Gingival hyperplasia around dental implants in jaws reconstructed with free vascularized flaps: a case report series

Free vascularized flaps are the gold standard for reconstruction of the facial skeleton after surgical ablation of pathologies or when important atrophy of the jaws exists. A frequent problem seen during prosthetic rehabilitation after reconstruction with free vascularized flaps is the onset of hyperplastic granulomatous reactive tissue around the prosthetic abutment of the implant. The features of this phenomenon seem to be directly related to the characteristics of the periimplant tissue and of the manufacturing materials of the prosthesis and abutments. This complication can be seen quite often; we found it in 7 of 40 patients (17.5%). It does not seem to significantly affect the survival rate of implants. The aim of the study was to analyze the behavior of such lesions and to suggest our clinical approach with the management of these kinds of patients and complications. To remove gingival hyperplasia, we used either a traditional cold scalpel or an electric cautery or laser. We had good results using these tools. The onset of this phenomenon was not influenced by either the kind of implant and free flaps used or by the local conditions of the patients (such as radiotherapy). The number of recurrences was highly influenced by the oral hygiene of the patients

Polyspecies aquaculture systems: The detrital trophic level

The production of species belonging to the detrital trophic level was investigated in a model-sized aquaculture system, with flowing, filtered seawater and controlled phytoplankton addition to experimental tanks containing the oyster, Crassostrea virginica. The biodeposits of feces and pseudofeces of the oysters supported on the bottom of one tank a population of the nereid polychaete, Nereis virens and in the other tank a mixed community of the capitellid polychaete, Capitella capitata and the amphipod, Corophium sp...

Subcutaneous emphysema during third molar surgery: a case report

Extraction of third molars is the most common surgical procedure performed in oral surgery on a daily basis and, despite surgical skills and expertise, complications may occur. Complications observed during or after third molar removal may include pain, swelling, bleeding, infection, sinus perforation and nerve damage. Fortunately, with a proper management and a good surgical technique, the incidence of such events is low. Subcutaneous emphysema associated with dental extraction occurs when the air from the high-speed dental handpiece is forced into the soft tissue through the reflected flap and invades the adjacent tissues, leading to swelling, crepitus on palpation and occasionally spreading through the tissue spaces of the fascial planes. Although rare, iatrogenic subcutaneous emphysema can have serious and potentially life-threatening consequences. Care should be taken when using air-driven handpieces. The access of air into the facial tissues is not limited to tooth extractions, but may also occur through other portals of entrance, such as endodontically treated teeth, periodontium and lacerations of intraoral soft tissues. When subcutaneous emphysema occurs, it must be quickly diagnosed and properly managed to reduce the risk of further complications. This report presents a case of subcutaneous emphysema occurred during extraction of a mandibular third molar extraction with the use of an air turbine handpiece. Case management is described and issues relative to the diagnosis and prevention of this surgical complication are discussed

CO2 laser ablation of oral leukoplakia: with or without extension of margins?

The purpose is to determine the sufficient extension of margins during laser ablation of oral leukoplakia and observe its short-term recurrence rate. Materials and Methods.The study was designed as a randomized controlled clinical trial was conducted on 33 oral leukoplakia lesions diagnosed in 30 patients (16 Females and 14 Males) with an age range between 39 and 79 years. The lesions were divided into three groups; Group A: 11 lesions in 11 patients, in which the laser ablation was done for the entire lesion without extension of margins; Group B: 11 lesions in 8 patients, in which the laser ablation was done for the lesion adding at least 3mm extension of margins; and finally the Group Control: consists of 11 untreated lesions in 11 patients, in which only “wait and see” approach was done. Results. Complete healing of 13 lesions occurred in both groups A and B. Complete regression of 3 lesions occurred in Group Control. After 6 months of follow-up, 6 of 9 lesions in both groups A and B that showed the recurrence, had shown an initial recurrence after 3 weeks of the laser ablation. Patients with no history of smoking habits showed complete healing of 87.5%, while in ex-smokers complete healing was 42.8%. The statistical analysis was performed, and the averages of all groups are significantly different (p <0.00001).Discussion.The primary treatment focuses on the elimination of associated risk factors (smoking, alcohol, and local irritating factors). In the literature, the recurrence rate varies between 13.6% and 40.7%, while in our study, it was 45.5% in Group A and 36.4% in Group B. Conclusion.The recommended extension of margins should be at least 3mm in width. Further research can be performed to evaluate the immediate re-ablation of the lesions which showed an initial recurrence after 3 weeks of laser ablation

