A history of suboptimal breastfeeding may increase the risk of developing anterior open bite, posterior crossbite, and class II canine relationship

Letter to the EditorGiampiero Rossi-Fedele, Esma J. Dogramac

Effect of an alcohol-based caries detector on the surface tension of sodium hypochlorite preparations

The purpose of this study was to evaluate the effect of an alcohol-based caries detector (Kurakay) on the surface tension of a conventional sodium hypochlorite (NaOCl) preparation, and a product containing a surface-active agent (Chlor-XTRA). The surface tensions of the following solutions were tested: NaOCl, a mixture of NaOCl and Kurakay 9:1 w/w, Chlor-XTRA, a mixture of Chlor-XTRA and Kurakay 9:1 w/w. Ten measurements per test solution were made at 20°C, using an optical method called the "Pendant drop method", with a commercially available apparatus. The addition of Kurakay reduced the surface tension for NaOCl (p0.05). Statistically significant differences between the NaOCl and Chlor-XTRA groups were found (p<0.05). The addition of an alcohol-based caries detector resulted in a reduction of the original surface tension values for NaOCl only. Taking into account the fact that mixtures of NaOCl and Kurakay have been used to assess the penetration of root canal irrigants in vitro, the related changes in surface tension are a possible source of bias.Giampiero Rossi-Fedele, Andrea R. Guastall

Effectiveness of photodynamic therapy and sodium hypochlorite on root canal system infected with Enterococcus faecalis - an in vitro study

Portuguese title: Eficácia da terapia fotodinâmica e do hipoclorito de sódio sobre o sistema de canais radiculares infectado com Enterococcus faecalis - um estudo in vitro Abstract and Keywords also in Portuguese. Journal title in English: Journal of Dental Science.Objective: The purpose of this study was to evaluate, in vitro , the effectiveness of photodynamic therapy and sodium hypochlorite over root canal system infected with Enterococcus faecalis . Methods: The root canals of 45 single-rooted human extracted teeth were enlarged up to a file 60, autoclaved, inoculated with Enterococcus faecalis and incubated for 30 days. The samples were divided into five groups (G1 – n=5; G2-G5 – n=10) according to the protocol of decontamination: G1 (negative control) – no procedure was performed; G2 – distilled water; G3 – photodynamic therapy (PDT); G4 – 2.5% sodium hypochlorite (NaOCl); and G5 – 2.5% NaOCl+PDT. Scanning electron microscopy (SEM) were performed to evaluate the effectiveness of proposed treatments. The assessment was made by images of each third at 5000x magnification for the canal wall and 10000x for the exposed tubule area. The presence of bacteria was scored by position ranks from 1 to 45, where the higher the value, the cleanliness of the sample. Data were subjected to one-way ANOVA followed by post-hoc Tukey test ( α =0.05). Results: Group 4 (2.5% NaOCl) and 5 (2.5% NaOCl + PDT) had the highest mean of position ranks for all thirds of the root canal in the canal wall, which was statistically different from groups 1, 2 and 3 ( p <0.05). Group 3 (PDT), group 4 (2.5% NaOCl) and 5 (2.5% NaOCl+PDT) had the highest mean of position ranks in the exposed tubule area, which was statistically different from groups 1 and 2 ( p <0.05). Conclusion: the association of 2.5% sodium hypochlorite + photodynamic therapy can be considered an effective protocol for the elimination of Enterococcus faecalis. = Objetivo: o propósito deste estudo foi avaliar, in vitro, a eficácia da terapia fotodinâmica e do hipoclorito de sódio sobre o sistema de canais radiculares infectados com Enterococcus faecalis. Metodologia: Os canais radiculares de 45 dentes humanos extraídos unirradiculares foram ampliados até a lima 60, autoclavados, inoculados com Enterococcus faecalis e incubados por 30 dias. As amostras foram divididas em cinco grupos (G1 – n=5; G2-G5 – n=10) de acordo com o protocolo de descontaminação: G1 (controle negativo) – não foi realizado procedimento; G2 – água destilada; G3 – terapia fotodinâmica; G4 – hipoclorito de sódio 2,5%; G5 – hipoclorito de sódio 2,5%+terapia fotodinâmica. Microscopia eletrônica de varredura foi realizada para avaliar a eficácia dos tratamentos propostos. A avaliação foi feita através de imagens de cada terço a 5000x de magnificação nas paredes do canal e 10000x na profundidade dos túbulos dentinários. A presença de bacterias foi determinada por intermédio de rank de posições a partir de 1 até 45, onde quanto maior o valor, maior a limpeza da amostra. Os dados foram submetidos a one-way ANOVA seguido por post-hoc de Tukey (α=0.05). Resultados: Grupo 4 (NaOCl 2,5%) e 5 (NaOCl 2,5%+PDT) obtiveram a maior media de posição de ranks para todos os terços do canal radicular na parede do canal, o que foi estatisticamente diferente dos grupos 1, 2 e 3 (p<0.05). Grupo 3 (PDT), grupo 4 (NaOCl 2,5%) e 5 (NaOCl 2,5%+PDT) obtiveram a maior méida de posição de ranks para todos os terços do canal radicular na profundidade dos túbulos dentinários, o que foi estatisticamente diferente dos grupos 1 e 2 (p<0,05). Conclusão: A associação de hipoclorito de sódio.Matheus Albino Souza, Liviu Steier, Giampiero Rossi-Fedele, Valdir Barth Júnior, Silvia Dias de Oliveira, José Antônio Poli de Figueired

