Microbial contamination of brand new nickel-titanium endodontic instruments.

AIMS: This study aims to estimate the microbial presence on the surface of different brand new NiTi endodontic instruments for clinical use. MATERIAL AND METHODS: Eleven different types of NiTi rotary endodontic instruments, obtained from their fresh opened original packages, were assigned to three different groups, according to packaging type and sterilization and tested for bacterial contamination. Isolated bacteria were identified by using standard microbiological methods and then counted. Differences observed in groups were analyzed statistically by using the one-way analysis of variance (ANOVA) for dependent samples and the Tukey HSD post hoc test. RESULTS: Statistical differences were found between instruments delivered in plastic boxes which bacterial count resulted higher than those obtained from instruments delivered in blisters (p<0.01). CONCLUSIONS: Some brand new endodontic instruments showed degrees of bacterial contamination that both quantitatively and qualitatively deserve to be considered in clinical procedures.

Root surface alterations following manual and mechanical scaling: A comparative study.

OBJECTIVES: The aim of this study was to investigate the morphological and surface roughness changes in dental root samples following periodontal scaling by hand curette, piezoelectric ultrasonic devices or a combination of these. METHODS: Twenty-four monoradicular teeth extracted as a result of periodontal disease were divided into 4 groups: Group A was treated by piezoelectric ultrasonic scaler Piezon® Master 400; Group P by piezoelectric ultrasonic scaler PiezoSmart® ; Group C using Gracey curette 7/8; Group AC by a combined technique of piezoelectric ultrasonic scaler Piezon® Master 400 and Gracey curette 7/8. The treated samples were then analysed using a white light interferometer and scanning electron microscopy (SEM). RESULTS: Roughness analysis revealed major surface alterations in Group C (Sa  = 24.98 µm); the samples treated using the combined technique (Group AC) showed reduced but still significant alteration (Sa  = 14.48 µm), while samples treated with the piezoelectric ultrasonic devices (Group A and Group P) presented the lowest roughness values (Sa  = 8.99 and Sa  = 4.45 µm, respectively). A significant difference was found between groups C and P (P = 0.036). SEM analysis confirmed the roughness analysis revealing non-homogeneous surfaces in Group C, while a less morphological alteration was noted in the other groups. CONCLUSION: All periodontal devices used in this in vitro study produced a certain degree of surface alteration. Hand curettes appear to have a major impact on surface integrity compared with piezoelectric ultrasonic devices.

Last-male sperm precedence in Rhynchophorus ferrugineus (Olivier): observations in laboratory mating experiments with irradiated males.

The Red Palm Weevil (RPW) Rhynchophorus ferrugineus (Olivier 1790) is an invasive pest from southeastern Asia and Melanesia that in the last 30 years has spread widely in the Middle East and Mediterranean Basin. Its stem-boring larvae cause great damage to several palm species of the Arecaceae family, many of which are economically important for agricultural and ornamental purposes. Therefore, great attention has recently been focused in studying this species to identify sustainable and effective eradication strategies, such as sterile insect technique (SIT). The rapid spread of RPW is associated with its high reproductive success. To evaluate the suitability of a SIT strategy, particular physiological and behavioral aspects of RPW reproduction, such as the presence of polyandry and post-copulatory sperm selection mechanisms, were investigated. To determine paternity of progeny from multiply mated females, double-crossing experiments were carried out confining individual females with either a wild-type male or a γ-irradiated male (Co-60). Fecundity and fertility of females were scored to evaluate post-copulatory sperm selection. Results showed that progeny were almost exclusively produced by the sperm of the second male, suggesting that a last-male sperm precedence is expressed at high levels in this species, and providing interesting insights for an area-wide RPW management strategy such as the SIT.

[VAP and oral hygiene.A systematic review].

