Influence of cavity lining and remaining dentin thickness on the occurrence of postoperative hypersensitivity of composite restorations

PURPOSE: To investigate the influence of the remaining dentin thickness after cavity preparation, calcium hydroxide lining, and two restorative systems on the occurrence of postoperative pain or hypersensitivity. MATERIALS AND METHODS: One hundred twenty-three fillings were placed in 123 healthy patients. The remaining dentin thickness after caries excavation was measured with the Prepometer device at the deepest area of the cavity. The cavities were allocated to three different groups (shallow, medium, and deep) on the basis of the Prepometer results. The decision to use a calcium hydroxide liner or not was made by tossing a coin. Cavities which were to be later treated with an indirect restoration were restored with a buildup material. The other cavities were treated with a hybrid composite. After 6 months, the patients were re-examined and interviewed concerning postoperative pain incidents or hypersensitivity. A logistic regression was performed for the statistical analysis. RESULTS: Logistic regression showed no statistically significant influence of any of the three different variables "cavity depth", "calcium hydroxide liner" and "restorative material" on the occurrence of pain or hypersensitivity. CONCLUSION: The occurrence of pain or hypersensitivity does not depend on the remaining dentin thickness, calcium hydroxide lining, or the restorative system used in the present study

Higher frequencies of HLA DQB1*05:01 and anti-glycosphingolipid antibodies in a cluster of severe Guillain-Barr, syndrome

Few regional and seasonal Guillain-Barr, syndrome (GBS) clusters have been reported so far. It is unknown whether patients suffering from sporadic GBS differ from GBS clusters with respect to clinical and paraclinical parameters, HLA association and antibody response to glycosphingolipids and Campylobacter jejuni (Cj). We examined 40 consecutive patients with GBS from the greater Munich area in Germany with 14 of those admitted within a period of 3 months in fall 2010 defining a cluster of GBS. Sequencing-based HLA typing of the HLA genes DRB1, DQB1, and DPB1 was performed, and ELISA for anti-glycosphingolipid antibodies was carried out. Clinical and paraclinical findings (Cj seroreactivity, cerebrospinal fluid parameters, and electrophysiology) were obtained and analyzed. GBS cluster patients were characterized by a more severe clinical phenotype with more patients requiring mechanical ventilation and higher frequencies of autoantibodies against sulfatide, GalC and certain ganglioside epitopes (54 %) as compared to sporadic GBS cases (13 %, p = 0.017). Cj seropositivity tended to be higher within GBS cluster patients (69 %) as compared to sporadic cases (46 %, p = 0.155). We noted higher frequencies of HLA class II allele DQB1*05:01 in the cluster cohort (23 %) as compared to sporadic GBS patients (3 %, p = 0.019). Cluster of severe GBS was defined by higher frequencies of autoantibodies against glycosphingolipids. HLA class II allele DQB1*05:01 might contribute to clinical worsening in the cluster patients

Analysis of genomic DNA from medieval plague victims suggests long-term effect of Yersinia pestis on human immunity genes

Pathogens and associated outbreaks of infectious disease exert selective pressure on human populations, and any changes in allele frequencies that result may be especially evident for genes involved in immunity. In this regard, the 1346-1353 Yersinia pestis-caused Black Death pandemic, with continued plague outbreaks spanning several hundred years, is one of the most devastating recorded in human history. To investigate the potential impact of Y. pestis on human immunity genes, we extracted DNA from 36 plague victims buried in a mass grave in Ellwangen, Germany in the 16th century. We targeted 488 immune-related genes, including HLA, using a novel in-solution hybridization capture approach. In comparison with 50 modern native inhabitants of Ellwangen, we find differences in allele frequencies for variants of the innate immunity proteins Ficolin-2 and NLRP14 at sites involved in determining specificity. We also observed that HLA-DRB1*13 is more than twice as frequent in the modern population, whereas HLA-B alleles encoding an isoleucine at position 80 (I-80+), HLA C*06:02 and HLA-DPB1 alleles encoding histidine at position 9 are half as frequent in the modern population. Simulations show that natural selection has likely driven these allele frequency changes. Thus, our data suggest that allele frequencies of HLA genes involved in innate and adaptive immunity responsible for extracellular and intracellular responses to pathogenic bacteria, such as Y. pestis, could have been affected by the historical epidemics that occurred in Europe