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1.
J Dent ; 105: 103569, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33385535

RESUMO

OBJECTIVES: To analyze retrospectively the clinical performance and survival of lithium disilicate inlays, partial crowns and crowns placed by undergraduate students. METHODS: 250 lithium disilicate posterior restorations (IPS™Emax Press) were evaluated. Mean service time was 6.6 years (79 months) with a maximum observation time of 8.5 years (102 months). Clinical performance was assessed using FDI Criteria. Descriptive statistics were used to display the distribution of the criteria. Success and survival of the restorations were calculated with the Kaplan Meier method. A Cox regression analysis was performed to detect influencing parameters for the survival or the success of the restorations. RESULTS: Survival and success rates of lithium disilicate indirect restorations were calculated at 6.6 years with 96.3 % and 93.8 %, respectively. After 8.5 years the survival rate was calculated with 94 % and the success rate with 83.8 %. 10 out of 250 restorations (4%) failed, while the main reasons for failure were fracture of material, debonding/loss of restoration, endodontic complications as well as recurrence of caries. A Cox regression analysis failed to show a correlation between restoration failure and the experience level of the students, an existing root canal treatment, type of tooth, bruxism or the use of rubber dam. CONCLUSIONS: Lithium disilicate indirect posterior restorations demonstrate a high success and survival rate after a mean service of 6.6 years when placed by undergraduate students with different levels of experience. Co-factors influencing the survival or success rate of these restorations could not be identified. CLINICAL SIGNIFICANCE: Lithium disilicate restorations show a good clinical performance up to 8.5 years when prepared by undergraduate students.

2.
Dermatol Ther ; : e14618, 2020 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-33263945

RESUMO

Sarcoidosis and sarcoid-like reactions (SLRs) may develop in association with various malignancies, as well as in association to certain oncologic drugs, including immune checkpoint inhibitors (ICIs). We aimed to perform a narrative review with regard to the development of ICIs-associated sarcoidosis or SLRs, and to discuss the corresponding diagnostic and therapeutic challenges raised in this scenario. Apropos of a melanoma patient developing SLRs while treated with ipilimumab and nivolumab, we searched for clinically evident, ICIs-associated sarcoidosis or SLRs in the English literature. We recorded the oncologic characteristics, including type of malignancy and type of ICI, the phenotypic characteristics of sarcoidosis/SLRs, as well as the impact on immunotherapy. Including our patient, we identified 80 ICIs-associated sarcoidosis or SLRs cases. Both sexes were equally affected (40 F/40 M) and the most common malignancy was melanoma (65/80, 81.3%). Concerning the oncologic treatment, there was a predilection for pembrolizumab (23/80, 28.7%), followed by the ipilimumab/nivolumab combination (21/80, 26.3%), ipilimumab (18/80, 22.5%), nivolumab (16/80, 20.0%). Although in the majority of the cases (52/80, 65.0%) there was no need for systemic prednisolone for the management of sarcoidosis, a significant proportion of patients finally discontinued ICIs treatment (44/80, 55.0%). Phenotypically, sarcoidosis and SLRs highly imitate oncologic progression posing diagnostic difficulties. A therapeutic dilemma is also raised when there is a need for systemic prednisolone, since the latter may jeopardize the therapeutic efficacy of immunotherapy. Sarcoidosis and SLRs, though rare, can present in oncologic patients treated with ICIs. Clinicians should be aware of this possibility and the related diagnostic and therapeutic challenges they have to face in this scenario.

4.
Dermatol Ther ; : e14514, 2020 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-33166029

RESUMO

The skin is the most common organ of involvement during the course of lupus erythematosus (LE). The literature data concerning the dermatoscopic patterns of the different clinical variants of cutaneous LE (CLE), namely chronic (CCLE), subacute (SCLE), and acute (ACLE), are scarce. To determine the dermatoscopic spectrum of CLE and to correlate the dermatoscopic features with the histological findings. This was a retrospective, observational, multicenter, cohort study. We evaluated the dermatoscopic features in a cohort of patients diagnosed with CLE. Furthermore, we investigated their frequency per clinical subtype and correlated them with the anatomic alterations. We included 79 patients. The most prevalent dermatoscopic features of CCLE included follicular plugs (86.4%, P < .01), patchy distribution (75%, P = .1) of mostly linear curved vessels (56.8%, P = .8), white scales (68.2%, P < .01), and structureless white color (68.2%, P < .01). The most common criteria of SCLE were patchy distribution (90%, P = .1) of mostly linear curved vessels (53.3%, P = .8) and fine white scales (60%, P < .01), while ACLE was characterized by erythema (100%, P < .05) and patchy distribution (100%, P = .1) of mostly dotted vessels (60%, P = .4). Follicular plugs/rosettes in dermatoscopy strongly correlated with follicular plugs in histology (rho = 0.919). Hyperkeratosis significantly correlated with white (rho = 0.644) and yellow/brown scales (rho = 0.225), telangiectasia with linear curved vessels (rho = 0.321) and white color with dermal fibrosis (rho = 0.623). Depending on CLE subtype, distinct dermatoscopic patterns are recognized. In CLE there is a high correlation between certain dermatoscopic criteria and the underneath anatomic alteration.

