Variation of Efficacy of Filtering Face Pieces Respirators over Time in a Dental Setting: A Pilot Study

Since aerosol continuously persists in dental settings, where different procedures and patients come in succession, the use of oronasal masks is highly recommended. Among them, respirators known as Filtering Face Pieces (FFP) show a protective superiority compared to surgical masks. Even concerning respirators classified as non-reusable, it is not known how many hours of use are necessary to compromise their filtering capacity. The aim of this study is to investigate the variations of filtering capacity of an FFP2 respirator over time, in order to safely optimize the timing of its use. Five respirators were worn by the same operator during clinical activity for different usage times (8, 16, 24, 32, 40 h), and one respirator was kept unused. All respirators underwent a bacterial filtration efficacy (BFE) test. T-test for paired data with Bootstrap technique and Wilcoxon test for paired data compared BFE values of the five tested FFP2s respectively at each time, and the areas with the corresponding values of the control respirator (FFp2-F). A generalized linear mixed effect model (GLM) was applied considering type of respirator and time as fixed effects and intercept as random effect. No significant statistical differences were present in the BFE of each time. Data obtained by the present study highlight the important ability of FFP2s to maintain their BFE over time, suggesting a long lasting protective function

A Proposed New Index for Clinical Evaluation of Interproximal Soft Tissues: The Interdental Pressure Index

The interdental pressure index (IPI) is introduced to specifically evaluate clinical interproximal-tissue conditions and assess the effect of interproximal hygiene stimulation. This index scores clinical responses of periodontal tissues to the apical pressure of a horizontally placed periodontal probe. It is negative when gingival tissues are firm, bleeding-free, and slightly ischemic by the stimulation; otherwise it is positive. The clinical validation showed high intraoperator agreement (0.92; 95% CI: 0.82\u20130.96; ) and excellent interoperator agreement (0.76; 95% CI: 0.14\u20131.38; ). High internal consistency with bleeding on probing () and gingival index (Cronbach\u2019s ) was obtained. Histological validation obtained high sensitivity (100%) and specificity (80%) for IPI+ toward inflammatory active form. The same results were recorded for IPI 12 toward chronic inactive form. IPI results as a simple and noninvasive method with low error probability and good reflection of histological condition that can be applied for oral hygiene motivation. Patient compliance to oral hygiene instructions is essential in periodontal therapy and IPI index can be a practical and intuitive tool to check and reinforce this important aspect

The connective tissue graft in the surgical treatment of epulis: a clinical case

OBJECTIVES Epulis is an asymptomatic lesion and its election treatment consists in the surgical excision that often produces important esthetic and functional alterations of the gingival complex. The purpose of this case report is to describe an alternative surgical approach to remove an epulis while preserving and improving the aesthetics of the much-gingival complex. MATERIALS AND METHODS A 29-years-old patient was referred for the evaluation of a hyper plastic gingival lesion localized on the buccal aspect of the upper central incisors. The histologic diagnosis was of pyogenic granuloma. After initial periodontal therapy and labial frenectomy, the patient underwent surgical treatment. A sub-epithelial connective tissue graft was interposed between a full-thickness muco-periosteal flap and the recipient bed, preserving the lesion. RESULTS AND CONCLUSIONS No post surgical complications were detected. More than a one year after surgery the patient exhibited no epulis with a stable gingival situation and no recurrence was detected. This technique seems to be able to remove the lesion and allow a thickness increase of the connective tissue underlying the mass, preventing post surgical gingival recessions and retraction scars and avoiding a second surgical reconstructive procedure

Assessment of C-Reactive Protein Levels in Periodontal Patients Using a Standard Laboratory Procedure

Abstract: Background: the aims of the randomized clinical trial were (i) to verify the association between periodontal disease and C-reactive protein (CRP) and (ii) to evaluate a possible reduction of serum CRP levels after non-surgical periodontal treatment. Methods: Thirty-two subjects, 18 affected by chronic periodontitis, and 14 periodontally healthy patients, aged between 21 and 65 (41± 13) were included. Clinical and radiographic examinations were used for each patient to obtain three dental indices that were used to evaluate severity of periodontal disease and changes after treatment. Periodontal patients were randomly assigned to one of two groups for different treatments: special oral hygiene instructions alone or in combination with scaling and root planing. Blood samples were taken for measurement of CRP levels and eritrosedimentation rate before and after treatment. Results: a reduction of clinical index CPSS was observed for both groups of periodontal patients after treatment but there were no statistically significant differences for CRP and ESR at baseline and between baseline and reexamination. Non statistically significant differences of CRP values between periodontal patients and healthy controls were found. Conclusions: CRP values don’t seem to change after non-surgical treatment of periodontitis, even in presence of a reduction of clinical indices

