Pattern of Primary Resistance of Helicobacter pylori to Clarithromycin among Pediatric Patients from North-Eastern Romania.

BACKGROUND: Helicobacter pylori antibiotic resistance has increased worldwide and affects the effectiveness of current therapies. The recommended first-line empiric treatment should be tailored to the local clarithromycin resistance rate. This study aimed to determine the pediatric patient profile and rate of clarithromycin resistance for patients diagnosed with Helicobacter pylori by gastric biopsy. METHODS: We studied 84 positive gastric samples for Helicobacter pylori. Positive results were confirmed by a rapid urease test and histopathological examination, with the type of gastritis established according to the Sydney System. Gastric biopsy samples were stored in RNA saver. Clarithromycin resistance was determined by a real-time polymerase chain reaction-based molecular assay after RNA-DNA extraction. RESULTS: Of the 84 biopsy samples analyzed, 35 (41.6%) were resistant to clarithromycin. Clarithromycin resistance was found mainly in girls (80%) with a mean age of 15 years (range 6-17 years). The history of prior exposure to clarithromycin was 91.6%. The concordance between the histopathological examination and the PCR test was 100%. CONCLUSIONS: One in 2.4 children infected with Helicobacter pylori had a strain resistant to clarithromycin. This resistant strain may be a reason for treatment failure in Romanian children, yet this is uninvestigated. The high rate of bacterial resistance to this antibiotic among children indicates the need for susceptibility testing before therapy.

Effect of Vegetable Juices on Properties of Two Resin Composites Used for Dental Caries Management.

Background and Objectives: Resin composites represent a class of materials widely used in restorative dentistry due to patient demands for better aesthetics. Colour changes in composite resins can occur due to intrinsic and extrinsic factors. Beverages, such as vegetable juices, can be some of these extrinsic factors. The purpose of this study was to investigate the colour stability and modification of microhardness of two resin composites before and after immersion in different vegetable juices. Materials and Methods: The colour of two resin composite materials (Gradia Direct Anterior-shade A2 and Valux Plus-shade A2) was measured before and after immersion in four different solutions: distilled water (as control), beetroot, carrot, and tomato juice. Colour values (L *, a *, b *) were measured over a white background with a colorimeter, using the CIE L *a *b * system. Colour change values were calculated after 1, 3, 5, and 7 days of immersion. Microhardness measurements were taken before and after seven days immersion in test media. Repeated measures analysis of variance (ANOVA) and independent t-tests were applied for statistical analysis. Results: All vegetable juices produced statistically different discolouration after immersion for 7 days (p < 0.05). Tomato juice produced the most discolouration for the Gradia Direct specimens, whereas beetroot juice and carrot juice produced the most discolouration for the Valux Plus specimens. Microhardness of the materials immersed for 7 days in vegetable juices was reduced compared to the ones immersed in distilled water. Conclusions: Vegetable juices, immersion time, and dental resin composites are significant factors that may affect colour stability and microhardness of composite resins.

Review of the Long-Term Outcomes of Guided Bone Regeneration and Autologous Bone Block Augmentation for Vertical Dental Restoration of Dental Implants.

Vertical bone resorption is a frequent consequence of tooth loss. Hence, implant-supported restorations imply, first of all, bone reconstruction. We aimed to review the current status of guided bone regeneration and autologous bone block augmentation for vertical dental restoration of dental implants. This review identified that between 2009 and 2022 there were few clinical studies that included more than 10 patients and a follow-up period of more than 5 years after bone restoration. The highest vertical bone gain was reported in the autologous bone grafting technique (4-7.6 mm), whereas the minimum augmentation was reported for one of the guided bone regeneration techniques. When comparing intraoral to extraoral bone blocks, the highest values for the mean vertical bone gains were obtained in the cases in which intraoral bone blocks were used as graft material. The highest rate of bone resorption was observed in the extraoral bone block group. Implant survival rate was not significantly influenced by surgical technique. Complications had a higher incidence in autologous bone block augmentation studies. Soft tissue recession showed similar results for guided bone regeneration as for autologous bone block augmentation. Vertical ridge augmentation is a predictable option for the reconstruction of alveolar ridges with severe atrophy, but complications can appear.

