Prediction of periapical status and tooth extraction.

AIM: To describe and analyse risk factors associated with prediction of periapical status, assessed using the full-scale Periapical Index (PAI) supplemented with extraction as outcome variable. METHODOLOGY: In 1997-1998, 616 randomly selected individuals from Aarhus County, Denmark, underwent a full-mouth radiographic survey. All 616 were re-invited in 2003-2004 and in 2008-2009, when 473 and 363 persons, respectively, consented and attended a new radiographic examination. The study population of the present investigation included 330 persons who had participated in all three examinations, and 143 persons who had participated in the first and second examination only. Using the full-mouth radiographic survey and interview information, the following variables were assessed: on person level - age, gender, smoking habits and number of teeth; on tooth level - presence of tooth, PAI, root filling, caries, marginal bone level, restoration, jaw and tooth group. The outcome variable was the 5 score PAI supplemented with extraction. The observation period was 5 years. Ordered logistic regression analyses were carried out for root filled and non-root filled teeth separately. The Regional Committee of Ethics approved the study. RESULTS: For both root filled teeth and non-root filled teeth, the baseline PAI score was the most important predictive factor of periapical status and extraction (P < 0.0001). Non-root filled teeth had in general a better outcome than root filled teeth. However, in non-root filled teeth, several other factors had a significant influence on the outcome, and the risk estimates were larger and showed a more pronounced variation between the different categories of predictive factors. For root filled teeth few variables, other than baseline PAI score, influenced the outcome significantly. CONCLUSION: The full-scale PAI was the strongest predictive factor of periapical status or extraction even when adjusted for additional factors, such as marginal bone level. A high baseline PAI score increased the risk for an impaired outcome. The large difference in risk estimates for non-root filled compared to root filled teeth documents the importance of separate analyses/studies for identification and quantification of predictive factors associated with periapical status and extraction of a tooth.

Chemical composition and anxiolytic evaluation of Achillea Wilhelmsii C. Koch essential oil in rat.

Herbal based remedies are used worldwide to treat psychiatric disorders. The aim of this study was to analyse the essential oil composition of Achillea Wilhemsii C. Koch (Asteraceae) and to evaluate its anxiolytic effects in the elevated plus maze (EPM) model of anxiety in rat. Gas chromatography/mass spectrometry (GC/MS) analysis of the essential oil showed that the main compounds of the oil were p-ocimen (23%), 1, 8-cineole (20.8%) and carvone (19.13%). The EPM results showed that 1 mg/kg (i.p.) of the oil significantly (P<0.05) increased the percentage of the time spent and the number of entries in the open arms of the maze while it did not change the total number of entries in the maze arms. These effects were not reversed with 2 mg/kg flumazenil and 5 mg/kg naloxone. We concluded that a minimum dose of 1 mg/kg of the oil has anxiolytic effects which are not probably mediated through GABA and opioid receptors.

Rapid and sensitive high performance liquid chromatographic determination of zonisamide in human serum application to a pharmacokinetic study.

An accurate and very rapid method for determination of zonisamide an antiepileptic drug, in human serum is described. The analytical procedure involves liquid-liquid extraction of the analyte and an internal standard (vanillin) from human serum by ethyl acetate as extracting solvent. Chromatographic separation was achieved using a monolithic C18 analytical column and a mixture of 0.05 M phosphate buffer containing triethylamine (1 ml/l; pH 2.7) and methanol (83:17 v/v) was used as the mobile phase. The detection wavelength was set at 240 nm. The calibration curve was linear over a concentration range of 0.015-6.4 µg/ml of zonisamide in human serum. The total run time of analysis was 3.5 min and the lower limits of detection and quantification were 0.005 and 0.015 µg/ml, respectively. The method validation was carried out in terms of specificity, sensitivity, linearity, precision, accuracy and stability. The validated method was applied in a randomised crossover bioequivalence study of two different zonisamide preparations in 24 healthy volunteers, and the assay was sensitive enough to measure drug levels up to 8 days following a single dose administration of zonisamide.

Risk factors for developing apical periodontitis in a general population.

AIM: To identify and describe individual and tooth-specific factors associated with the incidence or the persistence of apical periodontitis (AP) in a general population. METHODOLOGY: In 1997, 616 randomly selected individuals had a full-mouth radiographic survey. In 2003, 77% of the participants returned for a new full-mouth radiographic examination. All teeth were assessed individually and data recorded for caries, marginal bone level, and tooth restorations. Multiple logistic regression analyses were performed to identify predictors of AP in the individual. Conditional logistic regression analyses were used to identify risk factors for development of AP in a tooth. Independent variables included a number of individual and tooth-specific variables. RESULTS: Root fillings, coronal restorations, primary carious lesions, and reduced marginal bone level were associated with the incidence of AP in the individual. In teeth, the quality and presence of a coronal restoration was associated with the incidence of AP, and presence of a root filling also increased the risk of developing AP. Furthermore, an increased risk of developing AP was seen in relation to primary carious lesions, reduced marginal bone level, and molar teeth. The quality of the root filling was not associated with the incidence of AP, but the results suggest an association between the quality of the root filling and the healing of AP. CONCLUSIONS: Results from the present study demonstrate that it is important to provide high quality dental restorations to minimize the risk of pulpal infection. The clinical focus, in relation to the incidence of AP, should be on improving the quality of the coronal restoration. The quality of a root filling was not associated with the incidence of AP, but may be of importance in relation to healing of AP.

