Differences of subcortical structures in patients with nocturnal, diurnal and mixed seizures [Poster Abstract]

Volumetric changes of subcortical grey matter structures in epilepsy patients with different circadian profiles of seizure presentation

Rationale and design of the ESC Heart Failure III Registry - Implementation and discovery

AIMS Heart failure outcomes remain poor despite advances in therapy. The European Society of Cardiology Heart Failure III Registry (ESC HF III Registry) aims to characterize HF clinical features and outcomes and to assess implementation of guideline-recommended therapy in Europe and other ESC affiliated countries. METHODS Between 1 November 2018 and 31 December 2020, 10 162 patients with chronic or acute/worsening HF with reduced, mildly reduced, or preserved ejection fraction were enrolled from 220 centres in 41 European or ESC affiliated countries. The ESC HF III Registry collected data on baseline characteristics (hospital or clinic presentation), hospital course, diagnostic and therapeutic decisions in hospital and at the clinic visit; and on outcomes at 12-month follow-up. These data include demographics, medical history, physical examination, biomarkers and imaging, quality of life, treatments, and interventions - including drug doses and reasons for non-use, and cause-specific outcomes. CONCLUSION The ESC HF III Registry will provide comprehensive and unique insight into contemporary HF characteristics, treatment implementation, and outcomes, and may impact implementation strategies, clinical discovery, trial design, and public policy

Radiodensitometric Study Regarding Conservative Endodontic Therapy in Periapical Lesions

Introduction. Our study aimed to assess periapical healing processes using a quantitative method based on radiodensitometry. Material and methods. The evolution of periapical lesions in a study group of 10 patients taken in conservative endodontical therapy was monitorised through radiographs taken at baseline, after 12 months and after 24 months. The radiographs were scanned at 300 dpi resolution with an automated level of bright and contrast. Modification of bone density and periapical lesion size were assessed using radiodensitometry. Results and discussions. Radiodensitometry indicated objectively the increase of bone density and decrease of periapical radiotransparencies size that were correlated with time interval and preoperator diagnostic. Conclusions. Radiodensitometry can be useful for an objective cuantification of endododontic therapy success in chronic periapical periodontitis

The Assessment Of Root Canal Sealers Ph In The Treatment Of Periapical Inflammation Processes – An In Vitro Study

Introduction: The endodontic treatment represents the best conservative option for irreversible endodontically affected teeth maintenance on the dental arch. Besides the rigorous mechanic-chemical treatment, in aseptic conditions, the regenerative or, on the contrary, inhibitive qualities of the root canal sealer on the periradicular tissue play an important role in the long-term success of the treatment. The aim of the study The object of this study consisted in analysing the pH values of frequently used root canal sealers in the endodontic treatment, to make a series of correlations with their therapeutically indications. Materials and Methods We tested the following root canal sealers: AH-26 (De Trey), ZOE, Pulpispad (Spad, Dijon), Sealapex (Kerr), Endomethasone (Septodont), Endospad (Spad, Dijon). The materials were prepared according to the producer indications. The pH recordings were made on different time points: immediately after the preparation, after 24 hours, after a week and after two weeks. Results Our data analysis revealed a variation of the pH values of the 6 root canal sealers and differences in their pH values on different time recordings. The highest values were presented by Sealapex; in the alkaline values order, this was followed by Endomethasone and Endospad. The lowest pH values, to acid zones, were recorded from AH-26, ZOE and Pulpispad. Conclusions The presence in the root canal of an alkaline pH sealer ensures an additional opportunity for the infection control and tissue regeneration of the periradicular tissue. Due to this property, the root canal sealers that have calcium hydroxide in their composition are used more and more frequently

