B-vitamins intake, DNA-methylation of One Carbon Metabolism and homocysteine pathway genes and myocardial infarction risk: the EPICOR study.

BACKGROUND AND AIMS: Several epidemiological studies highlighted the association between folate and B-vitamins low intake and cardiovascular diseases (CVD) risk. Contrasting results were reported on the relationship between folate intake and DNA-methylation. Folate and B-vitamins may modulate DNA-methylation of specific enzymes which are included in the One-Carbon Metabolism (OCM) and in the homocysteine (Hcy) pathways. The aim of the study was to evaluate whether DNA-methylation profiles of OCM and Hcy genes could modulate the myocardial infarction (MI) risk conferred by a low B-vitamins intake. METHODS AND RESULTS: Study sample (206 MI cases and 206 matched controls) is a case-control study nested in the prospective EPIC cohort. Methylation levels of 33 candidate genes where extracted by the whole epigenome analysis (Illumina-HumanMethylation450K-BeadChip). We identified three differentially methylated regions in males (TCN2 promoter, CBS 5'UTR, AMT gene-body) and two in females (PON1 gene-body, CBS 5'UTR), each of them characterized by an increased methylation in cases. Functional in silico analysis suggested a decreased expression in cases. A Recursively Partitioned Mixture Model cluster algorithm identified distinct methylation profiles associated to different MI risk: high-risk vs. low-risk methylation profile groups, OR = 3.49, p = 1.87 × 10(-)(4) and OR = 3.94, p = 0.0317 in males and females respectively (multivariate logistic regression adjusted for classical CVD risk factors). Moreover, a general inverse relationship between B-vitamins intake and DNA-methylation of the candidate genes was observed. CONCLUSIONS: Our findings support the hypothesis that DNA-methylation patterns in specific regions of OCM and Hcy pathways genes may modulate the CVD risk conferred by folate and B-vitamins low intake.

Coronally advanced flap with or without enamel matrix derivative for root coverage: a 2-year study.

AIM: The purpose of this study was to assess the ability of enamel matrix derivative (EMD) to improve root coverage with a coronally advanced flap (CAF) during a 2-year follow-up. METHODS: Fifteen patients each with two single and similar bilateral Miller Class I or II gingival recessions (30 recessions) were selected. Each recession was randomly assigned to the test group (CAF+EMD) or the control group (CAF only). Clinical parameters recorded at baseline and at 6, 12 and 24 months were recession depth (R), recession width (WR), probing depth (PD), clinical attachment level (CAL) and keratinized tissue (KT). RESULTS: Reduction of R resulted in a significant CAL gain in both groups, whereas PD was not altered. In the test group, R decreased from 4.07 mm (SD+/-0.59) at baseline to 0.47 mm (SD+/-0.74) at 24 months, corresponding to a mean root coverage (MRC) of 90.67%, whereas in the control group R shrank from 4.13 mm (SD+/-0.74) at baseline to 0.60 mm (SD+/-0.83) at 24 months (MRC=86.67%). Complete root coverage was achieved at 24 months in 73.33% and 60% of the two groups. A significant KT increase was observed in both groups. CONCLUSIONS: Root coverage outcomes were similar in both groups and no statistically significant differences were found at all between them. Hence, the additional use of EMD to CAF is not justified for clinical benefits of root coverage, but as an attempt of achieving periodontal regeneration rather than repair.

Coronally advanced flap for the treatment of buccal gingival recessions with and without enamel matrix derivative. A split-mouth study.

