Effect of methylprednisolone, hyaluronic acid and pioglitazone on histological remodeling of temporomandibular joint cartilage in rabbits affected by drug-induced osteoarthritis.

BACKGROUND: The aims of this study were to assess the anti-degenerative effects of pioglitazone and to compare these effects with those of methylprednisolone and hyaluronic acid on drug-induced osteoarthritis in rabbits' temporomandibular joint cartilage. MATERIAL AND METHODS: The experiment was conducted on 40 Californian white rabbits. Degenerative changes were induced by intra-articular injections of papain. Subsequently, all of the animals were randomly assigned to one of four groups: 1) a control group that received no medications; 2) a group treated with 4 intra-articular injections of 2 mg (0.2 ml) of hyaluronic acid at weekly intervals; 3) a group treated with 4 intra-articular injections of 2 mg (0.1 ml) of methylprednisolone at weekly intervals; 4) a group administered pioglitazone orally in daily doses of 2 mg/kg of body weight. Four weeks after the beginning of drug administration, the rabbits were sacrificed. Sagittal sections of the intra-articular cartilage (discs) and mandibular condyles were stained with hematoxylin and eosin by the PAS technique and with van Gieson's solution. Histologic examinations, as well as cartilage thickness and number of cell layers measurements, were performed. RESULTS: Histologic assessment in cases of arthritis-associated pathologies revealed that changes occurred most frequently in the control group and least frequently in the pioglitazone group. There were no differences in the histological structures of the intra-articular discs. Cartilage thickness measurements demonstrated the thinnest cartilage in group 2 and the thickest in group 3. Analysis of cell layer numbers showed the most numerous layers in the pioglitazone group and the least in the control group. CONCLUSION: Pioglitazone and hyaluronic acid showed anti-degenerative properties compared to methylprednisolone in an animal model.

From ophthalmologist to dentist via radiology.

BACKGROUND: The aim of this paper was to analyze the causes of orbital cellulitis in connection with covert dental changes as well as to establish the role of radiological procedures in the final diagnosis and further treatment of such cases. MATERIAL/METHODS: Thirty-two patients, aged 25-56, 22 women and 10 men were diagnosed and treated between January 2007 and April 2011 at the Pomeranian Medical University in Szczecin. The patients were examined in the infirmary of the ophthalmological department due to unilateral blepharo-oedema, abrupt pain and vision disturbances; in 5 cases, body temperature increased up to 37.8°C was observed. Next, the patients underwent conventional X-ray examinations of the orbit to exclude any foreign bodies in the eyeball, as well as pantomographies to evaluate the dental status. Visible periapical or periodontal changes in dentition were analyzed with intraoral X-rays with the use of DIGORA System 2.1. Changes found in 3 patients on pantomograms and connected with iatrogenic procedures were further evaluated with CT (64 lines and 128 layers) in frontal, sagittal and axial projections. Orbital disorders were also diagnosed by an ophthalmologist and radiologist with Doppler ultrasound (US) examinations. A linear transducer of 7.5-10 MHz to observe the morphology and vascularity of the eyeball was applied. RESULTS: IATROGENIC TREATMENT WAS THE CAUSE OF SINUSITIS AND CELLULITIS IN THREE CASES: incorrectly implanted dental implant in one case, root of the 3(rd) molar pushed into the sinus in the second case, and communication between the maxillary alveolar process and the sinus after extraction in case of the third patient. Asymptomatic periapical osteolysis, periodontal disease or dead teeth were found in all cases. Diagnosis of orbital cellulitis of dental origin was determined on the basis of clinical, radiographic and ultrasound findings. Ophthalmologic and dental treatment was applied simultaneously. CONCLUSIONS: Co-operation between ophthalmologists, radiologists and dentists is necessary during the treatment of such orbital diseases.

[Metabolic changes in bone marrow in patients submitted to immunosuppressive treatment]. / Zmiany metaboliczne w tkance kostnej u pacjentów poddanych leczeniu immunosupresyjnemu.

A historical outline of the immunosuppressive treatment and related developments in transplantology is presented here. It is accompanied by a description of the essential knowledge of the bone marrow histology as well as of the role of mesenchymal stem cells (MSCs) in the regenerative processes occurring in the organism following tissue damage. We have reviewed contemporary knowledge of negative (quantitative and qualitative) changes in bone tissues caused by immunosuppressive treatment after an organ transplantation and mentioned prophylactic measures which may be used in such cases. We also describe basic immunosuppressive medications taking into account their side effects on the organism of the patient and, in particular, on the bone marrow metabolism as well as the mechanisms of their action at the cellular level.

