Effect of Surface Treatments and Different Adhesives on the Hybrid Layer Thickness of Non-carious Cervical Lesions

The quality of the hybrid layer created in non-carious cervical sclerotic lesions may determine the longevity of cervical composite restorations.

Cryptic deletions are a common finding in "balanced" reciprocal and complex chromosome rearrangements: a study of 59 patients

Using array comparative genome hybridisation (CGH) 41 de novo reciprocal translocations and 18 de novo complex chromosome rearrangements (CCRs) were screened. All cases had been interpreted as "balanced" by conventional cytogenetics. In all, 27 cases of reciprocal translocations were detected in patients with an abnormal phenotype, and after array CGH analysis, 11 were found to be unbalanced. Thus 40% (11 of 27) of patients with a "chromosomal phenotype" and an apparently balanced translocation were in fact unbalanced, and 18% (5 of 27) of the reciprocal translocations were instead complex rearrangements with >3 breakpoints. Fourteen fetuses with de novo, apparently balanced translocations, all but two with normal ultrasound findings, were also analysed and all were found to be normal using array CGH. Thirteen CCRs were detected in patients with abnormal phenotypes, two in women who had experienced repeated spontaneous abortions and three in fetuses. Sixteen patients were found to have unbalanced mutations, with up to 4 deletions. These results suggest that genome-wide array CGH may be advisable in all carriers of "balanced" CCRs. The parental origin of the deletions was investigated in 5 reciprocal translocations and 11 CCRs; all were found to be paternal. Using customized platforms in seven cases of CCRs, the deletion breakpoints were narrowed down to regions of a few hundred base pairs in length. No susceptibility motifs were associated with the imbalances. These results show that the phenotypic abnormalities of apparently balanced de novo CCRs are mainly due to cryptic deletions and that spermatogenesis is more prone to generate multiple chaotic chromosome imbalances and reciprocal translocations than oogenesis.

P-glycoprotein in proteoliposomes with low residual detergent: the effects of cholesterol

PURPOSE

There is evidence that cholesterol affects the ATPase and transport functions of P-glycoprotein (P-gp). To study the influence of cholesterol on P-gp in a well defined lipid environment, we reconstituted P-gp in egg phosphatidylcholine (PhC) and PhC/cholesterol proteoliposomes with negligible residual amounts of detergents.

MATERIALS AND METHODS

P-gp proteoliposomes were prepared by continuous dialysis from micelles consisting of P-gp, lipids, sodium dodecyl sulfate and cholate. Basal and modulator-induced ATPase activities were studied in an established enzyme assay. Modulator affinities to P-gp and to the lipid bilayers were determined by equilibrium dialysis.

RESULTS

In the absence of cholesterol the basal ATPase activity was six fold lower than in the presence of 20 or 40% cholesterol, and no P-gp binding and ATPase induction was detected for the tested modulators verapamil and progesterone. In proteoliposomes containing 20 and 40% cholesterol, respectively, the modulators showed significant P-gp binding and ATPase activation. The concentration of the modulators for half maximal activation of the ATPase was higher with 40% than with 20% cholesterol.

CONCLUSIONS

Cholesterol influences P-gp in three ways: (a) it enhances its basal ATPase activity, (b) it renders P-gp sensitive towards the modulators verapamil and progesterone and (c) it affects the modulator concentration at half maximal ATPase activation.

The influence of irrigating solutions on the accuracy of the electronic apex locator facility in the Tri Auto ZX handpiece

AIM

To determine the influence of various irrigating solutions on the accuracy of the electronic apex locator facility in the Tri Auto ZX handpiece.

METHODOLOGY

One hundred and forty teeth with single canals and mature apices, scheduled for extraction for either periodontal or prosthetic reasons in 76 patients were used. Following informed written consent local anaesthesia was administered, access cavities were prepared and pulp tissue removed. The teeth were then randomly divided into seven groups according to the irrigating solutions used. The root canal length measurements were completed using the Tri Auto ZX handpiece with automatic reverse function in the presence of one or other of the following solutions: 0.9% saline, 2.5% NaOCl, 3% H(2)O(2), 0.2% chlorhexidine, 17% EDTA, Ultracaine D-S or in the absence of an irrigating solution (control). Files were immobilized in the access cavity with composite resin. After extraction, the apical regions of the teeth were exposed and the file tips examined under a stereomicroscope. Distances between the file tips and the apical constriction were measured (mm) and analysed using a one-way anova and post hoc Tukey test.