6.
Clin Oral Investig ; 24(8): 2931-2941, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32607830

RESUMO

OBJECTIVES: The corona disease (COVID-19) is developing into one of the greatest challenges for healthcare professionals around the world. In this article, we report the detailed actions taken in the Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany, during the early phase of the COVID-19 pandemic. MATERIAL AND METHODS: After a joint on-site inspection of the dental clinic with the Department of Clinical Microbiology and Hospital Hygiene, existing clinical and hygiene protocols were adapted for COVID-19 patients. RESULTS: A comprehensive summary of the preparation of the facilities as well as pre- treatment, treatment and posttreatment protocols are described and arising problems are being discussed. CONCLUSIONS: The importance of rigorous hygiene and treatment protocols as well as a sufficient supply of PPE for dental offices and hospitals is highlighted. The measures reported may be subject to change due to the dynamics of the pandemic. CLINICAL RELEVANCE: The modes of transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (e.g., droplets, aerosols, and fomites) can pose a risk for dental healthcare professionals and patients alike. The presented measures may guide dental faculties and dental practices during the early stage of the COVID-19 crisis.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Odontologia , Surtos de Doenças , Pandemias , Pneumonia Viral , Alemanha , Humanos
7.
J Dent ; 97: 103333, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32305380

RESUMO

OBJECTIVES: Long-term survival of two highly viscous glass ionomer cements (Fuji IX GP Fast and Equia Fil) over a period of 6 years in vivo. METHODS: A total of 85 two- or three-surface class II restorations, comprising 43 Equia Fil / Equia Coat and 42 Fuji IX GP Fast / Fuji Coat LC, were placed in 34 patients. The restorations were re-evaluated after 6 years using the FDI criteria. The statistical analysis was performed with Fisher's exact test, the Wilcoxon signed-rank test, the Mann-Whitney U test and the Kaplan-Meier method. RESULTS: Forty-four restorations (22 Equia Fil and 22 Fuji IX GP Fast) could be assessed at the 6-year follow-up. During the whole study period, eight failures, four for each material, were observed. The main reasons for failure were material fractures and retention loss, which were partly combined with poor marginal adaptation or poor proximal anatomical form. Two failures may be attributed to insufficient application of the materials, as suspected according to the radiographs. The Kaplan-Meier survival proportion for Equia Fil restorations at 6 years was 86.5% and that for Fuji IX GP Fast at 6 years was 86.8% (log-rank p = 0.907). During the period from 3 to 6 years, only one filling in each group failed. CONCLUSION: Both materials showed acceptable and comparable survival rates after 6 years. CLINICAL SIGNIFICANCE: Highly viscous glass ionomer cement can be an acceptable restoration material for smaller class II cavities.


Assuntos
Cárie Dentária , Cimentos de Ionômeros de Vidro , Restauração Dentária Permanente , Humanos , Viscosidade
8.
Odontology ; 108(3): 358-365, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31707618

RESUMO

This study aimed to determine the temperature increase on the root surface during warm vertical compaction using three different obturation systems. Forty-five human single-rooted premolars were randomly assigned to one of three experimental groups of 15 teeth each for obturation with a System B unit, an Elements Obturation Unit, or a B&L SuperEndo Alpha II unit. All teeth were filled using the continuous wave of condensation technique with a set temperature of 200 °C. The temperature measurements were made with an infrared camera at 3 s (T0) and 1 min (T1) following activation of the heat plugger. T0 ranged between 48.1 and 84 °C depending on the obturation system. The mean value for T0 showed significant differences between various obturation systems (p = 0.001). The temperature increase on the root surface during the application of vertical compaction shows considerable variability depending on the obturation system.


