[Perforation of Meckel's diverticulum by a fishbone]. / Perforatsiya divertikula Mekkelya ryb'ei kost'yu.

Meckel's diverticulum is the most common congenital defect of the gastrointestinal tract. It is most often silent or asymptomatic. However, acute abdominal signs of obstruction, inflammation, hemorrhage and perforation are possible in other cases. Different foreign bodies can cause perforation of Meckel's diverticulum. We present an 18-year-old male who presented to the emergency department with abdominal pain within 48 previous hours. After evaluation, acute appendicitis was diagnosed and he underwent laparoscopic appendectomy. Meckel's diverticulum perforated by a fish bone was intraoperatively discovered. Incidental appendectomy and segmental resection of the ileum were performed.

Antibiofilm potential over time of a tricalcium silicate material and its association with sodium diclofenac.

OBJECTIVES: The objectives of this study are to investigate, over time, the antimicrobial activity against polymicrobial biofilms and ability to inhibit biofilm formation, of Biodentine (BD) alone and with 5% and 10% sodium diclofenac (DC). MATERIAL AND METHODS: The antimicrobial activity of BD alone and modified with 5% and 10% DC against polymicrobial biofilm growth in dentin was determined by a modified direct contact test. The study groups were (1) BD; (2) BD + 5% DC; and (3) BD + 10% DC. The viability of microorganisms after 1 and 4 weeks was quantified by means of an ATP assay and flow cytometry. The antibiofilm efficacy of the materials, preventing polymicrobial biofilm formation over time, was assessed by confocal laser scanning microscopy (CLSM). RESULTS: The results obtained with both the ATP test and flow cytometry showed that BD alone and with 5% and 10% DC exerted antibiofilm activity with respect to the control, in the two evaluated times (p < 0.001). Comparison between groups showed a tendency of increased antimicrobial effect, both over time and depending on the DC concentration. These results coincide with those obtained in CLSM analysis, where efficacy increased with time and DC concentration. CONCLUSIONS AND CLINICAL RELEVANCE: Biodentine, over time, showed antimicrobial and antibiofilm efficacy on polymicrobial biofilms. The addition of 5% and 10% DC to BD enhanced this effect, in a concentration- and time-dependent manner.

A laboratory study of root canal and isthmus disinfection in extracted teeth using various activation methods with a mixture of sodium hypochlorite and etidronic acid.

AIM: To evaluate in a laboratory setting the antibiofilm activity of several irrigating protocols including conventional irrigation, ultrasonic activation and XP-endo Finisher, with a mixture of sodium hypochlorite and etidronic acid in infected isthmuses and root canals of extracted human mandibular molar teeth. METHODOLOGY: Fifty-six mesial roots of mandibular molars, half of them with a continuous isthmus from the cervical to the apical third between the two root canals (type 1), and the other half with a continuous isthmus from the cervical to the middle third and one canal in the apical third (type 2), were included. The root canals were contaminated for 7 days with an Enterococcus faecalis suspension. There were three experimental groups plus a control group (n = 7 per type of root canal anatomy). All the root canals, except for the control group that was not treated, were chemomechanically prepared and then assigned to one of the experimental groups according to the final adjunctive procedure: conventional irrigation, ultrasonic activation or XP-endo Finisher activation. The irrigating solution used was a combination of 2.5% sodium hypochlorite and 9% etidronic acid, and the final protocols were applied for three cycles of 30 s with a 3 mL volume. The antibiofilm activity was evaluated at each location (root canal and isthmus) and third (cervical, middle and apical) using confocal laser scanning microscopy and the live/dead technique. Statistical analysis was performed using SPSS (descriptive statistics) and SUDAAN (P-value calculations). RESULTS: Root canals had significantly lower biovolume values than the isthmuses (P < 0.05). The biovolume in the root canals was significantly reduced in all the experimental groups in all the thirds except for conventional irrigation in the apical third (P > 0.05). In the cervical and middle thirds, ultrasonic activation was associated with the lowest biovolumes (P < 0.05), followed by XP-endo Finisher. In the isthmus, disinfection was similar in all the thirds for all the protocols. Conventional irrigation was associated with intermediate values with no significant differences from the control group or from the activated protocols (P > 0.05), although the latter were significantly different from the control group (P < 0.05). No differences were found between ultrasonic activation and XP-endo Finisher in the middle and apical thirds (P > 0.05) in the isthmuses. CONCLUSIONS: In this laboratory study on extracted teeth, the isthmus was more difficult to disinfect than root canals. In the root canals, ultrasonic activation and XP-endo Finisher had a greater effectiveness than conventional irrigation. In the isthmuses, no differences were observed between the two activation techniques and conventional irrigation.

