bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of bisphenol A on adult male mouse fertility
Authors: Al‐Hiyasat Ahmad S. , Darmani Homa , Elbetieha Ahmed M.
Published: March 2003

The aim of this investigation was to evaluate the effect of bisphenol A (BPA), a contaminant of resin‐based dental composites and sealants, on the fertility of male mice. Forty adult male Swiss mice were divided into four groups of 10. BPA (5, 25 and 100 ng kg−1) was administered intragastrically daily to the mice in the test groups and distilled water to the control group for 28 d. Male fertility was assessed by mating each mouse with two untreated females. Females mated with male mice having ingested 25 and 100 ng kg−1 BPA showed a significant reduction in pregnancy rates. Furthermore, the total number of resorptions out of the total number of implantations was significantly increased in females impregnated with males having ingested all three doses of BPA. Males having ingested 25 and 100 ng kg−1 BPA showed a significant reduction in testicular sperm counts and in the efficiency of sperm production. Epididymal sperm counts were also significantly reduced in males that had ingested BPA. There were significant reductions in the absolute weights of the testes and seminal vesicles. These results suggest that male fertility and reproduction is impaired by bisphenol A.
Treatment of dental anxiety disorders. Outcome related to DSM‐IV diagnoses
Authors: Kvale Gerd , Raadal Magne , Vika Margrete , Johnsen Bjørn Helge , Skaret Erik , Vatnelid Herborg , Øiamo Ingrid
Published: March 2003

In this study we evaluated treatment effects in 70 consecutively admitted patients in a specialized university clinic for treatment of dental fear. Thirty‐three (47%) of the patients fulfilled the diagnostic criteria for Specific Phobia alone (Dental Phobia, DP), 24 (33%) had severe dental anxiety without fulfilling the criteria for phobia (ND), and 13 (19%) fulfilled the criteria for multiple DSM‐IV diagnoses (MD). Dental anxiety was measured prior to, immediately after and at follow‐up (mean=19 months) using Corah's Dental Anxiety Scale and Dental Fear Survey. Dental attitudes were measured by Getz′ Dental Beliefs Survey. Dental attendance and everyday functioning were measured by self‐report. DP patients received significantly more treatment‐sessions as compared to the ND group. Despite significant overall reductions in scores on all psychometric instruments from pretreatment to follow up, patients in the MD group reported significantly more severe anxiety at pre‐ and post‐treatment and at follow‐up as compared to patients in the ND group. There was no interaction between diagnostic group and assessment occasion (pre treatment, post treatment and follow up) on the self‐reported anxiety. Patients reported significant improvements in self‐esteem, social relations and everyday functioning, regardless of diagnostic group. Sixty‐three percentage of the respondents had been to the dentist within 1 year after completed treatment. Patients treated by dentists who had received supervised training in exposure treatment had significantly more often seen the dentist at follow‐up.
Factors affecting degeneration in human temporomandibular joints as assessed histologically
Authors: Luder Hans‐Ulrich
Published: March 2003

The influence of sex, age, tooth loss, and articular disc position on temporomandibular joint (TMJ) degeneration was evaluated in specimens collected at autopsy from 15 women and 38 men ranging in age from 15 to 92 yr. The position of the articular discs was classified as normal or abnormal, tooth loss was both counted and categorized. Degenerative changes of the articular tissues were assessed histologically and quantified, taking into account both the severity of structural alterations and their extension along the articular surface. This was recorded separately in the condyle, disc, and temporal component, three latero‐medial joint regions, and putative load‐bearing and non‐load‐bearing surfaces. Analysis of covariance with repeated measures served for testing contributing factors. It showed that the effects of sex and the number of missing teeth were insignificant, whereas age up to about 55–60 yr and reduction of dental arch length proved to be the most important factors. Load‐bearing seemed to play a significant role mainly at younger ages, and the effect of disc position was significant, when internal derangement was combined with reduction of dental arch length. Thus, rising severity of TMJ degenerative changes appears to be associated primarily with increasing age. In addition, it may also depend on mechanical factors, in particular loss of molar support and, to a minor degree, abnormal disc position.
Influence of polymerization conditions on monomer elution and microhardness of autopolymerized polymethyl methacrylate resin
Authors: Lee Shyh‐yuan , Lai Yu‐lin , Hsu Tzai‐shin
Published: March 2003

Residual monomer contents and surface hardness are important factors in determining the serviceability of provisional restorations. The intent of this study was to systemically evaluate the effects of curing conditions on provisional polymethyl methacrylate (PMMA) resins which utilize a free‐radical polymerization reaction. Combinations of the three curing factors of temperature, pressure, curing environment (water/air) were adjusted during the fabrication of autopolymerized specimen disks. The initial hardness of tested materials was measured with a microhardness tester 1 h after disc fabrication, and the amounts of residual methyl methacrylate (MMA) released into water were analyzed by reverse‐phase HPLC after 7 d of water immersion. Results from multiple regressions showed that curing temperature was the dominant factor in improving resin surface hardness, whereas curing in water was the key factor for reducing the quantity of residual monomer. The pressure factor, which was thought to be critical for managing autopolymerized resins, showed no significant influences on the properties tested. ANOVA results showed that provisional PMMA resins cured in hot water, with or without pressure, significantly reduced the amount of residual MMA elution (up to 80%) and increased the microhardness values (up to 50%).
Effects of aging and cyclic loading on the mechanical properties of glass ionomer cements
Authors: Bapna Mahendra S. , Gadia Christine M. , Drummond James L.
Published: March 2003