Assuntos
Guta-Percha , Materiais Restauradores do Canal Radicular , Temperatura Alta , Humanos , Teste de Materiais , Obturação do Canal Radicular , Temperatura
9.
Quintessence Int ; 51(1): e1-e11, 2019 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-31813942

RESUMO

OBJECTIVE: To compare the clinical performance of two glass-ionomer cements in combination with two light-cured coatings in Class II cavities. METHOD AND MATERIALS: In total, 43 Equia Fil/Equia Coat and 42 Fuji IX GP Fast/Fuji Coat LC restorations were placed, in 34 patients. Only Class II cavities with two- or three-surface restorations were included. The clinical performance was evaluated at baseline, after 1, 2, and 3 years using the FDI criteria. For the statistical analysis, Fisher exact test, Wilcoxon signed-rank test and Mann-Whitney U test were applied. The success and survival of the restorations were calculated with the Kaplan-Meier method and a log-rank test was used to detect significant differences between the tested materials. RESULTS: At the 3-year recall, no significant differences could be detected between the two glass-ionomer cements for any of the evaluated criteria (Mann-Whitney U test, P > .05). When comparing the baseline with the recall data at 3 years for each material separately, significant changes could be observed in both materials for the criteria "surface luster," "fracture of material and retention," and "approximal anatomical form" (Wilcoxon signed-rank test, P < .05). Additionally, the Equia Fil restorations showed a notable change for the criteria "marginal adaptation" (Wilcoxon signed-rank test, P = .039). At the 3-year follow up, the Equia Fil and the Fuji IX GP Fast restorations exhibited an overall survival rate of 89.3% and 88.0%, respectively. Three fillings in each group failed. CONCLUSION: The two glass-ionomer cements tested performed similarly in Class II cavities in adult patients, with a moderate failure rate after 3 years. (Original article published in Quintessence Int 2019;50:592-602; doi: 10.3290/j.qi.a42692).

10.
Psoriasis (Auckl) ; 9: 91-96, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31696050

RESUMO

Uveitis, an inflammatory disorder of the mid-portion of the eye, is considered a relatively rare but very serious ocular complication of psoriasis. Data on the specific characteristics of uveitis in the background of psoriasis are extremely limited. The presence of uveitis in the context of psoriasis has been estimated to occur in 7-20% of the psoriasis cases. This incidence tends to be higher in patients suffering from psoriasis and psoriatic arthritis (PsA) or PSA alone. Psoriatic uveitis is usually bilateral, chronic, and severe. In term of pathogenesis, both psoriasis and uveitis are considered as paradigms of T-helper 1/T-helper 17 (Th1/Th17) inflammatory reactions. Certain cytokines such as tumor necrosis factor-α (TNF- α), Interleukin-17 (IL-17), IL-23, and IL-6 play a significant role in the pathogenesis of both psoriasis and uveitis. As uveitis shares common pathogenetic mechanisms with psoriasis in certain circumstances, both diseases may benefit from the same targeted biologic therapies. Undiagnosed and under-treated cases of psoriatic uveitis may cause significant morbidity and even vision loss. Larger prospective studies are needed in order to further investigate the association between these two entities.

11.
Quintessence Int ; 50(8): 592-602, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31286115

RESUMO

OBJECTIVE: To compare the clinical performance of two glass-ionomer cements in combination with two light-cured coatings in Class II cavities. METHOD AND MATERIALS: In total, 43 Equia Fil/Equia Coat and 42 Fuji IX GP Fast/Fuji Coat LC restorations were placed, in 34 patients. Only Class II cavities with two- or three-surface restorations were included. The clinical performance was evaluated at baseline, after 1, 2, and 3 years using the FDI criteria. For the statistical analysis, Fisher exact test, Wilcoxon signed-rank test and Mann-Whitney U test were applied. The success and survival of the restorations were calculated with the Kaplan-Meier method and a log-rank test was used to detect significant differences between the tested materials. RESULTS: At the 3-year recall, no significant differences could be detected between the two glass-ionomer cements for any of the evaluated criteria (Mann-Whitney U test, P > .05). When comparing the baseline with the recall data at 3 years for each material separately, significant changes could be observed in both materials for the criteria "surface luster," "fracture of material and retention," and "approximal anatomical form" (Wilcoxon signed-rank test, P < .05). Additionally, the Equia Fil restorations showed a notable change for the criteria "marginal adaptation" (Wilcoxon signed-rank test, P = .039). At the 3-year follow up, the Equia Fil and the Fuji IX GP Fast restorations exhibited an overall survival rate of 86.21% and 84.0%, respectively. CONCLUSION: The two glass-ionomer cements tested performed similarly in Class II cavities in adult patients, with a moderate to high failure rate after 3 years.


