Novel Use of Ophthalmic pH Paper to Diagnose Malicious Caustic Ingestion in a Pediatric Patient.

Occult caustic ingestion in the pediatric population is a challenging diagnosis to make in the emergency department. Failure to suspect and diagnose a caustic ingestion can lead to potentially life-changing comorbidities. Historically, the diagnosis of caustic ingestion has been clinical without any suitable diagnostic tools to aid in the suspicion of occult cases. In this case, we describe a novel use of ophthalmic pH paper to diagnose caustic ingestion in a three-year-old.

Differential response of Porphyromonas gingivalis to varying levels and duration of hydrogen peroxide-induced oxidative stress.

Porphyromonas gingivalis, an anaerobic oral pathogen implicated in adult periodontitis, can exist in an environment of oxidative stress. To evaluate its adaptation to this environment, we have assessed the response of P. gingivalis W83 to varying levels and durations of hydrogen peroxide (H(2)O(2))-induced stress. When P. gingivalis was initially exposed to a subinhibitory concentration of H(2)O(2) (0.1 mM), an adaptive response to higher concentrations could be induced. Transcriptome analysis demonstrated that oxidative stress can modulate several functional classes of genes depending on the severity and duration of the exposure. A 10 min exposure to H(2)O(2) revealed increased expression of genes involved in DNA damage and repair, while after 15 min, genes involved in protein fate, protein folding and stabilization were upregulated. Approximately 9 and 2.8% of the P. gingivalis genome displayed altered expression in response to H(2)O(2) exposure at 10 and 15 min, respectively. Substantially more genes were upregulated (109 at 10 min; 47 at 15 min) than downregulated (76 at 10 min; 11 at 15 min) by twofold or higher in response to H(2)O(2) exposure. The majority of these modulated genes were hypothetical or of unknown function. One of those genes (pg1372) with DNA-binding properties that was upregulated during prolonged oxidative stress was inactivated by allelic exchange mutagenesis. The isogenic mutant P. gingivalis FLL363 (pg1372 : : ermF) showed increased sensitivity to H(2)O(2) compared with the parent strain. Collectively, our data indicate the adaptive ability of P. gingivalis to oxidative stress and further underscore the complex nature of its resistance strategy under those conditions.

Sterilization analysis of contaminated healing abutments and impression copings.

This study investigated sterilization of used implant impression copings and healing abutments. Components were analyzed after contamination with Enterococcus foecalis, followed by multiple rounds of sterilization by both steam autoclave and Chemiclave protocols. The authors' results demonstrated that used components showed sterility equal to new components without any visible distortion. These data suggest that component resterilization and reuse may be justified or at least considered in clinical practice. Also, implications for cost savings in the placement of implants are advanced.

Minimum contact time and concentration of sodium hypochlorite required to eliminate Enterococcus faecalis.

INTRODUCTION: The purpose of this investigation was to determine the concentration of sodium hypochlorite and the irrigation time required to disinfect dentin cylinders infected with Enterococcus faecalis. METHODS: Four hundred fifty dentin cylinders (5 mm in diameter and 4 mm in height) with a lumen (2-3 mm in width) were prepared from freshly extracted bovine incisors. The cementum and predentin were then removed. The tubules were opened by using a 4-minute application with 17% ethylenediaminetetraacetic acid and 5.25% NaOCl and then exposed to E. faecalis (ATCC 4082) for 3 weeks in brain-heart infusion broth. The cylinders were then divided into 3 groups, and a 1.3%, 2.5%, or 5.25% concentration of NaOCl was applied in 5-, 10-, 15-, 20-, 25-, 30-, 35-, and 40-minute intervals for a total of 30 subgroups including positive and negative controls. Each test sample was placed into a tube of 2 mL brain-heart infusion broth and incubated for 72 hours. Absence of turbidity demonstrated no bacterial growth, whereas turbidity indicated presence of remaining viable bacteria. RESULTS: The most effective irrigation regimen was 5.25% at 40 minutes, whereas irrigation with 1.3% and 2.5% NaOCl for this same time interval was ineffective in removing E. faecalis from infected dentin cylinders. CONCLUSIONS: High concentration and long exposure to NaOCl are needed for elimination of E. faecalis contaminated dentin.

The antimicrobial effect of biopure MTAD on eight strains of Enterococcus faecalis: an in vitro investigation.

The purpose of this investigation was to determine the antimicrobial effect of MTAD as a final irrigant on eight strains of Enterococcus faecalis (E. faecalis) and to measure the minimum inhibitory concentration (MIC) and the minimum lethal concentration (MLC) of MTAD. The roots of 240 extracted human teeth were instrumented using 1.3% NaOCl and 17% EDTA. The roots were divided into eight groups and contaminated with one of eight strains of E. faecalis. After irrigating with 1.3% NaOCl, the root canal and the external surfaces were exposed to MTAD for 5 minutes. Roots or dentin shavings were cultured to determine the growth of E. faecalis. The results showed that this treatment regimen was effective in completely eliminating growth in seven of eight strains of E. faecalis. The MIC/MLC tests showed that MTAD inhibited most strains of E. faecalis growth when diluted 1:8192 times and killed most strains of E. faecalis when diluted 1:512 times.