Mineral trioxide aggregate (MTA) and calcium hydroxide as pulp-capping agents in human teeth: a preliminary report

AIM: To compare mineral trioxide aggregate (MTA) with calcium hydroxide when used as pulp-capping materials in human teeth. METHODOLOGY: Eleven pairs of maxillary third molars in subjects between 20 and 25 years of age were subjected to mechanical pulp exposure. The exposed pulps were capped with MTA or calcium hydroxide, covered with ZOE and restored with amalgam. A total of 14 teeth were extracted after periods of 1 week (two molars) 2 months (three molars), 3 months (five molars), 4 months (two molars) and 6 months (two molars). RESULTS: Histological evaluation demonstrated less inflammation, hyperaemia and necrosis plus thicker dentinal bridge and more frequent odontoblastic layer formation with MTA than calcium hydroxide. CONCLUSIONS: Although the results favour the use of MTA, more studies with larger samples and a longer follow up are suggested.     

The Effect of a Constant Electrical Field on Osseointegration after Immediate Implantation in Dog Mandibles: A Preliminary Study

PURPOSE: The long time span between insertion of implants and functional rehabilitation often inconveniences patients. Accelerating bone growth around dental implants can shorten this time span. This in vivo study evaluated the effect of a constant electrical field on bone growth around dental implants. MATERIALS AND METHODS: Four mongrel dogs were used in this study. Sixteen dental implants were placed immediately after extraction of the first premolar and molar teeth. A constant electrical field (CEF) generator was placed in the mucoperiostal pouch created from the subperiostral dissection under the inferior border of the dog's mandible and connected to the experiment side fixtures. CEF provided 3 V of electrical potential during osseointegration. Histologic sections were stained with hematoxylin-eosin and observed under light microscopy. The sections were analyzed histomorphometrically to calculate the amount of newly formed bone. Statistical analysis was performed with SPSS 11.0 computer software (alpha= 0.05). RESULTS: At the end of the first stage of the osseointegration (90 days) CEF group sections showed enhanced growth of the trabeculae compared with the control group. Statistical analysis revealed significant differences between experimental and control groups. Bone contact ratio was statistically significant in the experimental group (p= 0.001). An increase in the local bone formation and bone contact ratio was observed with direct electrical stimulation of the implant and the bone area around the implant. CONCLUSION: Minimal direct electrical current, which can produce an electrical field around the implant, can increase the amount of bone formation and decrease the time of osseointegration.     

Interleukin-13 in Iranian patients with visceral leishmaniasis: relationship to other Th2 and Th1 cytokines

The role of interleukin (IL)-13, a Th2 cytokine sharing many of the features of IL-4, has not previously been examined in patients with visceral leishmaniasis (VL). We examined sera from Iranian patients with VL caused by Leishmania infantum. Serum IL-13 was detected in 50% (22/44) of patients with active primary disease. In comparison, IL-10 was detected in 79.5% (35/44), interferon gamma (IFN gamma) in 38.5% (17/44), and IL-4 in only 5% (2/44) of these patients. With few exceptions all 3 cytokines were undetectable after clinical recovery following antimony therapy. Five of 7 patients (71%) who failed antimony therapy and had relapsing disease had similar levels of IL-10 to patients with active primary disease. However, with only 1 exception, IL-13, IFN gamma and IL-4 were not detected in such patients. These data suggest that relapsing disease may result from defective cellular immunity, unrelated to immunosuppression mediated by IL-10.     

The serum level of transforming growth factor beta1 and its association with Foxp3 gene polymorphism in Iranian women with recurrent spontaneous abortion

The aim of the study was to determine the role of transforming growth factor-beta1 (TGF-β1) and Foxp3 (rs3761548) promoter polymorphisms in Iranian women with recurrent spontaneous abortion (RSA). Eighty women with RSA were compared with eighty in a control group. Serum levels of TGF-β1 were measured using ELISA and Foxp3 (rs3761548) promoter polymorphisms using a PCR-RFLP technique. In addition, serum levels of TGF-β1 were compared in different genotypes in the two groups. The women's ages in the two groups were similar (30.15 ± 4.42 years [RSA] vs. 29.97 ± 4.51 [control]) as were serum TGF-β1 concentrations in case and control groups (53.42 ± 2.08 ng/ml in control and 56.31 ± 2.58 ng/ml in the RSA group; p = 0.4). Furthermore, there was no significant difference in the genotype frequencies of the rs3761548 Foxp3 gene between the two groups (p = 0.3) and the levels of TGF-β1 were similar in different genotypes. In conclusion, the data indicate that serum TGF-β1 levels and Foxp3 (rs3761548) promoter polymorphism is not a risk factor for RSA and that there is no association between the polymorphism and serum TGF-β1 levels.     

