bluuebunny/crossref_metadata_2025 huggingface dataset:
Disparate Geography of Consumption, Production, and Environmental Impacts
Authors: Ståhls Monika H. , Mayer Audrey L. , Tikka Päivi M. , Kauppi Pekka E.
Published: August 2010

International trade transfers social and environmental impacts across national borders. The consumption of forest products often takes place far away from industrial production sites, and mills procure raw material from remote forests. Finland produces about 10% of forest products that are traded internationally, with the majority of its exports destined for other European countries. Here we report and analyze data that demonstrate that international leakage, in relative terms, increased faster than the production of commodities. The international consumption of products made in Finland increased, and an increase in wood imports from Russia provided the raw material for most of the incremental production. The international consumption‐production system translated the increasing global demand for Finnish products into increased harvests in Russia, until the Russian customs duties started to increase in 2007. We argue that national and regional policies for the promotion of sustainable consumption and production must be analyzed and assessed from an international, holistic perspective.
Embodied Resource Flows and Product Flows
Authors: Duchin Faye , Levine Stephen H.
Published: August 2010

We develop the absorbing Markov chain (AMC) for describing in detail the network of paths through an industrial system taken by an embodied resource from extraction through intermediate products and, finally, consumer products. We refer to this as a resource‐specific network. This work builds on a recent literature in industrial ecology that uses an AMC to quantify the number of times a resource passes through a recycling sector before ending up in a landfill. Our objective is to incorporate into that analysis an input‐output (IO) table so that the resource paths explicitly take account of the interdependence of sectors through their reliance on intermediate products. This feature makes it possible to track multiple resources simultaneously and consistently and to represent both resources and products in mixed units. Hypothetical scenarios about technological changes and changes in consumer demand are analyzed with an IO model, and model solutions generate the AMC database. A numerical example is provided. We identify the three most critical enhancements to the standard IO model that will be needed for analyzing material cycles: the incorporation of waste‐processing sectors, stock and flow relationships, and international trade. The idea is to implement an AMC after each modeling step for analyses, such as tracking a resource extracted in one region to landfills in other regions and evaluating ways to intensify secondary recovery at key junctures in between.
Policy Strategies to Promote Eco‐Innovation
Authors: del Río Pablo , Carrillo‐Hermosilla Javier , Könnölä Totti
Published: August 2010

This article elaborates an integrated policy framework, including policy features and specific measures that can be implemented to mitigate the barriers to eco‐innovations. We claim that factors inhibiting the development and uptake of eco‐innovations are multifaceted and stem from different sources. This systems view, which highlights the multilayered conception of the obstacles to eco‐innovation, calls for a combination of environmental and technology policies adapted to the different barriers and characteristics of the technologies. Drawing on evolutionary economics, the article sheds light on the appropriate combinations of framework conditions and instruments that are most effective to promote eco‐innovation, considering different barriers and eco‐innovation types (process/product, mature/immature, and radical/incremental).
Antibody responses of Porphyromonas gingivalis infected gingivitis and periodontitis subjects
Authors: Gemmell E , Polak B , Reinhardt RA , Ecclestod J , Seymour GJ
Published: August 2010

Porphyrornonas gingivalis demonstrates a strong association with adult periodontitis although some individuals with the infection do not experience attachment loss. Therefore differences in the immune response to this organism may be of importance to the outcome of the disease.

OBJECTIVE: The aim of this study was to determine whether P. gingivalis positive subjects with and without periodontal breakdown, reacted differently to P. gingivolis antigens as assessed by the pattern of serum antibody reactivity.

MATERIALS AND METHODS: Two highly defined groups Of subjects were chosen for this study. Both demOnstrated p gingivalis in their plaque and both had responded to P. gingivolis as shown by the presence of serum antibodies* The two groups differed only in their apparent clinical susceptibility to periodontal breakd˜wn. Western blots of P. gingivolis membrane antigens were probed with sera from the two groups to determine their reactivity to specific antigens.

RESULTS: Analysis Of the immunoblots showed that there were no differences in either the total numbers of bands, Or bands recognized by the majority Of subjects in the gingivitis and adult periodontitis groups. There were however, four bands recognized by the majority of the gingivitis group and not by the majority Of the adult periodontitis group, there being a significant difference (P = 0.03) in the recognition of the 91.4‐kDa antigen band* A further five antigens Of lower molecular weight were seen by the majority of the adult periodontitis group and not by the majority of the gingivitis group. When sera were tested against purified p*gingivalis Lps, the results indicated that the five antigens seen by the majority Of the adult periodontitis group had molecular weights which were in the range exhibited by the Lps antigens. CONCLUSION: These results suggest that gingivitis and adult periodontitis subjects with P. gingivalis infection, may recognize different P. gingivalis antigens.
Effect of aluminum concentration on dental caries formation in the rat
Authors: Putt MS , Kleber CJ
Published: August 2010

OBJECTIVE: Topically applied aluminum (AI) reduced fissure caries in rats with indigenous microflora, but neither therapeutic activity nor concentration effects have been studied in animals infected with caries‐inducing bacteria. This study investigated the effects of solutions containing various Al concentrations on formation of smooth surface and sulcal caries in cariogenically challenged rats infected with Streptococcus sobrinus.

METHODS: Weanling rats, inoculated with S. sobrinus, were randomly assigned to six groups which were topically treated twice daily with water (treatment control), a NaF solution of 100 parts/106 F (positive control), or AIK(SO4)2 solutions containing 100, 1000, 2000, or 4000 parts/106 Al. Rats were fed a high‐sucrose diet and distilied water ad libitum for 10 weeks, then the molars were scored for enamel and dentin caries.

