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A study evaluating whether laser instrumentation and rotary instrumentation can eliminate Enterococcus faecalis (root canal infection) in anterior, single-rooted teeth, is presented.

P. Malfertheiner [1] M. Vieth [2] A. Leodolter [1] D. Jaspersen [3] J. Labenz [4] W. Meyer-Sabellek [5] S.N. Willich [6] G. Hasselgren [7] M. Stolte [2] [11/16] Role of [...]

There is widespread concern regarding the safety of silver-mercury amalgam dental restorations, yet little evidence to support their harm or safety. We examined whether mercury dental amalgams are adversely associated with cognitive functioning in a cross-sectional sample of healthy working adults. We studied 550 adults, 30-49 years of age, who were not occupationally exposed to mercury. Participants were representative of employees at a major urban medical center. Each participant underwent a neuropsychologic test battery, a structured questionnaire, a modified dental examination, and collection of blood and urine samples. Mercury exposure was assessed using a) urinary mercury concentration (UHg); b) the total number of amalgam surfaces; and c) the number of occlusal amalgam surfaces. Linear regression analysis was used to estimate associations between each marker of mercury exposure and each neuropsychologic test, adjusting for potential confounding variables. Exposure levels were relatively low. The mean UHg was 1.7 microg/g creatinine (range, 0.09-17.8); the mean total number of amalgam surfaces was 10.6 (range, 0-46) and the mean number of occlusal amalgam surfaces was 6.1 (range, 0-19). No measure of exposure was significantly associated with the scores on any neuropsychologic test in analyses that adjusted for the sampling design and other covariates. In a sample of healthy working adults, mercury exposure derived from dental amalgam restorations was not associated with any detectable deficits in cognitive or fine motor functioning. [ABSTRACT FROM AUTHOR]

Objective: To examine the pharmacokinetics of omeprazole during intravenous infusion in patients with varying degrees of liver dysfunction (Child-Pugh categories A to C).Design: Nonblinded single-period study.Patients: Thirteen patients, five males and eight females with a mean age of 59 years and proven hepatic cirrhosis, classified according to Child-Pugh criteria as A (n = 5), B (n = 4) or C (n = 4).Methods: Each patient received an 80mg bolus of omeprazole over 30 minutes followed by a continuous infusion of 8 mg/h for 47.5 hours. Blood samples were taken frequently throughout the infusion and during the subsequent 24-hour washout period for determination of omeprazole and its metabolites. Laboratory screening was also performed at the start of the study, after 72 hours and at the 14 day follow-up visit.Results: Data were evaluable for 12 patients. For omeprazole, the mean total area under the plasma concentration-time curve (AUC) was 286.5 micromol x h/L, peak plasma concentration was 14.9 micromol/L and terminal elimination half-life was 4.1 hours; these values were higher than those observed historically in control patient populations. Concentrations of the metabolite omeprazole sulphone were also increased, but there was a decrease in concentrations of hydroxy-omeprazole. Deviations from normal values increased with increasing disease severity for all parameters. For example, in patients with liver dysfunction of Child-Pugh categories A, B and C, AUC(48 )was 240.8, 280.4 and 323.3 micromol x h/L compared with 151.3 micromol x h/L in the historical control population. Despite its altered pharmacokinetics, omeprazole was not associated with any serious or untoward effects.Conclusion: Exposure to omeprazole following intravenous administration was higher in patients with liver dysfunction than in the normal population. However, even in patients with severely impaired liver function, the omeprazole plasma concentration did not change by more than 100% and the drug was well tolerated. [ABSTRACT FROM AUTHOR]

Objectives: Esomeprazole is the first proton pump inhibitor developed as an optical isomer. The aim of this study was to assess the potential effects of this agent on the electrocardiogram (ECG) in healthy volunteers. Study Participants and Methods: A pooled analysis was performed of 82 healthy male and female volunteers who received esomeprazole 40mg once daily in phase I open-label studies. 12-lead ECG recordings were completed at an initial screening visit (baseline) and at 1.5 and 3 hours postdose following esomeprazole administration for 5 to 7 days. The ECG recordings were interpreted by independent cardiologists blinded to the participants' drug treatment status. Participants were not allowed to have any concomitant medication. Results: At both 1.5 and 3 hours postdose, mean changes in QT and QTc intervals were small, and there was no clinically meaningful shift in the population means. Mean QTc interval showed a slight decrease overall. For all participants, absolute interlead dispersion was well within the tolerability margin of 100msec. No abnormal T or U waves, arrhythmias or other abnormalities were noted. Esomeprazole was well tolerated and there were no clinically relevant changes in tolerability variables. Conclusions: In this study of 82 healthy young individuals, esomeprazole, at a dose of 40mg, did not exhibit clinically relevant electrocardiographic effects. [ABSTRACT FROM AUTHOR]