Meta-analysis of open and endovascular repair of popliteal artery aneurysms

Objective

Endovascular popliteal artery aneurysm repair (EPAR) is increasingly used over open surgical repair (OPAR). The purpose of this study was to analyze the available literature on their comparative outcomes.

Immune responses to hepatitis B immunization 10–18 years after primary vaccination: a population‐based cohort study

We evaluated the immune response to neonatal HBV immunization in children of infected parents 10–18 years after primary vaccination. Healthy individuals immunized with an infantile course of three doses of HBV vaccine were tested for persistence of anti‐HB surface antibody (HBsAb). Those with an HBsAb level of <10 IU/mL received a booster dose of the vaccine with subsequent doses to those without protective titres. HBsAb concentrations were determined 4 weeks after each dose of the booster vaccine. The data were analysed separately for three age groups: 10–11, 12–14 and 15–18 years old. A total of 541 healthy individuals were studied. The highest seroprotection rate of 48% was observed in the youngest vaccinees (10–11 years old). This declined to 26.5% in the oldest (15–18 years old) group (P = 0.008). The youngest vaccinees showed the highest rate of anamnestic immune responses (96%). However, 25% of oldest individuals failed to mount an anamnestic immune response in challenge with a booster dose of the vaccine (P = 0.005), suggesting waning immunity with increasing age. Age (OR: 0.80; P = 0.01) and prebooster HBsAb levels (OR: 0.37; P = 0.01) identified responders to first booster doses of the vaccine by logistic regression analysis. The majority of high‐risk vaccinees showed anamnestic immune response 10–11 years after primary immunization. However, we found a significant proportion (25%) of older individuals with no anamnetic response, which suggests a waning of immune memory. Detailed long‐term follow‐up studies are necessary to determine the risk of natural infection among these individuals before a booster schedule can be recommended.     

Tapered arteriovenous grafts do not provide significant advantage over nontapered grafts in upper extremity dialysis access

ObjectiveAlthough tapered dialysis access grafts are often used in an effort to prevent ischemic steal, their efficacy is uncertain. Our goal was to use real-world data to assess the performance of these grafts with respect to primary patency and ischemic steal.MethodsThe Vascular Quality Initiative database was queried from 2010 to 2017 for all patients undergoing tapered dialysis grafts in the upper arm. Multivariable analysis was performed to analyze primary patency, ischemic steal, and reinterventions.ResultsWe identified 3608 patients who received dialysis access grafts, 1473 tapered grafts and 2135 nontapered grafts. The mean age was 64.8 years, and 43.4% of the patients were male. Tapered grafts were used more often in female patients (60.5% vs 54%), nonwhite patients (53.3% vs 47.7%), patients with no previous access (28% vs 26.3%), grafts with an antecubital brachial artery origin (50% vs 44.4%), and grafts with an antecubital cephalic vein target (7.4% vs 3.7%; P < .05). Three-month outcomes between tapered and nontapered grafts were similar for wound infection (1.4% vs 2%; P = .31), ischemic steal (4.1% vs 4.6%; P = .58), and arm swelling (3.5% vs 2.9%; P = .38). Multivariable analyses revealed that in comparison to nontapered grafts, tapered grafts did not affect primary patency rates (hazard ratio [HR], 1.17; 95% confidence interval [CI], 0.96-1.42; P = .11), ischemic steal (HR, 1.03; 95% CI, 0.64-1.65; P = .92), difference in endovascular reintervention (HR, 1.08; 95% CI, 0.74-1.16; P = .5), or operative reintervention (HR, 1.25; 95% CI, 0.86-1.82; P = .24).ConclusionsTapered grafts for upper extremity arteriovenous access do not affect primary patency, development of steal, or endovascular reintervention in comparison to nontapered grafts. Our findings do not support the routine use of these grafts in dialysis access to improve outcomes.