Fatty acid composition of human milk in Western Iran.

OBJECTIVE: To investigate the fatty acid composition of mature human milk in Western Iran with special focus on trans fatty acids. DESIGN: Observational study. METHODS: Milk samples were collected from 52 lactating mothers aging 19-39 y, from Western Iran. Subjects were asked to complete a diet questionnaire. Milk fatty acids were measured as 2-nitrophenylhydrazide derivatives by high-performance liquid chromatography. RESULTS: Saturated fatty acids were the main fraction of human milk (41.3%). Medium-chain fatty acids (C8:0-C14:0) constituted 24%, oleic acid (C18:1omega9) accounted for 30.9% and elaidic acid (C18:1T), the trans isomer of oleic acid, comprised 11.3% of the total milk fatty acids. Linoleic (C18:2omega6) and linolenic (C18:3omega3) acid contents were 13.8 and 1.1%, respectively. The level of the polyunsaturated fatty acids was 1.4% for arachidonic (C20:4omega6) and 0.2% for eicosapentaenoic (C20:5omega3) acid. CONCLUSIONS: The milk from Iranian lactating mothers, as compared to that from the American or European mothers, contained high levels of medium-chain and trans fatty acids. This difference may be attributed to the maternal diet with low animal protein and animal fat but with high carbohydrate and partially hydrogenated vegetable oils that carry large amounts of trans fatty acids. As the detrimental effects of trans fatty acids on blood lipids and cardiovascular diseases have been emphasized in the literature, a reduction of trans fatty acid content in the diet of Iranian mothers is suggested. SPONSORSHIP: Kermanshah University of Medical Sciences.

Bitewing examination with four digital receptors.

OBJECTIVES: To evaluate recording errors and patient discomfort during bitewing examinations using four digital receptors. METHODS: Seventy-eight patients had two bitewings taken on each side of the mouth with the intention of displaying the tooth surfaces from the distal surface of the canine to the distal surface of the most posterior molar, using four digital receptors, two charge-coupled device (CCD) and two photostimulable phosphor (PSP) systems. The patients scored their feelings of discomfort during the examination on a visual analogue scale. Receptor positioning errors in the sagittal plane were determined from the tooth surfaces present on each image and in the vertical plane from the presence of the alveolar bone crest. Cone positioning errors were determined from cone cuts. RESULTS: Canine and premolar surfaces were more often not depicted on the CCD images than on the PSP images (P<0.05). Cone cuts occurred in 19% of DenOptix images, in 9% of Digora images and in one Planmeca image. The bone crest was more often missing in the upper jaw on Planmeca images than on PSP images (P<0.01). In the lower jaw, Trophy images more often missed the bone crest than the other systems (P<0.05). Patients ranked the receptors as follows (with increasing discomfort): DenOptix, Planmeca, Digora and Trophy, with all being significantly different (P<0.05). CONCLUSIONS: It was more difficult to correctly position CCD sensors than PSP plates in the vertical plane, resulting in more images with missing alveolar bone crest. CCD sensors most often did not display the most anterior surfaces in a bitewing examination.

A rapid reversed phase high performance liquid chromatographic method for determination of etoposide (VP-16) in human plasma.

A rapid, simple and sensitive isocratic High Performance Liquid Chromatography (HPLC) method was developed to measure the concentration of etoposide in plasma samples with UV detection at 220 nm. The method uses a Bondapac C18 column at 60 degrees C. The mobile phase consists of Methanol: water (45:55 v/v) at a flow rate of 2.8 ml/min. Phenacetin was used as an internal standard. The plasma samples were extracted using ether with the organic layer evaporated under nitrogen. The residue was dissolved in 200 microl methanol with 20 microl injected into the HPLC column. The extraction method showed a recovery of 91.5+/-3% for etoposide. In this system, the retention time of phenacetin and etoposide were 3.3 and 4.4 min, respectively. The limit of detection of etoposide in plasma is 20 ng/ml and the limit of quantitation is 40 ng/ml. This analytical method has very good reproducibility (8.1% between-day variability at a concentration of 50 ng/ml). It is a fast, sensitive and economic method applicable for clinical and pharmacokinetic studies.