Alkaline phosphatase (EC 3.1.3.1 ) in developing teeth and in bone has been studied. Prior to hard tissue function a rather high enzyme activity was noted in differentiating odontoblasts, stratum intermedium, and outer enamel epithelium. A lower activity was observed in the cells of the dental papilla and stellate reticulum. After the onset of hard tissue formation the alkaline phosphatase activity was generally increased. Enzyme activity was also found in the proximal part of tall, secretory ameloblasts. In the short post-secretory ameloblasts a high enzyme activity was noted. At the onset of dentin mineralization there was an increase in enzyme activity in the cells of the subodontoblastic layer. In bone the highest alkaline phosphatase activity was found in osteoblasts. A difference was noted between the alkaline phosphatase of hard and soft tissues by means of the addition of inhibitors to the incubation media. Within the hard tissues it was possible to distinguish between two alkaline phosphatases after pretreatment with heat (56°C) or the addition of specific inhibitors (sodium metavandate, ortho-and pyrophosphate). An isoenzyme which was sensitive to these procedures was demonstrated in odontoblasts and in the pulpal connective tissue. Another alkaline phosphatase isoenzyme, which was resistant to pretreatment with heat or the addition of vanadate or phosphate, was demonstrated in the subodontoblastic cell layer, stratum intermedium and the outer cells of the reduced enamel epithelium. [ABSTRACT FROM AUTHOR]

A biologically acceptable closure of the apical part of the root canal prior to the filling of the canal proper would facilitate the sealing of the canal without overfilling. It would also act as a barrier protecting the periapical tissues from harmful components of the root filling material. A pulpectorny method with allogenic dentine chips packed in the canal to form a plug in contact with the extirpation wound, has been described in this article. The purpose of the present study was to assess the clinical and radiological long term results after pulpectomy and root canal obturation according to the dentine chips technique.

Temporary restorations are used between endodontic appointments for sealing the access cavity in order to preclude infection of the pulp tissue or the debrided canal. Therefore, the sealing qualities of temporary filling materials are of primary importance in endodontic therapy. Many studies have been related to the cytotoxicity of zinc oxide-eugenol cement, but few studies seem to have dealt with the cytotoxicity of other commonly used temporary filling materials. The purpose of this study was to evaluate the cytotoxicity of temporary filling materials by a test method recommended in the document of the Fédération Dentaire Internationale, the millipore filter method.

Objective: To study long and short term survival in patients aged 60 years or over admitted with a peptic ulcer bleeding and find out which factors influence outcome. Design: Cohort study with matched controls. Setting: Two emergency hospitals, Sweden Patients: 676 of the 687 patients aged 60 years or over admitted to the two emergency hospitals serving Gothenburg, Sweden during 1989–1993 who fulfilled the diagnostic criteria and whose case notes were available for study. Main outcome measures: Seven year survival rates and odds ratios for risk factors based on multiple logistic regression analyses. Results: 37 patients died and the timing was evenly distributed within the first 30 days of admission with a cumulated case-fatality rate of 5.5% at day 30. Mortality was increased among the patients compared with the control group during the subsequent years. Factors that influenced day 30 mortality were age and Forrest class. Conclusion: Mortality is increased among patients with peptic ulcer bleeding even long after the event. Old age and signs of recent haemorrhage increase the risk. [ABSTRACT FROM AUTHOR]

Eleven patients with lunatomalacia were treated by excision of the lunate and instillation of liquid silicone. The silicone vulcanised and formed an in-situ molded prosthesis. The patients were re-examined after a mean of 7.1 years. Four patients were pain-free and two had pain only at work; three had not been improved by the operation and two had undergone arthrodesis. The patients with good results all belonged to group IV pre-operatively. Surprisingly, no patient showed any sign of silicone synovitis, although all the prostheses except one had either fractured or deformed. The reasons for this are discussed and the indications for the operation established. [ABSTRACT FROM PUBLISHER]