Introduction: Non-vital bleaching is a non-invasive technique to treat the intrinsic discoloration of teeth of several etiologies. Hydrogen peroxide and sodium perborate are commonly used bleaching agents.
Aim: The aim of this case report is to demonstrate the non-vital bleaching technique in maxillary anterior teeth.
Method: Maxillary central incisors were isolated with rubber dam and root canal treatment was performed. Barrier space preparation was done using a heated instrument. Glass ionomer cement was used a barrier material. Mixture of hydrogen peroxide and sodium perborate was placed in the canal and sealed with intermediate restorative material. After 1 week, the procedure was repeated to achieve the desired results.
Conclusion: Non-vital bleaching is a minimally invasive procedure to restore the esthetics of a discolored non-vital tooth. However, care should be taken to prevent any post-operative complications.
The article presents a synthetic molecular characterization of the methicillin-resistant Staphylococcus aureus and describes the most important community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clones that circulate nowadays in the world: the main molecular and epidemiological characteristics, as well as notions related to the clinic of infections produced by these clones and their antibiotic resistance spectrum. The predominant clone of CA-MRSA in North America is USA300 - ST8-IV in North America, in Australia - Queensland (Qld) MRSA (ST93-IV), in Europe - ST80-IV, in Asia there is a high heterogeneity of clones population, in Africa the distribution of CA-MRSA clones is unclear, and in South America - USA 1100 and USA300-Latin American variant are predominant. The molecular diagnosis is performed by highly specialized institutions. The knowledge of clones allows the study of antibiotic resistance spectrum for each one, a fact of great importance for medical practice. Molecular epidemiology of the CA-MRSA shows that lowly restricted sales of antibiotics in shops and pharmacies, as well as medical prescribing practices without a laboratory investigation, especially in Eastern Europe and Asia, contribute to the development of new MRSA clones with increased resistance to antibiotics.
Colorectal cancer is one of the most frequent forms of cancer both in men and women, and patients with metastatic disease are now being exposed to an increasing number of therapeutic agents to improve the survival outcomes. Vascular endothelial growth factor (VEGF) has o key role in the tumor growth and spreading. The approval of 4 agents that target angiogenic pathways in combination with standard chemotherapy improve overall and progression free survival and offer many opportunities to sequencing the treatment in patients with metastatic colorectal cancer (mCRC). However, the most effective strategy for the use of these agents remains unclear. This article presents an overview of the actual evidence for the use of agents that target angiogenesis in the treatment of mCRC.
Aim: The aim is to evaluate the association between midline discrepancies and tempromandibular disorders (TMDs).
Methods: Literature search was performed by using various search engines to include human studies in English. TMDs include a wide variety of signs and symptoms such as pain in and around TMJ, jaw muscles, clicking and locking of jaws, pain during mandibular movement and restricted mandibular movements. The etiology is multifactorial, including one or several of the following factors like severe malocclusions (increased overjet, retroclination of incisors, cross bite, CR CO discrepancies etc), stress and psychological factors, structural abnormalities as possible etiology. There are controversies concerning the association between different traits of malocclusion and TMDs. The aim of the present study was to find out any association between signs and symptoms of TMDs with midline discrepancies, which represent an important trait of malocclusion.
Result: Of the seven studies evaluated in this systematic review for investigating the association between midline discrepancy and TMD, six had moderate grade (B) of evidence. Four studies of moderate grade evidence (B) showed a significant association between the presence of midline shift and TMDs, and the remaining studies (two) had non-significant association. Only one study had a strong grade of evidence (A) and interestingly it denies the presence of midline shift to be a causative factor for TMDs. So, it can be concluded that the results are inconclusive regarding the association of midline discrepancies with TMDs. Nonetheless, this requires concrete evidence which necessitates further long term research into this aspect.
Objectives: The purpose of this experimental study was to demonstrate the reduction of peritoneal adhesions formation in rats after intraperitoneal administration of rosuvastatin, due to its anti-inflammatory effect.
Method: Peritoneal adhesions were induced in 120 Wistar-Bratislava rats divided into 4 groups (n=30), using a parietal and visceral (cecal) abrasion model. Group I was designated as control group; in group II, a saline solution was administered intraperitoneally; in groups III and IV, a single dose of rosuvastatin solution, 10 mg/kg and 5 mg/kg respectively, was injected intraperitoneally. The serum values of tumor necrosis factor (TNF-α) and interleukin-1 (IL-1α) were determined on day 1 and day 7 postoperatively (ELISA). Macroscopic assessment of the peritoneal adhesions was conducted on day 14.
Results: Rosuvastatin therapy induced a significant decrease of tumor necrosis factor serum levels in groups III and IV, on day 1 and day 7 (p<0.01). Intraperitoneal administration of rosuvastatin correlated with a decrease of mean interleukin-1α levels on postoperative day 1 in groups III (p=0.0013) and IV (p=0.00011), but not on day 7, where the differences were no longer statistically significant (p=0.8) The reduction of postoperative peritoneal adhesions in the experimental rat model is supported by the anti-inflammatory effect of rosuvastatin, mediated mainly by the tumor necrosis factor.
