Clarithromycin as an Adjunct to One‐Stage Full‐Mouth Ultrasonic Periodontal Debridement in Generalized Aggressive Periodontitis: A Randomized Controlled Clinical Trial

Background: The aim of the present study is to evaluate the periodontal clinical and microbiologic responses and possible adverse effects of clarithromycin (CLM) combined with periodontal mechanical therapy in the treatment of patients with generalized aggressive periodontitis. Methods: Forty patients were selected and randomly assigned into one of two groups: 1) CLM (n = 20): one‐stage full‐mouth ultrasonic debridement (FMUD) associated with CLM (500 mg, every 12 hours for 3 days); and 2) placebo (n = 20): FMUD associated with placebo pills. Clinical and microbiologic parameters were evaluated at baseline and 3 and 6 months postoperatively. Results: Both treatments presented statistically significant clinical and microbiologic improvements. However, the CLM group presented lower means of probing depth for pockets ≥7 mm at 6 months (4.0 ± 1.7 mm) compared with the placebo group (4.7 ± 1.3 mm) (P = 0.04). In addition, the CLM group also presented greater reduction of Porphyromonas gingivalis (Pg) DNA counts at 6 months (P = 0.0001). Conclusion: Results from this study suggest both treatments are effective; however, adjunct use of CLM to FMUD leads to better reduction of deep pockets and Pg at 6 months compared with FMUD alone.     

Immunostimulatory capacity of dental casting alloys on endotoxin responsiveness

Statement of problem

Oral metal exposure has been associated with systemic and local adverse reactions, probably due to elemental release from the alloys. Although supraphysiological concentrations of salts from dentally applied metals can activate innate cells through TLR4 (Ni, Co, Pd) and TLR3 (Au), whether direct exposure to solid alloys can also trigger innate immune reactivity is still unknown.

Diagnostic accuracy of magnetic resonance imaging and clinical signs of temporomandibular joint disorders: a 10-year research update review

Objectives

To review the past 10 years of research in the diagnostic accuracy of magnetic resonance imaging (MRI) and clinical signs of temporomandibular joint (TMJ) disorders with pain, sound, and function limitation in the existing literature.

Methods

A review of the literature was performed to search for all articles published between 2006 and 2016, and those that met the selection criteria were examined.

Results

The MRI results ranged from 25.3 to 69% for findings in TMJ with sound, 17–74.5% for findings in TMJ with function limitation, and 13.3–77% for findings in TMJ with pain. The reasons for the TMJ symptoms were variable and MRI findings for temporomandibular disorders were seen in asymptomatic patients as well as symptomatic patients. No singular outcome measure can be suggested as a predictor for TMJ symptoms on MRI images.

Conclusions

To increase study comparability with MRI, a standardized terminology and evidence-based guidelines are required for correlations of clinical symptoms and MRI findings.

     

IL‐7 and immobilized Kit‐ligand stimulate serum‐ and stromal cell‐free cultures of precursor B‐cell lines and clones

Long‐term proliferating, D_HJ_H‐rearranged mouse precursor B‐cell lines have previously been established in serum‐ and IL‐7‐containing media from fetal liver, but not from bone marrow. Serum and stromal cells expose these pre‐B cells to undefined factors, hampering accurate analyses of ligand‐dependent signaling, which controls pre‐B cell proliferation, survival, residence and migration. Here, we describe a novel serum‐free, stromal cell‐free culture system, which allows us to establish and maintain pre‐B cells not only from fetal liver, but also from bone marrow with practically identical efficiencies in proliferation, cloning and differentiation. Surprisingly, recombinant kit‐ligand, also called stem cell factor, produced as a kit‐ligand‐Fc fusion protein, suffices to replace stromal cells and serum, provided that it is presented to cultured pre‐B cells in an optimal density in plate‐bound, insolubilized, potentially crosslinking form. Additional recombinant CXCL12 and fibronectin have a minor influence on the establishment and maintenance of pre‐B cell lines and clones from fetal liver, but are necessary to establish such cell lines from bone marrow.     

Reproducibility and Sensitivity of the 6-Minute Stepper Test in Patients with COPD

The aims of this study were to test the reproducibility of the 6-minute stepper test (6MST), and evaluate its accuracy in detecting improved functional capacity after pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD). Thirty-five COPD outpatients performed two 6MSTs in the same session, before (6MST₁ and 6MST₂) and after (6MST₃ and 6MST₄) PR. The performance, perceived exertion, heart rate and arterial oxygen saturation were measured during each 6MST. The performance was higher during the second 6MST of the same session (before PR: 514 strokes during the 6MST₂ > 471 strokes during the 6MST1, and after PR: 559 strokes during the 6MST₄ > 508 strokes during the 6MST₃; p = 0.04). After PR, 6MST performance was higher than before PR (6MST₃ > 6MST₁ and 6MST₄ > 6MST₂; P < 0.01). The bias (the difference in the number of strokes) between the two 6MSTs from the same session (before PR: 6MST₂-6MST₁ = 42 strokes vs after PR: 6MST₄-6MST₃ = 52 strokes) was not different (P = 0.34). However, both bias were greater than 0 (P < 0.001). The mean performances for the two 6MSTs of the same session (before PR: 6MST₁ and 6MST₂ and after PR: 6MST₃ and 6MST₄) were correlated with the bias between these performances (P < 0.01; r = 0.32). The perceived exertions were lower after PR (P < 0.02). The systematic improvement of performance (8–10%) during the second 6MST of the each session may be explained from the warming of hydraulic jacks of the stepper and/or learning effect. On the other hand, the 6MST seems sufficiently sensitive to detect functional capacity improvements after PR in patients with COPD.