The purpose of this study was to examine the effect of cyclic loading on the flexural strength and fracture toughness of a conventional glass ionomer cement (GIC), a metal containing GIC, hybrid GICs, and, for comparison, a composite. Two sets of specimens were evaluated: a set of controls (at 37°C and 95% humidity) and a set aged for 9 months at 37°C in water. The specimens were tested in static loading in air and water, and cyclic loaded in water. Cyclic loading and aging decreased the flexure strength of all materials significantly. However, wet static fracture toughness did not change on aging, and occasionally increased. Cyclic fracture toughness was lower with all materials except a hybrid glass ionomer without aging. Deterioration in properties was related to relative amount of glass ionomer vs. the resin component. Both flexural strength and fracture toughness of these materials were significantly affected by testing environment, aging and cyclic loading. The lower the resin component of the material, the lower the mechanical properties. The influence of these parameters should be given importance in considering their clinically durability in the oral environment.
Inter‐crystallite nanoretention of self‐etching adhesives at enamel imaged by transmission electron microscopy
Authors: Hannig Matthias , Bock Henning , Bott Burkard , Hoth‐Hannig Wiebke
Published: March 2003

The purpose of this in vitro study was to analyse the mode of action of self‐etching adhesive systems when applied for resin‐to‐enamel bonding. Transmission electron microscopy was used to investigate the enamel–resin interface after application of non‐rinsing self‐etching adhesive systems based on phosphoric acid estered methacrylates (Clearfil Liner Bond 2, Clearfil SE Bond, Etch & Prime 3.0 and Resulcin AquaPrime) compared with conventional phosphoric acid etching and bonding (Heliobond). Non‐decalcified ultrathin sections from the interface between enamel and self‐etching adhesive systems revealed a 1.5–3.2‐µm deep enamel surface layer characterized by a less‐dense arrangement of enamel crystallites separated from each other by nanometer‐sized spaces. A 1.5–3.2‐µm wide, netlike resinous structure was observed in corresponding decalcified specimens, indicating that self‐etching priming agents dissolve the peripheral and central part of the enamel crystallites, while simultaneously promoting inter‐ and intra‐crystallite monomer infiltration. A similar pattern, but greater depth (6.9 µm) of enamel surface hybridization was found in the phosphoric acid‐etched and bonded specimens. The nanoretentive interlocking between enamel crystallites and resin could explain the potential of self‐etching adhesive systems in resin‐to‐enamel bonding despite the less distinct enamel etching pattern observed in scanning electron microscopy investigations.
Periodontal microbiota and clinical periodontal status in a rural sample in southern Thailand
Authors: Papapanou P. N. , Teanpaisan R. , Obiechina N. S. , Pithpornchaiyakul W. , Pongpaisal S. , Pisuithanakan S. , Baelum V. , Fejerskov O. , Dahlén G.
Published: March 2003

We sought to determine (i) the association of subgingival bacterial profiles to clinical periodontal status in a population with limited access to dental care in Thailand, and (ii) the external validity of our earlier findings from a similar study in rural China. We examined 356 subjects, 30–39 yr old and 50–59 yr old, with respect to clinical periodontal status and subgingival plaque at maximally 14 sites per subject. Checkerboard hybridizations were used to analyse a total of 4343 samples. The prevalence of the 27 species investigated ranged between 87.2% and 100%. Discriminant analysis based on microbial profiles classified correctly 67.5% of all deep (≥ 5 mm) and 64.2% of all shallow sites, and 67.4% of all subjects with and 69.3% of all subjects without ≥ 3 deep pockets. High colonization by ‘red complex’ bacteria was four times as likely (95% Confidence Limits (CL) 2.5–6.6) in subjects with ≥ 10 sites with attachment loss of ≥ 5 mm, and 4.3 times as likely (95% CL 2.6–7.1) in subjects with ≥ 30 such sites. The data confirmed (i) the ubiquitous prevalence of the bacteria investigated in subjects with no regular access to dental care; and (ii) the high odds for periodontal pathology conferred by increased levels of specific periodontal bacteria.
Influence of food consistency on the rabbit masseter muscle fibres
Authors: Langenbach Geerling , Van De Pavert Sigurd , Savalle Willem , Korfage Hans , Van Eijden Theo
Published: March 2003

The plasticity of the masseter muscle was studied by comparing two groups of rabbits that were fed soft‐ and hard‐diet for 87 d. Incisors of the soft‐diet group were cut back to minimize the bite forces. Muscle fibres were immunohistochemically defined as fast‐ or slow‐contracting fibres and their cross‐sectional area was measured. The muscles of animals fed with the hard‐diet were composed of fibres with larger cross‐sectional areas than the soft‐diet group. The relative difference was larger in slow‐contracting fibres than in fast‐contracting fibres. The results were similar for the different regions of the muscle. No changes in fibre composition were found. In conclusion, the difference in food consistency, as induced in this study, caused changes in the muscle fibre cross‐sectional area that can be recognized from the altered necessary occlusal forces, which result from the modified forces developed by the masseter muscle.
T‐cell Cytokines in Pregnancy
Authors: PICCINNI MARIE‐PIERRE
Published: March 2003

PROBLEM: Immunological mechanisms induced by T cells may play an important role in preimplantation embryo development, in implantation process and in the phenomenon of fetal allograft tolerance.