RESULTS

Mean distances from the apical constriction to the file tip were longer in the 0.9% saline group (P<0.05). There was no statistically significant difference on file tip position between the other solutions.

CONCLUSIONS

Tri Auto ZX gave reliable results with all irrigating solutions apart from in the presence of 0.9% saline.

[Astigmatism in ocular neuromuscular nystagmus]

BACKGROUND

Data on refraction of patients with congenital nystagmus are not available in the literature.

PATIENTS AND METHODS

We have analysed the refractive errors in a cohort of 224 consecutive patients with congenital nystagmus, aged 1-57 years.

RESULTS

Refractive errors, i. e., myopia, hyperopia (> 0.50 dioptres) and astigmatism (> 1.25 dioptres), were found in 179 patients (79.91 %). Of them 8 were myopic (4.46 %), 19 were hyperopic (10.61 %) and 152 were astigmatic (84.91 %). Mean astigmatism was of 2.44 dioptres for right eyes and 2.74 dioptres for left eyes.

CONCLUSIONS

Astigmatism is extremely common in congenital nystagmus. Its presence is much higher than that found in normal populations. The amount of astigmatism found in nystagmus patients is noticeable. When considering he visual difficulties of patients with nystagmus, the astigmatic component should be taken in greatest consideration. Its presence should favour early surgery for anomalous head posture. Furthermore, refractive surgery should be considered as early as possible, for improving visual potential.

Reinforcement effect of polyethylene fibre in root-filled teeth: comparison of two restoration techniques

AIM

To compare in vitro two different fibre placement techniques on reinforcement of root-filled molar teeth with mesio-occluso-distal (MOD) cavities.

METHODOLOGY

Fifty sound extracted human mandibular molars were used (n = 10). Group 1 served as control. From group 2-5, endodontic access and standard MOD cavities were prepared. Following root canal treatment, group 2 was kept unrestored. In groups 3 and 4, the teeth were restored with composite resin (AP-X; Kuraray, Japan). A groove was prepared on occlusal surface of the finished restorations in group 4 from buccal to lingual direction. Polyethylene woven fibre (Ribbond; Seattle, WA, USA) was inserted in the groove in combination with flowable resin that was cured for 20 s and covered with composite resin. Cavity surfaces were covered with flowable resin in group 5, and polyethylene fibre was placed into the bed of resin in a buccal to lingual direction before the composite restoration was placed. All specimens were stored in 100% humidity at 37 degrees C for 24 h. Compressive loading of the teeth was performed by a universal testing machine at a crosshead speed of 0.5 mm min(-1) until failure. The data were recorded in Newton and submitted to anova and Tukey post hoc test.

RESULTS

The mean load necessary to fracture the samples in each group was: G1: 1671.57 +/- 131.54(a); G2: 375.21 +/- 34.30(b); G3: 749.47 +/- 124.54(c); G4: 1224.36 +/- 132.17(d); G5: 926.88 +/- 118.28(e). Different superscript letters demonstrate significant difference between groups.

CONCLUSIONS

Polyethylene fibre use over or under MOD composite restorations significantly increased fracture strength. However, when the fibre was placed on the occlusal surface of the restoration in buccal to lingual direction, significantly higher fracture resistance was observed.

Penetrance and clinical manifestations of non-hotspot germline RET mutation, C630R, in a family with medullary thyroid carcinoma

Germline mutations in specific hot spot-codons of the RET proto-oncogene are associated with multiple endocrine neoplasia type 2 (MEN 2). Clinical RET gene testing has been routine for the last 10 years in some countries. In Argentina, RET testing excluding MEN 2B was always reported with a mutation at codon 634, with one exception: we described a novel mutation T > C transition at codon 630 (C630R), the family to which we extend the study in the present report. This family comprised 29 members in four generations including 6 individuals affected with medullary thyroid cancer (MTC), positive for the C630R mutation and normal adrenaline/ noradrenaline and ionized calcium/parathyroid hormone levels. Two asymptomatic mutation carriers aged 5 and 11 years underwent total thyroidectomy. The histopathologic examination showed C-cell hyperplasia and microcarcinoma foci, while preoperative basal calcitonins were normal for both. Our report emphasizes the importance of testing for non-hot spot RET mutations in apparently mutation negative MEN 2 families. Furthermore, it would appear that C630R mirrors C634R in penetrance (100% in this family) and in early age of onset of MTC, although paradoxically, no pheochromocytomas and hyperparathyroidism have developed. In addition to recommending RET testing before 5 years of age; we also can postulate that codon 630 may be the key point along the extracellular domain, important in the tissue-specific penetrance.

