Two- to four-year follow-up analysis of three different pulpally involved high degree of difficulty cases managed with endodontic treatments using Mineral Trioxide Aggregate / Шинэ санаа Шинэ нээлт

@#Mineral Trioxide Aggregate (MTA) is a biocompatible, antibacterial, radiopaque, and dimensionally stable material after setting. Furthermore, it can set in the presence of moisture, and has a high sealing ability. The objectives of this study were to describe managements of three different exceptionally complicated endodontics cases using MTA, and to evaluate its outcomes of using MTA in long-term follow-up based on modern concept of endodontics. Case #1: A 23-year-old patient diagnosed with combined endodontic-periodontal lesion with palatogingival groove of maxillary right lateral incisor was referred to our department. A treatment of interdisciplinary approach involving root canal treatment, periodontal initial therapy, root resection, guided tissue regeneration and bone grafting was performed. The case showed complete clinical normalcy and radiographic healing on periapical radiograph after 3-year follow-up, and outcome was defined as healed. Case #2: A 33-year-old patient had a perforated resorptive lesion to mesial external root surface of tooth 21. The diagnosis was perforating internal root resorption with pulp necrosis and asymptomatic apical periodontitis. A treatment plan of revascularization with MTA coronal plug was made. The case #2 showed clinical normalcy, complete healing of alveolar bone and incomplete healing of resorptive area radiolucency on CBCT after 4-year follow-up, and outcomes were defined as healing. Case #3: An 18-year-old patient with pulp necrosis and chronic apical abscess at immature left maxillary lateral incisor with open apex received treatment of apexification with MTA and followed-up regularly. The case showed complete clinical normalcy and radiographic healing on periapical radiograph, but incomplete healing of the periapical lesion was observed on CBCT after 4-year follow-up. This outcome was defined as healing. 1. MTA may be a suitable material for use as a plug material that prevents infection and blood flow to the main root canal during periodontal surgery, perforation repair and internal root resorption filling and root canal obturation of apexification treatment. 2. Extruded MTA through the apical foramen may not have an adverse effect to periapical tissues, also could be result in osseous healing. Moreover, extruded MTA might have a property to resorb. 3. Tooth discoloration could be a potential drawback of white MTA when it is used as endodontic repair material and the discoloration tends to continuously develop for a while.

Human β-defensin-3 regulates the proliferation and the secretion of prostaglandin E2 and matrix metalloproteinase-1 in human gingival fibroblasts / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To observe the effect of human β-defensin-3 (HBD-3) on proliferation and the secretion of prostaglandin E2 (PGE2) and matrix metalloproteinase-1(MMP-1) in human gingival fibroblasts(HGF).</p><p><b>METHODS</b>The HGF were cultured with tissue-explant method and the fourth-generation HGF were plated in 96-well plate. All groups except the control group were treated with different concentrations of HBD-3 for 7 days. Then the HGF proliferation was evaluated with methyl thiazolyl tetrazolium(MTT) colorimetry and the secretions of PGE2 and MMP-1 at the 12th hours of each group were detected by enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>The result of MTT dynamic monitoring showed that the amount of HGF increased with time in all groups in concentration dependent manner.ELISA showed that the secretions of PGE2 and MMP-1 in 1.0 mg/L HBD-3 group were (350.56 ± 63.96) ng/L and (13.22 ± 0.59) µg/L, significantly higher than those in the control group and 10.0 mg/L HBD-3 group (P < 0.05).</p><p><b>CONCLUSIONS</b>HBD-3 promoted the proliferation of HGF. The low concentration of HBD-3 may play a role in immunoregulation through increasing the secretions of PGE2 and MMP-1.</p>

Therapeutic efficacy of salbutamol and dexamethasone added into whole lung lavage fluid in patients with pneumoconiosis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic efficacy and safety of salbutamol and dexamethasone added into large-volume whole lung lavage (WLL) fluid in patients with pneumoconiosis.</p><p><b>METHODS</b>A total of 176 patients with pneumoconiosis were randomly divided into control group (n=86) and treatment group (n=90). The control group received WLL with 0.9% sodium chloride solution, while for the treatment group, salbutamol and dexamethasone were added into the WLL fluid for both lungs at the 1st and 4th WLLs.Before and after WLL, the pulmonary wheezing, arterial partial pressure of oxygen (Pa02), peak airway pressure(Pa peak), amount of intrapulmonary residual fluid, forced expiratory volume in one second (FEVw) (72 h later),diffusion capacity for carbon monoxide (DLCO ), and forced vital capacity (FVC) were measured for comparison between the two groups.</p><p><b>RESULTS</b>After WLL, the treatment group had a significantly lower detection rate of pulmonary wheezing than the control group ( 13.3% vs 29.1 %, x2=5.028, ?=0.025), and the control group had a significantly higher incidence rate of pulmonary wheezing than the treatment group (21.8% vs 3.7%, 0R=5.423,95%CI 2.036-9.568 ). Compared with the control group, the treatment group had significantly higher Pa02 and significantly lower Pa peak and amount of intrapulmonary residual fluid (t =2.163 -4.132, P<0.05) and significantly higher FEV1, DLCO, and FVC (t=1.986-2.345, P<0.05) after WLL.</p><p><b>CONCLUSION</b>Salbutamol and dexamethasone added into large-volume WLL fluid may effectively alleviate bronchial spasm, reduce hypoxemia, and decrease Pa peak in patients with pneumoconiosis, thus promoting lung function recovery after WLL.</p>