Coverage of multiple recessions using the tunnel technique and a collagen matrix in the maxilla or mandible: a 6-month study.

Multiple recession defects in the dentition of the patients are routinely encountered in clinical practice and as such present a challenge for clinicians. Periodontal plastic surgical procedures aim to restore both esthetics as function in periodontal tissues. The objective of this study was to evaluate and compare the clinical efficacy of using a tunnel technique with a collagen matrix to cover multiple recessions in the maxilla or mandible. Fourteen patients were enrolled in the study. Patients in the maxilla-group and mandible-group were treated with xenogeneic collagen matrix using the tunnel technique. Clinical recordings were obtained at baseline and after 3 and 6 months. The percentage of average recession coverage (ARC), the percentage rate of patients with complete coverage of all recessions (CRC-1) and the percentage rate of complete coverage of recession defects (CRC-2) were evaluated after 3 and 6 months after the surgery. Statistically significant differences were observed in every parameter except probing depth between the baseline values compared to the values 3 and 6 months after the procedure in both groups. The mean ARC 6 months after the procedure was 96.8% in the maxilla and 81.3% in the mandible. At 6 months after the procedure, a complete root coverage was obtained in 2 out of 9 patients and 31 out of 39 recessions (79%) in the maxilla and 0 out of 5 patients and 10 out of 20 recessions (50%) in the mandible. A collagen matrix combined with the tunnel technique led to a satisfactory ARC, CRC- 2 and resulted in an unsatisfactory CRC-1.

Mechanisms of resistance to antimicrobial drugs in pathogenic Gram-positive cocci.

Many species of Gram-positive cocci are pathogenic. The most important are staphylococci, streptococci, and enterococci. Widespread usage of antibiotics was the main cause for the appearance and spread of resistance to almost all antimicrobials. The occurrence, mechanisms, and genetic background of resistance to antimicrobial drugs other than beta-lactams and glycopeptides among pathogenic staphylococci, streptococci, and enterococci are discussed in the text. Well-established agents (such as macrolides, lincosamides, streptogramins, aminoglycosides, quinolones, mupirocin, chloramphenicol) as well as new agents (linezolid, daptomycin, quinupristine/dalfopristine, ratapamulin, tigecycline, iclaprim and new generations of quinolones) are considered.

Mechanisms of the resistance and tolerance to beta-lactam and glycopeptide antibiotics in pathogenic gram-positive cocci.

Beta-lactams are the most frequently used antimicrobials in combating infections. In the case of gram-positive bacteria resistant to beta-lactams, glycopeptides are the first choice. The occurrence, mechanisms and genetic background of the resistance of pathogenic staphylococci, streptococci and enterococci to beta-lactam and glycopeptide antibiotics were discussed. The resistances to well-established antimicrobials, as well as new agents (ceftobiprole, oritavancin, telavancin, dalbavancin) were taken into consideration in the text.