Management of ankylosed primary molars with premolar successors: A systematic review

BackgroundThe authors conducted a systematic review to determine the clinical prognosis of and methods of managing ankylosed primary molars with permanent successors.MethodsThe authors searched electronic databases (PubMed, Scopus, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Cochrane Database of Systematic Reviews and Google Scholar) up to April 2012 with the assistance of a librarian specializing in health sciences databases. They also searched the gray literature. They selected clinical studies in which investigators assessed the prognosis of ankylosed primary molars with permanent successors; they also hand searched references of the selected articles to identify any additional studies that the electronic search may have missed.ResultsThe authors identified 3,529 original articles from the electronic database search and none from the hand search. Once selection criteria were applied, only four articles met all inclusion criteria and were included. The number of patients studied ranged from 15 to 107. The number of ankylosed primary molars investigated ranged from 26 to 263.ConclusionsAnkylosed primary molars often manifest with mild to moderate progressive infraocclusion. Conservative monitoring of ankylosed primary molars is recommended. The clinician should consider extraction if the permanent successor has an altered path of eruption, if the ankylosed primary molar is severely infraoccluded with the adjacent teeth tipping to prevent the successor from erupting, or both. The ankylosed molar often exfoliates spontaneously within six months; however, when exfoliation is more delayed, arch-length loss, occlusal disturbance, hooked roots or impaction of permanent successors may occur.Practical ImplicationsAnkylosed primary molars initially should be monitored closely for up to six months. If they do not exfoliate spontaneously, they should be removed, because arch-length loss, alveolar bone defects, impacted permanent successors and occlusal disturbances often occur when the removal is delayed.     

Long-term skeletal stability after maxillary advancement with distraction osteogenesis in cleft lip and palate patients: A systematic review

Objective:To systematically review the long-term skeletal stability after maxillary advancement with distraction osteogenesis (DO) in cleft lip and palate (CLP) patients.Materials and Methods:Electronic databases, grey literature, and reference list searches were conducted. The inclusion criteria were stability of maxillary advancement with distraction osteogenesis assessed at the posttreatment follow-up ≥ 1 year in CLP patients. Full articles were retrieved from abstracts or titles that appear to meet the inclusion criteria or lacked sufficient detail for immediate exclusion. Once full articles were collected, they were again reviewed considering more detailed inclusion criteria for a final selection decision. A methodologic quality assessment tool was utilized.Results:Thirty abstracts/titles met the initial search criteria, and 13 articles were finally selected. Overall, methodologic quality scores were high in only one randomized clinical trial. After maxillary advancement with DO in CLP patients, the long-term horizontal relapse in A-point was less than 15% in eight studies and between 20% and 25% in four studies. The study that was judged as a high-quality study reported 8.2% horizontal relapse in A-point. The relapse rate was higher in DO with external distracter device than DO with internal distracter device.Conclusions:Current evidence suggests maxillary advancement with DO has good stability in CLP patients with moderate and severe maxillary hypoplasia.     

Altered Immunogenicity of Donor Lungs via Removal of Passenger Leukocytes Using Ex Vivo Lung Perfusion

Passenger leukocyte transfer from the donor lung to the recipient is intrinsically involved in acute rejection. Direct presentation of alloantigen expressed on donor leukocytes is recognized by recipient T cells, promoting acute cellular rejection. We utilized ex vivo lung perfusion (EVLP) to study passenger leukocyte migration from donor lungs into the recipient and to evaluate the effects of donor leukocyte depletion prior to transplantation. For this purpose, female pigs received male left lungs either following 3 h of EVLP or retrieved using standard protocols. Recipients were monitored for 24 h and sequential samples were collected. EVLP‐reduced donor leukocyte transfer into the recipient and migration to recipient lymph nodes was markedly reduced. Recipient T cell infiltration of the donor lung was significantly diminished via EVLP. Donor leukocyte removal during EVLP reduces direct allorecognition and T cell priming, diminishing recipient T cell infiltration, the hallmark of acute rejection.     