RESULTS: Relative to the water control, NaF and all Al solutions significantly reduced prevalence of both smooth‐surface and fissure caries. Protection by Al solutions was greater on smooth surfaces than sulcal areas. Al treatments reduced smooth surface scores by 49–7I% and sulcal scores by 27–53%. For all comparisons the protective effect of the 100 parts/106 Al solution was less than solutions containing 1000 parts/106 Al or more. NaF and all Al solutions also significantly reduced the extent of lesion penetration into dentin.

CONCLUSIONS: Topically applied AI reduced the formation and progression of both smooth surface and Sul. cal caries and showed evidence of a dose response in a rat model infected with S. sobrinus.
Transforming growth factor‐β I coated β‐tricalcium phosphate pellets stimulate healing of experimental bone defects of rat calvariae
Authors: Okuda K , Nakajima Y , Irie K , Sugimoto M , Kabasawa Y , Yoshie H , Hara K , Ozawa H
Published: August 2010

OBJECTIVE: TGF‐β I‐coated β‐TCP pellets were grafted in experimental defects of rat calvariae to study the effects on new bone formation.

MATERIALS AND METHODS: The grafted sites were evaluated by light microscopy using hematoxylin‐eosin (H‐E) staining for histology and detection of alkaline phosphatase (ALPase) and tartrate‐resistant acid phos‐phatase (TRACPase) activities to demonstrate osteo‐blastic and osteoclastic cells. Confocal laser scanning microscopy (CLSM) was performed for morphometry of newly formed bone.

RESULTS: The sections showed more new bone formation in sites grafted with TGF‐β I ‐coated β‐TCP pellets (experimental sites) than those with β‐TCP pellets only (control sites). TRACPase‐positive and ALPase‐positive cells at experimental sites were more frequent than at control sites. The bone formation rate calculated by computerized CLSM pixel image analysis showed more new bone formation at the experimental sites than at control sites (3.4 ± 0.8% vs 9.3 ± 1.7% on week 2 and 11.8 ± 2.1% vs 39.8 ± 10.9% on week 4).

CONCLUSION: TGF‐P β I ‐coated β‐TCP pellets promote new bone formation and may be a useful modality in synthetic bone grafting.
Cellular immunity and hypersensitivity as components of periodontal destruction
Authors: Seymour GJ , Gemmell E , KjeIdsen M , Yamazaki K , Nakajima T , Hara K
Published: August 2010

BACKGROUND: Cellular immunity has been implicated in periodontal destruction for over 25 years. Studies in the 1970s used lymphocyte transformation and lympho‐kine assays to establish a role for cell‐mediated mechanisms in periodontal disease. lmmunohistological studies subsequently showed that the formation of gingivitis followed a similar pattern to the formation of a delayed type hypersensitivity reaction. Further functional studies suggested that a T cell/macrophage immunoregulatory imbalance may exist locally in the periodontitis lesion and that this imbalance may be antigen specific. RECENT EVIDENCE: More recently, T cell subsets have been dichotomised on the basis of their cytokine profiles. In general, Thl cells produce IL‐2 and IFN‐gamma while Th2 cells produce IL‐4, IL‐5 and IL‐6. The major function of Th l cells is to mediate delayed type hypersensitivity. In contrast the major function of Th2 cells is to provide B cell help.

HYPOTHESIS: A model for periodontal disease has now been developed based on this functional dichotomy which provides a framework for the study of cytokine profiles in periodontal disease. Early studies in this context have demonstrated a higher proportion of IL‐4 producing cells in periodontitis tissues suggesting a role for Th2 cells in the progressive lesion. Clonal studies have shown that the selection of a particular cytokine profile is not antigen dependent and that differences may be due to the host susceptibility although this remains to be determined.

CONCLUSION: These emerging data clearly establish a role for cell‐mediated mechanisms in the control of periodontal destruction and raise the possibility that in the future cytokine therapy for the treatment of periodontal disease in susceptible subjects may become a viable option.
In situ localization of cell synthesis and proliferation in periodontitis gingiva and tonsillar tissue
Authors: Takahashi K , Lappin D , Kinane DF
Published: August 2010

OBJECTIVE: Previous work indicates that large numbers of B and T cells accumulate in the periodontal soft tissues although we know little about cellular synthetic activity and proliferation at this site. The aim of this study was to examine lymphocytic cell synthetic activity and proliferation in periodontitis gingiva and compare this to a known site of leucocyte proliferation, namely the oro‐pharyngeal tonsils.

MATERIALS AND METHODS: Messenger RNA (mRNA) and 285 ribosomal RNA (285 rRNA) expressing cells in formalin‐fixed/paraffin‐embedded gingival and tonsillar tissue sections were detected by in situ hybridisation (ISH) using poly‐deoxyribothymidine and 28S probes respectively. In addition S‐phase proliferating and cycling cells were also detected by ISH with histone probes and by Ki‐67 immunohistochemistry. Ten gingival biopsy samples were obtained from adult periodontitis patients and five tonsillar biopsies from tonsillectomy patients. RESULTS: Both mRNA and 28S rRNA‐expressing cells were detected in all the samples tested. Plasma cells showed the strongest signal for the two probes and slight to moderate staining could be seen in epithelium, fibroblasts and endothelial cells. In contrast, gingival lymphocytes were either weakly stained or were unstained for these probes of synthetic activity. In tonsils, most lymphocytes in germinal centres showed moderate staining and mantol zone cells were much more weakly stained. In gingival samples, histone mRNA‐expressing and cycling (Ki‐67) cells were detected in 4/10, 10/10 cases respectively. These positive cells were mainly basal and suprabasal epithelial cells and a few mononuclear cells, whereas most germinal centre lymphocytes (B cells) were positive for this probe. The number of Ki67 positive cells was greater than histone mRNA bearing cells both in gingiva and tonsillar tissue. In contrast, mantol zone cells (mainly T cells) were sparsely stained by probes of cell proliferation.