METHODS: We review existing data on the role of T cells in pregnancy.

RESULTS: The production of LIF, interleukin (IL)‐4, IL‐10 and M‐CSF by the decidual T cells may contribute to the maintenance of pregnancy. T cells are not only confined to the uterus. T cells are also present in cumulus oophorus and are able to produce LIF and IL‐4.

CONCLUSIONS: These findings may provide an initial cue in favor of the possibility that different cytokines produced by T cells acting in concert are required to create a suitable microenvironment for the preimplantation embryo development and for the maintenance of pregnancy. T cells could work in parallel with other cells present in the decidua and cumulus suggesting a complex network of hormones, cytokines and cells.
Recurrent Reproductive Wastage and Immunologic Factors
Authors: MAKINO TSUNEHISA
Published: March 2003

Makino T. Recurrent reproductive wastage and immunologic factors. AJRI 2002; 48:266–268 © Blackwell Munksgaard, 2002

PROBLEM: The causes of recurrent reproductive wastage are varied and complex. The present study was designed to focus on the role of immunologic factors in cases where other causes were not evident.

METHOD OF STUDY: Over 20 years, more than 1500 couples were evaluated in our clinic because of recurrent spontaneous abortion. Women were tested for anti‐phospholipid antibodies and plasma contact proteins of the intrinsic pathway of blood coagulation after endocrine, organic, infectious and genetic etiologies of miscarriages were excluded.

RESULTS: Anti‐phosphatidylethanolamine antibodies, anti‐annexin antibodies, and factor XII deficiency were more common factors in recurrent spontaneous abortion patients than were anti‐cardiolipin antibodies in terms of induction of recurrent pregnancy losses. Paternal leukocyte immunotherapy of patients without such abnormalities was associated with a significantly improved success rate.

CONCLUSIONS: Recurrent reproductive wastage can be minimized by individualized therapy based on comprehensive evaluation of immunologic factors, including several anti‐phospholipid antibodies.
Value of Flow Cytometric Assay for the Detection of Antisperm Antibodies in Women with a History of Recurrent Abortion
Authors: AL‐HUSSEIN KHALED , AL‐MUKHALAFI ZUHA , BERTILSSON PER‐ANDERS , JAROUDI KAMAL , SHOUKRI MOHAMMED , HOLLANDER JOHANSON
Published: March 2003

PROBLEM: To verify the proposed relationship between recurrent spontaneous abortions and the presence of maternal antisperm antibodies (ASA) in women as detected by a sensitive and reliable method.

METHOD OF STUDY: The presence of maternal antipaternal immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies were determined against three different paternal antigens comprising T, B lymphocytes and semen cells by a sensitive flow cytometric crossmatch method to examine their possible correlation with pregnancy outcome.

Group 1 consisted of sera obtained from 24 women with a history of abortion, and lymphocytes and semen samples collected from their husbands at the same time of visiting the in vitro fertilization (IVF) Clinic at King Faisal Specialist Hospital and Research Center. Sera, lymphocytes and semen samples were also collected from six couples with no history of abortion who served as controls (Group 2).

RESULTS: Using a sensitive flow cytometric assay to analyse the samples, without knowledge of clinical status, elevated levels of both IgG and IgM were detected in Group 1. However, no significant association was found when compared with normal females who had healthy pregnancies.

CONCLUSION: Flow cytometry is a highly sensitive and specific tool for the detection of alloantibodies in human sera from patients with rejected transplanted organs. Our findings suggest that maternal antipaternal antibodies with respect to IgG and IgM classes do not play a major role in women with a history of recurrent abortions, despite the presence of increased levels of antibodies against three different sources of paternal antigens.
Interleukin‐12 Secretion by Peripheral Blood Mononuclear Cells is Decreased in Normal Pregnant Subjects and Increased in Preeclamptic Patients
Authors: SAKAI MASATOSHI , TSUDA HIROSHI , TANEBE KYOKO , SASAKI YASUSHI , SAITO SHIGERU
Published: March 2003

PROBLEM:  It has been reported that T‐helper (Th) 2 dominance in normal pregnancy shifts to Th1 dominance in preeclampsia. Peripheral blood mononuclear cell (PBMC) production of interleukin (IL)‐12, which induce Th1 responses, has not been compared between these clinical states.

METHOD OF STUDY:  Peripheral blood mononuclear cell from 35 non‐pregnant women, 35 healthy pregnant women, 12 mildly preeclamptic patients, and 15 severely preeclamptic patients were cultured for 24 hr. IL‐12 secretion was determined by enzyme‐linked immunosorbent assay (ELISA). Th1/Th2 ratios in PBMC were determined flow‐cytometrically, and the amounts of HLA‐DR and CD14 expression on the monocytes were obtained by flow cytometry.

RESULTS:  Peripheral blood mononuclear cell from healthy pregnant subjects secreted less IL‐12 than non‐pregnant women. PBMC from severely preeclamptic patients secreted more IL‐12 than those from healthy pregnant subjects, while IL‐12 secretion in mild preeclampsia resembled secretion in normal pregnancy. Th1/Th2 ratios correlated were positively with IL‐12. Increased HLA‐DR antigens and reduced CD14 expression, suggesting monocyte activation, were observed in preeclamptic patients, although monocyte counts were unchanged.