Assuntos
Cárie Dentária , Restauração Dentária Permanente , Adulto , Cimentos de Ionômeros de Vidro , Humanos
12.
Psoriasis (Auckl) ; 8: 1-5, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29441315

RESUMO

The recent advances in the understanding of psoriasis pathogenesis have clarified the pivotal role of interleukin (IL)-23. It is a heterodimeric cytokine consisting of two subunits, the unique p19 and the p40, which are shared with IL-12. The basic role of IL-23 in psoriasis is the activation and maintenance of the T-helper 17 pathway. New research findings indicate that IL-23 is more important than IL-12 in the pathogenesis of psoriasis. Based on that background, the selective targeting of the IL-23p19 subunit emerged as an attractive therapeutic option and led to the development of a new category of biologic agents. Three monoclonal antibodies that selectively inhibit the IL-23p19 subunit, guselkumab, tildrakizumab, and risankizumab, are in the pipeline for the treatment of moderate-to-severe psoriasis. In this article, we review the most recent efficacy and safety data regarding these IL-23p19 inhibitors.

13.
Clin Cosmet Investig Dermatol ; 10: 305-310, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28848358

RESUMO

Rosacea is a chronic skin disease characterized by facial erythema and telangiectasia. Despite the fact that many hypotheses have been proposed, its etiology remains unknown. In the present review, the possible link and clinical significance of Helicobacter pylori in the pathogenesis of rosacea are being sought. A PubMed and Google Scholar search was performed using the terms "rosacea", "H.pylori", "gastrointestinal disorders and H.pylori", "microorganisms and rosacea", "pathogenesis and treatment of rosacea", and "risk factors of rosacea", and selected publications were studied and referenced in text. Although a possible pathogenetic link between H. pylori and rosacea is advocated by many authors, evidence is still interpreted differently by others. We conclude that further studies are needed in order to fully elucidate the pathogenesis of rosacea.

14.
Artigo em Inglês | MEDLINE | ID: mdl-27799806

RESUMO

Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease that affects the hair follicles of the aprocrine gland-bearing anatomical areas of the body. It is characterized by deep painful nodules and abscesses that rupture and contribute to the formation of sinus tracks and scarring. The management of HS is based on the assessment of disease severity and a combination of medical and surgical treatment according to the European Guidelines. Adalimumab, a recombinant, fully humanized, anti-tumor necrosis factor alpha (anti-TNF-α) monoclonal antibody, is the only officially approved treatment for the management of moderate-to-severe HS. Case reports, concerning 42 patients who received adalimumab for severe HS (with the standard dose regimen for psoriasis), reported a cumulative response rate of 58% (≥50% in 23 patients) with a relapse rate of 71% (10 out of 14 patients). The most recent and most well-powered phase III, randomized placebo-controlled trials for the evaluation of the efficacy and safety of adalimumab in treatment of moderate-to-severe HS (PIONEER studies I and II) showed that the Hidradenitis Suppurativa Clinical Response (HiSCR) rate at week 12 was significantly higher for patients randomized to adalimumab compared to placebo. Adverse events were comparable to placebo. In conclusion, adalimumab, to date, holds the most robust data regarding treatment efficacy in HS. Larger, registry-based studies are needed to further establish the efficacy and safety profile of this anti-TNF-α agent in HS.

15.
J Cutan Med Surg ; 19(6): 555-60, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25917082

RESUMO

INTRODUCTION: T-helper 1 (Th1), Th17 cells, and their related cytokines are implicated in psoriasis pathogenesis although the contribution of each group of cytokines in psoriasis activity has not been fully clarified. OBJECTIVES: To investigate whether Th17-related cytokines are associated with psoriasis activity. METHODS: The serum levels of interleukin (IL)-1ß, 6, 8, 17Α, 22, 23, and tumor necrosis factor-α (TNFα) were measured with flow cytometry in 35 patients with plaque psoriasis (21 with stable and 14 with active disease) and in 20 healthy controls. RESULTS: Interleukin-6, 8, 17A, 22, 23, and TNFα were significantly elevated in psoriasis patients compared with controls. In the sensitivity analyses, patients with active disease showed significantly increased levels of IL-17A, IL-23, and IL-22 as compared to the group of patients with stable psoriasis. CONCLUSIONS: Our study highlights a possible crucial role of IL-17A, IL-22, and IL-23 in the activity of psoriasis and the early stages of the disease.


