled release of a Tramadol-Dexketoprofen combination.

The local administration of analgesic combinations by means of degradable polymeric drug delivery systems is an alternative for the management of postoperative pain. We formulated a Tramadol-Dexketoprofen combination (TDC) loaded in poly(vinyl alcohol) (PVA) film. Films were prepared by the solvent casting method using three different molecular weights of PVA and crosslinking those films with citric acid, with the objective of controlling the drug release rate, which was evaluated by UV-vis spectrometry. Non-crosslinked PVA films were also evaluated in the experiments. Differential scanning calorimetry (DSC) analysis of samples corroborated the crosslinking of PVA by the citric acid. Blank and loaded PVA films were tested in vitro for its impact on blood coagulation prothrombin time (PT) and partial thromboplastin time (PTT). The swelling capacity was also evaluated. Crosslinked PVA films of higher-molecular weight showed a prolonged release rate compared with that of the lower-molecular-weight films tested. Non-crosslinked PVA films released 11-14% of TDC. Crosslinked PVA films released 80% of the TDC loaded (p < 0.05). This suggests that crosslinking films can modify the drug release rate. The blank and loaded PVA films induced PT and PTT in the normal range. The results showed that the polymeric films evaluated here have the appropriate properties to allow films to be placed directly on surgical wounds and have the capacity for controlled drug release to promote local analgesia for the control of postoperative pain.

Root canal microorganisms and their antibiotic susceptibility in patients with persistent endodontic infections, with and without clinical symptoms.

Secondary/persistent infections are present in teeth with previous root canal treatment, and a great variety of anaerobic microorganisms has been observed in these infections. The antibiotics prescription is occasional; however, in some cases, it is essential, particularly when the general health condition of the patient is compromised. The aims of this study were to identify the associated microorganisms in diagnosis of persistent or secondary apical periodontitis and to evaluate the susceptibility level to the antibiotics most used. Fifteen patients with persistent or secondary apical periodontitis requiring endodontic re-treatment were included. Microbiological samples were taken from the root canals and incubated in thioglycollate under anaerobic conditions. Anaerobic CDC agar (formulated by the Center for Disease Control and Prevention) was employed as a culture medium and the microorganisms were identified using the API system. The microorganisms were subjected to antibiograms with three different antibiotics. Twenty-six microorganisms were identified, the most common genus was Enterococcus (26.8%), Streptococcus (19.22%), Aerococcus (19.1%), and Clostridium (11.4%). 48% of them were susceptible to amoxicillin, with 28% of resistance. For clavulanic acid/amoxicillin, the susceptibility occurred in 32%, with 28% of resistance; and for clindamycin, the susceptibility was present in 40%, with 52% of resistance. The most frequently detected associated microorganism for secondary infections was genus Enterococcus, which exhibited high resistance to the studied antibiotics.

Calcium hydroxide/iodoform nanoparticles as an intracanal filling medication: synthesis, characterization, and in vitro study using a bovine primary tooth model.

The aims of this in vitro study were to synthesize, characterize, and evaluate the efficacy of a Calcium Hydroxide/Iodoform nanoparticles (CHIN) paste compared with Ultrapex as intracanal filling medication using an experimental model of bovine primary teeth. CH nanoparticle synthesis was performed via the simple hydrolysis technique of reacting calcium nitrate with sodium hydroxide. SEM-EDS and FT-IR analyses were used to characterize the obtained product. 30% of CH nanoparticles were combined with 40% of iodoform and 30% silicone oil to prepare an intracanal filling paste (CHIN). All endodontic procedures were performed on 34 uniradicular primary bovine teeth. Every root canal was instrumented with K files (up to #35) and obturated with the nanoparticle paste (experimental) or Ultrapex® (control). Three outcome variables were studied: penetration depth through the root dentinal tubules, Ca2+ ion release, and filling paste dissolution rate. The obtained data were analyzed by Student's t test. The X-ray diffraction pattern of CH nanoparticles showed characteristic peaks at CH, as confirmed by FT-IR analyses in which an intense signal was observed at 3643 cm-1, characteristic of CH. In the morphological characterization, CH particles could be detected at the nanosize scale. When applied as intracanal filling, the CHIN paste exhibited a higher level of penetration through the root dentin tubules. The global mean penetration measures were 500 µm for the experimental paste and 380 µm for the control paste (p < 0.05). The release of Ca2+ ions (up to the seventh day) and the dissolution rate were significantly higher in the experimental paste group than in the control group. No significant differences were observed between the groups regarding pH levels. The findings of this study suggest the potential suitability of CHI nanoparticles as an alternative intracanal filling medication for infected or devitalized primary teeth.

