Plasma of Argon Affects the Earliest Biological Response of Different Implant Surfaces: An In Vitro Comparative Study.

The aim of this in vitro study was to evaluate the early cell response and protein adsorption elicited by the argon plasma treatment of different commercially available titanium surfaces via a chair-side device. Sterile disks made of grade 4 titanium (n= 450, 4-mm diameter) with 3 surface topographies (machined, plasma sprayed, and zirconia blasted and acid etched) were allocated to receive 4 testing treatments (2% and 10% protein adsorption and cell adhesion with MC3T3-E1 and MG-63). Furthermore, the specimens were divided to undergo 1) argon plasma treatment (10 W, 1 bar for 12 min) in a plasma reactor, 2) ultraviolet (UV) light treatment for 2 h (positive control group), or 3) no treatment (control group). Pretreatment surface analyses based on a scanning electron microscope and profilometer images were also performed. Profilometric analysis demonstrated that the evaluated specimens perfectly suit the standard parameters. The use of argon plasma was capable of affecting the quantity of proteins adsorbed on the different surfaces, notwithstanding their roughness or topographic features at a low fetal bovine serum concentration (2%). UV light treatment for 2 h attained similar results. Moreover, both the plasma of argon and the UV light demonstrated a significant increase in the number of osteoblasts adherent at 10 min in all tested surfaces. Within its limitations, this in vitro study highlights the potential biological benefits of treating implant surfaces with plasma of argon or UV, irrespective of the roughness of the titanium surface. However, in vivo experiments are needed to confirm these preliminary data and settle the rationale of a treatment that might be clinically relevant in case of bone-reparative deficiencies.

Unusual anchor pins placement and protocol deviations during computer-based implant placement in a patient with severe mandibular bone atrophy. A case report.

The aim of the study was to describe an unusual method to stabilize the surgical template during the treatment of a severely resorbed edentulous mandible by means of computer-guided implant surgery. Pre-operative computer-based planning revealed the difficulty to stabilize the surgical template in a 67-year-old healthy woman. A deviation of the original NobelGuide™ protocol was performed to ensure the stability of the surgical template: four anchor pins were used to stabilize the surgical template, two in the buccal side of the anterior template and two unusual pins were placed in the lingual site. Four straight TiUnite® Nobel Biocare™ implants were then placed, according to a modified All-on-4™ concept procedure, to avoid graft procedures and to reduce the cumulative chair-side treatment time and costs. A temporary restoration was placed immediately after implant placement. Three months later a definitive, full acrylic restoration was delivered.

Clinical guidelines for prevention of osteonecrosis of the jaws in patients in treatment with bisphosphonates: literature review and report of three cases.

Lately clinical evidence has suggested that the development of osteonecrosis of the jaws (ONJ) might be associated to assumption of high doses of nitrogen-bisphosphonate (N-BPs), quite common in the treatment of multiple myeloma and skeletal metastasis due to breast and prostate cancer. Bisphosphonates are used for the treatment of several pathologies such as osteoporosis, Paget's disease, multiple myeloma, malignant hypercalcemia, breast and prostate tumours, and other tumours associated with bone metastasis. Their use might improve patient's life standard, reducing pain and complications of the skeletal structure. In this report three clinical cases of ONJ of patients in treatment with BPs are presented, and the possible pathogenesis is analysed. Further-more, treatment guidelines for the management of patients in treatment with BPs who need restorative dental care and oral surgery are proposed.

Central odontogenic fibroma interesting the maxillary sinus. A case report and literature survey.