CONCLUSION:  Decreased IL‐12 secretion by PBMC may cause Th2 dominance in normal pregnancy, while increased IL‐12 secretion by activated monocytes may cause Th1 dominance in preeclampsia.
Testis‐Specific Antigen (TSA‐1) is Expressed in Murine Sperm and its Antibodies inhibit Fertilization
Authors: TRIVEDI RAM N. , NAZ RAJESH K.
Published: March 2003

PROBLEM: We recently cloned and sequenced a sperm‐specific antigen, designated as testis‐specific antigen‐1 (TSA‐1), from human testis. The present study was conducted to examine its expression and function in murine sperm, in order to find out whether or not the mouse can provide a suitable model for examining its immunocontraceptive effects.

METHOD OF STUDY: The antibodies (Ab) were raised against purified human rTSA‐1 in virgin female rabbits. The rTSA‐1 was run in sodium dodecyl sulphate–polyacrylamide gel electrophoresis (SDS–PAGE) and the gel containing the ˜ 18 kDa band was cut, minced and used for immunization to obtain the specific Ab. The immunoglobulins from preimmune bleed and from animals injected with adjuvant alone served as control. These Ab were analysed in enzyme‐linked immunosorbent assay (ELISA), Western blot procedure, immunoprecipitation procedure, immunocytochemical technique (ICT), immunobead binding technique (IBT), acrosome reaction and sperm–zona binding assay.

RESULTS: Active immunization of female rabbits with purified rTSA‐1 protein of ˜ 18 kDa, produced high titer Ab against the recombinant antigen. These Ab to rTSA‐1 were used in the present study. In Western blot procedure, rTSA‐1 Ab recognized a specific protein band of ˜ 24 ± 3 kDa in murine sperm extract, the band similar to found in human sperm extract. In the immunoprecipitation procedure, rTSA‐1 Ab immunoprecipitated the protein band of similar size from extracts of murine sperm and murine testis. The ICT and the IBT studies revealed the subcellular localization of TSA‐1 on the surface of acrosome and tail regions of the non‐capacitated and capacitated murine sperm cells. In functional bioassays, rTSA‐1 Ab inhibited the acrosome reaction and sperm–egg binding in vitro.

CONCLUSIONS: These data indicate that the TSA‐1 is expressed in murine sperm and may have a biological role in sperm function and sperm–egg binding. In vitro inhibition of capacitation/acrosome reaction and sperm–zona binding suggests that the mouse can provide a suitable model to examine the immunocontraceptive effects of TSA‐1 in actively immunized animals.
Normal Pregnancy is Associated with Peripheral Leukocyte Activation
Authors: LUPPI P. , HALUSZCZAK C. , TRUCCO M. , DELOIA J.A.
Published: March 2003

PROBLEM: Normal pregnancy has been described as both a pro‐inflammatory condition and a T helper (Th)2‐dominated state. Deviations in the percentage of different subpopulations of circulating leukocytes have been detected, although with conflicting results. This study was designed to analyse further the phenotype of subpopulations of peripheral blood leukocytes in normal pregnant women.

METHOD OF STUDY: Whole‐blood flow cytometry was used to differentiate subsets of leukocytes using directly labeled monoclonal antibodies to specific cell surface antigens and to a panel of activation‐associated markers in 33 normal pregnant women in their third trimester and in 26 non‐pregnant controls.

RESULTS: We found a significant increase in the proportion of granulocytes and of CD8+ T lymphocytes during pregnancy. Up‐regulation of the expression of adhesion molecules was observed on granulocytes, monocytes and T lymphocytes.

CONCLUSIONS: Pregnancy alters the representation of leukocyte subpopulations in the maternal circulation and is associated with systemic activation of leukocytes.
Differential Expression of Interleukins (IL)‐13 and IL‐15 in Ectopic and Eutopic Endometrium of Women With Endometriosis and Normal Fertile Women
Authors: Chegini Nasser , Roberts Marisa , Ripps Barry
Published: March 2003

PROBLEM:  Interleukins (IL) 13 and 15 are key regulators of inflammatory and immune responses, processes that are central to endometriosis and associated abnormalities. The present study examined (1) whether ectopic endometrial tissue expresses IL‐13 and IL‐15 (2) if their expression differs compared with matched eutopic endometrium and control endometrium from normal fertile women, and (3) if peritoneal fluids (PF) content of these cytokines reflects the disease compared with PF from women with peritoneal adhesions unrelated to endometriosis and those without pelvic pathology.

METHODS:  The expression of IL‐13 and IL‐15 mRNA and protein was determined using quantitative RT‐PCR, ELISA and immunohistochemistry.

RESULTS:  Ectopic endometrium expresses IL‐13 and IL‐15 mRNA and protein with elevated levels compared with eutopic and control endometrium, irrespective of the phases of the menstrual cycle, with predominance in IL‐13 expression. Endometrial epithelial cells were found to be the primary site of IL‐13 and IL‐15 expression. The PF content of IL‐13 and IL‐15 show a trend toward higher concentrations in women with adhesion and endometriosis, respectively, compared with fertile control without pelvic pathology.