BACKGROUND: The coronally advanced flap (CAF) is a predictable method for achieving root coverage in buccal gingival recessions. The use of enamel matrix derivative (EMD) has already been tested in treating intrabony defects. No clinical comparative study has been published evaluating the CAF in combination with EMD in treating buccal gingival recessions. METHODS: This split-mouth study was performed to assess the efficacy of EMD to improve the results of a root coverage procedure. Fourteen pairs of Miller Class I and II bilateral comparable defects were selected in 12 patients. In each patient, one site was randomly assigned to the test group and the contralateral site to the control group. The treatment consisted of a CAF procedure with (test) or without (control) EMD. Gingival recession (REC), clinical attachment level (CAL), probing depth (PD), and extension of keratinized tissue (KT) were recorded at baseline and 6 months postsurgery. RESULTS: The average initial REC was 3.71 mm (SD +/- 1.68) for the test group, and 3.50 mm (SD +/- 1.56) for the control group. The 2 groups were statistically homogeneous. The mean root coverage was 3.36 mm (SD +/- 1.55), corresponding to a value of 91.2% for the test group, and 2.71 mm (SD +/- 1.20), equal to 80.9% for the control group. The differences between the 2 groups were not statistically significant. The mean CAL gain was 3.57 mm (SD +/- 1.55) for the test group and 2.79 mm (SD +/- 1.19) for the control group. No changes of PD and KT were found. CONCLUSIONS: This study suggests that EMD does not seem to significantly improve the clinical outcomes of gingival recession treated by means of CAF, even though the test group showed slightly better results in terms of root coverage and CAL. Further studies with a larger number of teeth and higher statistical power are needed to support this conclusion.

Virulence factors of salmonella ser. enteritidis strains isolated in Italy from food-borne outbreaks.

Twelve Salmonella ser. Enteritidis strains phage type 4 isolated in Italy from different food-borne outbreaks were characterized for the expression of different virulence traits, for antibiotic resistance, and for plasmid DNA profile. All the twelve S. Enteritidis strains were able to invade and multiply within HeLa cell monolayers, even if at a lower efficiency if compared to an invasive Shigella flexneri strain. The strains were not hemolytic and produced only a moderate-level cytotoxic effect on HeLa cell monolayers. Moreover, all the strains examined produced mannose-sensitive hemagglutination with chicken erythrocytes but were not able to adhere to tissue culture cells. The strains did not produce the hydroxamate-type siderophore aerobactin or the specific ferric-aerobactin receptor. The S. Enteritidis strains were resistant only to spectinomycin, and eleven strains harbored a 38 MDa non-conjugative plasmid, while one strain harbored a 64 MDa conjugative plasmid which carried a colicinogenic activity-encoding locus. The uniformity of antibiotic resistance pattern, of the plasmid DNA content, and of the virulence factors produced indicated that the S. Enteritidis clinical isolates examined are clonally-related.

[Alveolar bone necrosis as a consequence of surgical intervention for hypophyseal adenoma]. / Necrosi ossea alveolare conseguente ad intervento chirurgico per adenoma ipofisario.

Tumours of the pituitary gland, originating from its anterior lobe, may produce hormones and therefore generate a situation of pituitary hyperfunction or cause the typical problems of endocranial expansive masses which compress residual glandular tissue. Surgery is necessary in order to remove a pituitary tumour and is currently performed in 96% of cases using a trans-sphenoidal route. The surgical approach entails making an incision in the upper vestibular fornix from cuspid to cuspid. The stripping of a full-thickness flap allows the front wall of the sphenoid sinus to be reached, passing through the nasal cavities; it is then eliminated. This allows the floor of the sella turcica to be visualized; the latter is then removed to expose the pituitary gland. Surgical complications arising during the use of the trans-sphenoidal route are rare and the surgical removal of the adenoma ensures a greater probability of recovery compared to radiotherapy in view of the elevated radioresistance of these neoformations. The paper then reports two cases of alveolar bone necrosis in the premaxillary sector following surgery for the removal of pituitary adenoma. Case report--The first patient male, aged 23, presented a sequestrum in the vestibular alveolar wall in correspondence with 1.1 and 1.2. The patient underwent two operations (one using a craniotomy route and the other using a trans-sphenoidal route) to remove a giant pituitary adenoma. The sequestrum was removed, but the radicular surfaces of 1.1 and 1.2 remained exposed. In order to re-cover them, an attempt was made to increase the quantity of keratinized gingiva using the two-stage technique described by Bernimoulin.(ABSTRACT TRUNCATED AT 250 WORDS)

[Focal infection in dentistry: the in vitro specific lymphocyte blast test]. / Infezione focale in odontostomatologia: test di blastizzazione specifica linfocitaria "in vitro".