Odontogenic fibroma (OF) is a rare benign odontogenic tumor deriving from the dental mesenchymal tissue and accounting for less than 5% of all odontogenic tumors. This paper presents an aggressive histologically diagnosed central odontogenic fibroma (COF) in a 17-year-old girl characterized by asymptomatic rapid growth with massive replenishment of the left maxillary sinus. We carried out a review of the literature to retrieve all published cases of COF especially focused on radiographic aspects and surgical treatment of cases characterized by clinical aggressive behaviour, as we observed in our patient. Search strategy included retrieval of English language papers, published from 1966 to today, in dental journals on MEDLINE/PubMed and EMBASE, and hand-searching of the bibliography of retrieved papers. Sixty-nine cases of COF were identified from 1954 to 2003 and a new one was added. We have compared characteristics of COFs according to age, gender, location, clinical and radiographic findings of aggressive development, and histology. We discuss clinical and radiographic aspects of our case compared with COFs previously published. We give suggestions for surgical treatment of COF in case of aggression to important anatomical structures.

Calcifying epithelial odontogenic (Pindborg) tumor. A clinical case.

Calcifying epithelial odontogenic tumor (CEOT), Pindborg tumor, is a rare benign odontogenic neoplasm representing about 0.4-3% of all odontogenic tumors. This tumor more frequently affects adults in an age range of 20-60 years, with a peak of incidence between 40 and 60 years. About 190 cases of CEOT have been reported in the dental literature. Fifty-two percent of cases of CEOT is associated with a tooth impacted and/or displaced by the tumor. The primary CEOT has a recurrence rate of 10-15%, after total excision, and its malignant transformation is a very rare occurrence. The authors report a case of primary intra-osseous CEOT, embedding the mandibular right second molar, in a 24 year-old male. Radiographs showed a well-defined unilocular osteolytic lesion, swelling and reabsorbing the mandible and displacing the inferior alveolar nerve. It was possible to perform conservative surgical treatment consisting of the enucleation of the tumor together with a portion of tumor-free bone cavity margin and the debridement of the inferior alveolar neuro-vascular bundle, which was surrounded by a tumor capsule-like structure. The postoperative histological examination of the tumor revealed typical benign features. The differential diagnosis and work-up of the tumor treatment are discussed in relation with its histological typing and localization in the jaws.

Benign cementoblastoma: a clinical case of conservative surgical treatment of the involved tooth.

The benign cementoblastoma (BC) or ''true'' cementoma is a rare benign neoplasm arising from the odontogenic ectomesenchyme and representing about 1% to 6.2% of all odontogenic tumors. The BC more frequently affects young males in an age range of 20-30 years, occurring in the mandible about 3 times more than in the maxilla, and it is always physically attached to the tooth roots. This tumor is often asymptomatic until it produces pain, expansion or swelling of the jaw segment or compression of the inferior alveolar nerve. Early diagnosis is essential to save the tooth by enucleating the tumor, filling the root canals and apicectomy or curettage of the affected roots. A case of BC embedding the mandibular first right molar and resorbing the vestibular cortical bone, in a 48 year-old male, is reported. The radiographic examination showed a well-defined mixed-density unilocular mass, confluent with both the tooth roots of the mandibular first molar and surrounded by a radiolucent rim. A combined endodontic-surgical treatment was performed with the aim to remove the tumor while saving the tooth. Histological findings, differential diagnosis and surgical treatment of the tumor are discussed and compared with similar cases in the literature.

Impact of season and discharge weight on complications and growth of Kangaroo Mother Care treated low birthweight infants in Mozambique.

This study aimed to determine the impact of season and weight at discharge on growth rate and complications in low birthweight infants treated with Kangaroo Mother Care (KMC) in Maputo, Mozambique. The study population included 246 infants of birthweight < 2000 g. Follow-up until 2400 g was obtained in 64%. There were no seasonal differences in weight gain and the risk of complications of infants treated with KMC in hospital. During the cold season after discharge, the risk of serious complications, including death, was higher (risk ratio 1.96; p = 0.02) and more readmissions occurred (risk ratio 2.77; p = 0.04). We postulate that after discharge mothers are unable to comply with the kangaroo position at all hours of the day and that exposure to low ambient temperatures may explain the more frequent occurrence of complications in the cold season. The weight at discharge did not affect complications or growth rate. We conclude that the current policy to discharge infants when having gained weight on 3 consecutive days, regardless of the actual weight, or whether the weight at birth has been regained, is adequate. In the cold season particularly, more efforts may be needed to ensure compliance with kangaroo position after discharge and to educate mothers on early signs of complications such as bronchopneumonia to encourage timely care seeking. With this method, low birthweight infants can grow adequately.