CONCLUSION:  Interleukins 13 and 15 are expressed in ectopic endometrium and present in PF of women with endometriosis and their elevated expression in ectopic endometrium suggests that these cytokines play a key role in local inflammatory/immune responses that are critical in endometriosis‐associated abnormalities.
Prognosis of replanted primary incisors after injuries
Authors: Kinoshita S. , Mitomi T. , Taguchi Y. , Noda T.
Published: March 2003

Abstract – Between 1979 and 1997, 58 avulsed primary teeth were treated at the Pedodontic Clinic of Niigata University Dental Hospital. Among these, we replanted six avulsed incisors of four patients and treated two teeth of two patients replanted at other dental clinics. Referring to the clinical records, oral photographs and radiographs, we examined the injury age, cause of injury, condition of tooth storage, length of time until replantation, and also the prognosis after replantation. Three teeth of two cases remained until eruption of their permanent successors, and one tooth of one case remained under observation without extraction. Although the other four teeth of three cases resulted in extraction, no secondary infection was detected due to replantation. The following reasons were suspected for the poor prognosis of the four teeth. One avulsed tooth was not fixed immediately after replantation. One replanted tooth might not have been compatible with the alveolar socket. In the other two teeth, the periodontal vital tissues might have been removed before replantation. It is generally suggested that replantation of primary teeth is not a good option. However, from the present results, it was considered that replantation can be an effectual method when the condition of the avulsed primary tooth is suitable.
Bacteria of asymptomatic periradicular endodontic lesions identified by DNA‐DNA hybridization
Authors: Gatti J. J. , Dobeck J. M. , Smith C. , White R. R. , Socransky S. S. , Skobe Z.
Published: March 2003

Abstract – Possible inclusion of contaminant bacteria during surgery has been problematic in studies of periradicular lesions of endodontic origin. Therefore, in this study, two different surgical techniques were compared. A second problem is that some difficult to cultivate species may not be detected using bacteriological methods. Molecular techniques may resolve this problem. DNA‐DNA hybridization technology has the additional advantage that DNA is not amplified. The purpose of this investigation was to determine if bacteria from periradicular endodontic lesions could be identified using DNA‐DNA hybridization. A full thickness intrasulcular mucoperiosteal (IS) flap (n=20) or a submarginal (SM) flap (n=16) was reflected in patients with asymptomatic apical periodontitis. DNA was extracted and incubated with 40 digoxigenin‐labeled whole genomic probes. Bacterial DNA was detected in all 36 lesions. Seven probes were negative for all lesions. In patients with sinus tract communication, in teeth lacking intact full coverage crowns, and in patients with a history of trauma, 4–13 probes provided positive signals. Seven probes were positive in lesions obtained by the IS, but not the SM technique. Two probes were in samples obtained with the SM technique, but not the IS. Only Bacteroides forsythus and Actinomyces naeslundii genospecies 2 were present in large numbers using either the IS or the SM technique. The SM flap technique, in combination with DNA‐DNA hybridization, appeared to provide excellent data pertaining to periradicular bacteria. These results supported other studies that provide evidence of a bacterial presence and persistence in periradicular lesions.
Cytotoxic effect of four root filling materials
Authors: Miletić I. , Anić I. , Karlović Z. , Maršan T. , Pezelj‐Ribarić S. , Osmak M.
Published: March 2003

Abstract – The aim of this study was to evaluate the cytotoxic effect of four root canal sealers: AH26, AH Plus, Diaket and Apexit. In the experiment two cell lines, human cervical carcinoma (HeLa) cells and mouse skin fibroblasts (L929), were used. Under aseptic conditions, the sealers were prepared according to the manufacturers' directions, and 0.01 mL of each material was placed in a 24‐well plate. The sealers were covered with cell suspension. The cytotoxicity was estimated by determining the number of viable cells by a light microscope, as well as the total number of cells 24 h, 48 h and 120 h after the treatment with mentioned materials. The results obtained in this study showed the high cytotoxcity of the new AH Plus root canal sealer, which was shown to be equally or more toxic to the standard AH26 and Diaket materials. Apexit was the least toxic sealer.
Healing of 208 intraalveolar root fractures in patients aged 7–17 years
Authors: Cvek Miomir , Andreasen Jens O. , Borum Mette K.
Published: March 2003

Abstract – This retrospective study consisted of 208 root‐fractured, 168 splinted and 40 not splinted incisors in young individuals (aged 7–17 years) treated in the period 1959–1973 at the Pedodontic Department, Eastman Institute, Stockholm. Clinical and radiographic analyses showed that 69 teeth (33%) had developed hard tissue (fusion) healing of fragments. Interposition of periodontal ligament (PDL) and bone between the fragments was found in 17 teeth (8%). Interposition of PDL alone was found in 74 teeth (36%). Finally, non‐healing with pulp necrosis and inflammatory changes between fragments was seen in 48 teeth (23%). Various clinical factors were analyzed for their relationship to the healing outcome with respect to healing/no healing and type of healing (hard tissue versus interposition of bone and/or PDL). Immature root and positive pulp sensitivity at time of injury was found to be significantly related to both pulp healing and hard tissue repair of the fracture. The same applied to concussion or subluxation of the coronal fragment compared to luxation with displacement (extrusive or lateral luxation). This relation was also represented by the variable millimeter diastasis between fragments before and after repositioning. Repositioning appeared to enhance the likelihood of both pulp healing and hard tissue repair. A positive effect of splinting, splinting methods (cap splints or orthodontic bands with an arch wire) or splinting periods could not be demonstrated on either pulp healing or type of healing (hard tissue versus interposition of bone and/or PDL). In conclusion, the findings from this retrospective study have cast doubts on the efficacy of long‐term splinting and the types of splint used for root fracture healing. It is suggested that the role of splinting and splinting methods be examined in further studies.
Lay knowledge of physical education teachers about the emergency management of dental trauma in Hong Kong
Authors: Chan Alex W. K. , Wong Thomas K. S. , Cheung Gary S. P.
Published: March 2003