Doxycycline-functionalized polymeric nanoparticles inhibit Enterococcus faecalis biofilm formation on dentine.

AIM: To evaluate in a laboratory setting the antimicrobial properties and the potential to inhibit biofilm formation of novel remineralizing polymeric nanoparticles (NPs) when applied to dentine surfaces and to ascertain the effect of the functionalization of these NPs with zinc, calcium or doxycycline. METHODOLOGY: The antimicrobial activity and inhibition of biofilm formation of polymeric NPs were analysed on human dentine blocks that were infected with Enterococcus faecalis before or after application of NPs. LIVE/DEAD ® testing under Confocal Laser Scanning Microscopy and bacterial culturing were employed to analyse biofilm biovolume and bacterial viability. Field Emission Scanning Electron Microscopy was also employed to assess biofilm morphology. One-way anova with Welch's correction and post hoc comparison by the Games-Howell test were performed for comparisons between groups. RESULTS: The un-functionalized NPs displayed the greatest antimicrobial activity against E. faecalis biofilms as they provided the lowest biovolume (3865.7 ± 2926.97 µm3 ; P < 0.001) and the highest dead/injured cells percentage (79.93 ± 18.40%; P < 0.001), followed by Dox-NPs (biovolume: 19,041.55 ± 17,638.23 µm3 , dead/injured cells: 45.53 ± 26.50%; P < 0.001). Doxycycline-loaded NPs had the largest values of inhibition of biofilm formation with the lowest biofilm biovolume (8517.65 ± 7055.81 µm3 ; P < 0.001) and a high dead/injured bacterial percentage (68.68 ± 12.50%; P < 0.001). Un-functionalized NPs did not reduce biomass growth (P > 0.05), but attained the largest percentage of compromised cells (93 ± 8.23%; P < 0.001), being able to disrupt biofilm formation. It also produced occlusion of dentinal tubules, potentially interfering with bacterial tubule penetration. CONCLUSIONS: A new generation of bioactive nano-fillers (doxycycline-functionalized polymeric NPs) had antibacterial activity and occluded dentinal tubules. Incorporating these NPs into endodontic sealers may have the potential to enhance the outcome of root canal treatment.

Bibliometric analysis and evaluation of the journal Medicina Oral Patología Oral y Cirugía Bucal (2008-2018).

BACKGROUND: In 2008 the journal Medicina Oral Patología Oral y Cirugía Bucal was included in Journal Citation Reports. To appraise its evolution and current status, this study carried out a bibliometric analysis and evaluation of the journal for the period 2008-2018. MATERIAL AND METHODS: From the Web of Science, Journal Citation Reports we obtained the indicators Journal Impact Factor (JIF), 5-year JIF, JIF without self-cites, Eigenfactor score and Article Influence score (2010-2017); and from the Core Collection database the following variables: number and article types, institutions and countries of origin of the authors (2008-2018), and the variable cited and citing journal data in 2017. Twelve articles/year (n=132) were randomly selected to gather: the time between submittal and acceptance of an article, number of authors/article, representation of each section, gender of first author, and funding. RESULTS: The journal occupied the third quartile of the JCR from 2010 to 2017, when it moved up to the second quartile. From 2008 to 2018 it published a total of 1,518 documents, 90% articles and 9.5% reviews. Sixty countries were represented, 48.68% of the documents coming from Spain, and overall 1,293 institutions were involved. Between submittal and acceptance of articles, the average time was 134.42 days, without differences between years. The mean of authors/article was 5.15, increasing over time. The sections most represented were Oral Medicine and Pathology, and Oral Surgery. There were no differences regarding the gender of the first author, and in general the authors did not provide information about funding received. CONCLUSIONS: The bibliometric results indicate a steadily improving position of this journal, along with a tendency to reduce self-citation. The time between reception of an article and its acceptance was very stable, the number of authors per article showed an increase, and there was a nearly equal representation of males and females as the first author.

