Shear strength after ethylenediaminetetraacetic acid conditioning of dentin

On the basis of previous studies, it was hypothesized that a chelating agent such as ethylenediamine-tetraacetic acid (EDTA) in a saturated aqueous solution (24%) can function as a dentin conditioning agent with exposure times comparable to that of phosphoric acid without compromising shear bond strength. Thirty caries-free human third molars, divided equally between two groups, were used. In group one, four experimental surfaces were prepared on each tooth, and cylindrical copper matrixes with a diameter of 5 mm were attached to the prepared surfaces. The experimental surfaces were then treated with a 24% EDTA gel for 30, 60, 120, or 240 sec, respectively. Dentin was bonded with All Bond 2, after which a flowable composite was added and light-cured. In group two, which served as control, two surfaces were prepared on each tooth. One surface was left unetched, whereas the other side was treated with 24% EDTA-gel for 30 sec. A shear bond strength test was performed at a crosshead speed of 1 mm/min until the composite debonded. There was no statistically significant difference (P< 0.89) between results of the shear bond strength test for the different EDTA conditioning times. The control group showed a significant difference in shear bond strength between untreated surfaces and surfaces conditioned for 30 sec with EDTA. Thus, the results indicate that the duration of EDTA gel conditioning of dentin surfaces need not exceed that of phosphoric acid in clinical practice to obtain an acceptable level of bond strength.     

A congenital teratoma with a cleft palate: report of a case

Teratomas are benign tumors containing cells from ectodermal, mesodermal and endodermal layers. They occur in about 1 in every 4000 births and most commonly in the sacrococcygeal region, followed by the ovaries. Congenital epignathus teratomas are rare embryological neoplasms localised in the region of head and neck. An epignathus is found in approximately 1:35,000 to 1:200,000 live births. This accounts for 2-9% of all teratomas. Size and location of the neoplasm in the oronasopharynx is variable. Teratomas are partly undiagnosed at the time of birth. They may exist with an intracranial extension or as small polyps. Large epignathi can lead to difficult management during and after birth. The case of a newborn girl with a combination of an epignathus and a cleft palate is described. The epignathus presented as a huge mass extending out of the mouth of the infant girl. On the day of birth debulking of the extraoral portion of the tumor, followed by intraoral exstirpation, was performed. The results of the histologic examination indicated a congenital epignathus. Six months later a recurrence was found.     

Site-specific oral colonization of mutans streptococci detected by arbitrarily primed PCR fingerprinting

The clonal diversity and colonization pattern of mutans streptococci within an individual were studied by using a total of 50 tooth site samples obtained from seven 3- to 7-year-old children. Five children contributed saliva samples. From the 7 subjects, 90, 74, 81, 53, 83, 103, and 114 isolates (a total of 598) representing Streptococcus mutans and Streptococcus sobrinus were included for arbitrarily primed polymerase chain reaction (AP-PCR) fingerprinting. The children harbored one to four different AP-PCR types of mutans streptococci. In 3 of the 7 children, the distribution of AP-PCR types of S. mutans differed depending on tooth site (chi-square test for heterogeneity, p<0.001), suggesting that mutans streptococcal clones may selectively colonize specific hard-tissue sites.     

Congenital infiltrating lipomatosis of the face

Congenital infiltrating lipomatosis of the face is a rare clinical entity. Since it was first described by Slavin and colleagues in 1989, only a few cases have been reported in the literature. A 6-year-old girl with congenital infiltrating lipomatosis of the right side of the face is presented, and treatment modalities are discussed.     

Anterior-inferior mandibular osteotomy in treatment of obstructive sleep apnea syndrome

In a prospective randomized study on treatment of obstructive sleep apnea syndrome, anterior-inferior mandibular osteotomy with the purpose of stretching the suprahyoidal muscle was performed as one of the treatment methods. Ten men aged 20 to 65 years, without cardiovascular or neurologic disease, with normal maxillomandibular relation, and having an apnea index between 5 and 25 were included in the study. After a specially designed osteotomy of the chin, the anterior suprahyoidal muscles were detached, stretched approximately 10 to 12 mm, and sutured. The chin was then placed in its original position and post-operative evaluation was performed. Although there were initial reports of decreased daytime sleepiness and less snoring after surgery, the results after 12 months were discouraging. Somnographic registration (apnea index, apnea/hypopnea index, and oxygen desaturation index) as well as cephalometric analysis failed to show positive results. Hence, suspension of the suprahyoidal muscles as a method of treatment for obstructive sleep apnea syndrome cannot be recommended.     

