Nasopharyngeal carriage of Streptococcus pneumoniae in healthy Turkish children after the addition of PCV7 to the national vaccine schedule

The aim of this study was to determine serotype distribution and investigate antimicrobial resistance patterns of Streptococcus pneumoniae in healthy Turkish children in the era of community-wide pneumococcal conjugate vaccine (PCV7). The study was conducted on 1,101 healthy children less than 18 years of age. Specimens were collected with nasopharyngeal swabs between April 2011 and June 2011. Penicillin and ceftriaxone susceptibilities were determined by E-test according to the 2008 Clinical Laboratory Standards Institute, and serotypes of the isolates were determined by Quellung reaction. The nasopharyngeal pneumococcal carriage rate was 21.9 % (241/1,101). Using the meningitis criteria of minimum inhibitory concentration values, 73 % of the isolates were resistant to penicillin and 47.7 % of them were resistant to ceftriaxone. Half of all pneumococcal isolates were serotyped as 19F (15.2 %), 6A (15.2 %), 23F (10.3 %), and 6B (9.3 %) and surprisingly, no serotype 19A was isolated. Serotype coverage rates of PCV7 and non-PCV7 were 46.2 and 53.8 %, respectively. The most common penicillin- and ceftriaxone-resistant serotypes were 6A, 6B, 14, 19F, and 23F. Penicillin- and ceftriaxone-resistant isolates were more prevalent in serotypes covered by PCV7 than the non-PCV7 serotypes. Conclusion: After the community-wide PCV7 vaccination, more non-PCV7 serotypes were isolated from the carriers compared to the time before PCV7 was used especially the serotype 6A, and the antimicrobial resistance of pneumococci was significantly increased.     

NO-cGMP signaling molecules in cells of the rat molar dentin-pulp complex

By the formation of cyclic guanosine 3',5'-monophosphate (cGMP), nitric oxide (NO)-sensitive enzyme-soluble guanylate cyclase (sGC) plays a receptor role for NO within the NO-cGMP signaling cascade, which is involved in vasodilatation and neurotransmission. The hypothesis that NO-cGMP signaling molecules modulate cells of the dentin-pulp complex was investigated in rat molars by histochemical, immunohistochemical, immuno-ultrastructural, and organ bath techniques. NO synthase (NOS) I-III, the sGC alpha(2)-subunit/beta(1)-subunit, and cGMP were detected in odontoblasts and blood vessels. NOS I, sGC alpha(2), and cGMP were identified in nerve fibers. Treatment of rat molars with the NO donor NONOate (10(-5) M) increased cGMP staining intensities in blood vessels and odontoblasts, while NO synthase inhibitor L-NAME (10(-4) M) attenuated intensity of the reaction products for cGMP, suggesting an effect of endogenous NO on sGC. These correlations of patterns and alterations of cGMP staining intensities after treatment with the NO donor or NO inhibitor might represent an NO-sGC-cGMP signaling-dependent modulation of odontoblasts, blood vessels, and nerve fibers in the dentin-pulp complex.     

Effects of mesiodistal inclination of implants on stress distribution in implant-supported fixed prostheses

PURPOSE: Patterns of von Mises stress values surrounding implants supporting fixed prostheses in the posterior edentulous maxilla were evaluated using 3-dimensional finite element analysis. MATERIALS AND METHODS: Implants were placed in maxillary bone in 2 different configurations. In the first configuration, implants were placed in the first premolar, second premolar, and second molar regions; in the second configuration, implants were placed in the second premolar and second molar regions, and a mesial cantilever was extended to the space of the first premolar tooth on the superstructure. On the implant placed in the socket of the second molar, 3 different inclinations were used (0, 15, and 30 degrees). Loading was applied in the vertical, oblique, and horizontal axes. RESULTS: Inclination of the implant in the molar region was found to result in increased stress. Significant increase in stress on the implant embedded in the premolar region was also seen in the design with the cantilever as compared to the conventional prosthesis design. Discussion: The stress concentrations observed at the neck of the implant were similar to results reported in the literature. CONCLUSION: The highest stress value obtained in the study was 194.2 MPa with oblique loading. This value did not exceed the endurance limit of pure titanium, which is 259.9 MPa.     

Orthodontic treatment of a patient with traumatic loss of maxillary incisors

Obtaining and retaining a good treatment result for traumatically lost incisors can be difficult for the clinician. In this case report, the management of a patient with the chief complaint of missing maxillary central incisors due to trauma is presented. The patient had a constricted maxilla with a bilateral posterior crossbite and an end-to-end relationship anteriorly. Orthodontic intervention took 19 months. The cusps and palatal surfaces of the canines were ground and flattened to meet the patient's esthetic requests.     

Interdisciplinary management of a patient with skeletal anteroposterior discrepancy, impacted canine, and missing teeth

For patients with complex dentofacial problems, orthodontic treatment is often not enough to obtain optimal esthetic and functional results. This case report demonstrates the treatment of a patient with skeletal anteroposterior discrepancy through an interdisciplinary approach and emphasizes the importance of collaboration with other dental disciplines to achieve the desired esthetic results.