Influence of dentine debris and organic tissue on the properties of sodium hypochlorite solutions.

AIM: To determine the free available chlorine of 2.5% sodium hypochlorite (NaOCl) alone and combined with 9% etidronic acid (HEDP) in the presence of inhibitors, organic tissue and organic tissue plus dentine debris; to evaluate the influence of dentine debris on the tissue-dissolving capacity of both NaOCl solutions; and to determine the antimicrobial action of these solutions when in contact with organic tissue and organic tissue plus dentine debris. METHODOLOGY: The available chlorine of the solutions over time in the absence and presence of the inhibitors was measured using a titration method. The organic tissue dissolution by the solutions alone and in the presence of dentine powder was evaluated by weighing bovine tissue specimens before and after exposure to the solutions for 3 and 10 min. For the antimicrobial activity, biofilms of Enterococcus faecalis were exposed to the solutions for 3 min in the absence and presence of organic tissue and organic tissue + dentine debris. The biovolume and percentage of damaged membrane cells of the biofilm were measured by means of confocal microscopy and the live/dead technique. Nonparametric tests were used to determine statistical differences (P < 0.05). RESULTS: Both inhibitors consumed the free available chlorine of the solutions over time. The presence of dentine debris significantly reduced the tissue dissolution capacity of the NaOCl solutions (P < 0.05). The percentages of biovolume reduction were not affected by the presence of the inhibitors in the two NaOCl solutions, whereas the percentage of damaged membrane cells was significantly reduced (P < 0.001). Overall, a similar behaviour was observed in the NaOCl and NaOCl/HEDP groups. CONCLUSIONS: The presence of organic tissue and organic tissue + dentine debris favoured rapid consumption of the free chlorine of NaOCl and NaOCl/HEDP. This resulted in a decreased ability to dissolve organic tissue without affecting the short-term antimicrobial activity.

Antimicrobial activity of ProRoot MTA in contact with blood.

Dental materials based on Portland cement, which is used in the construction industry have gained popularity for clinical use due to their hydraulic properties, the interaction with tooth tissue and their antimicrobial properties. The antimicrobial properties are optimal in vitro. However in clinical use contact with blood may affect the antimicrobial properties. This study aims to assess whether antimicrobial properties of the Portland cement-based dental cements such as mineral trioxide aggregate (MTA) are also affected by contact with blood present in clinical situations. ProRoot MTA, a Portland cement-based dental cement was characterized following contact with water, or heparinized blood after 1 day and 7 days aging. The antimicrobial activity under the mentioned conditions was assessed using 3 antimicrobial tests: agar diffusion test, direct contact test and intratubular infection test. MTA in contact with blood was severely discoloured, exhibited an additional phosphorus peak in elemental analysis, no calcium hydroxide peaks and no areas of bacterial inhibition growth in the agar diffusion test were demonstrated. ProRoot MTA showed limited antimicrobial activity, in both the direct contact test and intratubular infection test. When aged in water ProRoot MTA showed higher antimicrobial activity than when aged in blood. Antimicrobial activity reduced significantly after 7 days. Further assessment is required to investigate behaviour in clinical situations.

Efficacy of antimicrobial solutions against polymicrobial root canal biofilm.