[Lincomycin applied to the alveolus on TCP carrier and its effect on wound healing after surgical extraction of a third molar]. / Wplyw aplikowania do zebodolu linkomycyny na nosniku TCP na proces gojenia rany po chirurgicznym usunieciu zeba madrosci.

INTRODUCTION: The dental surgeon is often confronted by complications particularly after extraction ofunerupted lower third molars. The most common complication is alveolar periostitis. The healing process after extraction is accompanied by physiologic atrophy of the alveolus involving on the average 30% of bone tissue. Beta-tricalcium phosphate (TCP) is a synthetic material used in medicine to fill up bone defects caused by pathologic processes. The properties of TCP are appropriate for the material to be used as a carrier for drugs, in particular antibiotics. This study was undertaken to determine whether lincomycin applied to the alveolus on TCP carrier can be used to accelerate wound healing and reduce inflammation after surgical extraction of a third molar. MATERIALS AND METHODS: We enrolled 80 patients (males and females between the age of 18 and 50 years) who underwent extraction of a third molar at the Department of Dental Surgery, Pomeranian Medical University in Szczecin. Surgical difficulty in the patients according to the Pederson scale corresponded to grade 2 or 3 (medium or high difficulty). The study group consisted of 40 patients who received lincomycin on TCP. Beta-tricalcium phosphate (300-700 microm pores) obtained from the Department of Technology of Ceramics and Refractories, AGH University of Science and Technology in Cracow, was soaked with 500 mg of lincomycin in solution and applied to the dental alveolus after tooth extraction. The alveolus was tightly sutured. The control group comprised 40 patients not treated with lincomycin. The patients reappeared for examination on the first, third, and seventh day after surgery. Attention during follow-up was directed to alveolar periostitis, pain, and trismus. Pain intensity was assessed with the 10-degree Visual Analog Scale (VAS). RESULTS: We analyzed the subjective pain intensity reported during follow-up by the patients. In the study group, 20 patients reported no pain 24 hours after extraction. On the third day after surgery, alveolar periostitis was present in 15% of patients in the study group and 75% of patients in the control group. On the last day of follow-up, periostitis was present in only 2.5% of patients in the study group as opposed to 45% of patients in the control group. The differences were statistically significant (chi-square 36.05, p < 0.0001). CONCLUSIONS: (1) Lincomycin on TCP can be used to prevent alveolar periostitis. (2) Lincomycin on TCP reduces complications in the form of pain and trismus. (3) Beta-tricalcium phosphate prevents atrophy of the alveolar process.

[Missing maxillary: comprehensive orthodontic and prosthodontic treatment canines with endosseous implants]. / Brak klow w szczece--kompleksowe leczenie ortodontyczno-protetyczne z wykorzystaniem implantów sródkostnych.

INTRODUCTION: Impacted maxillary canines are a serious problem in orthodontics and prosthodontics. The incidence of impaction has been reported at 3.3% of the general population and is more common among women. Impaction of canines can be unilateral or bilateral, palatal or labial. The causes of this pathology are varied. Irrespective of the cause of impaction, missing canines represent first and foremost an esthetic problem. The aim of this study was to analyze the possibilities of reconstructing missing permanent maxillary canines in a given clinical situation. MATERIAL AND METHODS: We present the case of a young female with bilateral impaction of permanent and retention of deciduous maxillary canines. A detailed orthodontic investigation ruled out the possibility of forced eruption of impacted canines. Consequently, surgical extraction of impacted canines and prosthetic replacement of missing teeth using endosseous implants were done. RESULTS: The immediate functional and esthetic result in the patient was very good. As prosthetic crowns were cemented to the implants on the day of implantation, soft tissues received support without risk of contour change. The procedure ensured comfort for the patient without the need of wearing removable partial dentures. CONCLUSIONS: 1. Missing permanent canines represent a significant esthetic defect of dentition. 2. Surgical extraction and reconstructive treatment is an option when forced eruption of impacted canines proves impossible. 3. Close cooperation between the orthodontist and implant prosthodontist is necessary for a satisfactory esthetic result.

[Implant-prosthetic rehabilitation of patients with absence of maxillary lateral incisors]. / Leczenie implantoprotetyczne braku drugich siekaczy w szczece.