Analgesic action of gabapentin on chronic pain in the masticatory muscles: a randomized controlled trial

Chronic masticatory myalgia (CMM) can be defined as constant pain in the masticatory muscles for more than 6 months and is influenced by the central nervous system. The antiepileptic agent gabapentin acts centrally and is used for managing different types of chronic pain conditions. The objective of this study was to evaluate the analgesic action of gabapentin on CMM. In this 12-week randomized controlled clinical trial 50 patients were randomly allocated into two study groups: 25 received gabapentin and 25 received placebo. The outcome measures utilized were pain reported on a VAS (VAS-pain), Palpation Index (PI) and impact of CMM on daily functioning reported on a VAS (VAS-function). Thirty-six patients completed the study. Gabapentin showed to be clinically and statistically superior to placebo in reducing pain reported by patients (gabapentin=51.04%; placebo=24.30%; P=0.037), masticatory muscle hyperalgesia (gabapentin=67.03%; placebo=14.37%; P=0.001) and impact of CMM on daily functioning (gabapentin=57.70%; placebo=16.92%; P=0.022). It can be concluded from this study that gabapentin is effective for the management of CMM.     

Benchmarking of reported search and selection methods of systematic reviews by dental speciality

BACKGROUND: Previous evaluations showed that literature-search and selection methods reported in dental systematic reviews (SR) have improved since 2000. It is not known, however, whether these differences are consistent between the SR of the different dental specialities. METHODS: SR in dentistry published in the English language between 1 January 2000 and 14 June 2006 were located and then categorised by American Dental Association (ADA) recognised specialities. Search and selection methods were evaluated following an adaptation of the Cochrane Handbook for Systematic Reviews. Search and selection methods between dental specialities were compared using Pearson's chi-squared analysis and ranked. RESULTS: There were significant differences between specialities in the following criteria: documentation of search dates (P 0.003); inclusion-exclusion documentation (P 0.017); article selection by two or more reviewers (P 0.001); and inclusion of all languages (P 0.014). Periodontics SR met the most criteria followed by oral and maxillofacial surgery (OMS) and then dental public heath (DPH). Prosthodontics along with the area of oral and maxillofacial radiology (OMR) met the fewest. All dental SR had low compliance with four criteria, only 65.7% searched more than Medline, 50.4% had a search strategy documented with Boolean operators, 51.5% had article selection carried out by two or more reviewers and only 25.7% included all languages. CONCLUSIONS: Some dental specialities are better at reporting search and selection methods than others but all dental SR need some improvement in their reporting.     

Regulation of the host range of human papovavirus JCV.

Human papovavirus JCV is associated with the human demyelinating disorder progressive multifocal leukoencephalopathy. In tissue culture, the virus is largely restricted to growth in primary human fetal glial cell. In this study, we demonstrate two levels of regulation of the viral host range. Expression of the early JCV mRNA, which encodes the essential viral protein, large tumor antigen (T antigen), depends on recognition of the early enhancer/promoter elements by tissue-specific factors found in both human and rodent glial cells. In the presence of JCV T antigen, viral DNA replication requires a species-specific factor, presumably a component of DNA polymerase, which is found in a wide range of primate cells. We further demonstrate that simian virus 40 T antigen has sufficient homology to efficiently substitute for the analogous JCV protein in initiating viral DNA replication.     

Subclasses of cyclic GMP-specific phosphodiesterase and their role in regulating the effects of atrial natriuretic factor

Two subclasses of cyclic guanosine monophosphate (GMP)-specific phosphodiesterases were identified in vascular tissue from several beds. The activity of one subclass (phosphodiesterase IB) was stimulated severalfold by calmodulin and selectively inhibited by the phosphodiesterase inhibitor TCV-3B. The activity of the other subclass (phosphodiesterase IC) was not stimulated by calmodulin and was selectively inhibited by the phosphodiesterase inhibitor M&B 22,948. To assess the involvement of both subclasses in regulating cyclic GMP-dependent responses, the ability of TCV-3B and M&B 22,948 to potentiate the in vitro and in vivo responses to the endogenous guanylate cyclase stimulator atrial natriuretic factor (ANF) was evaluated. Both TCV-3B and M&B 22,948 relaxed isolated rabbit aortic and pulmonary artery rings and also potentiated the relaxant effect of ANF. In addition, both inhibitors produced small increases in urine flow and sodium excretion in anesthetized rats and potentiated the diuretic and natriuretic responses to exogenous ANF. M&B 22,948 (30 micrograms/kg/min) produced a threefold increase in the natriuretic response to simultaneously administered ANF, and TCV-3B (10 micrograms/kg/min) produced a twofold increase in the response to ANF. The results of the present experiments suggest that both the calmodulin-sensitive and calmodulin-insensitive subclasses of cyclic GMP-specific phosphodiesterase play a role in regulating the in vitro and in vivo response to ANF.