The effect of fibre insertion on fracture resistance of root filled molar teeth with MOD preparations restored with composite

AIM

To evaluate the effect of using flowable composite with or without leno woven ultra high modulus polyethylene fibre reinforcement on fracture resistance of root filled mandibular molars with mesio-occlusodistal (MOD) preparations.

METHODOLOGY

Sixty sound extracted human mandibular molars were randomly assigned to five groups (n = 12). Group 1 did not receive any preparation. From groups 2 to 5, the teeth were root filled and MOD preparations were created. Group 2 remained unrestored. Group 3 was restored with a dentine bonding system (DBS; SE Bond, Kuraray, Japan) and composite resin (CR) (AP-X; Kuraray). In group 4, flowable composite resin (Protect Liner F; Kuraray) was used before restoring teeth with CR. In group 5, leno woven ultra high modulus polyethylene ribbon fibre (Ribbond, Seattle, WA, USA) was inserted into the cavities in a buccal to lingual direction and the teeth were then restored with DBS and CR. After finishing and polishing, the specimens were stored in 100% humidity at 37 degrees C for 1 day. Compressive loading of the teeth was performed using a universal testing machine at a crosshead speed of 0.5 mm min(-1). The mean load necessary to fracture the samples were recorded in newtons (N) and were subjected to analysis of variance (ANOVA) and Tukey post-hoc test.

RESULTS

The mean load necessary to fracture the samples in each group were (in N): group 1: 1676.75 +/-154.63(a), group 2: 376.51 +/- 37.36(b), group 3: 733.23 +/- 133.33(c), group 4: 786.48 +/- 145.34(c), group 5: 943.63 +/- 121.15(d). There were statistically significant differences between the groups annotated with different letters.

CONCLUSIONS

(i) Use of flowable composite resin under composite restorations had no effect on fracture resistance of root filled molar teeth with MOD preparations, (ii) use of polyethylene ribbon fibre under composite restorations in root filled teeth with MOD preparations significantly increased fracture strength.

Effect of the gutta-percha solvents on the microhardness and the roughness of human root dentine

The purpose of this in vitro study was to evaluate the effect of gutta-percha solvents on the microhardness and the roughness of human root dentine. Forty-five recently extracted human mandibular anterior teeth were used. The teeth were sectioned longitudinally, embedded in acrylic resin and polished. Ninety specimens were divided into three groups containing 30 teeth each. In group 1, the specimens were treated with chloroform for 15 min. In group 2, the specimens were treated with halothane for 15 min. In group 3, distilled water was used and this group was served as control. All groups were then divided into two subgroups of 15 specimens each. The specimens, in groups 1a, 2a and 3a, were submitted to Vicker's microhardness indentations. Groups 1b, 2b and 3b were used for determination of the roughness of root dentine. The data were recorded as Vicker's numbers and Ra, mum for roughness test. The results were then analysed by one-way ANOVA and post hoc Tukey tests. The results indicated that chloroform and halothane did not affect the microhardness and the roughness of root dentine (P > 0.05).