Ventilator associated pneumonia (VAP) is a common nosocomial infection in intensive care units. International literature showed how the use of professional oral hygiene protocols provide an essential support in VAP prevention. The aim of this study is to provide a systematic and narrative updated review, to further demonstrate that a proper protocol of oral hygiene, in special needs patients, can reduce risk of developing VAP. In this study were analyzed 10 narrative and 3 systematic reviews. Systematic reviews were evaluated with AMSTAR checklist, INSA tool was used to analyze narrative reviews. The findings of this study suggest that the use of antimicrobials combined with tooth brushing can actively contribute to reducing the incidence of VAP.

Genetic and morphological studies of Trichosirocalus species introduced to North America, Australia and New Zealand for the biological control of thistles.

Trichosirocalus horridus sensu lato has been used as a biological control agent of several invasive thistles (Carduus spp., Cirsium spp. and Onopordum spp.) since 1974. It has been recognized as a single species until 2002, when it was split into three species based on morphological characters: T. horridus, Trichosirocalus briesei and Trichosirocalus mortadelo, each purported to have different host plants. Because of this taxonomic change, uncertainty exists as to which species were released in various countries; furthermore, there appears to be some exceptions to the purported host plants of some of these species. To resolve these questions, we conducted an integrative taxonomic study of the T. horridus species complex using molecular genetic and morphological analyses of specimens from three continents. Both mitochondrial cytochrome c oxidase subunit I and nuclear elongation factor 1α markers clearly indicate that there are only two distinct species, T. horridus and T. briesei. Molecular evidence, morphological analysis and host plant associations support the synonymy of T. horridus (Panzer, 1801) and T. mortadelo Alonso-Zarazaga & Sánchez-Ruiz, 2002. We determine that T. horridus has been established in Canada, USA, New Zealand and Australia and that T. briesei is established in Australia. The former species was collected from Carduus, Cirsium and Onopordum spp. in the field, whereas the latter appears to be specific to Onopordum.

A consensus conference on management of the lower third molar. Italian Society of Odontostomatological Surgery.

During the first Congress of the Italian University Schools of Oral Surgery, held in Rome on 18-20th February, 2010, a task force was convened by the Italian Society of Odontostomatological Surgery (SIdCO) to summarize the data collected from the current literature on selected aspects relating to the mandibular third molar and its removal. The task of the Conference Participants was to review and analyze the pertinent literature and to elaborate conclusive recommendations for the management of the lower third molar. The statements made and the recommendations presented represent the consensus of the Conference, which can be considered the official statement of the SIdCO.

Learning impact of education during pulmonary rehabilitation program. An observational short-term cohort study.

BACKGROUND: Among the several components constituting a pulmonary rehabilitation (PR) course, education may contribute to an individual's recognition of symptoms and worsening of the disease. However, the specific benefits of education is far greater than can be clearly documented to the health care providers. The aim of our preliminary study was to assess the learning impact of educational sessions (ES) in Chronic Obstructive Pulmonary Disease (COPD) patients referred to standard PR. METHODS: Six ES on 3 areas (Symptoms-Therapies, Aids, Mood) were applied during PR at our clinic. The learning effect was prospectively evaluated by a specific questionnaire (ESQ) in 285 COPD patients (age 69 +/- 8 years, FEV1 53 +/- 14 % pred), then grouped into those who have completed ES (Completers group, n = 226) or who did not (mean 2 +/- 1 ES) (Control group, n = 59). Total and partial ESQ scores, and PR outcomes (6-minute walking test-6MWD, effort-dyspnoea at Medical Research Council scale-MRC, and health-related quality of life scale-SGRQ) were assessed in a pre (T0) to post (Tend) design. RESULTS: Similar improvement in PR outcomes was recorded in both groups at Tend, whereas ESQ total and partial scores significantly increased in 'Completers' only (p < 0.001). ESQ-Aids score improved to a greater extent in Completers than in Control (+0.60 +/- 1.03 vs +0.27 +/- 1.27 point respectively, p = 0.036). A higher proportion of Completers improved above the median change of both ESQ total and aids scores (p < 0.05). CONCLUSION: Attending educational sessions produces a specific short-term learning effect during rehabilitation of COPD patients.

