Bisphosphonate-related osteonecrosis of the jaws: A report on 30 cases

Aim: To report a series of thirty cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Material and Methods: For 30 patients with BRONJ, gender, age, underlying diagnosis, type of bisphos- phonate (BP), administration route and duration, location and stage of osteonecrosis, symptoms and oral health status, radiological findings of the jaws, treatment and outcome, were recorded. Results: Underlying diagnoses in the series (12 male; 18 female; mean age 70.50 \ub1 9.62) were: 12 multiple myeloma, 7 breast cancer, 3 prostate carcinoma, 1 kidney/lung/ bladder/mediastinal cancer, 1 chronic lymphocytic leukemia, 1 osteoporosis, 1 palatal osteosarcoma + osteoporosis, 1 non-Hodgkin\u2019s lymphoma. Forty-seven osteonecrotic lesions were detected; 30 localized in the mandible, 17 in the maxilla; trigger events were tooth extraction in 31 cases (66%), periodontal disease in 4 (8.50%), incongruous dentures in 3 (6.40%), perimplantitis in 1 (2.10%), unknown in 8 (17%). Twenty-nine patients had received treatment using amino bisphosphonates (25 zoledronate, 2 pamidronate, 2 alendronate) and 1 clodronate; the administration route was intravenous in 27 patients, oral in 2 and intramuscular in 1. Mean number of doses to bone exposure for patients was 34.11 for zoledronate, 50.50 for pamidronate, 146 for alendronate, and 500 for clodronate. Among statistical data the only significant finding was that panoramic dental radiography gave no concrete support for diagnosis of ONJ lesions (p 64 0.04). Conclusions: Our case series reflects literature data. We emphasize the insufficient role of panoramic radiography to study osteonecrotic lesions and the role of poor oral hygiene

INvolvement of breast CAncer patients during oncological consultations: a multicentre randomised controlled trial--the INCA study protocol.

INTRODUCTION: Studies on patient involvement show that physicians make few attempts to involve their patients who ask few questions if not facilitated. On the other hand, the patients who participate in the decision-making process show greater treatment adherence and have better health outcomes. Different methods to encourage the active participation during oncological consultation have been described; however, similar studies in Italy are lacking. The aims of the present study are to (1) assess the effects of a preconsultation intervention to increase the involvement of breast cancer patients during the consultation, and (2) explore the role of the attending companions in the information exchange during consultation. METHODS AND ANALYSIS: All female patients with breast cancer who attend the Oncology Out-patient Services for the first time will provide an informed consent to participate in the study. They are randomly assigned to the intervention or to the control group. The intervention consists of the presentation of a list of relevant illness-related questions, called a question prompt sheet. The primary outcome measure of the efficacy of the intervention is the number of questions asked by patients during the consultation. Secondary outcomes are the involvement of the patient by the oncologist; the patient's perceived achievement of her information needs; the patient's satisfaction and ability to cope; the quality of the doctor-patient relationship in terms of patient-centeredness; and the number of questions asked by the patient's companions and their involvement during the consultation. All outcome measures are supposed to significantly increase in the intervention group. ETHICS AND DISSEMINATION: The study was approved by the local Ethics Committee of the Hospital Trust of Verona. Study findings will be disseminated through peer-reviewed publications and conference presentations. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01510964

X-ray photons attenuation characteristics for two tellurite based glass systems at dental diagnostic energies

X-ray photons attenuation characteristics for the two tellarite based glasses Bi2O3\u2013 B2O3\u2013 TeO2\u2013 TiO2 and PbO\u2013ZnO\u2013TeO2\u2013B2O3 have been investigated at dental diagnostic energies (between 30-80 keV) using Geant4 code and WinXcom software. The correlation coefficient (R2) is utilized to evaluate the extent to which Geant4 results are related to the WinXcom data. For the both series, R2 is close to 1 for all samples and this implies a perfect degree of association between the Geant4 and WinXcom data. The linear attenuation coefficient is proportionally increased with addition of TeO2 in both series, which implies that there is a decreasing tendency in the X-ray photon transmission corresponding with an increase in the TeO2 content in the glasses. The half value layer (HVL) decreases as the density increases and this decreasing is very notable at 70 and 80 keV. The maximum HVL for all samples occurs at 80 keV and this implies that the HVL gradually increases as the energy of the X-ray photons increase. Also, the increment of TO2 in the glasses (in both systems) leads to reduce the mean free path and BiTeTi6 and PbTeB6 samples have the lowest MFP. The MFP for both systems was compared with three heavy concretes and the comparison revealed that the selected systems can be utilized to fabricate protection masks used during diagnostic radiation of the head or oral cavity

The Role of IgLON Cell Adhesion Molecules in Neurodegenerative Diseases

In the brain, cell adhesion molecules (CAMs) are critical for neurite outgrowth, axonal fasciculation, neuronal survival and migration, and synapse formation and maintenance. Among CAMs, the IgLON family comprises five members: Opioid Binding Protein/Cell Adhesion Molecule Like (OPCML or OBCAM), Limbic System Associated Membrane Protein (LSAMP), neurotrimin (NTM), Neuronal Growth Regulator 1 (NEGR1), and IgLON5. IgLONs exhibit three N-terminal C2 immunoglobulin domains; several glycosylation sites; and a glycosylphosphatidylinositol anchoring to the membrane. Interactions as homo- or heterodimers in cis and in trans, as well as binding to other molecules, appear critical for their functions. Shedding by metalloproteases generates soluble factors interacting with cellular receptors and activating signal transduction. The aim of this review was to analyse the available data implicating a role for IgLONs in neuropsychiatric disorders. Starting from the identification of a pathological role for antibodies against IgLON5 in an autoimmune neurodegenerative disease with a poorly understood mechanism of action, accumulating evidence links IgLONs to neuropsychiatric disorders, albeit with still undefined mechanisms which will require future thorough investigations