Case-control study on cancer risk associated to residence in the neighbourhood of a petrochemical plant

The aim of the present study is to investigate cancer mortality and residence in the neighbourhood of the petrochemical plant located in Brindisi, South-eastern Italy. Cases were all subjects resident in Brindisi and in three neighbouring municipalities who died in the study area in 1996-1997 from lung cancer, pleural neoplasm, bladder cancer and lymphohematopoietic malignancies. Controls were subjects resident in the same area and deceased in 1996-1997 for any cause except those listed for the cases. Next of kin's of all study subjects were visited by an interviewer who collected anamnestic information. The main residence of each subject, defined as the longest held residence with exclusion of the last 10 years, was reported on a digitalized map of the study area (MapInfo). The study included 144 cases and 176 controls; response rate was 98%. Residence within 2 km from the centre of the petrochemical plant was associated with a 3 fold increase of the Odds ratios (OR) for lung cancer, which did not reach statistical significance. Living close to the petrochemical plant was associated with moderate increases of OR for bladder cancer and lymphohematopoietic neoplasms which did not reach statistical significance. In conclusion the present study has shown moderate increases in risk for lung, bladder and lymphohematopoietic neoplasms in the population resident within 2 km from the centre of the petrochemical plant in Brindisi. These figures were confirmed after adjusting for smoking habit, occupation and school level. Random misclassification may have somehow resulted in risk underestimation.

Anin vitrocomparison of adhesive systems to seal pulp chamber walls

AIM

To compare in vitro the sealing properties of five different dentine adhesive materials (Prime&Bond NT (PBNT); Prompt L-Pop (PLP); Clearfil SE Bond (CSEB); Scotchbond Multi Purpose Plus (SMPP); EBS-Multi (EBSM)) inside the pulp chamber.

METHODOLOGY

Seventy-five recently extracted human molar teeth were used. The roof of the pulp chambers and roots were removed under water cooling. Pulp tissue was removed, and the canal orifices were sealed. The pulp chambers were then treated with 5% sodium hypochlorite (NaOCl) for 1 min. The teeth were randomly divided into five groups of 15 teeth each. Adhesive systems were applied to the pulp chamber walls according to the manufacturers' instructions. The samples were connected to Plexiglass plates, and a fluid filtration method was used for quantitative evaluation of leakage. Measurements of fluid movement were made at 2-min intervals for 8 min. The quality of seal of each specimen was measured immediately, after 24 h, 1 week and 1 month. The data were statistically analysed by repeated-measurements multivariate anova, Friedman test, Wilcoxon signed rank test, Kruskal-Wallis of one-way anova and Mann-Whitney U-tests. The pulp chamber wall with and without NaOCl and resin-dentine interfaces of specimens were observed under a scanning electron microscope (SEM).

RESULTS

The leakage values of the materials were significantly different at different measurement periods. In all groups, leakage values decreased with time (P < 0.05). PBNT and PLP had the least leakage during immediate measurements (P < 0.05). After 1 month, leakage of all adhesive systems was not significantly different (P < 0.05). SEM observation of pulp chamber walls demonstrated that the irregular dentine surface without smear layer was present in the nontreated group. However, NaOCl application removed the collagen fibrils leaving the dentine surface smooth. At resin-dentine interfaces of specimens, no hybridization zone was observed.

CONCLUSIONS

None of the materials had created a perfect seal to the pulp chamber walls. PBNT and PLP had better sealing over the short term, but over the long term, there were no differences between the materials.

Risk of soft tissue sarcomas and residence in the neighbourhood of an incinerator of industrial wastes

AIMS

To investigate the association between occurrence of soft tissue sarcomas (STS) in Mantua and residence near an incinerator of industrial wastes.

METHODS

Cases were subjects with histologically confirmed primary malignant STS diagnosed 1989-98 in the population resident in Mantua and in the three neighbouring municipalities. Controls were randomly extracted from population registries, matched for age and sex. Residential history was reconstructed for all study subjects since 1960. Main residence was geographically positioned according to GPS standards.

RESULTS

The study included 37 STS cases (17 men and 20 women) and 171 controls. The incidence of STS in the area of study was estimated as 8.8 per 100 000 in men and 5.6 per 100 000 in women. The odds ratio associated with residence within 2 km, standardised by age and sex, was 31.4 (95% CI 5.6 to 176.1), based on five exposed cases. At greater distances, risk rapidly decreased, showing a fluctuation around the null value of 1.

CONCLUSION

The study shows a significant increase in risk of STS associated with residence within 2 km of an industrial waste incinerator; an aetiological role of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) can be hypothesised.

A quantitative evaluation of apical leakage of four root-canal sealers

AIM

This in vitro study evaluated the microleakage of root fillings involving four root-canal sealers including AH Plus (De-Trey, Switzerland), RoekoSeal (Roeko, Germany). Ketac-Endo (ESPE, (Germany) and Sultan (Sultan Chemists, USA.