Custom-Made Direct Metal Laser Sintering Titanium Subperiosteal Implants in Oral and Maxillofacial Surgery for Severe Bone-Deficient Patients-A Pilot Study.

BACKGROUND: Nowadays, a combination of classical subperiosteal implant designs with 3D imaging and printing allows one to reduce treatment time and provides support for fixed prostheses in cases where other techniques do not provide satisfactory results. This study aims to present a digital technique for the manufacturing of custom-made subperiosteal implants and what complications might appear after this type of surgery. METHODS: Sixteen patients treated with a custom-made DMLS titanium subperiosteal implant during the period between October 2021 and February 2022 were enrolled in the study. Orthopantomography (OPT) and cone-beam computer tomography (CBCT) were recorded for all patients. The measurements taken into account in this study were the fit and stability of implants, duration of surgery, implant survival, and early and late complications. RESULTS: The fit of the implants was extremely satisfactory, with a mean rating of 4 out of 5. The mean duration of the intervention was 86.18 min. At the end of the study, one implant was lost due to insufficient fit and recurrent, untreatable infections. Eleven implants (69%) were placed on the maxillary and five (31%) implants were placed on the mandible. CONCLUSIONS: Taking this into consideration, custom-made DMLS titanium subperiosteal implants could present satisfactory implant survival and low complication rates.

Association between Cone-Beam Computed Tomography and Histological and Immunohistochemical Features in Periapical Lesions Correlated with Thickened Maxillary Sinus Mucosa.

Background and Objectives: Odontogenic sinusitis is a frequently underestimated pathology with fewer symptoms in patients with periapical lesions, periodontal disease, or iatrogenic foreign bodies in the maxillary sinus. The aim of our study was to determine the correlation between maxillary sinusitis and periapical lesions using cone-beam computed tomography (CBCT) imaging and histological and immunohistochemical investigations. Materials and Methods: A total of 1450 initial patients diagnosed with maxillary sinusitis in the Ear-Nose-Throat (ENT) Department, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Romania, were treated with anti-inflammatory drugs. Of these, 629 still had unresolved symptomatology and were later referred to the Dental Medicine departments for further investigations. Only 50 subjects with periapical lesions in the premolar/molar maxillary area were included in the present study. All the periapical lesions were observed on CBCT and classified using the Periapical Status Index (PSI) and the mean maxillary sinus mucosa thicknesses (MSMT). The enrolled patients underwent surgical procedures with the excision of periapical lesions. The excised samples were submitted to the histological and immunohistochemical investigations. Results: The 50 patients presented periapical lesions of their maxillary teeth in 328 dental units. There was a higher prevalence of periapical lesions in men than in women (chi-square test). We observed a significant difference between the mean MSMT of individuals with periapical lesions compared to those without (p < 0.01). Mean MSMT was 1.23 mm for teeth without periapical lesions and 3.95 mm for teeth with periapical lesions. The histopathological study identified 50% cases with periapical granulomas, 10% cases with periapical granulomas with cystic potential, and 40% cases as periapical cysts. Immunohistochemical stainings showed that CD4+ helper and CD8+ cytotoxic T lymphocytes, along with CD20+ B lymphocytes and CD68+ macrophages, were diffusely distributed in all periapical cysts and in some periapical granulomas, but CD79α+ plasma cells characterized especially periapical granulomas. Conclusions: The current study observed a significant correlation between CBCT maxillary mucosa thickness and type of periapical lesion. Chronic inflammatory lympho-histiocytic infiltrate predominates in periapical lesions, supporting the idea that lesion progression is determined by a humoral-type (CD20+ and CD79α+ B lymphocytes) but also by a cellular-type (CD4+ and CD8+ T lymphocyte population) immune mechanism.