Electron beam structuring of Ti6Al4V: New insights on the metal surface properties influencing the bacterial adhesion

Soft tissue adhesion and infection prevention are currently challenging for dental transmucosal or percutaneous orthopedic implants. It has previously been shown that aligned micro-grooves obtained by Electron Beam (EB) can drive fibroblast alignment for improved soft tissue adhesion. In this work, evidence is presented that the same technique can also be effective for a reduction of the infection risk. Grooves 10-30 \u3bcm wide and around 0.2 \u3bcm deep were obtained on Ti6Al4V by EB. EB treatment changes the crystalline structure and microstructure in a surface layer that is thicker than the groove depth. Unexpectedly, a significant bacterial reduction was observed. The surfaces were characterized by field emission scanning electron microscopy, X-ray diffraction, confocal microscopy, contact profilometry, wettability and bacterial adhesion tests. The influence of surface topography, microstructure and crystallography on bacterial adhesion was systematically investigated: it was evidenced that the bacterial reduction after EB surface treatment is not correlated with the grooves, but with the microstructure induced by the EB treatment, with a significant bacterial reduction when the surface microstructure has a high density of grain boundaries. This correlation between microstructure and bacterial adhesion was reported for the first time for Ti alloys

Generation of cytocompatible superhydrophobic Zr–Cu–Ag metallic glass coatings with antifouling properties for medical textiles

Zirconium–Copper-based metallic glass thin films represent promising coatings in the biomedical sector for their combination of antibacterial property and wear resistance. However, finding a Zr–Cu metallic glass composition with desirable cytocompatibility and antibacterial property is extremely challenging. In this work, we have created a cytocompatible and (super-)hydrophobic Zr–Cu–Ag metallic glass coating with ≈95% antifouling properties. First, a range of different chemical compositions were prepared via Physical Vapor Deposition magnetron by co-sputtering Zr, Cu, and Ag onto a Polybutylene terephthalate (PBT) substrate among which Zr93·5Cu6·2Ag0.2, Zr76·7Cu22·7Ag0.5, and Zr69·3Cu30·1Ag0.6 were selected to be further investigate for their surface properties, antibacterial activity, and cytocompatibility. Scanning electron microscopy (SEM) images revealed a micro-roughness fibrous structure holding superhydrophobic properties demonstrated by specimens' static and dynamic contact angle measurements ranging from 130° to 150°. The dynamic contact angle measurements have shown hysteresis below 10° for all coated samples which indicated the superhydrophobicity of the samples. To distinguish between antifouling and bactericidal effect of the coating, ions release from coatings into Luria Bertani Broth (LB), and Dulbecco's Modified Eagle Medium (DMEM) solutions were evaluated by inductively coupled plasma mass spectrometry (ICP-MS) measurements after 24 ​h and 5 days. Antifouling properties were evaluated by infecting the specimens' surface with the Gram-positive Staphylococcus aureus and the Gram-negative Escherichia coli strain reporting a ≈95% reduction of bacteria adhesion as visually confirmed by FESEM and fluorescent live/dead staining. Human mesenchymal stem cells (hMSC) were used for direct cytocompatibility evaluation of coated samples and their metabolic activity was evaluated via relative fluorescence unit after 24 ​h and 5 days confirming that it was comparable to the controls (>97% viable cells). The results were further visualized by FESEM, fluorescent staining by Live/Dead Viability/Cytotoxicity Kit and confirmed the cytocompatibility of all coated samples. Finally, hMSC′ cytoplasm was stained by May Grunwald and Giemsa after 5days to detect and visualize the released ions which have diffused through the cells' membrane

Electrophoretic deposition of composite coatings based on alginate matrix/45S5 bioactive glass particles doped with B, Zn or Sr

In this research work composite coatings made of alginate and 45S5 bioactive glass particles doped with B, Zn or Sr were synthesized by means of electrophoretic deposition and characterized from morphological, compositional, thermogravimetric, mechanical and electrochemical points of view. The developed coatings were also subjected to in vitro test in SBF solution to evaluate their ability to induce hydroxyapatite precipitation and cytocompatibility evaluation using human primary fibroblasts. The obtained results demonstrated a good homogeneity of the coatings, high adhesion and a protective behavior towards the substrate. The thermogravimetric analysis proved that the glass amount was constant before and after the deposition and all the investigated coatings promoted the deposition of hydroxyapatite but with different kinetics. Since the Zn containing coating showed the best bioactive behavior it was subjected to cytocompatibility test, which demonstrated, after an initial reduction of cell viability, a good cell proliferation and the production of collagen from the ECM. These findings suggest that the obtained coatings are promising materials to coat metallic prosthetic devices