Fatal subarachnoid haemorrhage associated with dental local anaesthesia

A case is described of sudden death occurring after the use of a noradrenaline-containing local anaesthetic. Autopsy revealed a massive subarachnoid haemorrhage following a ruptured cerebral aneurysm. The noradrenaline in the local anaesthetic is thought to be an important factor in the cause of the rupture. It is recommended that preparations containing 1:25,000 noradrenaline not be used.     

Characterizing the specific coaggregation between Actinobacillus actinomycetemcomitans serotype c strains and Porphyromonas gingivalis ATCC 33277

A visual coaggregation study showed specific interspecies coaggregation between an Actinobacillus actinomycetemcomitans serotype c strain and Porphyromonas gingivalis strains ATCC 33277 and 381. We mutagenized A. actinomycetemcomitans SUNYaB 67 (serotype c) with transposon IS903phikan and isolated three transposon insertion mutants that had a reduced ability to aggregate with P. gingivalis ATCC 33277. The three transposon insertions in the mutant strains mapped to the genes at ORF12, ORF13 and ORF16 of the gene cluster responsible for producing serotype c-specific polysaccharide antigen (SPA). Western blot analysis with serotype c-specific antibody showed that these strains did not produce the high-molecular-mass smear of SPA. Furthermore, two SPA-deficient mutants and an SPA-producing mutant were constructed. The two SPA-deficient mutants were deficient for ORF12 and ORF14, which are necessary for the synthesis of serotype c-SPA, and the SPA-producing mutant was deficient for ORF17, which is not related to SPA synthesis. The ORF12- and ORF14-deficient mutants showed reduced ability to aggregate with P. gingivalis ATCC 33277, while the ORF17-deficient mutant aggregated with ATCC 33277 to the same extent as wild-type SUNYaB 67. Our findings suggest that serotype c-SPA of A. actinomycetemcomitans mediates coaggregation with P. gingivalis ATCC 33277.     

In vitro wear of indirect composite restoratives

STATEMENT OF PROBLEM: Indirect composite restoratives have been improved in their wear resistance and physical properties. Several new indirect composites claim to be successfully used for full coverage crowns, but there is limited information for wear values of these new indirect composites. PURPOSE: The purpose of this study was to evaluate the wear characteristics of 7 indirect composite restoratives and to compare them with a type III gold alloy by means of an in vitro wear test. MATERIAL AND METHODS: Seven indirect composites (2 photopolymerized and 5 photo/heat-polymerized types) and a type III gold alloy (control) were used. Cylindrical Class I cavities (4-mm diameter and 3-mm depth) were prepared in occlusally flattened extracted human molars. Inlays with respective materials were fabricated on duplicated stone casts according to the manufacturers' instructions. Three types of in vitro wear tests were completed by use of the University of Alabama wear simulator. The wear tests included generalized wear as simulation of the wear during mastication, localized wear as simulation of attrition by occlusal contact, and antagonistic enamel wear, which simulated the wear of enamel created by direct contact with the restorative materials. Seven specimens were tested for each material and wear mode, and the wear depths were measured on profilometric tracings with a 2-dimensional profilometer with 1-microm accuracy. All data were analyzed by 1-way analysis of variance, and multiple comparisons were performed with Fisher's test, for which the significant level was set at.05. RESULTS: The gold alloy control exhibited a very small amount of wear in both generalized wear (0.2 +/- 0.1 microm) and localized wear (13.8 +/- 5.0 microm) as compared with all composite specimens. The antagonistic enamel wear of gold alloy was similar with the value of Sculpture. The material group, which was post polymerized or post heat-treated, included BelleGlass, Sculpture, Estenia, and Cristobal+ and showed small values ranging from 1.6 to 2.2 microm in the generalized wear. For the localized wear, Estenia exhibited the minimum value (12.8 +/- 4.9 microm) that was statistically the same as the value of the gold alloy control. However, Estenia exhibited the greatest antagonistic enamel wear value (66.0 +/- 14.0 microm) of all materials tested in this study. It was statistically significant with other materials (P相似文献   

Effects of plaque control on the patency and occlusion of dentine tubules in situ