Abstract – The purpose of this study was to investigate the knowledge of a group of physical education (PE) teachers about the emergency management of dental trauma in Hong Kong. A postal questionnaire was sent to PE teachers in 100 randomly selected secondary schools in Hong Kong. A total of 166 teachers from 65 schools responded. Results show that a majority of the respondents have received formal teaching training (98.8%). While all but one teacher had received formal first aid training, only eight of them recalled that they had received advice on the management of dental trauma. Concerning the management of tooth fracture, 118 respondents (71.1%) gave an appropriate answer. In contrast, only 29 teachers (17.5%) were able to indicate the appropriate management for an avulsed tooth. Over 60% (102) of the respondents indicated it was “very urgent” to seek professional assistance if a permanent tooth has been avulsed, but they had little knowledge of the correct procedures for replanting or transporting avulsed teeth. Only 15 respondents (9%) pointed out that milk was the medium of choice for transporting avulsed teeth. Finally, over 90% (157) of respondents indicated that they had never received advice on the emergency procedures for the management of dental avulsion. The present study showed that the level of lay knowledge of management of dental injuries in a selection of PE teachers in Hong Kong is inadequate and educational campaigns are necessary to improve their emergency management of dental injuries.
Fracture resistance of human incisors and premolars: morphological and patho‐anatomical factors
Authors: Schatz Dorothee , Alfter Günter , Göz Gernot
Published: March 2003

Abstract – 305 extracted human front teeth and premolars were investigated for their dynamic resistance to fracture. Morphological factors, such as the anatomical class of tooth and root lengths, and patho‐anatomical factors, such as infractions, occlusal and cervical abrasions, composite and amalgam restorations and damage resulting from previous traumatic impacts, were taken into consideration. A comparison of stability after a defined impact stress showed that maxillary canines and premolars had the highest resistance to fracture; this differs significantly from the resistance of maxillary and mandibular incisors. The root length correlates directly with fracture energy and therefore to stability. Composite restorations with an adhesive joint were found to increase the resistance of a tooth to fracture, but amalgam restorations had a weakening effect. Cervical wedge‐shaped defects of the tooth cause considerable destabilization, but occlusal abrasion and infractions have only a moderate weakening influence. Previous traumatic stress reduces the resistance to fracture of a tooth by up to 85%. The fracture patterns generated were very similar to clinically observed tooth fractures, indicating the results to be clinically relevant.
Prevalence, causes and correlates of traumatic dental injuries among 13‐year‐olds in Brazil
Authors: Nicolau Belinda , Marcenes Wagner , Sheiham Aubrey
Published: March 2003

Abstract – A cross‐sectional survey was carried out. This involved 652 out of a total of 764 (85%) 13‐year‐old adolescents enrolled in private and public schools located in urban areas in Cianorte, Brazil. They were interviewed and examined for traumatic dental injuries by one trained examiner (B.N.) using validated criteria. Socio‐demographic data included sex, family structure (nuclear families, single parents and step‐parents) and socio‐economic indicators. Anthropometric measures included height and weight. The body mass index (BMI) was calculated (mean=20.1; SD=3.7). Those who had BMI scores equal or above the 85% percentile were considered overweight (BMI >23). The prevalence of traumatic injuries to the permanent incisors was 20.4%. The most common reported cause of injuries to the permanent incisors was falls (24.1%) followed by collisions with people or inanimate objects (15%), traffic accidents (10.5%), misuse of the teeth (6%), sports (2.3%) and violence (1.5%). Unknown causes accounted for 40.6%. Children from non‐nuclear families, overweight children and boys were 2.18, 1.93 and 2.19 times respectively more likely to have dental injuries than children from nuclear families, non‐overweight children and girls (P<0.01) after adjusting for family structure, BMI, sex, family income and level of education of the parents. The relationship between dental injuries and socio‐economic indicators was not statistically significant. In conclusion, being from a non‐nuclear family, overweight and a boy increased the risk of having traumatic dental injury, but the relationship with socioeconomic indicators was not statistically significant.
Laser Doppler Flowmetry for monitoring traumatized teeth
Authors: Lee Jessica Y. , Yanpiset Kallaya , Sigurdsson Asgeir , Vann William F.
Published: March 2003

