The purpose of this in vitro study was to evaluate two commonly used gutta-percha solvents for their effectiveness in dissolving several types of root canal sealers. Seven different sealers (AH26, AH Plus, Diaket, Roekoseal, Sankin Apatite Root Sealer, Sealapex, and Sultan U/P) were used in this study. After mixing according to the manufacturers' directions, each material was syringed into 30 glass capillary tubes, and a total of 210 tubes were placed in a humidifier at 37°C for one week to allow the materials to set completely. Each group of 30 tubes, obturated with one type of sealer, was then randomly divided into three subgroups, including 10 tubes each. Chloroform was used in the first ten tubes from each sealer group. Halothane was used for the second group. In the last group, the sealer was removed with files, without using any solvent. The time necessary to pass a file through to the end of the tube was recorded for each sample in seconds. Results were analyzed using one-way analysis of variance. Sealapex did not set at all unless in contact with air. Roekoseal did not adhere to the glass capillary tubes, and was therefore easily removed from the tube in all samples. AH26 and AH Plus root canal sealers tightly adhered to the tube walls, so none of the techniques were effective in removing them from the tubes within 30 min. Diaket root canal sealer was easily removed using solvents (P < 0.05). There was no advantage in using solvents to remove Sankin Apatite Root Sealer (P > 0.05). Solvents were found to be very effective in dissolving the Sultan U/P root canal sealer (P < 0.05). (J. Oral Sci. 45, 123-126, 2003)
Bacterial effects on in vitro mineralization of human periodontal fibroblasts (HPF) have not yet been examined in great detail. In our study, we investigated the effects of soluble extracts of the periodontopathic bacteria Porphyromonas gingivalis, Bacteroides forsythus and, Treponema denticola on cell proliferation, mineralization, as well as on osteoblastic markers present in HPF cultured in vitro, such as alkaline phosphatase (ALP) activity and collagen content. Periodontal fibroblasts stimulated by Bglycerophosphate, ascorbic acid and dexamethasone (BAD) or by dexamethasone and ascorbic acid (DA) were compared to unstimulated cells. During the cultivation period, the stimulation of HPF by combined dexamethasone and ascorbic acid (DA) had a strong inductive effect on proliferation, ALP activity and collagen formation. The extracts obtained from the periodontal pathogens had a suppressing effect on the proliferation rate of HPF. The extracts from P. gingivalis, B. forsythus and T denticola caused a decrease in ALP activity within 24 h of application. While extracts obtained from P. gingivalis and B. forsythus induced a reduction in collagen content in BAD-and DA-stimulated HPF cells, T denticola extracts led to an increase in collagen. Our data suggest that specific periodontopathic bacteria may suppress tissue regeneration in vivo not only by activating host defensemechanisms but also directly via a suppression of growth and differentiation of HPF and a reduction in the extracellular collagen matrix. For the process of pocket formation, not even the direct influence of viable bacteria seems to be necessary. Additionally, longdistance effects of bacteria harboured in periodontal pockets or in root canals may be of importance. (J Oral Sci. 45, 127-137, 2003)
The effect of cyclopiazonic acid (CPA) on changes in the intracellular free Ca2+ concentration ([Ca2+] i) evoked by bradykinin (BK), histamine (HIST) and thapsigargin (TG) was investigated in human gingival fibroblasts.CPA itself dose-dependently stimulated [Ca2+] i responses in both the absence and presence of extracellular Ca2+. Pretreatment with CPA (<5μM) enhanced the [Ca2+] i responses evoked by 5 nM BK and 1 mM HIST. However, CPA-pretreatment depressed the [Ca2+] i response evoked by 1μM TG in a dose-dependent manner. Moreover, CPA accelerated the Ca2+influx caused by 5 nM BK and 1mM HIST, but did not alter that caused by 1μM TG. These results indicate that CPA discharges intracellular Ca2+stores, resulting in their depletion, and enhances Ca2+influx across the plasma membrane. (J.Oral Sci.45, 139-144, 2003)
Porphyromonas gingivalis, a Gramnegative anaerobic bacterium, is considered to be one of the major etiologic agents of adult periodontitis. We previously succeeded in molecular cloning of a 200-kDa antigenic protein (200-k AP) from P gingivalis 381 by immunoscreening using sera from severe periodontitis patients and designated it as pMD101. We also identified amino acid sequences of the short peptide from a lysyl endopeptidase digested recombinant (r), 200-k AP, and found that the short peptide had exactly the same amino acid sequence as the hemagglutinin A (hagA) of P. gingivalis, which is thought to have potential use in a vaccine against periodontitis. In this study, we attempted to confirm whether 200-k AP was a molecule identical to hagA. DNA sequences of pMD157, a subclone encoding the 25-kDa antigenic region of pMD101, were identical to the same part of the hagA gene. The r200-k AP was purified for homogeneity and rabbits were immunized with it. The antibody against r200-k AP previously showed a similar Westernblot pattern as P. gingivalis lysate by monoclonal antibodies against hagA by literature and reacted to r130-kDa hemagglutinin. These findings suggest that 200-k AP is identical to hagA and that r200-k AP may be useful as an immunotherapy agent against periodontitis caused by P. gingivalis infection. (J. Oral Sci. 45, 145-152, 2003)