Lesion Sterilization Tissue Repair (LSTR) Approach Of Non-Vital Primary Molars With A Chloramphenicol-Tetracycline-ZOE Antibiotic Paste: A Scoping Review.

The study aimed to perform a systematic scoping review with the need of exploring the actual clinical applications of the chloramphenicol-tetracycline-ZOE antibiotic paste (CTZ) as a lesion sterilization tissue repair (LSTR) therapy agent. Following a scoping framework suggested by Arksey and O'Malley, relevant articles (randomized controlled trials, literature reviews, observational studies, in vitro studies, and clinical case-series reports) published over the last 15 years (in English, Spanish, or Portuguese languages) were identified and retrieved from five internet databases: PubMed, Embase/Ovid, Cochrane Library, Google Scholar, and EBSCO. By title and abstract screening and after removing duplicates, 11 articles were finally included in the present scoping review: five randomized/non-randomized clinical trials, five in vitro studies, and one case-series report. According to the collected information, there were no differences between CTZ paste and conventional pulpectomy, antibiotic pastes, and intracanal filling materials, considering the clinical, radiographic, antimicrobial activity, and periapical tissue biocompatibility outcomes. CTZ has shown excellent rates of clinical success and good radiographic results, with adequate antimicrobial effects; however, its biocompatibility has been put into doubt. Contemporary pediatric dentists should carefully consider the CTZ paste as an alternative endodontic approach for pulpally involved primary molars, with the advantages of being simple and fast, and taking into account the limitations of instrumental pulpectomy such as the microbiological and morphological complexity of primary root canals.

Synergistic interaction between 4-allyl-1-hydroxy-2-methoxybenzene (eugenol) and diclofenac: An isobolograpic analysis in Wistar rats.

Clinical and preclinical research that contributes pain palliation has suggested that drugs favor the expected effects and minimize the adverse effects. Among the most widely used strategies is the combination of analgesic drugs among those in the same group, with those in another group of analgesics or with co-adjuvants (nonanalgesic drugs or elements of traditional medicine). This work aims to evaluate the interaction between eugenol (EUG) and diclofenac (DFC) on nociception in the presence of a noxious stimulus through the formalin test and isobolographic analysis. The results indicate that EUG, DFC, or the combination of both produce an antinociceptive effect in rodents (p ≤ 0.05). Local co-administration of EUG and DFC gave a theoretical effective dose (Zadd ) 2,936.27 ± 155.33 µg/kg (p ≤ 0.05) significantly higher as compared to the effective experimental doses (Zmix ) of 866.89 ± 0.02 µg/kg in phase 1 and 292.88 ± 0.05 µg/kg in phase 2, with an interaction index of 0.29 and 0.09, respectively. These data allow concluding that the interaction derived from the joint administration of EUG and DFC, in the rodent at a local level, is synergistic.

Glass coatings to enhance the interfacial bond strength between veneering ceramic and zirconia.

The purpose of this study was to investigate the tensile bond strength (TBS) and shear bond strength (SBS) between a zirconia core and fluoroapatite-pressed ceramic after the application of glass 46SP6 and AP40 via the ISO-17095:2013 methodology. Sintered zirconia beams (n = 120) were divided into four groups: (a) control: no treatment; (b) ZirL: IPS-E max ceram ZirLiner coating; (c) glass AP40 coating; and (d) glass 46SP6 coating. A fluoroapatite ceramic (IPS e.max Zir Press, Ivoclar Vivadent) beam was injected perpendicularly on top of each zirconia (Zenostar, Wieland Dental) beam forming a cross-bonded specimen. All groups were sub-divided into two for tensile and shear bond strength tests using a universal testing machine. Data were analyzed using the Kruskal-Wallis, Pearson Chi2, and Mann-Whitney U test (α = 0.05). The failure modes were measured using a stereomicroscope for each group. Scanning electron and atomic force microscopy were also employed. Zirconia surface modification with glass AP40 showed higher TBS values followed by the ZirL group with statistical differences (p < 0.05). SBS values showed no statistical differences between the groups. AFM analysis showed higher roughness values (Ra) in the 46SP6 and AP40 groups (p < 0.05). Glass coating AP40 exhibited promising bond strength results between zirconia and fluorapatite veneering ceramic, making it better for chemical and mechanical interlocking which may improve bilayered restorations longevity.

Outcomes of direct pulp capping in vital primary teeth with cariously and non-cariously exposed pulp: A systematic review.

