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Background: The authors conducted a study to compare the effectiveness of two dry-field isolation techniques with that of a control technique (no isolation) in reducing spatter from a dental operative site.

Methods: The authors designed a benchtop experiment to evaluate spatter patterns after performing simulated occlusal surface preparations on three typodont teeth in a dental manikin. Fluorescein dye served as the marker to enable visualization of the spatter distribution. The authors compared the effectiveness of a nonisolated control consisting of high-volume evacuation (HVE) alone with that of two dry-field isolation techniques: a dental dam with HVE and the Isolite system (Isolite Systems, Santa Barbara, Calif).

Results: The authors performed a two-way analysis of variance. Both the Isolite device and the dental dam with HVE exhibited a significant decrease in the number of contaminated squares (P < .001) compared with that for the nonisolated control. In addition, overall, the results showed no statistically significant difference between the Isolite system and the dental dam with HVE (P = .126).

Conclusions: The study results showed that use of a dental dam with HVE or the Isolite system significantly reduced spatter overall compared with use of HVE alone.

Clinical implications: Isolation with a dental dam and HVE or with the Isolite system appears to aid in the reduction of spatter during operative dental procedures, potentially reducing exposure to oral pathogens.

Cardiovascular diseases (CVD) have a complex etiology determined by risk factors, which are in turn associated to a strong genetic component and to environmental factors. In the biological background for the development of CVD, low-grade chronic inflammation plays a role as a pathogenetic determinant of atherosclerosis. Dental infections have been associated with CVD. Periodontal disease is a chronic infection of the supporting tissues of the tooth that can lead to teeth loss. In recent years, a number of reports have demonstrated the possible relationship between periodontal disease and CVD. Apical periodontitis, on the other hand, is the late consequence of an endodontic infection, which is caused by the persistence of coronal caries and involves the root canal system of the tooth. Most of the time, it is a chronic infection. Some studies have found a correlation between a “composite status” of oral health (eg. caries, tooth loss, periodontal disease) and CVD, but only a few of them have addressed the association between apical periodontitis and CVD. This “state of the art” paper represents the first stage of an incoming study on the relationship between chronic endodontic infection and CVD.

INTRODUCTION:

This study set out to compare the efficacy of laser-activated and ultrasonically activated root canal disinfection with conventional irrigation, specifically its ability to remove bacterial film formed on root canal walls.

METHODS:

Seventy human premolars were shaped to an apical size #20, taper .07, sterilized, and contaminated in situ with oral bacteria for 1 week and incubated for 2 more weeks. Irrigation was done with 6% NaOCl (group 1), NaOCl ultrasonically activated with blunt inserts (group 2), or a pulsed erbium:YAG laser at nonablative settings (group 3) for a total of 60 seconds each. Positive and negative controls were also included. Aerobic bacterial sampling was performed, and the incidence of positive samples after 24 and 48 hours as well as bacterial counts (colony-forming units) were determined. Fixed and demineralized sections 1 mm and 4 mm off the apex were Brown-Brenn stained and assessed for remaining intracanal bacteria/biofilm and dentinal tubule penetration.

RESULTS:

All 3 canal disinfection protocols significantly reduced bacterial counts (P < .001). None of the 3 techniques predictably generated negative samples, but laser-activated disinfection was superior to the other 2 techniques in this aspect (P < .05). Histologic sections showed variable remaining bacterial presence in dentinal tubules at the 4-mm level and significantly less bacterial biofilm/necrotic tissue remaining at the 1-mm level after laser-activated irrigation (P < .05).

CONCLUSIONS:

Under the conditions of this combined in situ/in vitro study, activated disinfection did not completely remove bacteria from the apical root canal third and infected dentinal tubules. However, the fact that laser activation generated more negative bacterial samples and left less apical bacteria/biofilm than ultrasonic activation warrants further investigation.