Microbiological response to periodontal therapy: A retrospective study

Background: Periodontitis is a multifactorial infection caused by a complex of pathogenic bacterial species that induce the destruction of periodontal structures. Objective: The aim of this study is to evaluate the presence and bacterial load of six periodontal pathogens bacteria, measured at initial visit and after osseous surgery in patients affected by chronic periodontitis and treated between 2005 and 2007. Methods: This cohort study was carried out on a sample of 38 consecutive patients affected by severe chronic periodontitis, diagnosed at baseline on the basis of probing depths equal to 6.68 ± 1.47 mm. On each subject, a microbiological test was performed before periodontal initial therapy and after osseous surgery (one year later). Five compromised teeth were chosen for each patient (the same teeth, before and after surgery), for a total of 190 teeth. Real-time PCR based analysis computed total bacterial load of the samples and quantified six periodontal pathogens: Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum and Prevotella intermedia. Data collection was made consulting medical charts. Results: Pocket probing depth reduction after surgery was 4.50 ± 1.54 mm (p=0.0001). The mean number of sites with bleeding at baseline was 2.08 ± 1.17 and 0.58 ± 1.00 after surgery (p=0.001). The mean number of sites with suppuration at baseline was 0.26 ± 0.86 and 0 after surgery (p=0.02). Cell count of each pathogen and total cell count were significantly higher at baseline than after surgery. Almost all bacteria presented a mean percentage reduction equal to that of the total count, except for Aa and Pi, which seemed to show a greater resistance. The difference of bacterial load, both before and after surgery, between smokers and non-smokers was not statistically significant (p<0.05). A statistically significant correlation was detected between pocket probing depth variation and bleeding on probing variation before and after the surgery, controlling for age (r=0.6, p=0.001). No significant correlations were observed between pocket probing depth and bacterial loads, except for Pg (r=0.5, p=0.001), Tf (r=0.6, p=0.001) and Td (r=0.4, p=0.02). Conclusions: Reduction of presence and bacterial load of the examined periodontal pathogens bacteria after osseous surgery, along with periodontal pocket reduction, appeared to be essential to achieve and maintain periodontal stability over years

Effect of fixed orthodontic appliances on salivary properties

Objective. The purpose of this study was to evaluate the effect of fixed orthodontic appliances on the salivary flow rate, pH and buffer capacity after 1 year from bracket placement. Material and methods.The study population consisted of 20 healthy patients (mean age 16.5 \ub1 4 years) scheduled for fixed orthodontic treatment. Salivary samples were taken just before bracket placement (T0; baseline assessment) and after 1 year of treatment (T1; treatment assessment) using the GC Saliva-Check Kit (GC Corp., Belgium). Results. No statistically significant differences were detected for all the examined salivary properties between T0 and T1. Conclusions. Fixed orthodontic appliances did not have any effect on the flow rate, pH and buffer capacity of saliva after 1 year of fixed orthodontic treatment in the study sample

Sarcoidosis in a dental surgeon: a case report

<p>Abstract</p> <p>Introduction</p> <p>Although the causes of sarcoidosis are still unknown, past and current studies have provided evidence that this disease may be associated with occupational exposure to specific environmental agents. We describe a case of sarcoidosis in a dental surgeon with long exposure to inorganic dusts. To the best of our knowledge, this is the first report of this kind in the literature.</p> <p>Case presentation</p> <p>At the beginning of 2000, a 52-year-old Caucasian man, who worked as a dental surgeon, presented with shortness of breath during exercise, cough and retrosternal pain. After diagnosis of sarcoidosis, a scanning electronic microscopy with X-ray microanalysis of biopsy specimens was used in order to determine whether the disease could be traced to an occupational environmental agent. Results showed the presence of inorganic dust particles within sarcoidotic granulomas, and demonstrated that the material detected was identical to that found in a powder used by our patient for several years.</p> <p>Conclusions</p> <p>Although these results cannot be considered as definitive proof, they do however provide strong evidence that this disease may be associated with material used by dental surgeons.</p

Glutaraldehyde-based desensitizers' influence on bonding performances and dentin enzymatic activity of universal adhesives

Objectives: To evaluate the influence of two glutaraldehyde-based desensitizers (L: GLUMA Desensitizer, Heraeus Kulzer and G: GLUMA Desensitizer PowerGel) prior to the adhesive procedures on microtensile bond strength (&amp; mu;TBS) to dentin and endogenous enzymatic activity. Methods: Noncarious human third molars (N = 48) were cut to expose middle coronal dentin. Six experimental groups were formed according to the dentin pre-treatment (L or G) and the universal adhesives (IBU -iBond universal, Kulzer or AU -Adhese Universal, Ivoclar Vivadent) used in the self-etch mode (n = 8): 1) L/IBU; 2) G/ IBU; 3) IBU; 4) L/AU; 5) G/AU; 6) AU. Specimens were cut into sticks and stressed until failure after 24 h (T0) or 1 yr of aging (T12). Additional 4 teeth were used for in situ zymography evaluation and data were statistically analyzed (&amp; alpha; = 0.05). Results: Dentin pre-treatment, adhesive and aging statistically influenced bond strength and enzymatic activity (P&lt;0.001). AU demonstrated higher bond strength values than IBU (P&lt;0.001). The L resulted in higher bond strength compared to the G and control groups (P&lt;0.001). aging statistically influenced bonding performance, especially when no dentin pre-treatment was performed (P&lt;0.001). In situ zymography revealed that at baseline the control groups exhibited lower interfacial fluorescence compared to the experimental groups, irrespective of the adhesive used (P&lt;0,001). However, after 1 yr of artificial storage, no differences were found among the groups (P&gt;0.05). Conclusions: : Glutharldeadeyde-based products increased bond strength and determined a stabilization of the adhesive interface over time apparently not related to the MMPs inhibition. Clinical Significance: The results of this in vitro study suggest that the application of glutaraldehyde-based de-sensitizers prior to the adhesive procedures when associated with universal adhesives could result in increased bond strength and stabilization of the adhesive interface over time