A New Light on Vitamin D in Obesity: A Novel Association with Trimethylamine-N-Oxide (TMAO)

Abstract: Vitamin D deficiency and obesity are two public health problems extensively exacerbated over the last years. Among the several mechanisms proposed to account for the complex interplay between vitamin D and obesity, one that has gained particular attention is related to the emerging role of obesity-related changes in gut microbiota and gut-derived metabolites, such as Trimethylamine-N-oxide (TMAO). Vitamin D deficiency and high circulating TMAO levels are associated with body weight and the severity of non-alcoholic fatty liver disease (NAFLD). Considering the link of obesity with vitamin D on the one hand and obesity with TMAO on the other hand, and the central role of the liver in both the vitamin D and TMAO metabolism, the aim of this cross-sectional observational study was first, to confirm the possible inverse association between vitamin D and TMAO across different body mass index (BMI) classes and second, to investigate if this association could be influenced by the presence of NAFLD. One hundred and four adult subjects (50 males and 54 females; 35.38 ± 7.49 years) were enrolled. The fatty liver index (FLI) was used as a proxy for the diagnosis of NAFLD. Vitamin D deficiency was found in 65 participants (62.5%), while 33 subjects (31.7%) had insufficient levels, and the remaining subjects had sufficient levels of vitamin D. Subjects with both vitamin D deficiency and FLI-NAFLD had the highest TMAO levels (p < 0.001). By stratifying the sample population according to the BMI classes, vitamin D levels decreased significantly along with the increase of plasma TMAO concentrations, with the lowest vitamin D levels and highest TMAO, respectively, in class III obesity. Vitamin D levels showed significant opposite associations with circulating levels of TMAO (r = -0.588, p < 0.001), but this association was no longer significant after the adjustment for FLI values. The highest values of TMAO were significantly associated with the severity of obesity (OR 7.92; p < 0.001), deficiency of vitamin D (OR 1.62; p < 0.001), and FLI-NAFLD (OR 3.79; p < 0.001). The most sensitive and specific cut-off for vitamin D to predict the circulating levels of TMAO was ≤19.83 ng/mL (p < 0.001). In conclusion, our study suggests that high TMAO levels are associated with vitamin D deficiency and NAFLD. Further studies are required to investigate if there is a causality link or whether all of them are simply the consequence of obesity

Different water and light regimes affect ionome composition in grapevine (Vitis vinifera L.)

Many inorganic cations play a major role in winemaking processes and wine quality. For this reason, chemistry at the elemental level ("ionomic") of the grape berry is of concern not only to the viticulturist, but also to the oenologist due to their direct impact on juice and must composition, which in turn affect wine quality. The aim of this research was to evaluate the effect of reduced irrigation and incident light (by means of micronized calcite) on the berry skin ionome of the Italian red grape 'Aglianico'. The study was carried out in a five-years-old vineyard (Vitis vinifera L. 'Aglianico') located in Southern Italy. Half of the plants (IRR) were drip irrigated, whereas the other half were not irrigated (NIR). Half of IRR and NIR plants were treated with Megagreen® micronized calcite. In all the treatments, plant water status and gas exchange were determined. The mean values of stem water potential (ψw) during the experiment were –1.02 and –1.10 MPa in IRR and NIR, respectively. The calcite treatments did not show changes in ψw values if compared to the untreated ones. The values of gas exchange were not statistically different among the four treatments. Grape berries were separated into three groups of mass, and the levels of macroelements, microelements and lanthanides were measured. Irrigation and calcite significantly affected macroelements distribution in all the three groups of mass, with Fe, Cu and Zn being significantly higher in the IRR and calcite-treated treatments. The effect of irrigation on the changes in microelement levels was significant for some elements. Calcite-treated vines showed higher mean values of Co, Cd, Hg and Pb. Regarding lanthanides, in calcite-untreated vines, irrigation determined significant decreases in average La, Ce, Nd, whereas in calcite-treated vines, increases in the mean concentrations of Ce, Nd, Sm, Gd, Dy, Er and Yb were found. Generally, lanthanide levels did not change between calcite-treated and untreated vines, and in all the treatments Lu resulted to be the most abundant one. Macroelements, microelements and lanthanide levels generally decreased with decreasing berry weight. The dynamics of the extractability of metals from grape berries to must during fermentation could be used to predict wine quality during the following processes and for wine traceability purposes.