METHODOLOGY

Forty extracted human maxillary anterior teeth were used. The coronal part of each tooth was removed and the root canals were prepared using the step-back technique and apical enlargement to size 60 file. The specimens were randomly divided into four groups of 10 samples, filled with one of the test materials and gutta-percha cones by the cold lateral condensation technique. A fluid filtration method was used for quantitative evaluation of apical leakage. The leakage was measured by the movement of an air bubble in a capillary glass tube connected to the experimental root section. Measurements of fluid movement were made at 2-min intervals for 8 min. Water transport through existing voids in the obturated canals could be measured reproducibly in this way. The quality of the seal of each specimen was measured after 7,14 and 21 days.

RESULTS

Statistical analysis indicated that all the root fillings showed less leakage after 21 days (P < 0.05). Fillings incorporating Sultan showed significantly more leakage than all other sealers.

CONCLUSIONS

Root fillings with RoekoSeal in combination with cold lateral condensation technique showed better sealing than those with Ketac-Endo, AH Plus and Sultan sealers after 21 days. The fluid filtration test used in this study gave quantitative results and allowed nondestructive long-term evaluation of specimens.

Bonding strength to two different surfaces of dentin under simulated pulpal pressure

PURPOSE

The purpose of this in vitro study was to measure and compare the in vitro shear bond strengths (SBS) of the following dentin bonding systems to different dentin surfaces under simulated pulpal pressure: Liner Bond 2 (self-etching) (LB2), Liner Bond 2V (self-etching) (LB2V), Opti Bond Solo (single component) (OBS), Fuji Bond LC (filled) (FBLC), Prime & Bond 2-1 (single component) (P&B2-1), and Solid Bond (total etching) (SB).

MATERIALS AND METHODS

Occlusal and buccal surfaces of 60 extracted human molars were prepared to expose the dentin bonding surface. After being wet ground with 600-grit abrasive papers, teeth were randomly assigned to 6 equal groups of 10 each. The dentin surfaces were treated with the bonding systems mentioned above, and resin composite cylinders (Clearfil AP-X) were built up under simulated pulpal pressure when diluted bovine serum was used as the pulpal fluid. After one day of storage in 37 degrees C water, the specimens were shear tested to failure on an Instron machine.

RESULTS

The data were statistically analyzed with the Student's t-test and a post hoc Tukey test. Comparing buccal surfaces, the post hoc Tukey test indicated no significant differences among all the test groups (p > 0.05). On occlusal surfaces, the post hoc Tukey test indicated significant differences among the tested groups (p < 0.05). The Student's t test revealed significant differences between the occlusal and buccal shear bond strength values in LB 2, LB2V, and SB groups (p < 0.05).

CONCLUSION

The strength of adhesion to dentin depends upon both the adhesive system used - with self-etching systems tending to show higher bond strengths than the other materials tested - and the location of the dentin, with significantly higher SBS being found on buccal surfaces in 3 of the 7 tested bonding systems.

A pilot study of measurement of the frequency of sounds emitted by high-speed dental air turbines

Since the development and use of the high-speed dental air turbine some 45 years ago, concern has been expressed in the literature about a possible cause and effect relationship between use of the drill and hearing loss in dentists. The hearing threshold in humans varies with the frequency of sound. It is well known that dentists experience gradual hearing loss during their working life. The aim of this study was to measure the frequency of sounds emitted by high-speed dental air turbines under different working conditions. Five high-speed dental air turbines were used (2 x Trend TC-80 BC W&H Dentalwerk, Austria, 2 x Black Pearl Eco Bien-air, Switzerland, 1 x Trend TC-80 BC W&H Dentalwerk, Austria. Each turbine was tested under 8 different working conditions: under free working conditions the turbines were tested without burs, with fissure burs, with flare burs, with round burs and with inverted cone burs; under operation they were tested with fissure burs by application to a 3 x 3 x 10 mm amalgam block surface, a 3 x 3 x 10 mm composite block surface, and the occlusal surface of an extracted molar tooth. Forty sound recordings were made in total using a computer with a microphone (Shure 16 LC) located 30 cm away from the samples, at 10-s intervals using a mixer. Frequency analysis was done by a Cool Edit Pro 1.2 computer program. Data were analyzed by multi-variate analysis with the S.P.S.S 9.05 software program. The average measurement was 6860 Hz. According to the statistical analysis there was no significant difference in the frequencies recorded under different working conditions. There was also no significant difference among the different high-speed dental air turbines at alpha = 0,05, P > alpha /2 levels. These results indicate that under any working conditions, high-speed dental air turbines emit frequencies which can cause hearing loss.

