Er:YAG Laser and Fractured Incisor Restorations: An In Vitro Study.

Introduction. The aim of this study was to analyse the effects of an Er:YAG laser on enamel and dentine in cases of dental restorations involving fractured teeth, utilizing the dental fragment. Materials and Methods. Seventy-two freshly extracted bovine incisors were fractured at the coronal level by using a hammer applied with a standardized method, and the fragment was reattached by using three different methods: Er:YAG laser, orthophosphoric acid, and laser plus acid. The different groups were evaluated by a test realized with the dynamometer to know the force required to successfully detach the reattached fragment and by a microinfiltration test by using a 0.5% methylene blue solution followed by the optic microscope observation. Results. The compression test showed only a slight difference between the three groups, without any statistical significance. The infiltration test used to evaluate the marginal seal between the fracture fragment and the tooth demonstrated that etching with Er:YAG laser alone or in combination with orthophosphoric acid gives better results than orthophosphoric acid alone, with a highly significant statistical result. Discussion. Reattaching a tooth fragment represents a clinically proven methodology, in terms of achieving resistance to detachment, and the aim of this work was to demonstrate the advantages of Er:YAG laser on this procedure. Conclusion. This "in vitro" study confirms that Er:YAG laser can be employed in dental traumatology to restore frontal teeth after coronal fracture.

A case of bullous pemphigoid in infancy treated with local corticosteroids.

Bullous pemphigoid (BP) is an immune-mediated subepidermal vesiculobullous eruption, whose true incidence is unknown, but it is considered extremely rare in children, with a usually indolent course and rare relapses. Diagnosis is often belated, because of the invasive assessment with biopsy for typical immune-pathologic findings to differentiate it from Dermatitis Herpetiformis and Linear IgA bullous dermatosis (LABD), more common in children. A 4-year-old girl presented with one year history of erythematous-edematous and erythematous-bullous eruptions on the genitalia, periocular regions, dorsal and palmo-plantar surfaces. At onset erosions of the month and lips where considered a primary herpes simplex infection from the pediatrician, but repeated courses of systemic antivirals were completely ineffective, while application of a antibiotic-steroidal cream was of partial benefit. Histopathology showed a dermo-epidermal blistering, with a marked eosinophilic infiltrate. Direct immunofluorescence showed a characteristic positive linear IgG and C3 band at the basement membrane zone (BMZ). Complete hematic-chemical and instrumental examinations gave normal results, excluding associated pathologies. Due to paucity of lesions and good response to local treatment with moderate potency cortisones, in agreement with the parents, no systemic therapy was started. No recurrence occurred in the 2 year follow-up after complete remission. The case is reported for the rarity of the childhood form, and the importance of the differential diagnosis for management and treatment. Good response to topical treatment is stressed, avoiding the risks of long-term systemic drug administration.

A specific cystic fibrosis mutation (T3381) associated with the phenotype of isolated hypotonic dehydration.

We carried out molecular screening for mutations in the cystic fibrosis transmembrane regulator (CFTR) gene in eight children of Sardinian descent seen because of hypotonic dehydration associated with hyponatremia, hypochloremia, hypokalemia, and metabolic alkalosis; none had pulmonary or pancreatic involvement. All the patients had the T3381 mutation either in homozygosity or compound heterozygosity with another CF mutation. The T3381 mutation was not detected in patients with CF who had classic symptoms or in healthy persons of the same descent. These data suggest that the T3381 mutation is associated with a specific mild CF phenotype.