Assuntos
Interleucinas/sangue , Psoríase/sangue , Psoríase/patologia , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Estudos de Casos e Controles , Estudos Transversais , Feminino , Citometria de Fluxo , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Fator de Necrose Tumoral alfa/sangue , Adulto Jovem
16.
Int J Dermatol ; 54(9): 1105-8, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25557117

RESUMO

BACKGROUND: The incidence of non-infectious uveitis on a background of psoriasis is estimated to be 7-20%. The use of tumor necrosis factor-α (TNF-α) inhibitors as a treatment for refractory uveitis is emerging. METHODS: The psoriasis outpatient database at our referral center was searched for patients with concurrent diagnoses of psoriasis and uveitis. The medical records of the patients identified were reviewed for the use of TNF-α inhibitors. RESULTS: Five patients (three women and two men) were identified. All of them suffered moderate to severe psoriasis and chronic, bilateral uveitis. The patient with the most severe ocular inflammation was the only patient positive for human leukocyte antigen B27 (HLA-B27) and the only one to suffer from psoriatic arthritis. All patients had received treatment with adalimumab and had been evaluated at three and six months. Their psoriasis had responded excellently, and in four patients, uveitis had shown the complete remission of inflammation at six months. The fifth patient (HLA-B27+) exhibited improved uveitis activity but not complete remission at six months. CONCLUSIONS: Uveitis is an entity that should be considered when evaluating psoriasis patients with ocular complaints, even in the absence of arthritis. Anti-TNF-α monoclonal antibodies and adalimumab in particular seem to represent a promising therapeutic avenue for the treatment of refractory psoriatic uveitis. Larger randomized clinical trials are needed to confirm our conclusions.


Assuntos
Adalimumab/uso terapêutico , Psoríase/complicações , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Uveíte/complicações , Uveíte/tratamento farmacológico , Adulto , Anticorpos Monoclonais/uso terapêutico , Bases de Dados Factuais , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Humanos , Injeções Subcutâneas , Masculino , Pessoa de Meia-Idade , Psoríase/diagnóstico , Psoríase/tratamento farmacológico , Encaminhamento e Consulta , Estudos Retrospectivos , Amostragem , Índice de Gravidade de Doença , Resultado do Tratamento , Fator de Necrose Tumoral alfa/uso terapêutico , Uveíte/diagnóstico
17.
Dermatol Pract Concept ; 4(2): 55-8, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24855576

RESUMO

Solitary trichoepithelioma (TE) is a rare, benign tumor of follicular origin that in certain cases is difficult to differentiate from basal cell carcinoma (BCC). We report the case of an 8-year-old girl with a pale pink, soft lesion on the neck. The clinical image of the lesion was equivocal, while some dermoscopic findings-blue-gray globules and arborizing vessels-could not exclude the presence of BCC from the differential diagnosis, although that would have been a very unlikely case considering the age of the patient. The histopathologic examination established the diagnosis of TE. Given the occasion of this challenging case we try to list the key clinical, dermoscopic and histopathological characteristics of TE and BCC in order to elucidate the differential diagnosis of these two entities.

18.
Adolesc Health Med Ther ; 5: 25-34, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24729738

RESUMO

Psoriasis is a chronic inflammatory cutaneous disorder affecting 2%-4% of the world's population. The prevalence of the disease in childhood and adolescence ranges between 0.5% and 2%. The management of psoriasis in adolescence is an intriguing and complicated task. Given the paucity of officially approved therapies, the very limited evidence-based data from randomized controlled trials, and the absence of standardized guidelines, physicians must rely on published experience from case reports both from the field of dermatology as well as from the application of these drugs for other pediatric conditions coming from the disciplines of rheumatology, gastroenterology, and oncology. Psoriatic adolescents deal with a potentially disfiguring and lifelong disease that could permanently impair their psychological development. It must be clarified to them that psoriasis does not have a permanent cure, and therefore the main goal of treatments is to establish disease control and prolonged periods between flares. The majority of adolescents suffer from mild psoriasis, and thus they are treated basically with topical treatment modalities. Phototherapy is reserved for adolescents with mild-to-moderate plaque disease and/or guttate psoriasis when routine visits to specialized centers do not create practical problems. Systemic agents and biologics are administered to patients with moderate-to-severe plaque psoriasis, pustular psoriasis, or erythrodermic psoriasis.

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