Novel somatostatin receptor ligands therapies for acromegaly

Surgery is considered the treatment of choice in acromegaly, but patients with persistent disease after surgery or in whom surgery cannot be considered require medical therapy. Somatostatin receptor ligands (SRLs) octreotide (OCT), lanreotide, and the more recently approved pasireotide, characterized by a broader receptor ligand binding profile, are considered the mainstay in the medical management of acromegaly. However, in the attempt to offer a more efficacious and better tolerated medical approach, recent research has been aimed to override some limitations related to the use of currently approved drugs and novel SRLs therapies, with potential attractive features, have been proposed. These include both new formulation of older molecules and new molecules. Novel OCT formulations are aimed in particular to improve patients' compliance and to reduce injection discomfort. They include an investigational ready-to-use subcutaneous depot OCT formulation (CAM2029), delivered via prefilled syringes and oral OCT that uses a "transient permeability enhancer" technology, which allows for OCT oral absorption. Another new delivery system is a long-lasting OCT implant (VP-003), which provide stable doses of OCT throughout a period of several months. Finally, a new SRL DG3173 (somatoprim) seems to be more selective for GH secretion, suggesting possible advantages in the presence of hyperglycemia or diabetes. How much these innovations will actually be beneficial to acromegaly patients in real clinical practice remains to be seen

Comparison of two techniques for assessing the shaping efficacy of repeatedly-used NiTi rotary

Aim. The shaping capacity of NiTi rotary instruments is often assessed by photographic or micro-CT measurements, and these instruments are often used more than once clinically. This study was conducted to compare photographic and micro-computed tomography (micro-CT) measurements and to assess if repeated use of NiTi instruments affected the shape of canal preparation. Methods.Ten new sets of ProTaper Universal instruments were used in 60 resin blocks simulating curved root canals. Groups 1 to 6 (n=10) represented 1st to 6th use of the instrument, respectively. Digitized images of the prepared blocks were taken in both mesiodistal (MD) and buccolingual (BL) directions and area measurements (mm2) were calculated using AutoCAD. The volumes of the same prepared canals were measured using micro-CT (mm3). Statistical analysis was performed to detect differences between photographic and volumetric measurements, and differences between uses. Results. Two-way repeated measures ANOVA revealed significant differences between groups (p<0.001). Regarding measurement type, there were no significant differences between BL and MD measurements, but there were significant differences between micro-CT and BL (p<0.001) and micro-CT and MD (p=0.001). Significant differences were also noted between uses. Conclusions. Within the limitations of the present study, micro-CT is more discriminative of the changes in canal space associated with repeated instrument use than photographic measurements. Canal preparations are significantly smaller after the third use of the same instrument

Endodontic surgery with guided tissue regeneration comparison with only flap closure. A Case Report

Aim. Endodontic surgery has for aim to treat bone lesions due to root canal infections. the aim of the present study was to evaluate the periapical healing of apical defects 24 months after periradicular surgery and guided tissue regeneration in a series of consecutively treated patients. Methods. 10 patients were treated with guided-tissue regeneration and 10 without biomaterial and membrane after surgery. Root-end cavities, 2.5 to 3 mm deep, were prepared with piezo-ultrasonic tips. Root-ends were sealed using Super EBA. the choice of using or not GTR associated with deproteinized bovine bone for each patient was made by a computer-generated randomized table. For cases allocated to the GTR group, the defect was filled with anorganic bovine-bone mineral and then covered with a resorbable collagen membrane. The outcome was assessed by clinical and radiographic evaluation at 24 months follow-up. Results. All patients were recalled after 1, 3, 6, 12 and 24 months. At the one-year follow-up all teeth had successfully healed, healing was uncertain for 1 tooth after 24 months and 3 were classified as failure Conclusions. GTR as a complement of periapical surgery is not necessary for four-wall defects. However, it may be an indication for transosseous lesions. Guided tissue regeneration treatment of apicomarginal defects yields good results in terms of periapical and periodontal healing and should be considered as an adjunct to periradicular surgery in such cases

Control of torque accuracy in some endodontic motors

Aim. The aim of this study was to examine and compare the accuracy of torque limitation of different torque controlled motors and contra-angles used in endodontics. Methods. The real torque was measured with Dynamic Torque Measurement of Endodontic Systems, Magtrol HD-100-8NA-4811, Sirona Dental System; this dynamic torque measurement system is connected through a special instrument to the contra-angle of the endodontic motor under evaluation. In this study six different endodontic motors were analized: ATR EndoPlus, SIROEndo_Pocket, VDW.SILVER, VDW.GOLD, ASEPTICO Endo It e MAILLEFER X-Smart. For each motor the real torque was measured to a specific speed and it was compared to the value on the motor display, which was the set value of the operator. Results. ASEPTICO Endo It with +46% showed the highest upper deviation; also MAILLEFER X-Smart, ATR EndoPlus, VDW.GOLD and SIROEndo Pocket had a high deviation with 24%, +13%, +11% and +12% respectively; VDW.SILVER achieved the best results: the values of its torque settings were within the range +3%, -18% of deviation. Conclusions. Lower values of torque produce an efficiency loss while upper values increase the fracture probability; by this study VDW.SILVER is the motor which showed the best results for lower and upper values to set torque

Single visit procedure for root canal treatment and bleaching of a discolored tooth: a case report

Aim. Root canal treatment and bleaching of a discolored tooth is one of the most commonly used procedures in contemporary endodontics and restorative dentistry. A case of a discolored tooth in a maxillary left incisor in an 38 year old woman patient is reported. Methods. The patient came to our attention claiming the presence of a discolored tooth, requiring the immediate possibility of bleaching. Radiograph examination showed an incorrect endodontic treatment and the presence of a separated fragment of an endodontic instrument. The tooth was retreated and the fragment was removed with the use of ultrasonic instruments, the root canal was then shaped and irrigated copiously with 5% NaOCl and EDTA 17%, then a canal obturation was performed with warm gutta-percha. A power bleaching gel 38% Hydrogen peroxide was then used with a chemically activation for 30 minutes, and the tooth was immediately restored with a fiber post. Results. The clinical and radiographic examination at 4-6-12 -24 months showed a good root filling and a good margin seal of the restoration, and the color of the restoration was well integrated with the rest of the tooth. Conclusions. Endodontic retreatment, immediate bleaching, and fiber post cementation might be a viable alternative to conventional treatments