The use of etanercept as a non-surgical treatment for temporomandibular joint psoriatric arthritis: a case report.

Psoriatic arthritis (PsA) is a chronic inflammatory disease of the skin and joints characterized by extensive intra-articular bone resorption and silver-red scaly plaques most commonly found on extensor surfaces of the skin. When this arthritis affects the temporomandibular joint (TMJ) and does not successfully halt in its early degenerative process, patients may undergo invasive joint reconstruction that irreversibly changes the TMJ physiologic joint dynamics. This study presents a case of TMJ PsA: anterior open bite, limited range of motion, and erythematous desquamative plaques of the upper limb extensors surfaces. The patient previously received non-steroidal anti-inflammatory drugs, immunosuppressors, and corticosteroids over a four-year period while suffering the idiosyncratic drug side effects from long-term therapy without improvement in joint function or rash resolution. The treatment team then chose etanercept, a synthetic fusion protein therapy that binds with tumor necrosis factor (TNF)-alpha, to interrupt reactive inflammatory arthritis. The patient received the TNF-alpha inhibitor monthly for two years. This last treatment led to full remission of both joint symptomatology and skin lesions. Our results should encourage general dental practitioners' involvement in curing patients with psoriatic arthritis when it affects the TMJ.

Dense bone island of the jaw: a case report.

The "Dense Bone Island" (DBI) is a radiopaque lesion referred in leterature as idiopathic osteosclerosis, enostosis, focal osteosclerosis, periapical osteopetrosis, and bone scar. The DBI are accidentally found in routinary Xray of bone structures. In the maxillary bones, often localized in the mandible, especially in the molar region, with a reported incidence ranging from 2.3 to 9.7%. DBI does not seem to develop until the first phase of adolescence and it is usually found in adolescents and in young adults. In 40% of cases DBI seems to increase in size after a 10 year follow-up, because the DBI found in jaws and in long bones seem to increase proportionally to the bone growth. A case of a 26 years old patient and the surgical treatment is presented. This is the first reported case where complete X-ray Orthopantomography follow-up showed the evolution of the lesion since its onset.

Psoriasis of the dorsal surface of the tongue.

Psoriasis is primarily an inherited inflammatory skin disease, it is characterized by erythemato-squamous lesions that usually involve elbows, knees and the scalp. Oral manifestations are rare in psoriasis, infact, oral psoriasis involves 2% of psoriatic patients and usually it is observed with the onset of cutaneous lesions and progresses with them. Differential diagnosis should be done for Reiter's syndrome, leukoplakia and geographic tongue. The authors describe a case of tongue psoriasis without cutaneous lesions.

Surgical removal of a left lower third molar root after iatrogenic displacement in soft tissue. Case report.

Displacement of a tooth or a portion of it is an unusual but very serious event for the severe consequences it could have. Already Hill and Howe in the half of the past century understood and described the risks associated to this accident particularly frequent during impacted third lower molars avulsion. Displacements can be idiopathic or iatrogenic and the sites of displacements depend on the anatomy of the tooth and the surrounding region. After a complete review of the literature, the authors describe the surgical removal of a left lower third molar root displaced in the soft tissue after a first extraction of the entire tooth. The necessary precautions to limit the frequency of this accident are then discussed.

Primary and exclusive gingival localization of non-Hodgkin lymphomas. Case report.

A case of primary and exclusive gingival localization of a non-Hodgkin lymphoma (NHL) personally observed at the Surgical Out-patients Unit of the Department of Dentistry at the Umberto I Hospital in Rome, is described. A 71 year-old caucasian male was referred by his private dentist because of a severe pain at the soft tissue of the mandible even after dental, neurologic and parodontal treatments. At clinical examination, a severe gingival swelling in the symphysis region with hard bleeding, palpable lymph nodes and no important evidence in radiographic and CT examinations were found. After incisional biopsy and its examination, a diagnosis of NHL was made. Further examinations did not show metastasis dissemination. The patient was referred to the Hematology Department and after 4 chemotherapy cycles over 12 months, he completely recovered. After an introduction on NHL, the clinical case is described as well as how to make a correct diagnosis; moreover, the importance of the dentist in identifying diseases even not strictly related to oral cavity but whose signs and manifestations appear over there, is stressed.