Regional bond strengths of adhesive resins to pulp chamber dentin

Microleakage of oral microorganisms, which can occur due to the lack of sealing ability of permanent restorative materials, may cause failure of root canal treatments. Although a great deal of research has been done on sealing enamel and coronal dentin with resins, little research has been done on the adhesion of resins to the walls of pulp chambers. The purpose of this study was to evaluate regional bond strengths of two adhesive systems to the walls of pulp chambers. A section was made horizontally through the middle of the pulp chamber of extracted human third molars to divide the chamber into upper and lower halves. The pulp tissue was removed and the tooth segments were then divided into treatment subgroups. The pulp chambers were bonded with C&B Metabond (Parkell) or One-Step (Bisco), with or without 5% NaOCI pretreatment. The microtensile bond strengths of these resins to four different pulp chamber regions (bottom, wall, roof, and pulp horn areas) were then measured using an Instron machine. The data were expressed in MPa and were analyzed by a three-way ANOVA. Statistically significant differences were found among the test groups (p < 0.001). One-Step produced higher bond strengths to all pulp chamber regions except the floor, compared with C&B Metabond. The results indicated that high bond strengths can be achieved between adhesive resins and the various regions of the pulp chamber. This should permit the use of a thick layer of unfilled resin along the floor of the pulp chamber and over the canal orifices as a secondary protective seal after finishing root canal therapy.

High incidence of classic Kaposi's sarcoma in Mantua, Po Valley, Northern Italy (1989-1998)

The incidence of classic Kaposi's sarcoma was estimated in the province of Mantua, Po Valley, Northern Italy, yielding age-standardized rates of 2.5/100 000 men and 0.7/100 000 women (1989-98). Elevated rates in the rural zone of Viadana/Sabbioneta (5.0/100 000 men and 2.8/100 000 women) are among the highest so far reported for Italian communities.

Adhesive sealing of the pulp chamber

The purpose of this in vitro study was to evaluate quantitatively the ability of four different filling materials to seal the orifices of root canals as a secondary seal after root canal therapy. Forty extracted human molar teeth were used. The top of pulp chambers and distal halves of the roots were removed using an Isomet saw. The canal orifices were temporarily sealed with a gutta-percha master cone without sealer. The pulp chambers were then treated with a self-etching primer adhesive system (Clearfil SE Bond), a wet bonding system (One-Step), a 4-methacryloyloxyethyl trimellitate anhydride adhesive system (C&B Metabond), or a reinforced zinc oxide-eugenol (IRM). The specimens were randomly divided into four groups of 10 each. A fluid filtration method was used for quantitative evaluation of leakage. Measurements of fluid movement were made at 2-min intervals for 8 min. The quality of the seal of each specimen was measured by fluid filtration immediately and after 1 day, 1 wk, and 1 month. Even after 1 month the resins showed an excellent seal. Zinc oxide-eugenol had significantly more leakage when compared with the resin systems (p < 0.05). Adhesive resins should be considered as a secondary seal to prevent intraorifice microleakage.

A simple method for single anterior tooth replacement

PURPOSE

This article reports a case in which a recently extracted tooth was used as a natural tooth pontic bonded to the teeth on either side of the missing tooth using a Ribbond ribbon.

MATERIALS AND METHODS

A bondable, reinforcing polyethylene ribbon was used to bond a natural tooth pontic to adjacent teeth.

RESULTS

Acceptable esthetics were obtained and the result was satisfactory for the patient.

CONCLUSION

After one year of clinical use, direct construction of a single-tooth replacement using the natural tooth pontic still provided satisfactory esthetics and function. The technology which makes this adhesive restoration possible is the development of a high strength, high molecular weight, biocompatible polyethylene fiber. This easily handled material must be evaluated in long-term clinical studies.