Abstract – Laser Doppler Flowmetry (LDF) has been shown to be valuable in monitoring revascularization of immature incisors following severe dental trauma. Several investigators have demonstrated the ability of LDF to record blood flow signals from vital tooth pulps. In this case report, LDF was used for a 7‐year‐old child patient following a severe luxation of tooth #9. During follow‐up examinations the traumatized tooth was unresponsive to traditional vitality testing during the first 6 months; however, LDF indicated that revascularization had occurred much sooner. Until recently, CO2 ice has been the most effective method for sensitivity testing in trauma cases such as presented here. In this case, LDF gave us the assurance that we could defer invasive care during a critical time period when root canal therapy might have been initiated for this child patient.
Periodontal response to two intracanal medicaments in replanted monkey incisors
Authors: Thong Y. L. , Messer H. H. , Siar C. H. , Saw L. H.
Published: March 2003

Abstract – Intracanal medicaments are recommended for use in replanted teeth to inhibit inflammatory root resorption. This study compared the effect of calcium hydroxide (Pulpdent®) and a corticosteroid‐antibiotic paste (Ledermix®) on periodontal healing and root resorption following replantation. Incisors of eight Macaca fascicularis monkeys were extracted, stored dry for 15 min and replanted. After 11 days, root canals in two adjacent maxillary incisors were treated with one medicament and contralateral incisors with the other medicament, or left as untreated controls. Animals were sacrificed 8 weeks later and the teeth prepared for histomorphometric evaluation of periodontal ligament inflammation and root resorption. Periodontal ligament inflammation and inflammatory root resorption were markedly inhibited by both calcium hydroxide and corticosteroid‐antibiotic relative to untreated controls. Replacement resorption was lowest in the corticosteroid‐antibiotic group, and significantly (P<0.05) more normal periodontal ligament was present in this group (79.6%) than in calcium hydroxide and control groups (64.6% and 62.7%, respectively). Treatment with the corticosteroid‐antibiotic inhibited inflammatory resorption and was slightly more effective than calcium hydroxide in producing a periodontal healing response.
Effects of temperature, storage time and media on periodontal and pulpal healing after replantation of incisors in monkeys
Authors: Schwartz O. , Andreasen F. M. , Andreasen J. O.
Published: March 2003

Abstract  – The effect of temperature of various storage media and at varying storage periods upon periodontal ligament (PDL) and pulpal healing after tooth replantation was examined in green vervet monkeys (Cercopithecus aethiops). Mandibular lateral incisors with mature root formation were extracted and kept in dry storage at 22, 4 and −18 °C; in saline at 37, 22, 4 and −18 °C; or in saliva (i.e. in the buccal vestibule) at 37 °C for either 60 or 120 min prior to replantation. The animals were sacrificed 8 weeks after replantation and the replanted teeth examined histometrically. The following histological parameters were registered for each tooth: normal PDL, surface resorption, inflammatory resorption, replacement resorption (ankylosis), downgrowth of pocket epithelium, periapical inflammatory changes, and the extent of vital pulp. A total of 125 replanted teeth were examined. Storage in saliva at 37 °C showed a similar amount of normal PDL compared to saline storage for both 60 and 120 min. Saline storage for 60 or 120 min showed no difference in the extent of normal PDL when storage was compared at 37, 22 and 4 °C. However, storage at −18 °C resulted in significantly less normal PDL than storage at other temperatures. Dry storage for 60 min showed significantly less root resorption at 4 °C compared to 22 °C. Furthermore, dry storage at −18 °C showed significantly less normal PDL than storage at 4 °C. When the dry storage period was extended to 120 min, no difference was found between 22, 4 and −18 °C. It is concluded that the temperature (above 0 °C) of the storage medium is of importance only for dry storage and in such a situation only for shorter extra‐alveolar periods, i.e. for 60‐min storage and not for 120 min, where extensive destruction of the PDL always takes place. It is suggested that the temperature effect of 4 °C could be related to less evaporation from the PDL and thereby less damage to the PDL cells or a strict temperature effect upon cell metabolism. Pulp healing in all the cases was limited to the entrance of the pulp canal, and no significant pattern was found between storage media, time and temperature.
Traumatic dental injuries in children presenting for treatment at the Department of Pediatric Dentistry, Faculty of Dentistry, University of Jordan, 1997–2000
Authors: Rajab Lamis D.
Published: March 2003

Abstract  – Data pertaining to traumatic dental injuries of children seeking care at the teaching clinics of the Department of Pediatric Dentistry, Faculty of Dentistry, University of Jordan over a period of 4 years were analyzed. The prevalence of traumatic dental injuries was 14.2% from 2751 subjects. The peak incidence of injury was 10–12‐year age group. Boys were more affected (18.3%) than girls (10.1%). Most injuries occurred at home (63.2%), and falls were the leading cause of injuries (49.9%). Most injuries involved one tooth (69.3%) and maxillary central incisors were the most affected teeth (90.4%). The commonest injury was uncomplicated crown fracture (62.5%), then complicated crown fracture (28.7%). Only 17.1% of children sought treatment the same day or the day after the injury. At the initial examination, cases seen after a long post‐traumatic period required more complicated treatment than those presented within a short time period. Preventive educational program should be instituted in Jordan, directed at parents and school teachers to inform them about the importance of traumatic dental injuries and the benefit of immediate attendance for dental treatment. Furthermore, improving the knowledge of dental practitioners through continuing education would also help in minimizing sequelae of traumatic dental injuries.
Considerations and concepts of case selection in the management of post‐treatment endodontic disease (treatment failure)
Authors: Friedman Shimon
Published: March 2003

