Revisiting epilepsy and the electroencephalogram patterns in Angelman syndrome

Angelman syndrome is a neurogenetic disorder that severely affects global neurodevelopment due to modifications in the structure or functioning of UBE3A gene. Its prevalence ranges from 1:10,000 to 1:40,000. There are four main genetic types of AS transmission. A maternal deletion in 15q11.2-q13 is the most common type. There are three well-established electroencephalogram (EEG) patterns used as an ancillary tool for AS diagnosis. The main objectives are to scrutinize the EEG patterns in Angelman syndrome, their correlation to different types of seizures and to review the role of the EEG as an ancillary screening tool in the diagnosis of clinically suspected patients. Forty-three patients’ charts and their previously recorded EEGs were reviewed. A set of 34 patients with deletion type, paternal uniparental disomy type and imprint defect type AS were enrolled. AS diagnosis was confirmed either by fluorescent in situ hybridization test or Methylation Specific–Multiplex Ligation Probe Amplification test. Sequencing of UBE3A was not available. Frequencies and Chi-square tests were used for statistic analysis. Pattern I type EEG was observed in 22 (64.7 %) individuals. Pattern II accounted for 6 (17.6 %); Pattern III was evident in 11 (32.4 %). The three distinguished EEG patterns, more frequently Pattern I, when observed in the appropriate clinical setting, may heighten the index of suspicion for selecting patients who will need a molecular biology test to confirm the diagnosis of AS.     

Histomorphometric evaluation of the effect of bovine collagen granules on bone healing. An experimental study in rats

Collagen materials have been utilized in medicine and dentistry because of their proven biocompatibility and capability of promoting wound healing. The aim of the present experimental study was to perform a histomorphometric evaluation of the effect of bovine collagen granules on post-extraction alveolar wound healing in rats. Twenty male Wistar rats were submitted to bilateral extraction of the first lower molars under ketamine/xylazine anesthesia according to the technique previously described by Guglielmotti and Cabrini. Sterile Bovine collagen granules of approximately 80 +/- 10 microm (Membracel G, Lab. Celina, Buenos Aires) were hydrated with saline solution and placed into the right mesial socket (experimental side) with gentle pressure, completely filling the site. The contralateral sockets were considered as the control side. Sutures were not performed. After surgery neither special diet nor antibiotics were given. The rats were fed rat chow and water ad libitum. All the animals were killed on the 30th day following surgery by ether overdose. The jaws were dissected, radiographed, decalcified, and embedded in paraffin. Sections were obtained at the level of the first molar mesial socket in a buccolingual orientation and stained with hematoxylin-eosin. The trabecular area and volume density of trabecular bone were measured histomorphometrically. The trabecular area was greater in alveoli treated with collagen granules than in control alveoli (P<0.05). Values of volume density of trabecular bone were greater in experimental than in control sockets (P<0.05). This experimental study provides evidence for the use of bovine collagen granules as bone grafting material, as a therapeutic alternative to fill postextraction sockets.     

Effect of surface treatment of a glass-infiltrated alumina ceramic on the microtensile bond strength

This study evaluated the microtensile bond strength of a resin composite to a ceramic submitted to three surface treatments. Twelve glass-infiltrated alumina ceramic blocks (In-Ceram Alumina, VITA) and twelve resin composite blocks (Clearfil APX, Kuraray) with dimensions of 6mm x 6mm x 5mm were made. The surface of the ceramic was wet-grounded with # 600, 800 and 1200-grid sandpaper, and the blocks were divided in three groups: Group 1 - sandblasting with aluminum oxide - particles 110mm (Micro-Etcher, Danville); Group 2 - Rocatec System (ESPE): Tribochemical silica coating (Rocatec pre-powder + Rocatec-Plus powder + Rocatec-Sil); Group 3 - CoJet System (3M/ESPE): silica coating (silica oxide + ESPE-Sil). The ceramic blocks were cemented to the resin composite blocks with Panavia F (Kuraray Co), following the manufacturer's instructions, under load of 750g for 10min. The samples were stored (distilled water / 7 days / 37O C) and sectioned in two axis, x and y, with diamond disk under cooling in order to obtain samples (S) with 0.6 ± 0.1mm2 of adhesive area (n=36). The S were attached in adapted device for the microtensile test that was performed at an universal testing machine (EMIC), at a speed of 1mm/min. The results (MPa) were submitted to ANOVA and Tukey's test (p<0.05): G1 - 15.36; G2 - 30.98; G3 - 31.25. Groups 2 (Rocatec) and 3 (CoJet) presented larger bond strength than group 1. There was no statistical difference between group 2 and group 3.     