Subantral filling by deantigenated heterologous bone and immediate fixture placement.

AIM: A successful implant therapy depends on sufficient quantity of available bone. Latero-posterior maxillary area often represents a hardly useful zone for routine implant therapy in long time edentulous patients. Standard procedures of maxillary sinus lifting are the goals of implant-prosthetic rehabilitation. Among different grafting materials used in this kind of procedures, the deantigenated heterologous bone reliability has been tested. METHODS: In a clinical case of maxillary bone atrophy (Misch classification, SA3) a deantigenated heterologous bone grafting and immediate fixture placement has been performed; before prosthetic finalization a biopsy in the grafting site has been carried out in order to obtain an histological evaluation of the graft integration. RESULTS: The histological analysis and X-ray at 1 year follow-up show the formation of osteoid tissue integrated with the surrounding bone tissue, reaching bone maturity by calcification. In spite of a longer time for grafting integration, the advantages of a single-time surgery and the reduction of surgical timing are stressed. CONCLUSIONS: X-rays and histological results lead authors to consider the tested heterologous bone as a valid alternative to autologous bone, especially in those patients where it is preferable to avoid a second surgical site in order to take an inlay graft.

Rare compound odontoma of the mandible in a 7-year-old child: case report.

BACKGROUND: A compound odontoma is a mixed tumor of odontogenic origin, in which both ectodermal and mesenchymal cells exhibit complete differentiation, resulting in the formation of tooth structures. It occurs with equal frequency in both sexes, and is often initially asymptomatic. CASE REPORT: A 7-year-old boy was recently examined in our Department for management of a compound odontoma. Surgical treatment was invasive because of the size of the lesion, but it was possible to use interceptive orthodontic treatment to restore the dental arch.

Unusual vascular hamartoma of the hard palate. A case report.

Hamartomas are tumour-like malformations usually present since birth or which may develop during puberty. Hamartomas are related to anatomical development errors. Hamartomas are rarely found in the head and neck district. The case of an unusual vascular hamartoma localised in the hard palate of a 50-year-old female with no significant medical or family history is reported. Surgical treatment was performed by means of an excisional biopsy.

Factors affecting R6 fungicide toxicity on sea urchin fertilization and early development: roles of exposure routes and mixture components.