Dear Colleagues

I feel honoured and excited to participate in Endodontic Topics, the new review journal focusing on all aspects of the science and art of endodontics, and I hope you will join me in celebrating this first issue, wherever you are! In contrast to future issues, which will focus on one area each, this issue covers different areas, all reviewed by my fellow Associate Editors. I selected the following review for this issue because it touches on several topics that have been assigned to me to cover in the future. In this review, you will find reference to endodontic treatment outcome criteria, concepts of endodontic health and disease, decision‐making, treatment outcome of apical surgery and orthograde re‐treatment, post‐operative pain associated with the aforementioned procedures, removal of crowns and posts, as well as broken instruments, perforation repair, retrograde re‐treatment and more. All of these topics are dealt with in this article in the context of case selection in the management of post‐treatment disease. In the future, however, you will see the focus shifting to examining each of these topics on their own, with many of them being reviewed in greater detail by those researchers and clinicians quoted in this review. So, to my mind, this review is not just a review but a sign of things to come.

I look forward to working with many knowledgeable colleagues in the future to develop good quality, comprehensive and critical reviews for your benefit. I hope you find these reviews exciting and useful.
Screening the human protocadherin 8 (PCDH8) gene in schizophrenia
Authors: Bray N. J. , Kirov G. , Owen R. J. , Jacobsen N. J. , Georgieva L. , Williams H. J. , Norton N. , Spurlock G. , Jones S. , Zammit S. , O'Donovan M. C. , Owen M. J.
Published: March 2003

Abnormalities in synaptic connectivity and plasticity have been implicated in the pathophysiology of schizophrenia. Molecules involved in the development and maintenance of neural circuitry include the recently cloned protocadherins. Human protocadherin 8 (PCDH8) is homologous to ‘arcadlin’, a molecule shown to play a role in hippocampal synaptic function in the rat. The gene encoding PCDH8 maps to a region on chromosome 13 where linkage to schizophrenia has been reported. In this study, the entire expressed sequence of the PCDH8 gene and over 800 bp of the 5′ flanking region were screened for polymorphisms in 30 DSM‐IV schizophrenia individuals using Denaturing High Performance Liquid Chromatography (DHPLC). A total of nine single nucleotide polymorphisms were identified, including three in the first exon that are predicted to change the amino acid sequence. One polymorphism, causing the Trp7Arg change in the putative signal peptide, showed a trend towards excess of the arginine encoding allele in a case‐control sample consisting of 520 DSM‐IV schizophrenia patients and 535 matched controls from the UK (χ2 = 3.72, P[1df] = 0.054). However, this polymorphism did not show preferential transmission to schizophrenic individuals in a separate sample of 203 proband–parent trios from Bulgaria. A second, rare single nucleotide variation, predicting the non‐conservative amino acid change Glu39Ala, was found in one schizophrenic individual and their affected sibling but not in a further 352 affected individuals, nor 357 controls. These results suggest that any contribution of PCDH8 polymorphisms to schizophrenia susceptibility is likely to be weak, although the existence of rare variations of stronger effect cannot be excluded.
Laparoscopic treatment of acute small bowel obstruction: A multicentre retrospective study
Authors: Levard Hugues , Boudet Marie‐Jeanne , Msika Simon , Molkhou Jean‐Michel , Hay Jean‐Marie , Laborde Yves , Gillet Michel , Fingerhut Abe ,   French Association for Surgical Research
Published: March 2003

Background:  Laparoscopic surgery is thought to promote early recovery and quicker return to bowel function. The objective was to evaluate the rate and predictive factors of success, the causes of failure, the morbidity, and mortality during and after hospitalization, as well as to determine whether laparoscopic treatment of acute small bowel obstruction offers the same benefits as for other laparoscopic procedures.

Methods: The records of 308 patients with acute small bowel obstruction treated laparoscopically in 35 centres between 1 October 1988 and 30 September 1996 were retrospectively reviewed.

Results: Treatment was implemented completely by laparoscopy (‘success’ group) in 168 patients (54.6%). Conversion to laparotomy (‘failure’ group) was required in 140 patients (45.4%; during the same operation in 126 patients and after a median delay of 4 days (range: 1–12 days) in 14 patients). There were significantly more successes in patients with a history of one or two surgical interventions than in those with more than two (56%vs 37%; P < 0.05). There were significantly more successes in patients who had undergone appendectomy only (67/94; 71%) than in patients who (i) had no antecedent surgery (52%; P < 0.05), or (ii) underwent other surgery (33%; P < 0.001). The rate of success was significantly higher (P < 0.001) in patients operated on early (< 24 h) and in patients with bands (54%), than in those with adhesions (31%) or with other causes of obstruction (15%). The median duration of postoperative ileus was significantly shorter in the ‘success’ group than in the ‘failure’ group (2 days vs 4 days; P < 0.001). The median duration of postoperative hospital stay was shorter in the ‘success’ group than in the ‘failure’ group (4 days vs 10 days; P < 0.001). Fewer immediate wound complications were sustained in the ‘success’ group than in the ‘failure’ group (1.2%vs 10.7%; P < 0.001). The total number of immediate or delayed complications and particularly the number of recurrent obstructions after hos­pitalization as well as the number of deaths did not differ significantly between the two groups.

Conclusions: Successful laparoscopic treatment of small bowel obstruction can be expected in patients who are seen early, and who have had one or two previous interventions (particularly appendectomy, especially if bands are found).