The use of chelating agents with passive ultrasonic irrigation enhances root canal filling sealing ability

Title, Abstract and Keywords published in both English and Spanish. Spanish title: El uso de agentes quelantes con irrigación ultrasónica pasiva mejora la capacidad de sellado de la obturación de conducto radicular.The aim of this study was to compare the influence of a final rinse with and without passive ultrasonic irrigation (PUI), using 17% ethylenediaminetetraacetic acid (EDTA) or 10% citric acid (CA), with 2.5% sodium hypochlorite (NaOCl) with PUI, on the sealing ability of root canal fillings. Root canal instrumentation was performed in single-rooted premolars using NaOCl as the irrigant. Subsequently, the roots were randomly allocated into four experimental groups (n=23): EDTA+PUI, EDTA, CA+PUI, CA and control group: NaOCl+PUI. The specimens were root-filled using gutta-percha with a resin-based sealer and inserted into a device to measure glucose leakage at 7 and 30 days. Kruskal-Wallis and Mann- Whitney tests were used to evaluate the differences between the solutions and with or without PUI. Friedman’s ANOVA was used to compare time points (P<0.05). PUI groups showed lower infiltration values (EDTA+PUI 0.74±0.77 and CA+PUI 5.32±1.45) when compared to the groups on which PUI was not performed (EDTA 7.20±2.18 and CA 20.73±4.70), this difference was significant for EDTA (P<0.01) and CA (P=0.000). Also, EDTA showed less glucose infiltration than CA, with or without PUI (P<0.005). NaOCl+PUI showed a higher cumulative glucose infiltration (22.92±9.71). A final rinse using EDTA or CA with PUI enhances the sealing of root canal fillings. EDTA showed less infiltration. = El objetivo de este estudio fue comparar la influencia de una irrigación final con o sin activación ultrasónica pasiva (PUI), utilizando ácido etilendiaminotetraacético (EDTA) al 17% o ácido cítrico (CA) al 10%, con hipoclorito de sodio (NaOCl) al 2,5% con PUI, sobre el sellado de la obturación de conductos radiculares. Después de la instrumentación utilizando NaOCl como irrigante, premolares de raíz única se asignaron aleatoriamente a cuatro grupos experimentales (n = 23): EDTA+PUI, EDTA, CA+PUI, CA y grupo de control: NaOCl+PUI. Los conductos se obturaron utilizando gutapercha con un sellador a base de resina y se insertaron en un dispositivo para medir la infiltración de glucosa a los 7 y 30 días. Se utilizaron las pruebas de Kruskal-Wallis y Mann-Whitney para evaluar las diferencias entre las soluciones y con o sin PUI. Se utilizó el ANOVA de Friedman para comparar los puntos temporales (P <0,05). Los grupos de PUI mostraron menores valores de infiltración (EDTA+PUI 0,74±0,77 y CA+PUI 5,32±1,45) en comparación con los grupos en los que no se realizó PUI (EDTA 7,20±2,18 y CA 20,73±4,70), esta diferencia fue significativa para EDTA (P <0,01) y CA (P = 0,000). Además, EDTA mostró menos infiltración de glucosa que CA, con o sin PUI (P <0,005). NaOCl+PUI mostró una mayor infiltración acumulada de glucosa (22,92±9,71). Una irrigación final con EDTA o CA con PUI mejora el sellado de la obturación de conducto radicular. EDTA mostró menos infiltración.Gisele Jung Franciscatto, Giampiero Rossi-Fedele, Manuela Favarin Santini, Mariana de Carlo Bello, Minéia Weber Blattes and Carlos Alexandre Souza Bie

