Super-EBA as an endodontic apical plug.

Forty extracted human single-rooted teeth were sequentially instrumented with nickel-titanium rotary files to a size 0.36 mm at the working length. Ten teeth were randomly assigned to the two control groups. The other 30 teeth were randomly divided into three groups and were obturated by a 5-mm apical plug of either Super-EBA, IRM, or laterally condensed gutta-percha and Roth's sealer. After 2 days, and at 1 month, the samples were tested for microleakage by the fluid filtration system under 15 psi. The negative controls were used to consider the time that it took the fluid filtration system to stabilize. A one-way analysis of variance showed that, at 1 month post obturation, there was no statistical difference in the ability of the three materials to seal the apex from coronal microleakage. However, at 2 days, Super-EBA gave a significantly better seal than IRM or laterally condensed gutta-percha and sealer.

The effect of isopropyl alcohol desiccation on apical sealability of two commonly used endodontic cements.

The present study was undertaken to determine the ability of alcohol desiccation to improve the apical seal by removing residual moisture from the canal. From the results of this study, isopropyl alcohol did not improve the sealability of either Roth's 801 sealer or AH26 sealer. Thus, the employment of this technique should be questioned on the basis of the potential source of irritation of the alcohol and the addition of an extraneous procedural step.

Natural modifiers of the inflammatory process in the human dental pulp.

Concentrations of the protease inhibitors alpha 1-antitrypsin and alpha 2-macroglobulin were determined in normal and inflamed human dental pulps. Carious pulpal exposure which is associated with polymorphonuclear leukocyte infiltration and release of lysosomal enzymes was chosen as the point of verifiable inflammatory activity in the pulp. Normal samples were collected from nondiseased third molar teeth treatment planned for extraction and inflamed human pulps were collected from teeth with deep carious lesions. One half of each sample was assayed for concentration of protease inhibitors by enzyme-linked immunosorbent assay and the remaining half was examined histologically to verify the clinical diagnosis and categorize the extent of the inflammatory process. alpha 1-Antitrypsin and alpha 2-macroglobulin were detected in normal and inflamed human dental pulps in the nanogram per milliliter range. Statistically significant differences were found in the concentrations of alpha 2-macroglobulin (p less than 0.01) in moderate to severe inflammation versus normal pulp categories and between mildly inflamed pulps and moderate to severely inflamed pulps (p less than 0.05). Although differences in concentrations of alpha 1-antitrypsin were seen between inflamed and normal pulps, the differences were not statistically significant. The presence of these two protease inhibitors in the human dental pulp tissue and the increase in their concentration in acute inflammation indicates that these proteins play a role in the pathogenesis of pulpal inflammatory disease.

Determination and relationship of C-reactive protein in human dental pulps and in serum.

C-reactive protein (CRP), an acute phase protein synthesized by the liver, increases in serum as much as 3000 times above its normal level in response to acute inflammation. The purpose of this study was to determine whether CRP levels in dental pulps could be correlated with the histological disease status of the pulp and with systemic blood levels of CRP. Inflamed and necrotic pulps were extirpated during routine endodontic therapy. Normal pulps were removed from extracted, intact third molars. One half of each pulp specimen was placed in formalin for histological study; the other half was frozen for immunological study. A serum sample was obtained from each patient at the end of the dental visit. CRP levels were determined by the enzyme-linked immunosorbent assay. Pulps were categorized histologically as normal, inflamed, inflamed/necrotic, or necrotic. The correlation between CRP levels of pulp and serum was not significant. CRP levels of normal pulps differed significantly only from inflamed pulps (p less than 0.05, Dunnett). This increase in CRP appears to be a local phenomenon resulting from the interaction of CRP with various inflammatory mediators in the pulp.

An analysis of worldwide safety experience with auranofin.

A total of 3,475 patients with rheumatoid arthritis have received auranofin (AF) during clinical trials in 27 countries. Over a 4-year period, treatment with AF was relatively well tolerated. Most reactions were mild, easily managed and occurred during the first few months of treatment. Gastrointestinal side effects were the most common problems reported with AF followed by mucocutaneous reactions. Less frequently observed were conjunctivitis, proteinuria and, rarely, thrombocytopenia. The percentage of patients withdrawn for adverse effects per patient-year was less with AF when compared to injectable gold (14 vs 40%). These results confirm previous reports of AF safety and improved tolerance versus parenteral gold.

Auranofin: a unique oral chrysotherapeutic agent.

Auranofin is a chemically unique gold coordination complex with demonstrated antiarthritic properties on oral administration. Its pharmacokinetic and immunologic profiles are distinct from injectable gold compounds. When auranofin is added to a regimen of salicylates and/or a nonsteroidal antiinflammatory drug for the treatment of RA, significant additional therapeutic benefit is observed. Published studies indicate that auranofin given 6 mg per day approaches the efficacy of parenteral gold salts in the treatment of rheumatoid disease. Noticeable improvement in clinical and laboratory parameters of disease activity has been observed by the third month of auranofin therapy. Further benefit occurs in some patients during the remainder of the first year of treatment. In the more than 3,000 patients treated with auranofin, the most frequently reported side effects were gastrointestinal (mainly diarrhea) and mucocutaneous. Most side effects were mild in nature and the withdrawal rate due to all adverse reactions averaged 11%. Auranofin differs from injectable gold by producing more gastrointestinal but fewer mucocutaneous reactions. The severity of these reactions is less with auranofin and causes fewer withdrawals from therapy.