Influence of cement thickness and mechanical cycling on the push-out bond strength between posts and root dentin

The aim of this study was to assess the influence of mechanical cycling and cement thickness on the bond strength between fiber posts and root dentin. Forty bovine teeth were sectioned (16 mm) and randomly assigned to four groups (n = 10). Specimens in Groups 1 and 2 were cemented using a thinner cement layer, while specimens in Groups 3 and 4 were cemented using a thicker cement layer. Groups 2 and 4 were submitted to mechanical cycling. Four slices per specimen were produced and submitted to push-out testing. Bond strength values were not affected by mechanical cycling (P = 0.2893), although the thickness of the cement layer did affect bond strengths (P = 0.0059, thinner > thicker). Tukey's test showed that Group 1 (19.27 MPa) had a higher mean bond strength value than Group 3 (12.4 MPa) and Group 4 (13.6 MPa), while Group 2 (15.0 MPa) was statistically similar to all groups. These results indicate that a thicker cement layer negatively affected the push-out bond strength between a fiber post and root dentin, regardless of whether the specimens were subjected to mechanical cycling.     

Clinical and radiographical evaluation of a resin-based root canal sealer: a 5-year follow-up

A retrospective clinical and radiographical analysis of 5-year postendodontic treatment with a resin-based sealer (EndoRez; Ultradent Products Inc, South Jordan, UT) and gutta-percha was conducted. The results after 14 to 24 months were reported previously. Of 180 patients, 120 responded to the 5-year recall. Success of root canal treatments was based on absence of clinical symptoms, a normal or slightly widened periodontal ligament, and absence or reduction of periapical radiolucencies in patients who had preexisting lesions. Root canals had been adequately filled to the working length in 92 teeth (76.66%) and short in 13 (10.83%). Fifteen cases (12.50%), filled flush at the initiation of the experiment, showed slight resorption of the filling material at the apex within the lumen of the root canal. Of the 10 roots with extrusion, none had radiographic evidence of sealer in the periradicular tissues after 5 years. All patients were free of clinical symptoms. Four cases (3.3%) showed partial healing, whereas 8 cases (6.66%) were judged failures. A life table analysis revealed a cumulative probability of success of 86.3% at the 5-year recall with a 95% confidence interval of 79.7 to 91.0. The clinical and radiographical data suggest that the tested resin-based sealer used in conjunction with gutta-percha performed very well as a root canal sealer over a period of up to 5 years.     

Fracture strength of teeth with flared root canals restored with glass fibre posts

OBJECTIVE: To investigate the fracture strength and pattern of failure of teeth with weakened roots reconstructed by different procedures. METHODS: In an in vitro study root posts were placed in 50 endodontically treated canines, divided into 5 groups (n=10) as follows: cast metallic post; glass fibre post with smaller diameter than the root canal; glass fibre post with smaller diameter than the root canal + glass fibre strips; glass fibre post with smaller diameter than the root canal + accessory glass fibre posts; anatomical post (glass fibre post with smaller diameter than the root canal, relined with low viscosity composite resin). Posts were luted with resin cement and the coronal portion of posts was constructed with composite resin. Metallic crowns were cemented on the posts. Specimens were submitted to compressive load in a universal testing machine. Fracture strength values of each group were compared. RESULTS: Fracture strength values were for Groups 1-5 respectively: 1087.06; 745.69; 775.41; 920.64; 876.12kgf, with significant differences between Groups 1 and 2 and between Groups 1 and 3 (p<0.05). Observed patterns of fracture were: Group 1 - 100% of roots fractured; Groups 2 and 4 - variable fracture modes; Group 3 - 60% of fractures occurred in the cervical root third; Group 5 - 50% of failures occurred in the coronal portion of the post. CONCLUSIONS: The fracture strength of teeth with cast metallic posts, teeth with anatomical posts or teeth with glass fibre posts combined with accessory posts was similar. All teeth restored with cast metallic posts presented fractures and were unfavourable to maintenance of the remaining tooth structure. Teeth with fibre posts (Groups 2 to 5) presented variable fracture modes; however, the maximum percentage of unfavourable fractures was 30%.