CONCLUSION: These results indicate that local proliferation of B cells does not occur in periodontitis gingiva in contrast with tonsillar tissue, although plasma cells showed strong synthetic activity in both tissues. T cells did not appear to proliferate greatly nor undergo active synthesis in either of these tissues. These findings substantiate previous hypotheses that specific leucocytes predominate in the gingival tissue through selective homing rather than by local proliferation.
Pigmented lateral periodontal cyst and other pigmented odontogenic lesions
Authors: Buchner A. , David R , Carpenter W , Leider A
Published: August 2010

OBJECTIVE: To report a case of lateral periodontal cyst (LPC) with marked melanin pigmentation in a 38‐year‐old Black male and to discuss the phenomenon of melanin pigmentation in odontogenic cysts and tumors.

RESULTS: Histologically, the epithelial lining of the LPC contained an abundant amount of melanin granules throughout the entire epithelium. Ultrastructurally, epithelial cells contained mature melanosomes (stage IV melanosomes). Melanophages containing aggregates of melanosomes were identified in the connective tissue cyst wall. Perusal of the literature revealed that melanin pigmentation in odontogenic lesions is uncommon. Melanin has been reported in calcifying odontogenic cyst (18 cases), odontogenic keratocyst (8 cases), adenomatoid odontogenic tumor (3 cases), ameloblastic fibroma (3 cases), odontoma (2 cases), and amelobastic fibro‐odon‐toma, odonto‐ameloblastoma, and odontogenic fibroma (I case each).

CONCLUSIONS: Almost all pigmented odontogenic lesions occurred in Blacks and Asians; they are almost non‐existent in Whites. Thus, racial pigmentation probably plays an important role in such lesions.
The frequency of fungal infection in biopsies of oral mucosal lesions
Authors: Barrett AW , Kingsmill VJ , Speight PM
Published: August 2010

OBJECTIVE

To determine the frequency of fungal infection in biopsies of oral mucosal lesions.

MATERIALS AND METHODS: Histopathology reports issued between 1991–1995 inclusive were reviewed. During this period, a single section of each mucosal biopsy had been stained using the periodic acid‐Schiff (PAS) technique.

RESULTS: A total of 223 (4.7%) biopsies contained PAS‐positive fungi: 191 individuals were affected, 124 (64.9%) of whom were male. There was a significant (P < 0.01) positive association of fungal infection with moderate and severe epithelial dysplasia, median rhomboid glossitis and squamous papillomas. Where a subsequent biopsy was available, 21.9% dysplasias which were infected with fungi worsened in histological severity, as compared with 7.6% of dysplasias which were not infected at any stage. There was a significant negative association of fungal infection with benign fibrous overgrowths (P < 0.01), benign hyperkeratoses, lichenoid reactions and pyogenic granulomas (P < 0.05). The difference in frequency of infection between the tongue and other sites was also significantly higher (P < 0.01).

CONCLUSIONS: There is a statistically significant association between histologically‐determined fungal infection and epithelial dysplasia, and we recommend that a PAS stain be performed whenever oral epithelial dysplasia is diagnosed, especially in male patients. On histological confirmation of dysplasia, anti‐fungal therapy should be considered in the management of these lesions.
Medication induced gingival overgrowth
Authors: Marshall RI , Bartold PM
Published: August 2010

A number of idiopathic, pathological and pharmacological reactions may result in an overgrowth of the gingiva. This review concentrates on those overgrowths associated with various pharmacological agents. The pharmacokinetics and side effects of each drug associated with gingival overgrowth are discussed along with the clinical and histological features and treatment. By examining the possible pathogeneses for these overgrowths we propose a unifying hypothesis for the causation based around inhibition of apoptosis and decreased collagenase activity modulated by cytoplasmic calcium.
Malignant peripheral nerve sheath tumour in the maxilla associated with von Recklinghausen's disease
Authors: Muraki Y , Tateishi A , Tominaga K , Fukuda J , Haneji T , Iwata Y
Published: August 2010

Malignant transformation of neurofibromatosis is one of the most serious complications of von Recklinghausen's disease (VRD). The most common associated malignancy is the malignant peripheral nerve sheath tumour (MPNST). Few cases of MPNST associated with VRD in the maxillary region have been reported. This report describes a rare case of MPNST in the maxilla and the aggressive nature of MPNST associated with VRD.
A case of Burkitt's lymphoma that presented initially with resorption of alveolar bone
Authors: Mitsudo K. , Tohnai I. , Hayashi Y. , Ueda M. , Yambe M. , Hirose Y.
Published: August 2010

A 16‐year‐old male was evaluated for a 1‐month history of alveolar bone resorption, which had been treated with endodontics by a neighborhood dentist. Intraoral examination showed slight gingival swelling and teeth mobility. However, no tumor mass was seen. The panoramic image showed resorption of alveolar bone and loss of teeth lamina dura. Because he complained of general fatigue, he was introduced to the internist. Biopsies of gingiva and bone marrow aspiration revealed a massive proliferation of lymphoblasts expressing CD10, 19, 20 and HLA‐DR antigens on the surface. Their karyotypes were abnormal; 46, XY, t (8;14) (q24;q32).Accordingly, he was diagnosed as Burkitt's lymphoma, and received intensive chemotherapy which relieved his symptoms and decreased his tumor. However, his disease soon became refractory to chemotherapy, and he died 11 weeks after the onset.
Clinical Oral Medicine: The clinical assessment of oral dryness is a significant predictor of salivary gland hypofunction
Authors: Longman LP , McCracken CFM , Higham SM , Field EA
Published: August 2010