IL-1beta and TNF-alpha regulate IL-6-type cytokines in gingival fibroblasts

Interleukin-6 (IL-6)-type cytokines are pleiotropic molecules capable of stimulating bone resorption and expressed by numerous cell types. In the present study, we tested the hypothesis that gingival fibroblasts may exert local osteotropic effects through production of IL-6 and related cytokines. IL-6-type cytokine expression and regulation by IL-1beta and tumor necrosis factor-alpha (TNF-alpha) were studied in fibroblasts from the non-inflamed gingiva of healthy individuals. Constitutive mRNA expression of IL-6, IL-11, and leukemia inhibitory factor (LIF), but not of oncostatin M (OSM), was demonstrated, as was concentration-dependent stimulation of IL-6 and LIF mRNA and of protein by IL-1beta and TNF-alpha. IL-11 mRNA and protein were concentration-dependently stimulated by IL-1beta. The signaling pathway involved in IL-6 and LIF mRNA stimulation involved MAP kinases, but not NF-kappaB. The findings support the view that resident cells may influence the pathogenesis of periodontal disease through osteotropic IL-6-type cytokine production mediated by activation of MAP kinases. Abbreviations: IL-1alpha (interleukin-1alpha); IL-1beta (interleukin-1beta); IL-6 (interleukin-6); IL-11 (interleukin-11); LIF (leukemia inhibitory factor); OSM (oncostatin M); alpha(1)-coll. I (alpha(1)-collagen I); ALP (alkaline phosphatase); BMP-2 (bone morphogenetic protein-2); OC (osteocalcin); BSP (bone sialoprotein); TNFR I (tumor necrosis factor receptor I); TNFR II (tumor necrosis factor receptor II); IL-1R1 (interleukin-1 receptor 1); GAPDH (glyceraldehyde-3-phosphate dehydrogenase); RPL13A (ribosomal protein L13A); mRNA (messenger ribonucleic acid); cDNA (complementary deoxyribonucleic acid); PCR (polymerase chain-reaction); BCA (bicinchoninic acid); ELISA (enzyme-linked immunosorbent assay); alpha-MEM (alpha modification of Minimum Essential Medium); and FCS (fetal calf serum).     

Delayed assessment of the nasolacrimal system at naso-orbito-ethmoid fractures and a modified technique of dacryocystorhinostomy

Nineteen patients between 8 and 65 years of age (mean age 32) who were treated for naso-orbito-ethmoid area traumas and suffering from epiphora were evaluated. The time after the trauma was at least 4 months. The patients were divided into two groups. The first group consisted of 10 (52.7%) patients who have undergone a surgical procedure for the fractures before. The second group has 9 (47.3%) members who have never been surgically treated after trauma. All of the patients were evaluated with dacryocystography. Obstruction was found to be in the bony nasolacrimal canal in 13 (68.4%) patients. The nasolacrimal canal was intact in six (31.6%) of the patients. Dacryocystorhinostomy (DCR) was essential for five (50%) of the patients in the first group and eight (88.8%) of the patients in the second group. No additional surgical intervention was carried out for nasal deformities of the patients resulting from naso-orbito-ethmoid fractures. Palpebral malposition was present in six (32%) patients. Relief in tear flow was supplied in all patients. Our aim is to compare the outcomes of a modified technique of DCR and incidence of nasolacrimal system injury in patients with naso-orbito-ethmoid fractures and epiphora on whom reduction was or was not carried out. In conclusion, early surgical reduction of naso-orbito-ethmoid fractures should be performed to prevent problems and deformities of the nasolacrimal system.