The aim of this randomised, parallel, double-blind study, in which 28 adult patients diagnosed with chronic gingivitis or early stages of chronic periodontitis were recruited, was to evaluate the efficacy of 'Gamadent' toothpaste compared to a placebo toothpaste. 'Gamadent' toothpaste has all the basic constituents of a toothpaste with the addition of a sea cucumber extract (SCE) of the species Stichopus sp. 1 to improve the healing potential of tissues. The placebo has the same basic constituents minus the extract. Out of the 28 patients, 14 were placed in the test group who used the 'Gamadent' toothpaste, and 14 patients were placed in the control group (2 control subjects defaulted and were excluded), who brushed using the placebo toothpaste. The longitudinal study was carried out over a period of 3 months with assessments made at baseline, 1 month, 2 months and 3 months after conventional therapy at the baseline visit. The clinical parameters used during the trial were Plaque Index (PI), Gingival Index (GI), Papilla Bleeding Index (PBI) and Probing Pocket Depth (PPD). A predetermined number of sites on a molar, premolar, canine and an incisor were examined and evaluated in each quadrant. After the baseline assessment, the patients had full mouth scaling and debridement as well as oral hygiene instructions. Patients were instructed to brush their teeth twice a day with the toothbrush provided (Oral-B plus, size 35) and toothpaste (test or control), using the Bass technique. At the 1-month assessment, therewere significant mean reductions to baseline mean values in PI (P < 0.005) and GI (P < 0.001) in the test group as compared to the control group. At the end of the 2-month interval, significant reductions were observed in PI, PBI and PPD (P < 0.001). By the end of 3 months, there were significant differences in the mean reduction of all the parameters i.e. PI, PBI, GI and PPD (P < 0.001), between the test and control sites. In conclusion, 'Gamadent' toothpaste provided noteworthy benefits, producing statistically significant improvement in all clinical parameters compared to the placebo during the healing phase after conventional initial therapy. (J. Oral Sci. 45, 153-159, 2003)
Though oral candidosis is an opportunistic fungal infection that commonly affects immunocompromised patients, little is known of its occurrence as a complication of Non-Hodgkin's lymphoma. This paper reports a case of oral candidosis in a 20-year-old Indonesian woman with this lymphoproliferative disease. She presented with acute pseudomembranous candidosis on the dorsum and lateral borders of the tongue, bilateral angular cheilitis and cheilocandidosis. The latter is a rare clinical variant of oral candidosis, and the lesions affecting the vermilion borders presented as an admixture of superficial erosions, ulcers and white plaques. Clinical findings were confirmed with oral smears and swabs that demonstrated the presence of hyphae, pseudohyphae and blastospores, and colonies identified as Candida albicans. A culture from a saline rinse was also positive for multiple candidal colonies. Lip and oral lesions were managed with Nystatin. The lesions regressed with subsequent crusting on the lips, and overall reduction in oral thrush. As Non-Hodgkin's lymphoma is a neoplastic disease that produces a chronic immunosuppressive state, management of its oral complications, including those due to oral candidosis, is considered a long-term indication. (J Oral Sci. 45, 161-164, 2003)
Pemphigus refers to a group of diseases characterized by painful lesions caused by intraepidermal acantholytic structures in the skin and mucous membrane. The exact nature of the disease remains unknown. Pemphigus is a rare chronic mucocutaneous disease characterized by intra-epithelial bulla formation, due to autoantibodies directed against proteins of the desmosome-tonofilament complex between keratinocytes. The bullous lesions are painful, slow to heal and with a tendency to become invasive. Any part of the oral cavity may be affected, with the soft palate, buccal mucosa and lips being the most common sites. The high doses and prolonged administration of corticosteroids often required to control the disease result in several side effects, many of which are serious or life-threatening. In the present case, steroid treatment was begun at 180 mg/day and subsequently increased to 250 mg/day and 350mg/day Oral lesions were treated locally with 0.2 % chlorhexidine gluconate in addition to systemic corticosteroids containing an immunosuppressive. Oral lesions were observed to recur without healing completely. Respiratory problems occured, necessitating direct lung radiographs and computerised tomography. Pulmonary embolism was diagnosed and the patient was transferred to the vascular surgery department. Unfortunately the patient died due to pulmonary embolism on the seventh day. Pemphigus vulgaris (PV) is a chronic autoimmune mucocutaneous disease that often primarily involves the oral cavity. Therefore, early diagnosis of oral symptoms is crucial for the successful treatment of PV. Although there is no consensus regarding the initial steroid dosage needed to induce remission, it is suggested that high doses of corticosteriods may cause fatal complications. (J. Oral Sci. 45, 165-169, 2003)
Knowledge of the position of the mental foramen is important both when administering regional anesthesia and performing periapical surgery in the mental region of the mandible. This study determines the position of the mental foramen in a selected Malay population. One hundred and sixty nine panoramic radiographs of Malay patients retrieved from a minor oral surgery waiting list were selected to identify the normal range for the position of the mental foramen. The foramen was not included in the study if there was any mandibular tooth missing between the lower left and right first molars (36-46). The findings indicated the most common position for the mental foramen was in line with the longitudinal axis of the second premolar (69.2 %) followed by a location between the first and second premolar (19.6 %). The right and left foramina were bilaterally symmetrical in three of six recorded positions in 67.7 % patients. The mental foramen was most often in line with the second premolar. (J. Oral Sci. 45, 171-175, 2003)
Most cerebrovascular accidents (CVAs), commonly referred to as noncardiogenic strokes, occur as a result of atherosclerosis involving the common, internal and external carotids arteries, due to atheroma formation. Several factors influence atheroma formation, such as hypertension, smoking, diabetes mellitus, hypercholesterolemia, obesity and sedentary lifestyle among others. When atheromas are positioned inside the vessel lumen, they alter the flow of blood, causing the stroke. These atheromas, that are calcified plaques, can be observed in panoramic radiography. (J. Oral Sci. 45, 177-180, 2003)
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