Association of vital pulp therapy outcomes with tooth type, arch location, treatment type, and number of surfaces destroyed in deciduous teeth: A retrospective study

There is a paucity of information concerning vital pulp treatment outcomes in the undergraduate teaching setting. This study aimed to determine which type of deciduous molar, arch location, type of vital pulp therapy, and the number of carious surfaces involved had a better prognosis when carried out by undergraduate dental students. The method used was the review of clinical records of 590 patients with 600 deciduous molars, that visited the outpatient undergraduate dental clinics for vital pulp therapy. Statistical analysis used to determine the associations of tooth type, arch location, treatment type, and the number of carious surfaces involved in successful outcomes was logistic regression analysis with significance set at p &lt; 0.05. According to the regression analysis model results, there was a significant association based on tooth type (p &lt; 0.05) and arch location (p = 0.003). In addition, there was a significant association based on the type of treatment performed (p = 0.036). However, there was no significant association in success rates based on the number of carious surfaces involved (p = 0.873). In conclusion, second deciduous molars and maxillary deciduous molars had a better overall prognosis, and indirect pulp therapy was revealed to be more highly associated with successful treatment outcomes in comparison to ferric sulfate pulpotomy in our setting

Root perforations: a review of diagnosis, prognosis and materials

Root perforation results in the communication between root canal walls and periodontal space (external tooth surface). It is commonly caused by an operative procedural accident or pathological alteration (such as extensive dental caries, and external or internal inflammatory root resorption). Different factors may predispose to this communication, such as the presence of pulp stones, calcification, resorptions, tooth malposition (unusual inclination in the arch, tipping or rotation), an extra-coronal restoration or intracanal posts. The diagnosis of dental pulp and/or periapical tissue previous to root perforation is an important predictor of prognosis (including such issues as clinically healthy pulp, inflamed or infected pulp, primary or secondary infection, and presence or absence of intracanal post). Clinical and imaging exams are necessary to identify root perforation. Cone-beam computed tomography constitutes an important resource for the diagnosis and prognosis of this clinical condition. Clinical factors influencing the prognosis and healing of root perforations include its treatment timeline, extent and location. A small root perforation, sealed immediately and apical to the crest bone and epithelial attachment, presents with a better prognosis. The three most widely recommended materials to seal root perforations have been calcium hydroxide, mineral trioxide aggregate and calcium silicate cements. This review aimed to discuss contemporary therapeutic alternatives to treat root canal perforations. Accordingly, the essential aspects for repairing this deleterious tissue injury will be addressed, including its diagnosis, prognosis, and a discussion about the materials actually suggested to seal root canal perforation.Carlos Estrela, Daniel de Almeida Decurcio, Giampiero Rossi-Fedele, Julio Almeida Silva, Orlando Aguirre Guedes, Álvaro Henrique Borge

Bioactive plasma coatings on orthodontic brackets: In Vitro metal ion release and cytotoxicity