AIM: To evaluate the antibiofilm activity of 2.5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), 2% alexidine (ALX) and 0.2% cetrimide (CTR) alone and in combination on mature polymicrobial root canal biofilms on human dentine using confocal laser scanning microscopy (CLSM). METHODOLOGY: Twenty-eight human dentine specimens were infected for 21 days with microbial samples collected from infected root canals of three volunteers. Antibiofilm activity of the irrigating solutions was evaluated after 3 min of contact time under CLSM. For quantification purposes, bioimage_L software was used. The variables evaluated were the log10 of total biovolume (µm3 ) and percentage of live cells (green) population. Statistical analysis of both variables was performed using an anova test and a post hoc Duncan test to determine significant clusters amongst groups. The variable green population percentage was previously subjected to the normalized Anscombe transformation. RESULTS: The NaOCl group had a total biovolume and percentage of live cells significantly lower than the other groups (P Ë‚ 0.001). The addition of 0.2% CTR significantly increased the antimicrobial effect of 2% CHX (P Ë‚ 0.001). There were no significant differences between 0.2% CTR, 2% ALX and the combination of both (P Ë‚ 0.05). CONCLUSIONS: Overall, 2.5% NaOCl dissolved and killed bacteria significantly more efficiently when used against polymicrobial mature biofilm on human dentine. Cetrimide improved the antimicrobial activity of chlorhexidine and alexidine.

The effect of benzalkonium chloride additions to AH Plus sealer. Antimicrobial, physical and chemical properties.

OBJECTIVES: The aim of this study was to determine the antimicrobial and antibiofilm activities and physicochemical properties of AH Plus sealer mixed with different concentrations of benzalkonium chloride (BC). METHODS: AH Plus was tested alone and mixed with 1%, 2% and 3% of BC. The antimicrobial and antibiofilm activities of the sealers against Enterococcus faecalis were evaluated by the direct contact test (DCT) and by confocal laser scanning microscopy, respectively. Setting time, flow and solubility were assessed according to ANSI/ADA specifications. Microhardness and contact angle tests were also performed. The chemical changes of the sealers were evaluated by X-ray diffraction analysis, and both Fourier transform infrared spectroscopy (FT-IR) and attenuated total reflectance Fourier transform infrared (ATR FT-IR). RESULTS: AH Plus+3% BC was the only sealer to promote total elimination of E. faecalis and the biovolume in this group was significantly lower than in the rest of the sealers (p>0.05). The physical properties of the sealers were according to the ANSI/ADA specifications. The microhardness decreased significantly when BC was added and a significant reduction in contact angle was obtained when incorporating 2% and 3% BC (p<0.05). No phase changes were observed with the modified sealers. CONCLUSIONS: The addition of 2% or higher concentrations BC to AH Plus showed antimicrobial and antibiofilm activities without affecting the properties specified in ANSI/ADA standards. However, additives to the root canal sealer altered other physical and chemical properties that are not commonly found in the literature to evaluate filling materials. CLINICAL SIGNIFICANCE: The present study highlights that the antimicrobial properties of AH Plus can be significantly improved with the addition of BC. Testing beyond what is specified in standards may be indicated.

Antimicrobial activity of Chlorhexidine, Peracetic acid and Sodium hypochlorite/etidronate irrigant solutions against Enterococcus faecalis biofilms.

AIM: To evaluate the antimicrobial effect of 2.5% sodium hypochlorite alone (NaOCl) and associated with 9% HEBP (NaOCl/HEBP), 2% peracetic acid (PAA) and 2% chlorhexidine (CHX), on the viability of Enterococcus faecalis biofilms attached to dentine. METHODOLOGY: Biofilms of E. faecalis were grown on the surface of dentine blocks for 5 days and then exposed to the irrigating solutions for 3 min. Distilled water was used as the control. The total biovolume and the percentage of dead cells of the infected dentine were measured by means of confocal microscopy and the live/dead technique. Nonparametric tests were used to determine statistical differences (P < 0.05). RESULTS: NaOCl and the NaOCl/HEBP mixture were associated with a significantly greater percentage of dead cells, followed by PAA (P < 0.05). No significant antimicrobial effect of CHX was observed in comparison with the control group. Total biovolume decreased significantly in NaOCl, NaOCl/HEBP and PAA solutions in comparison with the CHX and control groups. CONCLUSIONS: NaOCl alone or associated with HEBP were the most effective irrigant solutions in dissolving and killing E. faecalis biofilms.

Reduction in Enteroccocus faecalis counts - a comparison between rotary and reciprocating systems.

