A retrospective evaluation of crown-fractured permanent teeth treated in a pediatric dentistry clinic

Abstract –  A retrospective study was carried out on the dental trauma records of 93 patients (55 boys, 38 girls) with 129 crown-fractured teeth. The patients' average age was 9.57 years (SD 1.57), ranging between 7 and 15 years. Uncomplicated crown facture (comprising enamel–dentin) was the most observed type of injury ( n  = 107, 83%). Only 15 patients (16.13%) sought treatment in less than 24 h following the injury. Of 41 injured teeth (31.79%) the apices were open at the time of presentation at the clinic. The initial treatment of these injured teeth were interim restoration with acid-etch and composite (69%), Cvek amputation (2.33%), fragment reattachment (1.55%), apexification (APX, 10.07%), and root-canal treatment (RCT, 17.05%). Out of 94 teeth, which were diagnosed as vital on admittance, 23 (24.46%) later developed pulp necrosis and required APX or RCT depending on their apical status. In 66 teeth (51.16%) definitive treatment was provided with only esthetic restoration (ER), while in 15.50% and 26.68% of injured teeth ER was carried out following APX and RCT, and RCT, respectively. Definitive treatment was provided in 3–6 months for 29.45% of the injured teeth, while 27.13% and 20.16% of teeth received definitive treatment within 1–3 months and 6 months to 1 year, respectively. Type of crown-fracture, elapsed time following injury, and vitality of the tooth on admittance and pulp necrosis observed were significantly related to the total time spent for definitive treatment ( P  < 0.05).     

Secondary social anxiety in hyperkinesias

This is a comparison study that is aimed to investigate and compare the frequency and severity of secondary social anxiety disorder (SAD) in patients with hyperkinesias, which is associated with a significant sense of disfigurement and compromised social interaction. Patients with hemifacial spasm (n = 20), cervical dystonia (n = 20), and essential tremor (n = 20) were evaluated by SCID‐I, Liebowitz Social Anxiety Scale, Hamilton Anxiety and Depression Rating Scales, and Sheehan Disability Scale. The DSM‐IV H criterion excluding social anxiety related to a medical condition was disregarded for the diagnosis of secondary SAD. The control group (n = 60) consisted of matched healthy subjects. The frequency of the diagnosis and severity of symptoms were compared and associations with sociodemographic and clinical factors were explored. There was no difference between three patient groups in terms of the frequency or the severity of secondary SAD. Younger age and depressive symptoms were associated with the severity of secondary SAD, while severity or duration of the movement disorder or social disability was not. This study revealed a high frequency of secondary SAD in hyperkinesias, emphasizing the need for psychiatric assessment, especially for younger and depressed patients, who seem to be at greater risk. © 2007 Movement Disorder Society     

The effects of long-term sleep deprivation on the long-term potentiation in the dentate gyrus and brain oxidation status in rats

Disrupted-in-Schizophrenia 1 (DISC1) is a susceptibility gene for major mental illnesses, including bipolar disorder and schizophrenia. Although the roles of DISC1 in nervous system development and functions are increasingly recognized, pathophysiological mechanisms underlying a range of neuropsychiatric symptoms caused by DISC1 mutations remain unclear. Here we show that DISC1 enhances synaptic vesicle transport along microtubules. Knocking down DISC1 expression results in attenuated vesicle transport in primary cortical neurons. Likewise, expressing the dominant-negative, breakpoint mutant version of DISC1 causes defective vesicle transport, by disrupting the assembly between the kinesin-1 adaptor FEZ1 and the cargo protein Synaptotagmin-1 (Syt-1). In addition, lithium, a mood-stabilizing agent used for the treatment of bipolar disorder, can restore the assembly of FEZ1 and Syt-1, and normalizes the defective transport caused by the dominant-negative DISC1. Thus, this study addresses a new role of DISC1 in organelle transport in neurons, and suggests that this cellular pathway could be therapeutically targeted for the treatment against neuropsychiatric diseases.     

Transient cortical blindness and successful recovery after coronary bypass surgery

Left ventricular injury has a bad prognosis, especially when a coronary artery is involved. After perforation of the left cardiac ventricle by a knife, a 19-year-old male patient presented with: (i) complete bilateral visual loss; (ii) left anterior descending (LAD) artery injury; (iii) severe systemic hypotension. Under emergency conditions and cardiopulmonary bypass, the LAD artery was revascularized by a saphenous vein graft. Bilateral blindness recovered within several days. Cerebral hypoxia as a result of severe systemic hypotension was the most likely underlying mechanism.     

