Antimicrobial susceptibility of 1042 strains of Streptococcus mutans and Streptococcus sobrinus: comparison from 1985 to 1989

A total of 1042 strains of Streptococcus mutans and Streptococcus sobrinus isolated between 1985 and 1989 were tested to study the evolution of their sensitivity to penicillin, amoxycillin, amoxycillin/clavulanic acid, cefuroxime, tetracycline, erythromycin, spiramycin, acetyl spiramycin, lincomycin and clindamycin. The strains were taken from stock cultures and isolated from human saliva and dental plaque. The minimal inhibitory concentration (MIC) was determined by an agar dilution method. Except for spiramycin and acetyl spiramycin, all the antibiotics inhibited 100% of the strains with concentrations less than or equal to 2 micrograms/ml. Microorganisms from both species underwent a slow progressive loss of sensitivity to all the antibiotics over a 5-year period of study, showing statistically significant results in most cases.     

Reconstruction of the defect at the donor site of the temporalis muscle flap

A method for the immediate correction of the defect created at the donor site of the temporalis muscle flap is described. It uses a performed acrylic prosthesis. A case is presented in which the prosthesis could have been used to good effect, and two cases are reported to show the successful use of this technique.     

A comparative study of the treatment of unilateral fractured and dislocated mandibular condyles in the rabbit

This study evaluated the results of three methods of managing simulated unilateral dislocated fractured mandibular condyles in the rabbit. The first method consisted of surgical reduction of the fractured condyle to its anatomic position and its subsequent fixation with a titanium plate. The second method differed from the first by completely detaching the condyle, then replacing it as free graft. The third method left the fractured condyle in its dislocated position outside the glenoid fossa. Eighteen rabbits were used, 6 animals for each method. Half the animals in each group were killed at 4 weeks, the other half at 14 weeks postoperatively. Clinical, morphologic, functional, radiologic, and histologic examinations were conducted on all animals. The results indicated that open reduction with internal fixation with no disruption of the blood supply to the condyle provided the most favorable results. While closed reduction without internal fixation gave good functional results, definite reduction in ramus height on the operated site was observed in this group of animals. Animals that had open reduction and internal fixation using the condyle as a free graft did not do as well as the other two groups. Despite good mouth opening and occlusion, more animals showed facial asymmetry and it was more severe. None of the condyles were lost as result of necrosis, but healing took longer when compared with the other group of animals.     

Characterization of the immunologic responses to human in vivo acquired enamel pellicle as a novel means to investigate its composition

Human acquired enamel pellicle is formed by molecules selectively adsorbed onto tooth surfaces. The present work describes the use of monoclonal antibody (mAb) technology as a novel approach to identify micro amounts of components present in pellicle. MAbs were obtained with reactivities against statherin, histatin, mucous glycoprotein 1(MGI), albumin, amylase and human immunoglobulins (Igs), indicating that these are pellicle components, which was further confirmed by immunoblotting. No mAbs against proline-rich proteins (PRPs), lysozyme, mucous glycoprotein 2 (MG2), carbonic anhydrase, lactoferrin or peroxidase were obtained, suggesting that these components are absent, present in low amounts, or exhibit low antigenicity. Further characterization of the binding epitopes of some of th e obtained anti-MGO, anti-statherin and anti-histatin mAbs were carried out and the biological relevance is discussed. The results open up the possibility that immunization with human pellicle and mAbs production can be employed to identify hitherto unknown constituents of pellicle.     

A virtual reality dental simulator predicts performance in an operative dentistry manikin course

This study was designed to test the ability of a virtual reality dental simulator to predict the performance of students in a traditional operative dentistry manikin course. Twenty-six dental students were pre-tested on the simulator, prior to the course. They were briefly instructed and asked to prepare 12 class I cavities which were automatically graded by the simulator. The instructors in the manikin course that followed were unaware of the students' performances in the simulator pre-test. The scores achieved by each student in the last six simulator cavities were compared to their final comprehensive grades in the manikin course. Class standing of the students in the simulator pre-test positively correlated with their achievements in the manikin course with a correlation coefficient of 0.49 (P = 0.012). Eighty-nine percent of the students in the lower third of the class in the pre-test remained in the low performing half of the class in the manikin course. These results indicate that testing students in a dental simulator, prior to a manikin course, may be an efficient way to allow early identification of those who are likely to perform poorly. This in turn could enable early allocation of personal tutors to these students in order to improve their chances of success.     

Inhibitory effect of synthetic histatin 5 on leukotoxin from Actinobacillus actinomycetemcomitans

Actinobacillus actinomycetemcomitans is a gram-negative bacterium strongly implicated in the pathogenesis of juvenile periodontitis. This periodontal pathogen synthesizes a leukotoxin that destroys human polymorphonuclear leukocytes (PMNs), and this toxin is thought to be responsible for the virulence of A. actinomycetemcomitans. It was therefore of interest to assess whether major virulence factors of periodontal pathogens were neutralized by salivary components. This study focuses on the effect of histatins, components of the nonimmune oral defense system, on leukotoxin activity. Leukotoxin was extracted with polymyxin B from freshly grown anaerobic cultures of A. actinomycetemcomitans strain Y4. PMNs isolated from blood of healthy human volunteers were incubated in a cytotoxicity assay containing PMNs (10(7) cells/ml) and leukotoxin preparation (0-500 microg/ml) in Hanks' balanced salt solution at 37 degrees C for 0-120 min with or without synthetic histatin 5 (0-500 microM). Cytotoxicity was measured by release of lactate dehydrogenase (LDH) at different time intervals. Histatin 5 neutralized the toxic effect of the leukotoxin preparation in a concentration-dependent manner, with an IC(50) value of 150 microM. When PMNs were preincubated with histatin 5 (300 microM), washed and subsequently exposed to leukotoxin, no protective effect was observed. This observation suggests a mechanism of inhibition whereby histatin 5 either directly neutralizes the leukotoxin or interferes with the leukotoxin-PMN interaction. The inhibitory effect of histatin 5 on leukotoxic activity may suggest a new biological function of histatins in the oral cavity as a naturally occurring secondary antibiotic.     

Oral lichen planus: a preliminary clinical study on treatment with tazarotene

OBJECTIVE: The rationale for using tazarotene in oral lichen planus (OLP) is its regulatory action on the growth and differentiation of keratinocytes and on inflammation. This randomized, placebo-controlled study addresses evaluation of the effects of topic tazarotene in the treatment of OLP. DESIGN: The degree of lesions before and after treatment scored by a 6-score scale in six cases treated with tazarotene was statistically compared with those of six controls treated with placebo. SUBJECTS: Twelve patients with hyperkeratosic OLP were randomly allocated to treatment with tazarotene gel 0.1% b.i.d. or with placebo for eight consecutive weeks. METHODS: The statistical comparison was executed by means of Wilcoxon analysis for paired data. RESULTS: Patients treated with tazarotene presented a significant reduction of their lesions as compared with the control group. Among transitory side-effects, burning sensation and taste abnormalities were observed. CONCLUSION: Topical tazarotene may be a valuable therapeutic tool in the treatment of hyperkeratotic OLP.