AIM: To compare the chemomechanical reduction and regrowth of Enterococcus faecalis between rotary and reciprocating systems in root canal preparation. METHODOLOGY: Seventy-six single-rooted human mandibular premolars were selected and standardized to 15 mm in length. Root canals were enlarged up to a size 25 K-file and irrigated with distilled water and then were infected with E. faecalis for 4 weeks. The specimens were divided into 3 groups (n = 24) for instrumentation with Mtwo, Twisted File and WaveOne. Each group was further divided into two subgroups (n = 12) according to the irrigant used: distilled water or 5.25% sodium hypochlorite (NaOCl). Before and after rotary preparation, microbiological samples were collected using three sterilized paper points, and efficacy was expressed as reduction in percentage. The proportion of grown samples for 60 days was evaluated using nonparametric Kaplan-Meier survival analysis. Differences amongst groups were tested using the log-rank test at a significance level of 0.05. RESULTS: In the main root canal, the percentage reduction in the distilled water and 5.25% NaOCl groups ranged from 95.9% to 100%, with no significant differences amongst the three systems (P > 0.05). The bacterial regrowth in NaOCl groups revealed that Mtwo had the lowest number of samples regrown at 60 days, giving statistically significant differences with respect to Twisted File (P = 0.029) and WaveOne (P = 0.005). CONCLUSIONS: Reciprocating and rotary systems resulted in similar percentage reduction in E. faecalis when using either distilled water or 5.25% NaOCl solution. Over time, the Mtwo system was more effective regarding disinfection.

Discriminant ability for caries risk of modified colorimetric tests.

OBJECTIVE: The aim of this study was to evaluate the relationship between the caries risk in children over a two-year period and their baseline caries status, salivary levels of mutans streptococci and lactobacilli, and results of the Alban test and modifications thereof using different substrates. STUDY DESIGN: Ninety-five children aged 6-7 were examined in Granada (southern Spain) for dental caries at baseline and every six months. Stimulated saliva was sampled and inoculated in 7 colorimetric tests based on Snyder's medium with different sugars and polyalcohols. A mutans streptococci and lactobacilli count was performed (Dentocult SM strip® and Dentocult LB®). Caries risk proportions were contrasted against the potential predictor variables, i.e., basal caries history and salivary tests, by means of the Mantel Haenszel test for linear association, based on a chi-square distribution with 1 degree of freedom (df). RESULTS: Caries index, lactobacillus count and colorimetric tests showed significant, but limited, and non-different discriminant abilities. Increasing values of all predictor variables, except for Dentocult SM®, were related to increasing caries risk proportions. CONCLUSION: Colorimetric test results and caries history showed similar correlation values as caries predictors.

Genotypes of Streptococcus mutans in saliva versus dental plaque.

OBJECTIVE: The aim of this study was to investigate whether genotypes of Streptococcus mutans strain can be detected as effectively in saliva samples as in plaque samples from buccal surfaces and occlusal surface fissures of permanent first molars. DESIGN: The study included 20 school children aged 6-7 years who were positive for mutans streptococci. Samples of stimulated saliva and of dental plaque on buccal surfaces and occlusal surface fissures of permanent first molars were collected. Samples were cultivated in MSB agar. Up to nine isolates compatible with mutans streptococci were obtained and identified by means of biochemical tests. All isolates identified as S. mutans were genotyped by arbitrarily primed polymerase chain reaction. RESULTS: A total of 28 genotypes of S. mutans were isolated: 23 in saliva samples, 23 in buccal surface plaque samples, and 16 in plaque samples from occlusal surface fissures. CONCLUSIONS: Although, saliva sampling did not reveal all genotypes isolated, it was equally as effective as plaque sampling from the buccal surfaces of permanent first molars, and more effective than plaque sampling from fissures on their occlusal surfaces.