Shigellosis in Mozambique: the 1993 outbreak rehabilitation--a follow-up study.

In this paper we describe a dysentery outbreak in Mozambique during 1993. A total of 47,483 cases and 199 deaths were reported, with an incidence rate of 292.5/100,000 and a fatality rate of 0.25% for the whole country. Of the 144 districts in the country 123 were affected: those situated along the principal communications routes and corridors had high incidence rates, up to 3308/100,000. All the provincial capitals were affected with incidence rates between 59.6 and 4381.8/100,000. Shigella dysenteriae type 1 was identified as the aetiological agent. This strain was sensitive to nalidixic acid, cephalosporins, gentamicin and kanamycin, and resistant to tetracyclines, trimethoprim, chloramphenicol, ampicillin, sulphisoxazole, cotrimoxazol and erythromycin. This is the first dysentery epidemic caused by S. dysenteriae type 1 reported in Mozambique. The epidemic still continues. Population movements after the war, poor levels of sanitation and poverty contributed to the gravity of the outbreak.

Colera em Mocambique no seculo XIX : II. tratamento utilizado na epoca

Este e o segundo artigo de uma serie de tres; relativa a epidemia de colera que assolou a Ilha de Mocambique; de Fevereiro a Marco no ano de 1859. No presente artigo apresentam-se e analisam-se aspectos relacionados com o diagnostico e tipo de tratamento utilizado; os recursos humanos e materiais existentes e o estabelecimento de um sistema de organizacio sanitaria onde participaram para alem do pessoal de saude; elementos da comunidade para apoio ao tratamento domiciliar dos casos. O aspecto mais importante; tendo em conta outras epidemias ocorridas durante o mesmo periodo na Europa e America; foi a participacio activa da populacio em relacio as medidas de tratamento preconizado palas autoridades de saude

[Chronic gastritis in childhood. A possible cause of recurrent abdominal pain]. / Gastrite cronica in età pediatrica. Una possibile causa di dolore addominale ricorrente.

The peptic disease is not the commonest cause of recurrent abdominal pain, among the organic aetiology. Only recently the gastric disease as cause of abdominal pain has been described in pediatric age. We have studied 11 children aged 6 to 12 years, who were examined for recurrent abdominal pain. We found that this symptom was due to chronic gastritis. We have valued these patients on the basis of the clinical manifestations, endoscopic and biopsy findings. A family history of peptic disease was found to be highly significant. We can therefore consider the gastritis as a possible organic aetiology of recurrent abdominal pain after ruling out any other organic causes.

[Gastrointestinal fiber endoscopy in children: diagnostic and therapeutic contribution]. / La fibroendoscopia digestiva in età pediatrica: contributo diagnostico e terapeutico.

The diagnostic and therapeutic value of gastrointestinal endoscopy in adults is well established. Our study, performed in pediatric patients confirms its usefulness and emphasises its easy execution and little risk in children. The availability of small caliber fiberendoscopes and the simple medication permit its wide and sure use. The direct visualization of mucosal surface allows to see even small alteration always not found by roentgenological examination and to pick up aimed bioptic specimens. The therapeutic contribution revealed itself affective in our experience, permitting polipectomy and consequently rectal bleeding removal. It was possible at last by this technique to make the follow-up of patients with ulcerative colitis avoiding them repeated irradiations. We can thus conclude that gastrointestinal endoscopy has an important diagnostic and therapeutic value also in pediatric patients for the study of gastrointestinal diseases.