OBJECTIVES: To compare subjective complaints of xerostomia and salivary gland dysfunction and a clinical assessment of oral dryness with an objective measurement of salivary gland dysfunction, in a group of UK patients attending a Dry Mouth Clinic. The aim of the study was to identify signs and symptoms that may be of predictive value for salivary gland hypofunction (SGH) in clinical practice

METHODS: This prospective study investigated 214 patients who attended a Dry Mouth Clinic, held at Liverpool University Dental Hospital. Patients gave a history of xerostomia for a minimum of 6 months and were asked standardised questions to subjectively assess oral dysfunction. The oral mucosa was then clinically assessed for dryness and sialometry was performed. Unstimulated whole saliva flow rates (UFR) of <0.2 ml min‐1 were considered to be indicative of SGH.

RESULTS: One or more symptoms of oral dysfunction were reported in 178 (83%) patients, in addition to xerostomia. The clinician diagnosed oral dryness in 105 patients. Objective evidence of SGH was found in 125 (58%) of patients. The clinicians' subjective assessment of oral dryness was indicative of a reduced UFR (P < 0.0001) and a significant predictor of an UFR 0.2 ml min 1 using logistic regression analysis (odds ratio 9.6; 95% CI 4.8 and 19.3). The mean UFR of patients who reported symptoms of oral dysfunction was significantly lower than the mean UFR of patients who reported no oral dysfunction. Using logistic and multiple regression analyses, symptoms of oral dysfunction were not found to be significant predictors of either an UFR <0.2 ml min 1 or a reduced UFR.

CONCLUSIONS: The clinical assessment of oral dryness was a significant predictor of SGH, in this selected group of patients. Patients who complain of xerostomia may have additional symptoms of oral dysfunction indicative of a reduced UFR.
Periodontal Disease: Papillon‐Lefèvre syndrome: analysis of HLA antigens
Authors: Nitta H , Kato H , Umeda M , Kuwata S , Ishikawa I
Published: August 2010

OBJECTIVES: Papillon‐Lefèvre syndrome (PLS) is a rare disease associated with prepubertal periodontitis. Our previous studies demonstrated that three unrelated patients with PLS showed the similar antigen‐specific immune responses to Actinobacillus actinomycetemcomitans. The initiation of antigen‐specific immune responses was involved with human leukocyte antigens (HLA) on antigen‐presenting cells. The aim of this study was to examine HLA haplotypes in the three patients with PLS.

SUBJECTS AND METHODS: The three PLS patients, their mothers and the father of one patient participated in this study. HLA class I and class II antigens were determined serologically and DNA typing for DRB1 and DQB1 was performed using the restriction fragment length polymorphism‐polymerase chain reaction method.

RESULTS: The distribution of serologic HLA haplotypes, in two of three patients, was found to be quite similar. The DNA typing revealed that DRB1*0406, DRB1*08032, DQB1*0302, DQB1*06011 genotypes were shared in the two patients. The probability of sharing these four DNA types in unrelated individuals was nearly 1:40,000 in the Japanese population.

CONCLUSION: Our results suggest that HLA antigen may be included as a possible host factor in the pathogenesis of PLS and that a genetically controlled immune response may account for an increased susceptibility to periodontal infection.
Dental Practice: Practices of Maryland dentists: oral cancer prevention and early detection ‐ baseline data from 1995
Authors: Horowitz AM , Drury TF , Canto MT
Published: August 2010

OBJECTIVES: To investigate practices and opinions of general dentists in Maryland, USA, related to oral and pharyngeal cancer prevention and early detection.

DESIGN AND METHODS: A pre‐tested, 34‐item questionnaire, cover letter and addressed, stamped envelope were mailed in the summer, 1995, to a simple random sample of 800 members and non‐members of the American Dental Association practicing in Maryland. A reminder postcard was sent 3 weeks after initial mailing; a second complete mailing to all non‐respondents 6 weeks after first mailing.

RESULTS: Over 90% of dentists asked about patient's current use of tobacco but only 77% assessed patient's history of tobacco use and types and amounts used. Fewer (66%) asked about present use of alcohol. Ninety percent reported providing an oral cancer examination at the initial appointment for patients 40 years of age or older; only 6% provided the examination for edentulous patients and only 40% reported palpating lymph nodes of patients 80% or more of the time.

CONCLUSIONS: Dentists' reporting on providing oral cancer examinations and taking appropriate health histories are disappointing. These results call for comprehensive educational interventions in terms of changes in dental curricula and as continuing education courses especially since most dentists were interested in continuing education courses on oral cancer prevention and early detection.
Effects of antibodies to glucosyltransferase on soluble and insolubilized enzymes
Authors: Wunder D , Bowen WH
Published: August 2010

OBJECTIVE: Previous studies have shown that glucosyl‐transferase enzymes (Gtfs) of Streptococcus mutans adsorbed to saliva coated hydroxyapatite (sHA) have distinct properties from the same enzymes in solution. The purpose of the present study was to determine the effects on enzyme activity of polyclonal antibodies raised to Gtfs in a soluble form and bound to sHA.

