How is the biocompatibilty of dental biomaterials evaluated?

All biomaterials used in dentistry must be evaluated for biocompatibility using screening assays to protect patient health and safety. The purpose of this review is to explain the international biocompatibility guidelines, and to explain the structure of a test program. The test program requires the structured assessment of materials into four phases; general toxicity, local tissue irritation, pre-clinical, and clinical evaluation. Different types of screening assays are available, and it is important to understand the advantages and limitations of the various types of assays that are available, so that they can be selected for appropriateness and interpreted accurately. New scientific advances in terms of the chemical properties of dental materials, tissue engineering, stem cell, genetic transfer, biomaterial, and growth factor therapies are under development. These new therapies create improved opportunities to restore and regenerate oral tissues, but they can also present new hazards to patients. Prior to their clinical use, these new technologies must be proven to be safe, and not hazardous to human health. A structured biocompatibility assessment and advice on the selection of assays are outlined to evaluate these new therapies

Clinical Performance of Viscous Glass Ionomer Cement in Posterior Cavities over Two Years

In this controlled prospective clinical study the highly viscous glass ionomer cement Ketac Molar was clinically assessed in Class I and Class II cavities. Forty-nine subjects (mean age 32.3 years) received 108 restorations placed by six operators in conventional Black I and II type cavities with undercuts after excavating primary lesions or after removing insufficient restorations. At baseline, and after 6, 12, and 24 months, restorations were assessed by two independent investigators according to modified USPHS codes and criteria. Impressions of the restorations were taken and epoxy replicas were made. Between the baseline and the 24-month recall, 51 representative samples were analyzed at 130 × magnification by use of a stereo light microscope (SLM). Recall rates were 83% after 6 months, 50% after 12 months, and 24% after 24 months. Failure rates after 24 months were 8% for Class I and 40% for Class II fillings, mainly due to bulk fracture at occlusally loaded areas (Kaplan Meier survival analysis). Significant changes over time were found for the criteria “surface roughness”, “marginal integrity”, “restoration integrity”, and “overall judgement” (P < .05; Friedman test). SLM analysis revealed statistically significant differences for the following criteria over time (baseline/6 months/12 months (in % of entire evaluable margin length); P < .05; Friedman 2-way ANOVA): perfect margin 37/19/11, negative step formation 26/49/57, gap formation 2/7/9, and overhang 24/11/8. Replicas exhibited mainly negative step formation as main finding due to apparently inferior wear resistance (P < .05). Gap formations were more frequently observed in Class II restorations than in Class I (12% versus 3% after 12 months; P < .05, Mann-Whitney-U test). The evaluated margin lengths were not statistically different (P > .05, Friedman 2-way ANOVA)

Validation and implementation of a diagnostic algorithm for DNA Detection of Bordetella pertussis, B. parapertussis, and B-holmesii in a Pediatric Referral Hospital in Barcelona, Spain

This study aimed to validate a comprehensive diagnostic protocolbased on real-time PCR for the rapid detection and identification ofBordetella per-tussis,Bordetella parapertussis, andBordetella holmesii, as well as its implementationin the diagnostic routine of a reference children’s hospital. The new algorithm in-cluded a triplex quantitative PCR (qPCR) targeting IS481gene (inB. pertussis,B. hol-mesii, and someBordetella bronchisepticastrains), pIS1001(B. parapertussis-specific)andrnaseP as the human internal control. Two confirmatory singleplex tests forB.pertussis(ptxA-Pr) andB. holmesii(hIS1001) were performed if IS481was positive. An-alytical validation included determination of linear range, linearity, efficiency, preci-sion, sensitivity, and a reference panel with clinical samples. Once validated, the newalgorithm was prospectively implemented in children with clinical suspicion ofwhooping cough presenting to Hospital Sant Joan de Deu (Barcelona, Spain) over12 months. Lower limits of detection obtained were 4.4, 13.9, and 27.3 genomicequivalents/ml of sample for IS481(onB. pertussis), pIS1001and hIS1001, and 777.9forptxA-Pr. qPCR efficiencies ranged from 86.0% to 96.9%. Intra- and interassay vari-abilities were 3% and 5%, respectively. Among 566 samples analyzed,B. pertus-sis,B. holmesii, andB. parapertussiswere detected in 11.1%, 0.9% (only in females 4 years old), and 0.2% of samples, respectively. The new algorithm proved to be auseful microbiological diagnostic tool for whooping cough, demonstrating a low rateof other non-pertussis Bordetellaspecies in our surveilled areaPeer ReviewedPostprint (author's final draft

Lecciones de Gomorra. La ficción nos muestra cómo la arquitectura y el urbanismo determinan la eterna lucha entre pecado y redención en la ciudad de Nápoles

The end of the TV series Gomorrah -a brutal portrait of the Neapolitan mafia based on the novel by Roberto Saviano- invites us to reflect on some urban and architectural aspects of the city of Naples, the true main character of the show. We go back to the urban origins of the Napoli suburbs and how the mafia capos imposed their socio-economic control. Gomorrah establishes a dual relationship of documentation and dramatization of the architectural heritage of the city. In the series we see reflected the importance of the relationship between domestic and urban spaces and the constant dispute between sin and redemption that governs the fate of Naples.El final de la serie Gomorra, brutal estampa de la mafia napolitana basada en la novela de Roberto Saviano, nos invita a reflexionar sobre algunos aspectos urbanísticos y arquitectónicos de la ciudad de Nápoles, verdadera protagonista del relato. A partir de la ficción, nos remontamos a los orígenes urbanísticos de la periferia de Nápoles y cómo la mafia impuso su control socio-económico. Gomorra establece una relación dual de documentación y dramatización del patrimonio arquitectónico de la ciudad. En la serie vemos reflejada la importancia de la relación entre los espacios domésticos y urbanos y la constante disputa entre pecado y redención que rige el destino de Nápoles