Methylenetetrahydrofolate reductase gene polymorphisms in children with attention deficit hyperactivity disorder

Objective: The purpose of this study was to evaluate the relationship between 5,10- methylenetetrahydrofolate reductase (MTHFR) polymorphisms and Attention Deficit Hyperactivity Disorder (ADHD) in a sample of Turkish children.Study Design: MTHFR gene polymorphisms were assessed in 40 patients with ADHD and 30 healty controls. Two mutations in the MTHFR gene were investigated using polymerase chain reactions and restriction fragment length polymorphisms.Results: Although there were no statistically significant differences in genotype distributions of the C677T alleles between the ADHD and the control groups (p=0,678) but the genotypic pattern of the distributions of the A1298C alleles was different between the ADHD patients and the controls (p=0,033).Conclusions: Preliminary data imply a possible relationship between A1298C MTHFR polymorphisms and the ADHD.     

The effect of irrigation temperature on bone healing

Objective: Osteotomies, performed by rotational instruments, can cause temperature rise on the bone and elevated temperature can disrupt the bone healing. When the osteotomies are performed for the insertion of miniscrews, the bone healing disruption may cause stability loosening or failures. Saline irrigation is mostly used for the prevention of the heat generation during osteotomy.Purpose: The purpose of this study was to evaluate the effect of the saline irrigation temperature on bone healing.Material and Method: Standardized drilling and miniscrew placement was performed in the tibias of 18 Sprague Dawley rats with rotating bur uncooled, cooled with 25°C and 4°C saline irrigations. After the 21 days, the difference in healing was observed between the uncooled and cooled groups.Results: Although there was no statistically significant difference between the group irrigated with 25°C and 4°C saline for newly bone formation, osteoblasts were seen more active and bone marrow was more dynamic in group 4°C than group 25°C. There is no disadvantage to use 25°C, but it may be better to use 4°C for rapid healing.     

Ankaferd Blood Stopper Is More Effective Than Adrenaline Plus Lidocaine and Gelatin Foam in the Treatment of Epistaxis in Rabbits

Background

Epistaxis is an important emergency that can sometimes be life threatening without effective intervention. Persistent and recurrent bleeding can lead to aspiration, hypotension, hypoxia, or even severe and mortal cardiovascular complications. Providing prompt hemostasis is important, and the hemostatic method used must be easily and locally applicable, efficient, and inexpensive.

Objective

The aim of this study was to assess the hemostatic efficacy of Ankaferd Blood Stopper (ABS) in an experimental epistaxis model and to determine the histopathologic alterations with topical ABS application.

Methods

Twenty-eight New Zealand rabbits were evaluated in 4 study groups. Topical ABS, gelatin foam (GF), adrenalin + lidocaine (AL), and serum physiologic as negative control (C) were applied to the animals for controlling epistaxis. The bleeding was generated with a standard mucosal incision in all groups. Cotton pieces soaked with ABS, AL, C, and GF were applied to the nasal bleeding area. Time of hemostasis was recorded. Tissue samples were obtained after hemostasis for histopathologic examination. The samples were stained with hematoxylin and eosin (HE) and phosphotungstic acid hematoxylin (PTAH) and were examined under a light microscope. In this experimental study, the observers were blind to ABS, AL, and C but not to GF, because of its solid nature.

Results

Median durations required for hemostasis in ABS, AL, GF, and C groups were recorded as 30, 90, 90, and 210 seconds, respectively. The time until termination of bleeding in the ABS group was significantly shorter than that in the AL, GF, and C groups (P = 0.002, P = 0.002, and P = 0.001, respectively). On histopathologic evaluation, after staining with HE, minimal fibrin at the incision edges and a few extravasated erythrocytes were observed in the C, AL, and GF groups. In the ABS group, a dark amorphous material surrounded by fibrin, filling the space between the edges of incisions, was noticed. Fibrin was determined in the C, GF, and AL groups with PTAH stain and in the positive control group. In the ABS group, it was observed that the amorphous substance surrounded by fibrin seen in the HE sections was not stained with PTAH.

Conclusions

Topical nasal ABS application controlled epistaxis faster than C, GF, and AL in this animal bleeding model. The bleeding model used here might fail to replicate the type of injury that would be likely to result in life-threatening bleeding in humans, which should be considered a limitation of the present study. The histopathologic findings in the nasal incision area suggest that ABS might affect global hemostasis by inducing a unique protein network formation, potentially representing a different mechanism of action among conventional antihemorrhagic applications.