MATERIALS AND METHODS: Antiserum was raised in six New Zealand White rabbits using the purified glucosyl‐transferase enzymes (Gtfs) of S. mutans, GtfB, GtfC, or GtfD as soluble antigens or adsorbed to hydroxyapatite (HA, insolubilized). The antisera were examined for their ability to react to these Gtfs and Gtf from Streptococcus sanguis (GtfSs) in Western blot formats as well as inhibit enzyme activity in solution and insolubilized.

RESULTS: Antibodies raised against GtfB or GtfC detected all Gtf enzymes examined in Western blots; antibodies raised to GtfD reacted strongly to GtfD and GtfSs, poorly to GtfC, and was non‐reactive with GtfB. Antibodies to GtfB or GtfC inhibited activity of GtfB and GtfC in solution by 90% or more. Enzyme activity adsorbed to sHA was inhibited from 70% to 80% by the same antisera. These same antibodies possessed no specific effect on the activities of either GtfD or GtfSs. Antibodies raised to the GtfD enzyme inhibited activity of GtfD (80% to 90% inhibition) and GtfSs activity (50% to 80%) in solution. In contrast the GtfD antibodies had no effect on the activity of either GtfB or GtfC enzymes in solution. Modest inhibitory effects were noted on GtfC and GtfSs enzymes bound to sHA, but no inhibition was observed for sHA‐bound GtfB or GtfD.

CONCLUSION: These data show that some antibodies effective against enzymes in solution may have significantly lesser inhibitory effects against the same enzymes insolubilized. Further, presentation of Gtf antigen immobilized to HA has only a minor influence on the production of antibodies inhibitory to Gtf activity.
Structure‐activity relationships of sialogogic heptapeptides analogous to physalaemin
Authors: Gao C , Abe K
Published: August 2010

OBJECTIVES: The rationale behind this study was to determine in detail which amino acids in physalaemin are crucial to its sialogogue activity, with a view of synthesizing new sialogogues which might be of use in the treatment of dry mouth.

METHODS: With the progressive elimination of amino acids, one by one, from the C‐ and N‐terminal regions, 126 heptapeptides were newly synthesized by the multi‐pin peptide method, for comparison with 11 naturally occurring tachykinins.

RESULTS: The C‐terminal amide in position 11 was essential for salivation, but not the pyrolidine group or the N‐terminal amino acid residues in positions 1 to 4. In 18 heptapeptides in which M in position 11 (M11) was replaced by another amino acid, one by one, none caused salivation. In 18 heptapeptides, in which L10or G9was replaced, three peptides caused salivation but none had significantly increased secretory activities. In 18 hepta‐peptides in which Y8was replaced, four caused salivation but only one (I) had significantly increased secretory activity. In 18 heptapeptides in which F7was replaced, only Y caused salivation but with significantly reduced secretory activity. In contrast, in 18 heptapeptides in which K6and N5were replaced, most caused salivation and some of them had significantly increased secretory activities.

CONCLUSIONS: It is concluded that the sequence FYGLM‐NH2conserved in the C‐terminal region of phys‐alaemin is optimal, that amides in position 11 and F7are very important for salivation, but that K6and N5can be replaced by some other amino acids, resulting in increased secretory activities.
Immediate Loading of the Maxilla with Prefabricated Interim Prosthesis Using Interactive Planning Software, and CAD/CAM Rehabilitation with Definitive Zirconia Prosthesis: 2‐Year Clinical Follow‐up
Authors: PAPASPYRIDAKOS PANOS , LAL KUNAL
Published: August 2010

Immediate loading in implant dentistry has provided several advantages for both patients and clinicians. Recent advances in computer‐aided design/computer‐aided manufacturing (CAD/CAM) technology, medical imaging and rapid prototyping have added to the armamentarium of implant dentistry in terms of efficiency, accuracy and predictability. Rapid prototyping and CAD/CAM technology are used to fabricate stereolithographic surgical templates for flapless implant placement. In addition to that, this technology is also used for the fabrication of zirconia frameworks. The zirconia‐based implant restorations are gaining popularity in implant prosthodontics combining esthetic properties with strength and biocompatibility. The purpose of this article is to illustrate the steps for implant rehabilitation of the edentulous maxilla with zirconia prosthesis and report the 2‐year clinical follow‐up of novel technological advances in surgical placement, provisionalization and fabrication of a definitive restoration.

CLINICAL SIGNIFICANCE

A comprehensive approach to full mouth implant rehabilitation using cutting edge technology is illustrated in a simplified manner.

(J Esthet Restor Dent 22:223–234, 2010)
Morphologic Texture Characterization Allied to Cigarette Smoke Increase Pigmentation in Composite Resin Restorations
Authors: MATHIAS PAULA , COSTA LEONARDO , SARAIVA LETÍCIA OLIVEIRA , ROSSI THAIS ARANHA , CAVALCANTI ANDREA NÓBREGA , DA ROCHA NOGUEIRA‐FILHO GETÚLIO
Published: August 2010

Statement of the Problem:  The staining effect of tobacco smoke on resin color is clinically observed. However, there is no evidence determining whether this staining is increased on texturized surfaces or if the color change is superficial and can be removed by repolishing procedures.

Objective:  To evaluate the effect of tobacco smoke on the color of a composite with smooth or texturized surfaces, before and after repolishing.