A technical fungicide mixture, R6 and its components, cymoxanil (CYM) and cupric oxychloride (Cu-OCl), were tested by sea urchin bioassays (Paracentrotus lividus and Sphaerechinus granularis). A set of toxicity endpoints was evaluated including both lethal and sublethal effects with the following endpoints: (a) acute embryotoxicity, (b) developmental defects, (c) changes in sperm fertilization success, (d) transmissible damage from sperm to the offspring, and (e) cytogenetic abnormalities. Acute effects on developing embryos were observed as early (prehatch) mortality at R6 levels > or =25 microg/ml. The pesticide mixture R6 was tested at realistic concentrations, ranging from 25 ng/ ml to 2.5 microg/ml, and the two components, CYM and Cu-OCl, were tested, either alone or in mixture, at concentrations equal to their levels in the corresponding R6 solutions. R6 was either dissolved in filtered seawater (water only, W-O), or spiked in "pristine" silt-clay sediment or soil samples before bioassays. Developmental toxicity of R6, following W-O dissolution, displayed a significant dose-related increase of larval malformations and differentiation arrest at concentrations of 750 ng/ml to 2.5 microg/ml both in P. lividus and in S. granularis larvae. Developmental toxicity was removed in spiked sediment up to R6 nominal levels (25 microg/ml), 10-fold above the embryotoxic R6 levels in W-O exposure. No significant developmental toxicity was exerted by CYM or Cu-OCl (W-O exposure) up to their concentrations equivalent to 2.5 microg/ml R6. The laboratory-prepared mixture of CYM and Cu-OCl, in the same concentration range, only resulted in minor effects, as larval retardation, suggesting the presence of toxic impurities (or additional components) in the R6 formulation. When sperm from either P. lividus or S. granularis were exposed to R6 before fertilization, a W-O exposure resulted in a dose-related decrease in fertilization of P. lividus sperm (up to 250 microg/ml R6), whereas S. granularis sperm underwent a significant increase of fertilization rate at the highest R6 nominal levels (up to 25 microg/ml). Equivalent CYM or Cu-OCl levels were ineffective on sperm fertilization success in both species. The offspring of S. granularis sperm exposed to 25 microg/ml R6 showed a significant increase in larval malformations, which were not detected in the offspring of R6-exposed P. lividus sperm. Again, CYM or Cu-OCl was unable to exert any transmissible damage from sperm to the offspring in either species. The present study raises the case of possible discrepancies between toxicity of a technical mixture and of its analytical-grade components, also providing evidence for a loss of pesticide toxicity following dispersion in an environmental matrix such as sediment or soil.

An atypical intronic deletion widens the spectrum of mutations in hereditary spastic paraplegia.

OBJECTIVE: To identify the genetic mutation responsible for autosomal dominant spastic paraplegia (HSP) in a large family with a "pure" form of the disorder. BACKGROUND: The disease locus in most families with HSP is genetically linked to the SPG4 locus on chromosome 2p21-p22. Some of these families have mutations in the splice-site or coding regions of the spastin gene (SPAST). METHODS: Linkage and mutational analyses were used to identify the location and the nature of the genetic defect causing the disorder in a large family. After the disease phenotype was linked to the SPG4 locus, all 17 coding regions and flanking intronic sequences of SPAST were analyzed by single-strand conformation polymorphism analysis (SSCP) and compared between affected and normal individuals. Direct sequencing and subcloning methods were used to investigate incongruous mobility shifts. RESULTS: The genomic sequence of SPAST showed a heterozygous four--base pair deletion (delTAAT) near the 3' splice-site of exon three in all 11 affected individuals but not in 21 normal family members or in 50 unrelated controls (100 chromosomes). CONCLUSIONS: This study identifies an atypical intronic microdeletion in SPAST that causes HSP and widens the spectrum of genetic abnormalities that cause the disorder.

The basal transcription factors TBP and TFB from the mesophilic archaeon Methanosarcina mazeii: structure and conformational changes upon interaction with stress-gene promoters.

Transcription of archaeal non-stress genes involves the basal factors TBP and TFB, homologs of the eucaryal TATA-binding protein and transcription factor IIB, respectively. No comparable information exists for the archaeal molecular-chaperone, stress genes hsp70(dnaK), hsp40(dnaJ), and grpE. These do not occur in some archaeal species, but are present in others possibly due to lateral transfer from bacteria, which provides a unique opportunity to study regulation of stress-inducible bacterial genes in organisms with eukaryotic-like transcription machinery. Among the Archaea with the genes, those from the mesophilic methanogen Methanosarcina mazeii are the only ones whose basal (constitutive) and stress-induced transcription patterns have been determined. To continue this work, tbp and tfb were cloned from M. mazeii, sequenced, and the encoded recombinant proteins characterized in solution, separately and in complex with each other and with DNA. M. mazeii TBP ranks among the shortest within Archaea and, contrary to other archaeal TBPs, it lacks tryptophan or an acidic tail at the C terminus and has a basic N-terminal third. M. mazeii TFB is similar in length to archaeal and eucaryal homologs and all have a zinc finger and HTH motifs. Phylogenetically, the archaeal and eucaryal proteins form separate clusters and the M. mazeii molecules are closer to the homologs from Archaeoglobus fulgidus than to any other. Antigenically, M. mazeii TBP and TFB are close to archaeal homologs within each factor family, but the two families are unrelated. The purified recombinant factors were functionally active in a cell-free in vitro transcription system, and were interchangeable with the homologs from Methanococcus thermolithotrophicus. The M. mazeii factors have a similar secondary structure by circular dichroism (CD). The CD spectra changed upon binding to the promoters of the stress genes grpE, dnaK, and dnaJ, with the changes being distinctive for each promoter; in contrast, no effect was produced by the promoter of a non-stress-gene. Factor(s)-DNA modeling predicted that modifications of H bonds are caused by TBP binding, and that these modifications are distinctive for each promoter. It also showed which amino acid residues would contact an extended TATA box with a B recognition element, and evolutionary conservation of the TBP-TFB-DNA complex orientation between two archaeal organisms with widely different optimal temperature for growth (37 and 100 degrees C).