COMPARATIVE STUDY ON VITALITY PRESERVATION OF YOUNG PERMANENT TEETH USING BIOACTIVE MATERIALS

Introduction Traumatic injuries and decays are the biggest challenges to the integrity of a young permanent tooth .The aim of this study was to compare the biostimulating and repairing action of mineral trioxide aggregate (MTA) and of the mineral aggregate with ceramic nanoparticles (BioAgreggate) with calcium hydroxide action, in terms of clinical-radiological parameters, after vital pulp therapy in young permanent teeth affected by dental caries or traumatic injury. Material and methods The study was conducted on a sample of 36 teeth from 31 patients of both sexes, aged between 7 and 15 years (mean 9.3 ± 1.9 years), divided into three groups, and took place for a period of up to 4 years. Results The results concerning the effectiveness of the three materials used were evaluated in terms of clinical and radiological manifestations. These were significantly correlated (Ȥ2 = 35.3, r = 0.705, p = 0.003, 95% CI), the study demonstrating an important differences between the three groups of teeth. Final evaluation showed a significant association (Ȥ2 = 18.69, r = 0.725, p = 0.001, 95% CI) between the material used and the final results. Conclusions Following clinical aseptic procedures, after removing bacterial contamination, applying a bio-stimulative dressing and an hermetic crown sealing, there are high chances (about 95%) that the pulp of a young permanent tooth, even seeming irreversibly inflamed, to return to the original status and continue to exercise its functions with longterm preservation of vitality

CLINICAL, HISTOLOGICAL AND RADIOLOGICAL ASPECTS REGARDING THE INFLUENCE OF SOME EXTERNAL FACTORS ON THE PULP-DENTIN COMPLEX

The present study aimed at assesssing – by clinical, histological and radiological investigations – the influence of some external factors on the pulp-dentin complex, and at providing a causal interpretation of the structural changes observed. Materials and methods. Clinical and radiological exams were performed on 65 old patients with ages between 60-75, and also on 40 young patients with ages between 20-35, presenting different dental-periodontal pathologies. The pulp-dentin complex was submitted to a morphopathological examination, to highlight the structural changes observed at microscopic level. Fragments of dental pulp were imersed in a 4% formaldehyde solution with phosphate buffer 0.1 M., pH 7.2, for 12 -14 hours, at a temperature of 4ºC, and 3-5 µm thick slices were prepared. The slices were coloured with hematoxylin-eosine (HE), by the trichromic technique – Masson. Photographies were taken with a Zeiss microscope, with Kodak 200 ASA. Results. Significant differences were observed, between the two groups of patients, as to the external factors that produce structural changes on pulp-dentin organ. In the group of young patients dental caries and coronal fillings prevailed, while the group of old patients was mostly associated with atrition and chronic marginal periodontitis. Out of the 40 young patients, 30 presented chronic dental caries (75%), while, among the 65 old patients, only 24 presented dental caries (36.9%). The percentages of coronary fillings between the two study groups were close, which could be considered as one of the causes producing changes in the pulp-dentin organ, following aggresive preparation of cavities, the action of materials used for the protection of pulp-dentin complex or of the materials used for coronry fillings. Conclusions. Dental pulp has a remarkable ability to counteract the action of harmful factors, producing a mineral barrier and stimulating the reparatory processes. Changes in the endodontic space can be produced in both experimental groups, but more intensely and more frequently in the old patients. The endodontic space is modified, both physiologically and pathologically, including deposition of secondary or tertiary dentin (reactionary or reparative dentin), as well as pulp reactions, such as: inflammation, fibrosis, calcium degeneration or vacuolisis. At cell level, microsocopic images showed a decrease of the odontoblasts number and sizes, as well as a reduced fibroblasts/fibrocytes ratios. These changes are associated with progressive vascular and nervous changes, that can be considered both theis cause and effect. These pathological transformations are related with a more difficult preparation of the endodontic space and can be considered as having a major role in the failure of endodontic therapy