Upwelling and outwelling effects on the benthic regime of the continental shelf off Galicia, NW Spain

The benthic regime off the Galician coast of NW Spain was surveyed to assess biogenic enrichment from coastal upwelling and detritus outwelling from the rías, large coastal embayments: the Rías Altas along the northern and the Rías Bajas along the western coast, which have intense mussel aquaculture. Sediment samples were collected from 1984 to 1986 and used for geological, microbiological, and macrofaunal studies. Sub-bottom acoustic profiler records and grab and core samples identified two main mud deposits on the western shelf that were aligned north to south and parallel with the coastline. The major axis of the mud deposit, which extended south to the Portuguese border, is associated with the three most southern rías (Arosa, Pontevedra and Vigo) along the western shelf. Sediment particle size analysis showed that sediments on the western shelf were heterogeneous, and grain size increased from the inner shelf to the shelf break. On the northern shelf, sediments exhibited a more homogeneous textural distribution. Sediment organic matter followed a similar pattern with that of particle size. The highest organic matter values, 10%, occurred on the western shelf nearest the Rías Bajas, but these values decreased offshore to between 2 and 4%. On the northern shelf organic matter content was generally less than 4% but with patches of higher organic content. The composition and structure of macroinfauna on the northern shelf, where seasonal coastal upwelling results in benthic enrichment, showed mainly small, surface feeding, and fast growing polychaetes. In contrast, macroinfauna on the western shelf showed more subsurface, deposit-feeding polychaetes. A main difference between the two shelves is that off the rías Bajas, besides coastal upwelling, outwelling from the highly productive rías Bajas, with their intense mussel aquaculture, also enriches the coastal sediment regime with a steady source of organic matter. Although seasonal and interannual variations occurred in the benthic bacteria, their general density distribution followed the pattern of organic matter content and particle grain size seasonally and interannually. The highest numbers of bacteria occurred in the upwelling region off the northern shelf and nearest the Rías Bajas on the western shelf. Both coastal upwelling and organic outwelling from the rías Bajas support benthic production alongthe western Galician shelf. The main commercialdemersal finfishalongthis coast is hake, Merluccius merluccius and blue-whiting, Micomesistius poutassou. The norwegian lobster, Nephrops norvegicus is also an important crop, and is more abundant off the rías Bajas in the finer and organic-richsediments where there are abundant prey resources of benthic infauna

Genotoxicity assessment of three nutraceuticals containing natural antioxidants extracted from agri-food waste biomasses

Grapes and apples are the most cultivated fruits in the Mediterranean basin and their agricultural processing is responsible for the production of a large amount of bio-waste. The reuse of this food biomass would increase the volume of recyclable/renewable biomaterial and lower the environmental impact due to the increasing demand for these biological products. To this purpose, agri-food waste from grape and apple processing have become an important source of phytochemicals, and many pharmaceutical industries are using it as starting material to produce dietary supplements, functional foods, and food additives for human consumption. In virtue of the chemical diversity and complexity of agri-food biowaste, developers and producers of nutraceuticals are advised to assess the safety of their final nutraceutical products, in compliance with European Food Safety Authority regulation. Here, we use the Ames test to assess the mutagenicity of three nutraceuticals obtained from agri-food waste biomasses: Taurisolo® from grape pomace of Vitis vinifera L. cv 'Aglianico', AnnurComplex® from Malus pumila M. cv 'Annurca' and Limoncella Apple Extract from Malus domestica B. cv 'Limoncella'. The results showed that all three nutraceuticals were non-mutagenic