Clinical-pathological correlations in Warthin tumors of parotid gland: a series of 10 cases.

Warthin tumor is described using various terms, such as papillary cystadenoma lymphomatosum, adenolymphoma or monomorphic adenoma. It is a medical condition related to the salivary glands, namely a benign cystic tumor which contains an epithelial component and an abundant lymphoid stroma. It is also named Warthin tumor after Aldred Scott Warthin, the pathologist who described this entity in 1929 by observing it in two patients. Warthin tumor is a benign one and ranks secondly in terms of the most common not malignant salivary gland tumor located in the parotid gland. Because of its cystic nature, from the clinical point of view, it appears to be a slow-growing tumor often fluctuant on palpation. In terms of the treatment of choice, complete excision with wide tumor-free margins is preferred. The aim of the present article is to evaluate possible correlations between clinical-pathological features and postoperative complications in a target group made up of 10 patients diagnosed with Warthin tumor of the parotid gland admitted for surgery in a period of 21 years and to compare the results with literature.

Clinical, imaging and histopathological correlations of gingival overgrowth: a retrospective analysis in northeastern Romanian population.

BACKGROUND: Gingival overgrowth refers to an increase in the size of the gingival tissue. The etiology varies, and is often a multi-factor issue; what may contribute to gingival enlargement are aspects, such as disease, local and systemic conditions and idiopathic factors. The aim of the present study is to analyze and to correlate the clinical, epidemiological, imaging and histopathological (HP) features of gingival overgrowth in northeastern Romanian population. PATIENTS, MATERIALS AND METHODS: We conducted a clinical, imaging, and pathological study on 98 patients with gingival overgrowth, who underwent a surgical intervention for a gingival biopsy in the Office of Oral and Maxillofacial Surgery, "Prof. Dr. Nicolae Oblu" Emergency Clinical Hospital, Iasi, Romania, during a 14-month period (January 1, 2018 to February 28, 2019). All patients with localized gingival overgrowth had clinical and imaging investigations done and then were referred to an oral and maxillofacial facility. A surgeon performed the excision of the gingival overgrowth and then sent the surgical specimens to the Laboratory of Pathology for HP examination. RESULTS: Local inflammation was found responsible for the gingival overgrowth in most of the cases, with the number of females outnumbering that of the males. A very good correlation was found between clinical and HP diagnosis when epithelial hyperplasia, peripheral giant cell granuloma and pyogenic granuloma were involved and a moderate one when fibrous hyperplasia was involved. CONCLUSIONS: These findings suggest that the occurrence of gingival overgrowth can have many causes, which highlights the importance of clinical pathology in assisting practitioners with making a better diagnosis.

Osseointegration of chemically modified sandblasted and acid-etched titanium implant surface in diabetic rats: a histological and scanning electron microscopy study.

INTRODUCTION: The aim of this study is to assess the osseointegration of different dental implants surfaces in diabetic rats. MATERIALS AND METHODS: In this study, were used 56 male Wistar rats, average weight of 300-350 g. Diabetes was induced by a single intraperitoneal injection of Streptozotocin. The glucose levels and weight of rats were periodically evaluated. After the diabetes mellitus is confirmed, the sandblasted, large-grit, acid-etched (SLA) and SLActive endosseous dental implants (TAG dental implants, TAG Medical, Israel), made of titanium alloy, Ti-6Al-4V, 1 mm diameter and 3 mm in length were inserted in the distal metaphysis of the left femur. RESULTS: Diabetic rats have naturally lower number of bone cells and bone-implant contact (BIC%) than healthy rats when using the SLA implant, but when using SLActive implant, diabetic and healthy rats have the same numbers. CONCLUSIONS: The use of the SLActive surface resulted in positive effects in healthy and especially in diabetic animals, which demonstrate that could improve the osseointegration progress in humans with diabetes.