Materials and Methods:  Forty composite specimens were allocated into four groups (N = 10): Smooth surface not exposed (G1) and exposed to tobacco smoke (G2), texturized surface not exposed (G3), and exposed to tobacco smoke (G4). During 21 days, G2 and G4 were daily exposed to the smoke from 20 cigarettes. Color measurements were carried out at baseline, after 21 days, and after repolishing. Variables L* (luminosity), b* (blue‐yellow), and ΔE (total color change) were statistically analyzed (repeated measures analysis of variance/Tukey).

Results:  Texturized and smooth specimens presented similar luminosity at baseline. Tobacco smoke significantly reduced L* in G2 and G4, and increased b* in G4. After repolishing, L* increased and b* reduced in stained groups, but values continued to be different from baseline ones. Repolishing significantly reduced ΔE, but values from stained groups were still greater than that from unstained groups.

Conclusion:  Tobacco smoke changes the color of composite, and surface texture can increase the staining. Repolishing reduces superficial staining, but this procedure may not return the composite to baseline color.

CLINICAL RELEVANCE

Smokers that will receive anterior composite restorations should be warned about the negative cosmetic effect of the smoking habit on the color of restorations.

(J Esthet Restor Dent 22:252–261, 2010)
Bond Strength of Two Resin Cements on Dentin Using Different Cementation Strategies
Authors: MARQUES MELO RENATA , ÖZCAN MUTLU , BARBOSA SILVIA HELENA , GALHANO GRAZIELA , AMARAL REGINA , BOTTINO MARCO ANTONIO , VALANDRO LUIZ FELIPE
Published: August 2010

Purpose:  This study evaluated the microtensile bond strength of two resin cements to dentin either with their corresponding self‐etching adhesives or employing the three‐step “etch‐and‐rinse” technique. The null hypothesis was that the “etch‐and‐rinse” adhesive system would generate higher bond strengths than the self‐etching adhesives.

Materials and Methods:  Thirty‐two human molars were randomly divided into four groups (N = 32, n = 8/per group): G1) ED Primer self‐etching adhesive + Panavia F; G2) All‐Bond 2 “etch‐and‐rinse” adhesive + Panavia F; G3) Multilink primer A/B self‐etching adhesive + Multilink resin cement; G4) All‐Bond 2 + Multilink. After cementation of composite resin blocks (5 × 5 × 4 mm), the specimens were stored in water (37°C, 24 hours), and sectioned to obtain beams (±1 mm2 of adhesive area) to be submitted to microtensile test. The data were analyzed using 2‐way analysis of variance and Tukey's test (α = 0.05).

Results:  Although the cement type did not significantly affect the results (p = 0.35), a significant effect of the adhesive system (p = 0.0001) was found on the bond strength results. Interaction terms were not significant (p = 0.88751). The “etch‐and‐rinse” adhesive provided significantly higher bond strength values (MPa) with both resin cements (G2: 34.4 ± 10.6; G4: 33.0 ± 8.9) compared to the self‐etching adhesive systems (G1: 19.8 ± 6.6; G3: 17.8 ± 7.2) (p < 0.0001). Pretest failures were more frequent in the groups where self‐etching systems were used.

Conclusion:  Although the cement type did not affect the results, there was a significant effect of changing the bonding strategy. The use of the three‐step “etch‐and‐rinse” adhesive resulted in significantly higher bond strength for both resin cements on dentin.

CLINICAL SIGNIFICANCE

Dual polymerized resin cements tested could deliver higher bond strength to dentin in combination with “etch‐and‐rinse” adhesive systems as opposed to their use in combination with self‐etching adhesives.

(J Esthet Restor Dent 22:262–269, 2010)
Efficacy and Safety of Tadalafil 20 mg on Demand vs. Tadalafil 5 mg Once-a-Day in the Treatment of Post-Radiotherapy Erectile Dysfunction in Prostate Cancer Men: A Randomized Phase II Trial
Authors: Ricardi Umberto , Gontero Paolo , Ciammella Patrizia , Badellino Serena , Valentino Franco , Munoz Fernando , Guarneri Alessia , Rondi Nadia , Moretto Francesco , Filippi Andrea Riccardo , Ragona Riccardo , Tizzani Alessandro
Published: August 2010

Introduction

The role of phosphodiesterase type 5 inhibitors in the treatment of post-radiotherapy erectile dysfunction (ED) has not been extensively investigated.

Aim

To compare the efficacy and safety of on-demand 20-mg tadalafil (arm A) with the newly released tadalafil 5-mg once-a-day dosing (arm B) in patients with ED following radiotherapy for prostate cancer (PC).

Methods

Randomized study to receive on-demand 20-mg or once-a-day 5-mg tadalafil for 12 weeks.

Main Outcome Measures

Changes in the International Index of Erectile Function (IIEF) domain scores and Sexual Encounter Profile (SEP) question 2 and 3 positive response rates.

Results

Fifty-two out of 86 screened patients were randomized. Forty-four patients were evaluable for efficacy. A significant improvement in all domains of the IIEF was observed in both arms (P = 0.0001) with mean erectile function domain scores values of 25 and 27.1 for the 20-mg and 5-mg tadalafil, respectively (P = 0.19). SEP 2 and 3 positive response rates increased from 0% in both arms at baseline to 81% and 70% in the 20-mg arm and 90% and 73% in the 5-mg arm, respectively, at the end of treatment (P = 0.27). End of treatment global efficacy question positive answers were 86% in the 20-mg arm and 95% in the 5-mg arm (P = 0.27). Higher treatment compliance was shown in arm B (100%) as compared with arm A (86%). There was a nonstatistically significant trend toward fewer side effects in favor of the 5-mg daily dose arm.