Perceived Confidence of DPT Students with Telehealth to Examine Neurologic Patients during COVID 19 Pandemic

Purpose/Hypothesis: Within the neuromuscular courses (NM1, NM2) in the DPT program at the University of St. Augustine for Health Sciences (USAHS), some form of patient integration is offered to prepare students for different aspects of patientcare, including examination and treatment. The utilization of telehealth provided an opportunity to continue patient integration experiences while maintaining a safe and socially distant environment. Patients with neurological conditions were integrated into both courses as a form of patient integration. The purpose was to investigate student perceived confidence in using telehealth to examine and treat neurological patients. For this study, the data was based on the primary questions: (1) is there a difference in confidence in the examination, assessment and treatment of patients with a neurological condition as a result of using telehealth? and (2) if so, what specific components differentiate confidence as a result of the telehealth experience? Number of Subjects: Ninety students were included in the final analysis (48.7% male). Materials and Methods: This cross-sectional IRB approved study enrolled DPT students from the Miami Campus in theNM1and NM2course. Students answered the Physiotherapy Self-Efficacy (PSE) survey and a focused questionnaire at baseline and after the second experience to assess their confidence in utilizing telehealth as a form of patient integration. Analysis included descriptive statistics, averages, and trends. Paired T-test and Cohen’s d estimated effect size was used to compare student perceived confidence. Results: Two telehealth sessions were completed (one in each course). The mean total score of the PSE increased 59% (28.2 + 10.6 to 44.9 + 9.0). Significantly higher total means cores in the PSE at the end of telehealth experience were noted. Conclusions: The results suggest that student’s level of confidence was significantly lower before the first-time participation in telehealth. However, they showed significantly greater perceived confidence in their ability to complete a neurological examination and treatment using telehealth as a result of the two experiences. Clinical Relevance: The use of telehealth is novel within DPT programs and may provide educators with additional opportunities to facilitate patient integration. In addition, telehealth may increase students’ self-confidence in completing a neurological examination and treatment which is linked to a positive effect on student’s success

The role of angiogenesis in implant dentistry part I: review of titanium alloys, surface characteristics and treatments

Background: Angiogenesis plays an important role in osseointegration process by contributing to inflammatory and regenerative phases of surrounding alveolar bone. The present review evaluated the effect of titanium alloys and their surface characteristics including: surface topography (macro, micro, and nano), surface wettability/ energy, surface hydrophilicity or hydrophobicity, surface charge, and surface treatments of dental implants on angiogenesis events, which occur during osseointegration period. Material and Methods: An electronic search was performed in PubMed, MEDLINE, and EMBASE databases via OVID using the keywords mentioned in the PubMed and MeSH headings regarding the role of angiogenesis in implant dentistry from January 2000-April 2014. Results: Of the 2,691 articles identified in our initial search results, only 30 met the inclusion criteria set for this review. The hydrophilicity and topography of dental implants are the most important and effective surface characteristics in angiogenesis and osteogenesis processes. The surface treatments or modifications of dental implants are mainly directed through the enhancement of biological activity and functionalization in order to promote osteogenesis and angiogenesis, and accelerate the osseointegration procedure. Conclusions: Angiogenesis is of great importance in implant dentistry in a manner that most of the surface characteristics and treatments of dental implants are directed toward creating a more pro-angiogenic surface on dental implants. A number of studies discussed the effect of titanium alloys, dental implant surface characteristic and treatments on agiogenesis process. However, clinical trials and in-vivo studies delineating the mechanisms of dental implants, and their surface characteristics or treatments, action in angiogenesis processes are lagging

The role of angiogenesis in implant dentistry part II: the effect of bone-grafting and barrier membrane materials on angiogenesis

Background : In implant dentistry, bone substitute materials and barrier membranes are used in different treatments including guided bone regeneration (GBR), socket preservation, alveolar ridge augmentation, maxillary sinus elevation, and filling bony defects around the inserted dental implant. One of the most important factors in prognosis of treatments using these materials is the growth of new blood vessels in applied areas. Present review was performed to evaluate the effect of the bone-grafting and barrier membrane materials on angiogenesis events. Material and Methods : An electronic search was performed in PubMed, MEDLINE, and EMBASE databases via OVID using the keywords mentioned in the PubMed and MeSH headings regarding the role of angiogenesis in implant dentistry from January 2000-April 2014. Results: Of the 5,622 articles identified in our initial search results, only 33 met the inclusion criteria set for this review. Among bone substitute materials the autogenous bone-grafts, and among the barrier membranes the collagenous membranes, had the highest angiogenic potentials. Other bone-grafting materials or membranes were mostly used with pro-angiogenic factors to enhance their angiogenic properties. Conclusions: Angiogenesis is one of the key factors, which plays a critical role in success rate of GBR technique and is seriously considered in manufacturing bone-grafting and barrier membrane materials. However, there is still lack of clinical and in-vivo studies addressing the effect of angiogenesis in treatments using bone-grafting and barrier membrane materials

The Coronavirus Disease-19 Infection and the Oral Mucosa

BACKGROUND: The current coronavirus disease (COVID-19) pandemics induced a modification of daily life and clinical practice. Health care workers, particularly dentists and dental hygienists, have been obliged to limit their activity and to establish new operative protocols. AIM: We aimed to discuss an easy protocol for the prevention of cross-infections in dental settings. METHODS: We revised literature data about COVID-19 and oral health to establish how to work safely with dental patients. RESULTS AND CONCLUSION: A few papers are currently available about the effective prevention of COVID-19 during dental procedures. Most of the revised articles report a potential strong effectiveness of povidone-iodine and its safety for both patients and dental professionals