To elucidate the nature of dentine hypersensitivity, the effects of plaque control on the patency and occlusion of dentinal tubules were investigated systematically in situ using human dentine slabs embedded in partial dentures. The dentine slabs were divided into three groups. In group I, the dentine slabs were kept in an oral cavity without plaque control. In group II, plaque was removed mechanically by brushing. Plaque control was carried out chemically using chlorhexidine in group III. After being kept in the oral cavities for 1, 2 and 3 weeks, the slabs were removed from the partial denture, followed by SEM observation to determine the morphological changes of the dentinal tubules. When no attempt was made to remove plaque, the diameter of tubule orifices increased to 390% of the original values within 3 weeks. In contrast, dentinal tubules were found to be occluded, i.e. the tubule orifices became <20% of the original value within 1 week when plaque control efforts were made, using either method of plaque control. We conclude that plaque control plays one of the key roles in the patency versus occlusion of dentinal tubules, and thus in the aetiology and natural reparative process of dentine hypersensitivity.     

Odontogenic carcinoma with sarcomatous proliferation. A case report

An unusual case of odontogenic carcinoma of the mandible showing a sarcomatous proliferation is described. The tumour had caused invasive bone destruction with extension into the soft tissues of the cheek. It was successfully treated by resection of the mandible and radical neck dissection. Although ameloblastomatous features were observed in an infrabony area, the majority of the intrabony lesion consisted of a proliferation of epithelial cells arranged in fine strands or networks which were randomly scattered in a collagenous stroma in the periphery. The tumour cells assumed a fibroblastic appearance and were intermingled with stroma cells in the extrabony lesion. The lesion could not be placed in any of the three entities of odontogenic carcinoma in the WHO classification.     

Evaluation of transitional implant stabilized overdentures: a case series report

Transitional implants (TI) can immediately improve the stability and retention of existing unstable mandibular complete dentures. This study evaluated the improvement of mandibular complete denture stability and retention with the use of TI. Three TIs were placed in the intraforaminal region of the edentulous mandible of seven patients (three men, four women; mean age 69.7 years). The patients' existing mandibular complete dentures were immediately modified to TI-stabilized overdentures. Their masticatory movements (mandibular movements during mastication) were measured using a commercially available tracking device (BioPACK, Bioresearch, Japan), both before TI placement and about 1 month after delivery of the TI-stabilized overdentures. The mean time of each chewing phase (opening, closing, and occluding) and coefficients of variation were calculated. The patients also completed a questionnaire about the foods they could chew and indicated on a 100 mm Visual Analog Scale (VAS) their personal levels of comfort, ease of chewing, speech, and stability. For masticatory movements, there were no significant differences (P > 0.05) between the TI-stabilized overdentures and existing complete dentures. However, the number of foods that could be chewed increased, and the stability and comfort were reported as improved with the TI-stabilized overdentures. Using TIs, the stability and comfort of the existing mandibular complete dentures studied in this report could be immediately improved.     

Cytotoxicity of bisphenol A glycidyl methacrylate on cytochrome P450-producing cells

Of the cytochrome P450 (CYP) family of carcinogen-activating enzymes, CYP3A is the major form found in human livers. The purpose of this study was to investigate the cytotoxic effects of dental resin monomers after being metabolized by CYP3A4 and CYP3A7, using a colony formation assay and a neutral red assay. Specimen wells were plated with transfected cells derived from the Chinese hamster lung at 100 cells well(-1). The experimental group consisted of CYP-producing 3A4-10 and 3A7-40 cells, while the control group consisted of non-CYP-producing CR-119 cells. Bisphenol A (BPA) and bisphenol A glycidyl methacrylate (Bis-GMA) and a positive control (Aflatoxine Bl) were added separately to each well and cultured for 7 days. After cultivation, the number of the colonies was counted and IC50 values were determined. The data were statistically analysed by a Student's t-test. The resultant of IC50 values indicated that the monomers were not metabolically activated by CYP3A4 or CYP3A7 as compared with the control (P < 0.05). We also confirmed that these monomers act neither as activators nor as inhibitors of CYP3A4 and CYP3A7.