Cutaneous and systemic hypersensitivity reactions to implanted metals are challenging to evaluate and treat. Although they are uncommon, they do exist, and require appropriate and complete evaluation. This review summarizes the evidence regarding evaluation tools, especially patch and lymphocyte transformation tests, for hypersensitivity reactions to implanted metal devices. Patch test evaluation is the gold standard for metal hypersensitivity, although the results may be subjective. Regarding pre-implant testing, those patients with a reported history of metal dermatitis should be evaluated by patch testing. Those without a history of dermatitis should not be tested unless considerable concern exists. Regarding post-implant testing, a subset of patients with metal hypersensitivity may develop cutaneous or systemic reactions to implanted metals following implant. For symptomatic patients, a diagnostic algorithm to guide the selection of screening allergen series for patch testing is provided. At a minimum, an extended baseline screening series and metal screening is necessary. Static and dynamic orthopaedic implants, intravascular stent devices, implanted defibrillators and dental and gynaecological devices are considered. Basic management suggestions are provided. Our goal is to provide a comprehensive reference for use by those evaluating suspected cutaneous and systemic metal hypersensitivity reactions.

Dentists and patients are facing a perplexity between saving a compromised tooth through endodontic treatment and restoration or by extraction and replacement with an implant. The purpose of this paper was to compare the success rates of these two treatments. Success was measured as the longevity of the tooth or implant. Studies which met strict inclusion criteria to ensure best evidence were included. Searches were performed in Ovid Medline, Pubmed, Scopus database, and the Cochrane Library. Evidence-based groups were formed following the assessment of inclusion/exclusion criteria. The overall success rates for primary endodontic, nonsurgical retreatment, and surgical treatment were (86.02%), (78.2%), and (63.4%), respectively, implants was 90.9%. In conclusion, choice between implant and endodontic therapy cannot be exclusively based on outcome as both treatments differ in the biological process, diagnostic modalities, failure patterns, and patients preferences. More research is required with improved study designs before long-term success rates can be compared.

Diagnosis, instrumentation, obturation and restoration are the main steps involved in the treatment of teeth with pulpal and periapical diseases. Elimination or significant reduction of irritants and prevention of recontamination of the root canal after treatment are the essential elements for successful outcomes. Although many advances have been made in different aspects of endodontics within the last few years to preserve natural dentition, the main objective of this field re-mains elimination of microorganisms from the root canal systems and prevention of recontamination after treatment. The common belief that inadequate obturation is the major cause of endodontic failures has been proven to be fallacious as obturation reflects the adequacy of cleaning and shaping. In other words, what you take out of a root canal may be more important than what you put in it.

Sevoflurane is currently used as an inhaled anaesthetic agent with few adverse drug reactions. Skin reaction after general anaesthesia is uncommon. We report a case of fluoroderma after exposure to sevoflurane

Little is known about hair mineral status in fibromyalgia patients. This study evaluated the characteristics of hair minerals in female patients with fibromyalgia compared with a healthy reference group. Forty-four female patients diagnosed with fibromyalgia according to the American College of Rheumatology criteria were enrolled as the case group. Age and body mass index-matched data were obtained from 122 control subjects enrolled during visit for a regular health check-up. Hair minerals were analyzed and compared between the two groups. The mean age was 43.7 yr. General characteristics were not different between the two groups. Fibromyalgia patients showed a significantly lower level of calcium (775 µg/g vs 1,093 µg/g), magnesium (52 µg/g vs 72 µg/g), iron (5.9 µg/g vs 7.1 µg/g), copper (28.3 µg/g vs 40.2 µg/g) and manganese (140 ng/g vs 190 ng/g). Calcium, magnesium, iron, and manganese were loaded in the same factor using factor analysis; the mean of this factor was significantly lower in fibromyalgia group in multivariate analysis with adjustment for potential confounders. In conclusion, the concentrations of calcium, magnesium, iron, and manganese in the hair of female patients with fibromyalgia are lower than of controls, even after adjustment of potential confounders.