OBJECTIVE: To summarize the clinical/radiographic outcomes from the evidence of studies published since 1988 on different DPC agents applied on vital pulp-exposed primary teeth. METHODS: The following electronic databases were searched: PubMed, Embase, Cochrane Library, Dentistry and Oral Science Source, and Google Scholar. Inclusion criteria were randomized controlled trials (RCTs) published between January 1988 and December 2019, with at least 6 months of follow-up, comparing the clinical and radiographic success rates of two or more DPC agents applied in primary teeth with cariously and non-cariously exposed pulp. RESULTS: Initial searches identified 83 potentially relevant studies on DPC in primary teeth. Sixty-four of these studies were excluded, whereas 19 articles satisfied the inclusion criteria and were retrieved in full text for data extraction and a methodological quality assessment. Finally, 12 of these articles were included in the systematic review. Low and moderate risks of bias were observed. Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. CONCLUSIONS: For DPC in primary teeth, this systematic review found that diverse new biologically and compatible agents with promising success rates are currently available for paediatric dentistry practitioners. There is no evidence that justifies discarding the judicious use of DPC procedures in primary teeth.

Pain and Anxiety Levels Using Conventional versus Computer-Controlled Local Anesthetic Systems in Pediatric Patients: A Meta-Analysis.

The objective of this systematic review and meta-analysis was to compare the pain/anxiety levels associated with the anesthetic process by conventional and computer-controlled delivery systems (CCDS) in children. Four electronic databases (PubMed, EMBASE, Scopus, Google Scholar, and Dentistry & Oral Science Source/EBSCO) were comprehensively explored for eligible studies, in English or Spanish, published from January 1995 to December 2019. A systematic literature review and meta-analysis were conducted according to the PRISMA statement, including only randomized controlled clinical trials. An exhaustive search was performed in different electronic databases under a specific PICO-posed question. Relevant studies were selected based on titles and abstracts, and the full texts were retrieved. From these articles, important information was extracted. Wand demonstrated significantly lower pain than the conventional injection did. In the subgroup by pain scale analysis, the Facial Image Scale and Wong-Baker Faces Pain Scale showed a significant difference in favor of the CCDS. In general, the reviewed evidence shows that less perceived pain and anxiety occur when the local anesthetic technique is performed with a CCDS than with the traditional technique.

Effect of Five Commercial Probiotic Formulations on Candida Albicans Growth: In Vitro Study.

PURPOSE: The objective was to evaluate the antagonistic effect of Lactobacillus and Bifidobacterium recovered from five commercial probiotics on the growth of C. albicans. STUDY DESIGN: The Lactobacillus and Bifidobacterium strains of five commercial probiotics were recovered and grown: Probio Hp+®, ProBiseis®, Lactipan®, Liolactil®, and Lacteol Fort®; 50 mg of each was hydrated and grown in Lactobacilli MRS (De Man, Rogosa and Sharpe) broth and incubated at 37°C with stirring (120 RPM) for 24 hours. Serial dilutions of 10-1 to 10-7 were made and viability was verified and quantified. For the antagonism tests, a suspension/inoculum of Lactobacillus strains recovered from each commercial preparation (4-30 × 109) and C. albicans ATCC 90028 (1.5-8 × 108) was prepared in MRS broth and incubated for 48 hours at 36°C, then plated on Dextrose Sabouraud Agar with Chloramphenicol and Rogosa Agar and the colony-forming units (CFU) were quantified. Additionally, viability was evaluated using the LIVE/DEAD® Yeast and Bacterial Viability kit. RESULTS: The probiotic that produced the highest acidity of the medium was Lactipan®, followed by Probiseis® and Liolactil®, while Probio Hp+® showed the least change. Probiseis® was determined to have the highest growth of probiotic bacteria and the highest inhibition on C. albicans, followed by Lactipan®; Liolactil® and ProbioHp+® showed the least effect. In fluorescence tests, ProBiseis® showed the best effect, followed by Liolactil® and Lactipan®; Probio Hp+® had less of an effect. CONCLUSIONS: Two commercial products (ProBiseis and Lactipan) whose formulations have L. acidophilus, L. casei, L. rhamnosus, L. plantarum, B. infantis, and S. thermophilus have a greater inhibitory effect on C. albicans ATCC 90028.

Inclusive Dentistry: Integral Management of Pediatric Patients with Intellectual Disability and/or Communication Impairments. Case-Series Reports.