Estudio psicopatológico sobre la creatividad y la perversión (la extraña inquietud en el cine de Greenaway) / Psychopathological study about creativity and perversion (the uncanny in the Greenaway´s cinema)

Podrían calificarse de artistas perversos desde la psicopatologíaa Buñuel, Bergman, Hitchcock o Greenawayporque en sus películas conviven lo imaginario y larealidad provocando en los espectadores esa extrañainquietud (Das Unheimliche) de la que nos hablanFreud y Heidegger. Estas perversiones sadomasoquistasy exhibicionistas son sólo el escaparate en que asomanlos cadáveres descuartizados por forenses obstinados ylos libros del saber condenados a contar las historias dela humanidad olvidando la inocencia de las víctimas.Para el inconsciente el asesinato no requiere un cuerpofísico y un acto criminal concreto. El pensamiento ordenaen el vacío los hechos, las secuencias numéricas–rituales y mágicas– y en el diccionario babélico losalfabetos pierden el sentido literal por el significadomítico. Dejando de un lado la perversión, pero sin exterminarlade nuestra mirada, dirigimos la atención a lacreatividad de Greenaway analizando los contenidos dealgunas de sus películas y exposiciones desde el psicoanálisisy/o el esquizoanálisis deleuziano. El deseo y lamuerte, la omnipotencia y el miedo sugieren la necesidady las defensas de la creación. La fragmentación delos cuerpos, el renacimiento y la resurrección en lasmaquinarias del tiempo son imágenes prisioneras ennuestro inconsciente y la realidad es un sueño desconcertantedel cual no podemos despertar

They could be described as perverse artists from the ;;Psychopathology Buñuel, Bergman, Hitchcock or ;;Greenaway because in their movies the imaginary and ;;the reality cohabit causing in the spectators that stranger ;;experience of the Uncanny/Das Unheimliche (Freud ;;and Heidegger). These sadomasochist and exhibitionist ;;perversions are only the cabinet in wich they appear the ;;cadavers quartered by obstinate forensic surgeons and ;;the books of the knowledge condemned to count the ;;Humanity’s histories, forgetting the innocence of the ;;victims. For the unconscious the murder doesn’t require ;;a physical body and a concrete criminal act. The ;;thought orders in the empty space the facts, the numerical, ;;ritual and magic sequences and in the Babel dictionary ;;the alphabets lose the literal sense for mythical ;;meaning. Leaving aside the perversion, but without ;;exterminating it of our look, we direct the attention to ;;the creativity of Greeenaway analyzing the contents of ;;some of his movies and exhibitions from the psychoanalysis ;;and/or schizoanalysis (Freud and Deleuze). ;;The desire and the death, the omnipotence and the fear ;;suggest the need and the defences of the creation. The ;;fragmentation of the bodies, the rebirth and the resurrection ;;in the machineries of the time are images prisoners ;;in our unconscious and the reality is a disconcerting ;;dream from which we cannot wake up

Implementación de un sistema de calidad en la Red Nacional de Bancos de Tumores del Centro Nacional de Investigaciones Oncológicas / Implementation of a quality assurance programme in the spanish national tumour bank network promoted by the Spanish National Cancer Center

Los Bancos de Tumores son una pieza fundamental en la oncología actual, tanto en investigación como en asistencia. Su actividad se define en base a una serie de protocolos hospitalarios que permiten el estudio molecular de grandes series de neoplasias, de forma que su más eficaz diseño es el trabajo en red cooperativa. Las políticas de control de calidad son una parte esencial de los servicios, públicos o privados, basados en plataformas tecnológicas. En este sentido, la investigación biosanitaria y la asistencia clínica debería desarrollar progresivamente sistemas de gestión de calidad que minimicen el riesgo de errores derivados de la ausencia de protocolización de sus actividades, el riesgo de errores derivados del uso inapropiado de tecnología y, por ultimo, localizar y solucionar problemas relacionados con la calidad final. El presente artículo presenta las bases del programa de garantía de calidad puesto en marcha por la Red Nacional de Bancos de Tumores promovida por el CNIO, una plataforma cooperativa que agrupa a algunos de los principales hospitales españoles

Tumour banks are a centrepiece in current oncological research and assistance. Their activity is defined by a series of hospital protocols that allow molecular studies of tumour samples, and networking appears to be the best environment for tumour banks to grow in. Public and private service sectors must include quality control policies, especially if they are related to technological platforms. In this sense, bio-sanitary research support or welfare services, should progressively develop quality control systems that minimize errors derived from the lack of protocol; they should minimize errors derived from the incorrect use of technology and equipments; and finally, they should find and solve weak points in terms of final quality. The following article presents the quality assurance policy basis of the Spanish National Tumour Bank Network promoted by The Spanish National Cancer Centre (CNIO), a cooperative platform formed by some of the main Spanish hospitals

Sealant and fluoride varnish in caries: a randomized trial.