Conclusions: Rosuvastatin prevents the formation of postoperative peritoneal adhesions in rats. This effect may be linked to the inhibition of proinflammatory cytokines release in the early stages of adhesions formation. The present study suggests that rosuvastatin may be an efficient pharmacological agent in the prevention of postoperative peritoneal adhesions development, and requires further studies as it has a promising application value.
Introduction: India is home to many tribes which have an interesting and varied history of origins, customs and social practices. Oral health care in tribal areas is limited due to shortage of dental manpower, financial constraints and the lack of perceived need for dental care among tribal masses.
Objective: To assess orthodontic treatment need among tribal children of Indore division, Central India.
Methods: A cross-sectional house to house survey was carried out among 800 tribal children aged 5 to 15 years old in two major tribal districts of Indore division. Permissions and consent were obtained from local administrative authorities, ethical committee and parents respectively. A structured proforma was used to record demographic data. Examination for dentofacial anomalies was conducted according to WHO 1997 survey methods. Descriptive tables and analytical tests like ANOVA, post-hoc and chi-square test were employed.
Results: The mean age was 9.75(±2.43) years. The mean DAI score among 12 to 15 years old children was 23.19±5.22. Female exhibited higher (24.51±5.34) mean DAI score compared to males (22.12±4.87) (p<0.05). The Patelia tribes (24.38±5.13) reported higher mean DAI score than Bhilala (23.02±5.69) and Bhil tribe (22.73±4.79) (p<0.005).
Conclusion: The tribal children had minor malocclusion with no or slight treatment need. Categorization of orthodontic treatment need according to malocclusion severity is particularly important for the planning of corresponding public policies. The isolation of the villages, lack of transportation options imposes limitations on the availability of health professionals to provide dental services.
Background and aims: Using free quadriceps tendon graft for anterior cruciate ligament (ACL) reconstruction has become more popular in the last years due to the low morbidity at the harvest site and biomechanical and structural properties similar to other types of graft (hamstring and patellar tendons). As long as the tibial tunnel fixation with interference screws is considered the standard fixation, femoral fixation is still an open subject. Even though the most common type of femoral tunnel fixation are the cortical suspension devices, the type of suture used for tying the graft to the loop is still evaluated and discussed. We aimed to evaluate the resistance and elongation of a double whip stitch used for tying a tendon to the loop of a cortical suspension device.
Method: We used 10 porcine flexor digitorum profundus as free graft for a graft-suture-cortical suspension device construct using the double whip stitch. The total length of the construct and tendon length were recorded before and after the test was performed. Tensioning curves, total construct elongation and maximum tension at breaking point were electronically recorded on the testing device's software. The mean values and coefficient of variance were assessed.
Results: We noted the breaking of the suture wire where the wires passed through the loop of the cortical suspension device as final point for all tests. The mean of maximum load was 505.68N (Max=639.38 N; min=358.93 N; SD=82.88078 N) and the mean of total construct elongation was 39.54784mm (Max= 48.60466 mm; min=31.74853 mm; SD=4.85371 mm).
Conclusion: With some minor improvement in technique and graft preconditioning and pretensioning, the double whip stitch can be used in connecting a free tendon to a cortical suspension device.
Background and aim: The purpose of breast-conserving surgery (BCS) for women with cancer is to perform an oncological radical procedure with disease-free margins at the final histological assessment and with the best aesthetic result possible. Intraoperative resected specimen ultrasound and intraoperative resected specimen mammography may reduce the rates of positive margins and reexcision among patients undergoing conserving therapy. Our objective is to compare the two methods with the histopathological results for a preset cut off and asses which parameters can influence the positive margin status.
Method: A prospective study was performed on 83 patients who underwent breast conservation surgery for early breast cancer (pT1-3a pN0-1 M0) between 2014 and 2016. After excision the specimen was oriented in the operating room by the surgeon. Metallic clips and threads were placed on margins: one clip and the long thread at 12 o'clock, two clips and the short threads at 9 o'clock. The next step was intraoperative ultrasound assessment of the specimen. For the margins under 2 mm we performed selective margin shaving, followed by mammography to identify and document the lesion and finally histopathological examination of the specimen with reporting the gross and microscopic margins. The positive margins required re-excision or boost of radiation at the posterior or anterior margins, depending on the case.
Results: We set a cut-off at 2 mm. The sensitivity and specificity of the intraoperative margin assessment via the ultrasound method were 90.91% (95% CI 70.84-98.88%) and 67.21% (95% CI 54-78.69%) respectively. The sensitivity and specificity of the intraoperative margin assessment via the mammographic procedure were 45.45% (95% CI 24.39-67.79%) and 85.25% (95% CI 73.83-93.02%) respectively. There was positive correlation between the histopathological and intraoperative ultrasound exam (p=0.018) and negative correlation between the histopathological exam and the post-operative mammographic exam (p=0.68). We found a positive correlation between the positive margin status and age (<40), preoperative chemotherapy, intraductal carcinoma, inflammatory process around the tumor, and the immunohistochemical triple negative profile.
Conclusions: According to our results, the intraoperative ultrasound of the breast specimen for a cutt-off at 2 mm can decrease the rates of margin positivity compared to the mammographic procedure and has the potential to diminish the number of subsequent undesired re-excisions.
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