POSSIBILITIES TO ASSESS THE BONE PERIAPICAL REMINERALISATION USING RADIODENSITOMETRIC MEASUREMENTS

Aim of the study This study aimed to explore the possibility that digitized conventional periapical radiographs to be used for an accurate assessment and measurement of the results of the endodontic treatment for patients with chronic apical periodontitis (CAP). Material and methods The study included 20 patients (12 males, 8 females) with ages between 18-38 years, presenting severe CAP with non-surgical endodontic treatment recommendation. For each patient, conventional intraalveolar periapical radiographs were taken initially (before and after treatment completion) and at interval of 24 months. The endodontic therapy used intracanalar medications (calcium hydroxide paste for 14 days) and endodontic sealer (Endoflas, Sanlor) with high antibacterial and remineralisation properties. The group of digitized radiographs was submitted to the radiodensitometric measurement. Results The results regarding the success rate of CAP healing were as follows: 1 case had no periapical healing (5%), 11 cases presented (55%) partial bone periapical healing and 8 cases (40%) presented complete periapical healing with total absence of periapical radiotransparence. The degree of bone remineralisation for the cases with partial bone healing varied between 52% and 80%, with a mean value of 66%. Conclusions The radiodensitometric measurements of periapical and CAP area provides a tool of quantitative assessment of the healing of CAP after completion of endodontic treatment

THE USE OF CBCT-PAI INDEX IN THE ASSESSMENT OF CHRONIC PERIAPICAL LESIONS

The aim was to assess the CBCT-PAI index performance in the chronic periapical lesions diagnosis and evolution monitoring before and 3 months post-treatment. Material and methods. The study was performed on a group of 10 teeth diagnosed with chronic periapical lesions. CBCT were recorded before and after 3 months of endodontic treatment. Ez3D 2009 Plus software allowed the accurate measurement of bone lesions before and 3 months after treatment. The changes of CBCTPAI index after endodontic treatment were assessed by recording mean values, minimum and maximal values. Results. CBCT-PAI mean value lowest decrease was recorded for the coronal-apical slice (18.62%), while CBCT-PAI highest decrease was recorded for buccal-lingual slice (28.44%). Regarding maximum and minimal values, CBCT-PAI lowest decrease was recorded for the coronalapical slice (2.71%), while CBCT-PAI highest decrease was recorded for the buccal-lingual slice (39.70%). Conclusions. CBCT-PAI index can be used as a reliable and accurate tool in the diagnosis and the assessment of periapical lesions post-treatment evolution

STUDY ON THE Ph INFLUENCE ON SURFACE MICROHARDNESS OF SOME REPAIR MATERIALS USED IN ENDODONTICS

Introduction The irrigating solutions used in endodontic therapy have different pH values and different chemical properties that have sometimes been found to adversely affect the physical and chemical characteristics of reparing materials. These materials are used mainly in areas of inflamed tissue, with a lower pH. Aim of the study To evaluate the changes in the hardness of two dental materials depending on pH variations and to determine which of the additives they are combined with gives them greater stability to pH variations. Material and methods The changes in surface microhardness (Vickers microhardness) of two repair materials: Grey MTA (Dentsply Tulsa Dental, USA) and BioAggregate (Innovative BioCeramix Inc., Vancouver, Canada), mixed with four different vehicles (distilled water, physiological saline, lidocaine and calcium chloride) and subsequently subjected to different environmental pH values. Vickers microhardness of each specimen was measured by means of Emcotest M1C 010 model. Results The analysis of the average surface hardness of the two repair materials showed a significant increase in hardness at high pH (pH = 7) and higher values for BioAggregate as compared with MTA. Conclusions Ph variations of the environment in which biomaterials are setting reduce their microhardness and surface resistance, and this was more significant when the two materials were combined with lidocaine and distilled water

HEALING OF CHRONIC PERIAPICAL PERIODONTITIS IN THE ELDERLY: IS IT AGE REALATED?

Endodontic retreatment in elderly patients for healing periapical periodontitis is more often required. Because of the increasing number of older adults in the population and the desideratum to maintain natural teeth for mastication and esthetics, endodontic treatment outcome in elderly people has to become predictable. Our clinical case highlights that even large, multiple periapical periodontitis can be healed in elderly people. Eliminating microbial infection by correct cleaning and shaping and preventing reinfection by proper root canal filling lead to a decrease in the size or even total healing of apical pathosis in relatively healthy elder patients, no matter the age