Conclusions

In the study population, both tadalafil formulations generated significantly high response rates according to the outcome measures and were well tolerated. The once-a-day 5-mg dosing showed higher compliance and marginally reduced side effects, thus making it an attractive alternative to on-demand therapy for ED in post-radiotherapy PC patients.
Progress in hematopoietic stem cell transplantation as allogeneic cellular gene therapy in thalassemia
Authors: Isgrò Antonella , Gaziev Javid , Sodani Pietro , Lucarelli Guido
Published: August 2010

Allogeneic hemopoietic stem cell transplantation (HSCT) represents one of the best cures for thalassemia. Currently, HSCT for thalassemia consists of allogeneic stem cell gene therapy and still awaits autologous genetically modified stem cell transplantation. HSCT for thalassemia has substantially improved over the last two decades, due in large part to improvements in preventive strategies, the effective control of transplant‐related complications, and the development of new preparative regimens. A risk classes‐based approach to transplantation in thalassemia has led to disease‐free survival probability of 87, 85, and 80% in classes 1, 2, and 3 patients, respectively. Adult thalassemia patients, who are higher risk patients for transplant‐related toxicity due to an advanced phase of the disease, have a cure rate of 65% with current treatment protocol. Patients who do not have matched family or unrelated donors could benefit from haploidentical mother‐to‐child transplantation. Overall, the results of this type of transplantation appear encouraging.
Pathogenesis and management of iron toxicity in thalassemia
Authors: Hershko Chaim
Published: August 2010

In thalassemia major, iron overload is the joint outcome of multiple blood transfusions and an inappropriately increased iron absorption associated with ineffective erythropoiesis. Threshold values for iron toxicity are a liver iron concentration exceeding 440 mmoles/g dry weight, serum ferritin >2500 ng/mL, DFO urinary iron excretion >20 mg/day, and transferrin saturation >75%. The outpouring of catabolic iron that exceeds the iron‐carrying capacity of transferrin results in the emergence of non‐transferrin‐bound iron (NTBI). NTBI is cleared preferentially by the liver and myocardium at a rate exceeding 200 times that of transferrin iron. NTBI catalyzes the formation of free radicals, resulting in oxidative stress and damage to mitochondria, lysosomes, lipid membranes, proteins, and DNA. The long‐term consequences of iron toxicity, including cirrhosis, myocardiopathy, and endocrine disorders, are preventable and mostly reversible by effective iron chelation therapy. Recent technologic advances in the documentation of organ‐specific siderosis and the improved efficiency of iron chelating programs resulted in a spectacular improvement in the prevention of iron‐induced end‐organ failure and improved survival in thalassemic patients.
Thalassemia as a global health problem: recent progress toward its control in the developing countries
Authors: Weatherall D.J.
Published: August 2010

The thalassemias, together with sickle cell anemia and its variants, are by far the most common monogenic diseases. They occur at their highest frequency in countries of the developing world where their control and management is hampered by a lack of knowledge of their true prevalence, adequate services for their management and control, and support by their governments and international health agencies. However, there has been some progress recently in addressing these problems and there are several ways in which the lot of children with thalassemia in poor countries could be improved in the future. Over the last 20 years there has been considerable improvement in the control and management of the thalassemias in the richer countries of the world. Unfortunately, however, this is not the case for many of the developing countries, where there have been few improvements in the control of the numbers of births of babies with thalassemia or in the care of thalassemic children since the frequency of the problem started to become evident in the 1960s. Here, I will try to assess the current situation in these countries and examine some of the potential approaches for improving the current situation.
Humanized mouse models of Cooley's anemia: correct fetal‐to‐adult hemoglobin switching, disease onset, and disease pathology
Authors: Huo Yongliang , McConnell Sean C. , Liu Shanrun , Zhang Tingting , Yang Rui , Ren Jinxiang , Ryan Thomas M.
Published: August 2010

β thalassemia major or Cooley's Anemia (CA) has been difficult to model in mice due to their lack of a fetal hemoglobin gene equivalent. This summary describes novel preclinical humanized mouse models of CA that survive on human fetal hemoglobin at birth and are blood‐transfusion dependent for life upon completion of their human fetal‐to‐adult hemoglobin switch after birth. These CA models are the first to recapitulate the temporal onset of the disease in human patients. These novel humanized CA disease models are useful for the study of the regulation of globin gene expression, synthesis, and switching; examining the onset of disease pathology; development of transfusion and iron chelation therapies; induction of fetal hemoglobin synthesis; and the testing of novel genetic and cell‐based therapies for the correction of thalassemia.
Deferasirox—current knowledge and future challenges
Authors: Porter John B.
Published: August 2010

Since the last Cooley's symposium in 2005, our knowledge and clinical experience with deferasirox had advanced considerably. This has been based on prospective multicenter clinical trials, on a scale hitherto unprecedented for chelation therapy, now totalling over 7,400 patients. Here, current knowledge about the clinical effects of deferasirox is described in key areas, namely, the pharmacokinetics and its relevance to mechanisms of action; effects on iron balance; effects on serum ferritin; long‐term tolerability; and effects on cardiac iron removal. Challenges for future research include a better understanding of the relationship of serum ferritin to iron balance; the optimal target level and rate of decrease in serum ferritin to achieve a “soft landing,” as ferritin values fall below 500–1,000 μg/L; the use of surrogate markers, such as mT2*, to infer the likely effects on long‐term survival; and the safety and efficacy of deferasirox when combined with other chelators.
Fertility potential in thalassemia major women: current findings and future diagnostic tools
Authors: Singer Sylvia T. , Sweeters Nancy , Vega Olivia , Higa Annie , Vichinsky Elliott , Cedars Marcelle
Published: August 2010