INTRODUCTION: The absence of maxillary lateral incisors caused by traumatic or genetic reasons or as a result of endodontic failure is a difficult problem for an implantologist. The difficulties are the result of bone deficiency in all three dimensions, irregularity of interdental papillae locations and often convergence of roots of the neighbouring teeth. The aim of this study was to present the complexity of orthodontic and implant-prosthetic treatment of the absence of maxillary lateral incisors. MATERIAL AND METHODS: Between 2003 and 2007, 11 patients with absence of maxillary lateral incisors were treated in the Department of Oral Surgery of the Pomeranian Medical University in Szczecin. In 5 cases the incisors were congenitally absent, 2 patients lost their incisors because of traumatic injuries and in 4 patients the absence was a result of treatment failures (perforations, fractures, endodontic failures). The average age of the patients was 27 years. The purpose of the initial, orthodontic part of the treatment was to obtain enough space for implantation. During the next part implants were placed in the bone. 15 Zimmer-Dental and Alfa-Bio implants were placed altogether (3.3 and 3.7 mm diameter, 13-16 mm length). Due to bone deficiency, in 11 cases alveolar distraction was necessary and in the rest of the cases bone substitute materials were used to obtain enough amount of bone. Only in 2 patients the implants were loaded immediately, the remaining received prosthetic reconstruction after 6 months; 1 implant was lost (6% of all placed implants). CONCLUSIONS: Implant-prosthetic treatment of single front tooth absence needs cooperation of multiple dental specialties. Implantation with the help of the described alveolar distraction technique seems to be a promising way of reconstruction in cases of bone deficiency.

[Endodontic treatment or dental implant treatment?]. / Leczenie endodontyczne czy implantologiczne?

INTRODUCTION: The main purpose of today's dental treatment is the longest possible retention of teeth with all its functional and esthetic aspects. Thanks to modern endodontic techniques and microsurgical procedures, it is possible today to treat and keep teeth that would have had to be extracted before. On the other hand, the latest development of forms and surfaces of dental implants, improved operation techniques and precision in preparing superstructures have determined a significant increase of percentage of successful implantations and survival rate of the implants, widening the range of possibilities of prosthetic reconstructions. The aim of this study is to present current, often ambiguous view on the problem of long-term effects of endodontic treatment and its impact on teeth retention compared with effects of dental implant treatment and to try to answer the question: extirpation or implantation? MATERIALS AND METHODS: The comparative research was based on studies published within two databases: PubMed and Medline. RESULTS: Studies from a 10 years' period show similar percentage of surviving teeth after endodontic treatment and surviving implants: between 86 and 94 per cent with slight advantage of the implants. Esthetic problems, the time needed for implantation procedures and high costs of implant treatment make implantation less attractive and accessible. However, anatomical limitations ofmultirooted teeth, extensive periapical granulomatic lesions or considerable crown and root destruction are all indications for implant treatment. The lack of clear-cut evaluation criteria regarding both endodontic and implant treatment success makes statistic analysis impossible.

The concentration of forming and resorption markers in menopausal period women with osteoartrosis changes at spinal vertebrae.

Introduction Osteoartrosis is a genetically determined disease, which develops on multisystem diseases, spreads on joint cartilage, overcartilage bone and soft structure of the joint. The aim of the work is to evaluate the relationship between mineral density of spinal vertebrae and the concentration of basic progesterone and progesterone after a test with metoklopramid.. Material and methods. The research was based on 50 women, aged 50,7+/-4,4 , in an early physiological postmenopausal period, divided into two groups, the control and the exam group, depending on mineral density of spinal vertebrae. The concentration of estradiol, estron, prolaktyn, prolaxtic/MCP, osteocalcyn, prokolagen, alkali bone fhosphatase, total calcium and ionic calcium in serum and pirydynolin, dezoksypirydynolin and total calcium in urine were tested. Statistic analysis was made by means of statistic packet Statistica Pl version 5 of StatSoft company. Results. In women with osteoartrosis, the concentration of estradiol, alkali bone fhosphatase, pirydynolin and dezoksypirydynolin significantly decreased, the concentration of basic prolaktyn and prolactin after a test with metoklopramid significantly increased, and the concentration of estron, prokolagen, osteocalcyn, total calcium and ionic calcium in urine and serum insignificantly decreased. Conclusion 1.The decrease of bone metabolism markers in women with osteoartrosis may contribute to handicap of osteoblasts and osteoklasts function. 2. Dopaminergic treatment should be used in women with osteoatrisis syndrome who have frequent hyperprolactynic problems 3. Lack of correlation between the mineral density of spinal vertebrae and the concentration of pirydynolin and dezoksypirydynolin in women with osteoartrosis suggest that resorption disease is not the main pathogenic factor of osteoartrosis diseases.