The role of oxidative stress in developmental and reproductive toxicity of tamoxifen.

The antiestrogen tamoxifen (TAM) is widely used as a drug against breast cancer and is currently being tested as a chemopreventive agent. However, a number of studies showed genotoxic and carcinogenic effects of TAM. These effects are thought to be related to oxygen radical overproduction which occurs during TAM metabolic activation. There is no evidence, thus far, on TAM toxicity to embryos and gametes. The present study was designed to elucidate the mechanisms of TAM-induced developmental, reproductive and cytogenetic toxicity towards sea urchin (SU) embryos with regard to the possibility of TAM-initiated oxidative stress. Embryo cultures from SU were subjected to long-term (throughout embryogenesis) or short-term (two hours) incubation with TAM at concentrations from 10(-8) to 10(-5) M. The experiments on TAM-induced toxicity to gametes were carried out with SU sperm, or unfertilized eggs, suspended in TAM (10(-8) to 10(-6) M). To assess the effects of TAM to embryos or to gametes, developmental defects, embryonic mortality, fertilization success, and cytogenetic abnormalities were scored. Oxidative damage to DNA and lipids was detected by measurements of 8OHdG levels and lipid peroxidation, respectively. Reactive oxygen species (ROS) production by eggs and embryos was recorded by luminol-dependent chemiluminescence (LDCL) and cytochrome c reduction methods. The changes in activities of SU superoxide dismutase (SOD) and catalase were also evaluated. TAM exerted: a) early embryonic mortality to exposed embryos and to the offspring of exposed eggs; b) developmental defects to the offspring of exposed sperm; c) decrease in sperm fertilization success, and d) cytogenetic effects in the offspring of exposed sperm or eggs. These morphological effects corresponded to the state of oxidative stress in SU embryos (increased oxidative damage to DNA and lipids and induction of antioxidant enzymes). Since TAM did increase significantly ROS production by embryos, it is suggested that TAM may be metabolically activated by SU embryonic oxidases and peroxidases, which in turn could be induced by TAM. The present study provides further support to the utilization of the SU system as a useful model to help elucidate mechanisms of chemical teratogenesis and carcinogenesis.

Bilateral mandibular cysts associated with cyclosporine use: a case report.

Cyclosporin A (CsA) is used in the treatment of patients undergoing renal transplantation. There are a number of side effects associated with its use. In particular, the gingival overgrowth represents the most important in the oral cavity. The authors present a case of bilateral mandibular cysts in an 8-year-old boy, treated with CsA after renal transplantation. The genesis of the mandibular cysts might be associated with the combined use of CsA and a calcium channel blocker post-transplantation. CsA-induced gingival overgrowth might contribute to cysts by two mechanisms: interference with control mechanisms that regulate the reabsorption of gingival stromal tissue, allowing progressive dental eruption, and an increase in the gingival connective tissue components. Gingival hypertrophy might mechanically obstruct the eruption of the developing tooth.