Preserving fertility, preventing early menopause, and predicting reproductive ability have become crucial for many adult thalassemia major females. Luteinizing hormone/follicle‐stimulating hormone (LH/FSH) and estradiol, commonly used for assessment of fertility potential in thalassemia, have a poor predictive value. Current reproductive practice uses markers of ovarian reserve testing, which were not yet studied in thalassemia women. We explored the relationship between liver iron concentration (LIC) and fertility status in 26 females (mean 30 years old). Seventeen (65%) of them experienced primary or secondary amenorrhea. Levels of LH/FSH and estradiol were low or undetectable in 48% and 35% of patients, respectively and did not correlate with age, presence of amenorrhea, and LIC. This further addresses the need for utilization of current available methods for assessment of fertility capacity in thalassemia, which will also allow future correlation with pituitary iron measures by MRI as well as early intervention for fertility preservation.
Hepcidin in β‐thalassemia
Authors: Nemeth Elizabeta
Published: August 2010

Iron overload is the principal cause of morbidity and mortality in β‐thalassemia with or without transfusion dependence. Iron homeostasis is regulated by the hepatic peptide hormone hepcidin. Hepcidin controls dietary iron absorption, plasma iron concentrations, and tissue iron distribution. A deficiency in this hormone is the main or contributing factor of iron overload in iron‐loading anemias such as β‐thalassemia. Hepcidin deficiency results from a strong suppressive effect of the high erythropoietic activity on hepcidin expression. Although in thalassemia major patients iron absorption contributes less to the total iron load than transfusions, in non‐transfused thalassemia, low hepcidin, and the consequent hyperabsorption of dietary iron is the major cause of systemic iron overload. Hepcidin diagnostics and future therapeutic agonists may help in management of patients with β‐thalassemia.
Deferiprone
Authors: Piga Antonio , Roggero Simona , Salussolia Ilaria , Massano Davide , Serra Melania , Longo Filomena
Published: August 2010

Deferiprone (DFP) has been evaluated in a wide range of disorders, but most data come from transfusion‐dependent thalassemia. The safety and tolerability profile includes gastrointestinal complaints, liver enzymes elevation, weight gain, arthropathy, neutropenia, and agranulocytosis. The last requires close monitoring of blood count and precludes the use of DFP in conditions with bone marrow abnormalities. The efficacy profile is similar among the three available chelators. For DFP, the choice of dosage is crucial to optimize the effect on liver iron concentration, according to the iron load degree and transfusional iron input. Growing evidence indicates that DFP, alone or in combination with deferoxamine, is effective in removing cardiac iron and preventing cardiac iron load. The available data consolidate an important role of DFP in the management of iron overload. There is a need to compare directly the relative value of the available chelators in the long‐term prevention of iron toxicity by well‐designed randomized controlled trials.
Strategy for a multicenter phase I clinical trial to evaluate globin gene transfer in β‐thalassemia
Authors: Sadelain Michel , Rivière Isabelle , Wang Xiuyan , Boulad Farid , Prockop Susan , Giardina Patricia , Maggio Aurelio , Galanello Renzo , Locatelli Franco , Yannaki Evangelia
Published: August 2010

Globin gene transfer in autologous hematopoietic stem cells offers a potentially curative treatment option for patients suffering from β‐thalassemia major who lack an HLA‐matched hematopoietic stem cell donor. Based on extensive preclinical investigation, we are initiating a phase I clinical trial using G‐CSF mobilized, autologous CD34+ cells transduced with a vector similar to the original TNS9 vector. Our first mobilizations in adult β‐thalassemic subjects have been well tolerated and yielded the required CD34+ cell dose. To minimize toxicity to enrolled subjects, and in the absence of a demonstrated requirement for myeloablative conditioning, our trial will use a reduced intensity conditioning regimen. Because low vector titers may adversely affect efficacy and safety, we have focused on vector manufacturing processes. We are now in a position to transfer our globin lentiviral vectors in a clinically relevant dosage (averaging 0.8 vector copy per cell in bulk CD34+ cells) and to supply clinical grade vector to collaborating centers in the U.S.A. and in Europe. We anticipate that the first U.S. trial of globin gene transfer will start in 2010.
Evidence of the involvement of K+ channels and PPARγreceptors in the antidepressant-like activity of diphenyl diselenide in mice
Authors: Wilhelm Ethel A , Jesse Cristiano R , Bortolatto Cristiani F , Barbosa Nilda B V , Nogueira Cristina W
Published: August 2010

Objectives

This study investigated the involvement of different types of K+ channels and PPARγ receptors in the antidepressant-like effect of diphenyl diselenide in mice.

Methods

Mice were pretreated with subeffective doses of K+ channel inhibitors (tetraethylammonium, glibenclamide, charybdotoxin and apamin), openers (cromakalim, minoxidil), GW 9662 (a PPARγ antagonist) or vehicle. Thirty minutes later the mice received diphenyl diselenide in either an effective or a subeffective dose, 30 min before a tail-suspension test.

Key findings

Pre-treatment with tetraethylammonium, charybdotoxin or apamin combined with a subeffective dose of diphenyl diselenide was effective in decreasing the immobility time in the mouse tail-suspension test. The reduction in the immobility time elicited by an effective dose of diphenyl diselenide in this test was prevented by the pretreatment of mice with minoxidil and GW 9662.

Conclusions

Diphenyl diselenide elicited an antidepressant-like effect and this action was mediated, at least in part, by modulation of K+ channels and PPARγ receptors.