Little is known about the effect of discontinuation of sealant or fluoride varnish. The purpose of this study was to compare sealant with fluoride varnish in the prevention of occlusal caries in permanent first molars of children over a nine-year period: 4 yrs for program evaluation plus 5 yrs of discontinuation. A clinical trial was conducted on three groups of six- to eight-year-old schoolchildren: a control group (n = 45); a group (n = 37) in which sealant was applied and reapplied up to 36 mos; and a group (n = 38) in which fluoride varnish was applied and re-applied up to 42 mos. Percent caries reduction was studied in these initially healthy molars with complete occlusal eruption: 129 (control), 113 (sealant), and 129 (varnish) molars met inclusion criteria. Of these, 76.7%, 26.6%, and 55.8% had developed occlusal caries at 9 yrs, which implies caries reductions of 65.4% (SE = 8.5%) for sealants vs. control and 27.3% (SE = 10.2%) for varnish vs. control. Furthermore, the varnish program was not effective during the discontinuation period.

Efectividad del barniz de clorhexidinatimol sobre el índice de paca en el síndrome de Down / Effectiveness of a thimol-clorhesidine varnish on plague index in Down's syndrom

Se ha realizado un ensayo clínico a doble ciego con el objetivo de evaluar la eficacia en la reducción de placa bacteriana del barniz de clorhexidina-timol en escolares con síndrome de Down. Tanto el grupo test (n=18) como el grupo control (n=16), recibieron dos aplicaciones de Cervitec (clorhexidina 1 por ciento + timol 1 por ciento), y de Cervitec-placebo respectivamente, separadas una semana entre sí. Se recogió el índice de placa de Silness-Loe al inicio, a las 24 y 72 horas de la primera aplicación (semana 1ª), así como a las 24 y 72 horas de la segunda aplicación (semana 2ª). En los dos grupos se observó una reducción significativa, frente a la medición inicial (media: 1.68 en test, y 1.59 en control), de los índices de placa. Comparativamente, el grupo test presentó una reducción significativamente mayor que el control en todas las mediciones. Se concluye que el barniz de clorhexidina-timol es eficaz en la reducción del índice de placa en escolares con síndrome de Down (AU)

Mutans streptococci and lactobacilli in saliva after the application of fissure sealants.

Because dental fissures may serve as reservoirs for mutans streptococci, preventive measures should be taken to control microbial concentrations at these sites. This study estimated the influence that sealing permanent first molars would have on the levels of mutans streptococci and lactobacilli in saliva of healthy seven-year-old schoolchildren. Permanent first molars were sealed in 31 children without caries (NC group) and in 32 children with caries (C group). None of the children had caries in their permanent first molars. Conventional methods were used to count mutans streptococci and lactobacilli in saliva before applying the sealant and again at 4 and 12 weeks after application. Baseline counts of lactobacilli and mutans streptococci were significantly higher in the C group. A significant reduction in mutans streptococci was observed in the NC group at 4 and 12 weeks. It was concluded that fissure sealants in permanent first molars can help reduce salivary levels of mutans streptococci in children without caries.

In vitro antibacterial activity of glass-ionomer cements.

The in vitro antibacterial activity of the glass-ionomer restorative cements Ketac-Cem, Ketac-Bond, Ketac-Silver and Vitrebond was studied in conjunction with 32 strains of five bacteria involved in the development of caries: Streptococcus spp., Lactobacillus spp., Actinomyces spp., Porphyromonas spp. and Clostridium spp. The agar plate diffusion method was used for the cultures, which included a chlorhexidine positive control. All the glass-ionomer cements tested inhibited bacterial growth, but with considerable differences in the scope of their action. Of the four cements, Vitrebond, a resin-modified glass-ionomer cement, was determined to be the most effective bacterial inhibitor.