The authors used an "in vitro" test of specific blastogenic response to streptococcal antigens, to evidence a sensitivity status in chronic odontogenic infections. The authors didn't find always a direct correlation between specific lymphoproliferative response and haematologic tests but found a good correlation with clinics. They conclude an increased value of specific lymphoproliferative response as predictive meaning of metafocal diseases.

Radiologic-prosthetic planning of the surgical phase of the treatment of edentulism by osseointegrated implants: an in vitro study.

An original prosthetic planning involving CT scan is described; it provides the surgeon with a template for use during the surgical phase of osseointegrated implant treatment. The final prosthodontic reconstruction was planned in a preliminary in vitro study. The CT scan provided a three-dimensional study of the underlying bone, to determine the position, angulation, and depth of the fixture to be used. The specially developed "positioner" decreased the possibilities of error in perforating the mandible. A second CT scan verified whether there were errors in positioning the fixtures. The satisfactory results and the predictability of the final rehabilitation led to the adoption of this method in a clinical research program on human patients.

[Clinico-epidemiological research on the incidence of masticatory dysfunctions in periodontal patients]. / Indagine clinico-epidemiologica sulla frequenza delle disfunzioni dell'apparato masticatorio in individui parodontopatici.

The frequency of symptoms and signs of the craniomandibular-system dysfunctions were analysed in 70 patients selected because of their periodontal disease. The data obtained were compared with other data connected with epidemiological studies made on not-selected people.

[Compound odontoma. Presentation of a clinical case]. / Odontoma composto. Presentazione di un caso clinico.

After a short examination of odontomas, a clinical case is described in which the presence of a voluminous odontoma at the mandibular angle demanded a bone grafts to heal the residual cavity.

[Clinico-surgical evaluation of dental elements in bone inclusions]. / Valutazione clinico-chirurgica degli elementi dentari in occlusione ossea.

Dental inclusions are assessed on the basis of clinical and operating statistics relating to the years 1981-1985 and comprising 815 patients and 1445 treated teeth. The results confirm the predominance of inclusions among female patients and the prevalence of the mandibular site; the most frequently included teeth are the lower eighths followed by the upper eighths, the upper canines and the second lower premolars. Inclusions are bilateral in most cases. These findings are in substantial agreement with the epidemiological data recorded in the literature. The operating series shows that the type of surgical treatment varies with the localisation of the tooth (anterior or posterior), its relationship with contigous teeth and with the surrounding anatomical structures and the age of the patient. Teeth in the posterior sector are usually extracted. At young age, germectomy is carried out for orthodontic purposes; at mature age, teeth are extracted to prevent the formation of periodontal pockets and the aggravation of caries and their complications. On the other hand, for teeth in the anterior sector, surgery is usually merely the first stage in treatment and is followed by treatment of orthodontic type with traction, in view of the important aesthetic and functional role of the labial teeth.

Immunohistochemical localization of fibronectin in structures of the human oral cavity: dental pulp and gingiva.

The distribution of fibronectin (FN) in the dental pulp and gingiva of the human adult was investigated by indirect immunofluorescence and indirect immunoperoxidase techniques. FN could not be demonstrated in the connective tissue of the dental pulp even in the blood vessels. On the contrary, a positive stain was obtained in the ground substance at the base of the odontoblast cell bodies and in various structures of a denticle which was accidentally found in the pulp of one of the examined teeth. The lack of FN in the dental pulp could mean that this tissue, sometimes considered to be of an immature and undifferentiated type, is instead a mature one. The subepithelial connective tissue and the epithelium of the gingiva were examined. The distribution of FN in the connective tissue of the gingiva was found to be similar to that described in other types of connective tissue; high concentrations were found both in the epithelial cells and around them. This finding is described here for the first time and remains to be verified in other types of stratified epithelia.