The metal ion release characteristics and biocompatibility of meta-based materials are key factors that influence their use in orthodontics. Although stainless steel-based alloys have gained much interest and use due to their mechanical properties and cost, they are prone to localised attack after prolonged exposure to the hostile oral environment. Metal ions may induce cellular toxicity at high dosages. To circumvent these issues, orthodontic brackets were coated with a functional nanothin layer of plasma polymer and further immobilised with enantiomers of tryptophan. Analysis of the physicochemical properties confirmed the presence of functional coatings on the surface of the brackets. The quantification of metal ion release using mass spectrometry proved that plasma functionalisation could minimise metal ion release from orthodontic brackets. Furthermore, the biocompatibility of the brackets has been improved after functionalisation. These findings demonstrate that plasma polymer facilitated surface functionalisation of orthodontic brackets is a promising approach to reducing metal toxicity without impacting their bulk properties.Lasni Samalka Kumarasinghe, Neethu Ninan, Panthihage Ruvini Lakshika Dabare, Alex Cavallaro, Esma J. Dogramacı, Giampiero Rossi-Fedele ... et al

Maternal Subcutaneous and Visceral Adipose Ultrasound Thickness in Women with Gestational Diabetes Mellitus at 24-28 Weeks&apos; Gestation

BACKGROUND: Preeclampsia is a major pregnancy complication with adverse short- and long-term implications for both the mother and baby. Screening for preeclampsia at 11-13 weeks' gestation by a combination of maternal demographic characteristics and medical history with measurements of biomarkers can identify about 75% of women that develop preterm-preeclampsia with delivery at <37 weeks' gestation and 90% of those with early-preeclampsia at <32 weeks, at a screen positive rate of 10%. A recent trial (Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention) has reported that in women identified by first-trimester screening as being at high-risk for preeclampsia, use of aspirin (150 mg/day from the first to the third trimester), compared to placebo, reduced the incidence of preterm-preeclampsia, which was the primary outcome, by 62% (95% confidence interval, 26-80%) and the incidence of early-preeclampsia by 89% (95% confidence interval, 53-97%). The surprising finding of the trial was that despite the reduction in preeclampsia the incidence of admission to the neonatal intensive care unit, which was one of the secondary outcomes, was not significantly affected (odds ratio 0.93, 95% confidence interval, 0.62-1.40). OBJECTIVE: To examine the effect of prophylactic use of aspirin during pregnancy in women at high-risk of preeclampsia on length of stay in the neonatal intensive care unit. STUDY DESIGN: This was a secondary analysis of data from the Aspirin for Evidence-Based Preeclampsia Prevention trial to assess evidence of differences in the effect of aspirin on length of stay in neonatal intensive care. Bootstrapping was used for the comparison of mean length of stay between the aspirin and placebo groups. Logistic-regression was used to assess treatment effects on stay in the neonatal intensive care unit. RESULTS: In the trial there were 1620 participants and 1571 neonates were liveborn. The total length of stay in neonatal intensive care was substantially longer in the placebo than aspirin group (1696 vs. 531 days). This is a reflection of significantly shorter mean lengths of stay in babies admitted to the neonatal intensive care unit from the aspirin than the placebo group (11.1 vs. 31.4 days; a reduction of 20.3 days (95% confidence interval, 7.0-38.6; p=0.008). Neonatal intensive care of babies born at <32 weeks' gestation contributed 1856 (83.3%) of the total of 2227 days in intensive care across both treatment arms. These occurred in 9 (1.2%) of the 777 livebirths in the aspirin group and in 23 (2.9%) of 794 in the placebo group (odds ratio 0.42; 95% confidence interval, 0.19-0.93; p=0.033). Overall, in the whole population, including zero lengths of stay for those that were not admitted to the neonatal intensive care unit, the mean length of stay was longer in the placebo than aspirin group (2.06 vs 0.66 days; reduction of 1.4 days (95% confidence interval, 0.45-2.81; p=0.014). This corresponds to a reduction in length of stay of 68% (95% confidence interval, 20-86%). CONCLUSIONS: In pregnancies at high-risk of preeclampsia administration of aspirin reduces the length of stay in the neonatal intensive care unit by about 70%. This reduction could essentially be attributed to a decrease in the rate of births at <32 weeks' gestation, mainly because of prevention of early preeclampsia. The findings have implications for both short- and long-term healthcare costs as well as infant survival and handicap