Dental treatment for anxious or fearful intellectually disabled children/adolescents (IDCA) may present great challenges, due to deficits in cognitive, intellectual, language, and social abilities, in conjunction with limited adaptive behavior. In many cases, it is necessary for the Dentist to implement advanced behavioral control techniques. Inclusive Dentistry (ID) considers profoundly each patient's individual interests and likes, including the social and family situations, for choosing the respective personalized plan -contemplating potential risks and benefits- for the behavior control, in order to obtain the maximal possible cooperation of the patient in the dental chair. Through ID, the Pediatric Dental Practitioner aims to alleviate the anxiety and fear of IDCA in the clinical setting, in such a way that these patients are positively motivated, on a long-term basis, for current and future oral care, both at the dental office and at home. This management approach may be a time-consuming method or require more effort by the dentist, but it reaps benefits when applied for many mild-to-moderate (and some severe) IDCA. The Practitioner must possess the knowledge, in-depth understanding, and professional training for the adequate use of ID during the behavioral management of anxious or fearful IDCA. The aim of the present report was to describe four representative clinical cases of IDCA at our Clinic, managed under the philosophical principles of ID.

Agreement analysis of three mandibular third molar retention classifications.

INTRODUCTION: Pell & Gregory and Winter classifications are basic in third molar categorization; Sánchez-Torres classification is used in Mexico, but it has not been previously evaluated. OBJECTIVE: To assess the degree of agreement in the radiographic evaluation of impacted mandibular third molar with the use of three classifications: Pell & Gregory, Winter and Sánchez-Torres. METHOD: Observational, descriptive, inter-observer degree of agreement study that included 10 oral and maxillofacial surgeons and 10 training residents, who recorded the radiographic categorization of third mandibular molars (left and right) according to Pell and Gregory, Sánchez-Torres and Winter classifications. Inter-observer degree of agreement was assessed with Fleiss' kappa test. RESULTS: Pell and Gregory classification obtained the lowest degree of agreement (kappa = 0.05 and 0.185), followed by Sánchez-Torres classification (kappa = 0.125 and 0.326); Winter had the best agreement, with kappa = 0.28 and 0.636 for oral and maxillofacial surgeons and training residents, respectively. CONCLUSION: The Winter classification showed an acceptable (moderate) degree of agreement to classify mandibular third molars by training residents.

INTRODUCCIÓN: Las clasificaciones de Pell y Gregory y de Winter son básicas en la categorización de terceros molares; la clasificación de Sánchez Torres es usada en México, pero no había sido evaluada previamente. OBJETIVO: Evaluar el grado de acuerdo en la valoración radiográfica de terceros molares mandibulares impactados, con el empleo de tres clasificaciones: Pell y Gregory, Winter y Sánchez Torres. MÉTODO: Estudio observacional, descriptivo, de concordancia interobservador, que incluyó a 10 cirujanos orales y maxilofaciales y 10 residentes en formación, quienes registraron la categorización radiográfica de terceros molares mandibulares (izquierdos y derechos) de acuerdo con las clasificaciones de Pell y Gregory, Sánchez Torres y Winter. Se evaluó el grado de acuerdo entre observadores mediante la prueba de kappa de Fleiss. RESULTADOS: La clasificación de Pell y Gregory obtuvo el menor grado de acuerdo (kappa = 0.05 y 0.185), seguida de la clasificación de Sánchez Torres (kappa = 0.125 y 0.326); el mejor valor lo obtuvo la clasificación de Winter, con kappa = 0.28 y 0.636 para cirujanos orales y maxilofaciales y residentes en formación, respectivamente. CONCLUSIÓN: La clasificación de Winter mostró un grado de acuerdo aceptable (moderado) para categorizar terceros molares mandibulares en los residentes en formación.

AMPA receptors modulate the reorganization of F-actin in Bergmann glia cells through the activation of RhoA.

Alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid glutamate receptors have been shown to modulate the morphology of the lamelar processes of Bergmann glia cells in the molecular layer of the cerebellum. Here we suggest that reorganization of F-actin may underlay the changes in the morphology of the lamelar processes. Using the fluorescent staining of F-actin with Phalloidin and the quantification of RhoA activation through immunoprecipitation or pull-down assays, we show that RhoA is activated after stimulation of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptors and leads to the reorganization of the actin cytoskeleton of Bergmann fibers. This reorganization of the actin cytoskeleton is reflected in the form of an increase in the intensity of the F-actin staining as well as in the loss of the number of Bergmann fibers stained with Phalloidin. Moreover, using a pharmacological approach, we show that activation of RhoA and the change in the intensity of the F-actin staining depends on the activation of PI3-K, focal adhesion kinase, and protein kinase C, whereas changes in the number of Bergmann fibers depend on external calcium in a RhoA independent manner. Our findings show that glutamate may induce a form of structural plasticity in Bergmann glia cells through the reorganization of the actin cytoskeleton. This may have implications in the way the synaptic transmission is processed in the cerebellum.