Utilizzo di Mineral Trioxide Aggregate nella riparazione di perforazioni della forcazione: due casi clinici

Aims: Mineral Trioxide Aggregate (MTA), a Portland Cement-like materi- al, developed in 1993 by M. Torabine- jad, has been suggested in the treat- ment of furcal perforation. The aim of this study is to describe two case reports of teeth with furcal perforation treated with mineral trioxide aggre- gate. Clinical cases: two molars with a furcal perforation, due to decay and iatro- genic mistake, respectively, were treated with Mineral Trioxide Aggregate during the conventional retreatment. Clinical and radiological controls show the healing of periodontal tissues. Conclusions: the MTA seems to be the best material in the treatment of furcal perforation. Its excellent action may be connected with highly reduced quantity of liquid and bacterial leak- age, and this clinical condition seems to allow the healing of periodontal tissues

L'anatomia endodontica dei secondi molari superiori: ricerca ex vivo

Aim: of the present study was to deter- mine anatomic complexities which can be seen in maxillary second molars, with a specific attention to the presence of MB2 (second mesio-buccal) canals. Methodology: 50 maxillary second molars, which had been extracted for periodontal reasons, were selected for the study, following strict exclusion cri- teria. After determining the different roots, only the mesio-buccal one was examined. Location and number of canals were determined (i) after a normal access cavity, (ii) after a wider removal of dentine from the chamber floor, and (iii) after sectioning the root 4 mm be- low the cementum-enamel junction. Data were collected and analyzed. Results: MB2 canals were present in 44% of the examined teeth (20% of ca- ses showed Weine 2 configuration, while the remaining 24% showed Weine 3 configuration). It was possible to estabilish patency in MB2 canals only in 28% of cases. Conclusions: MB2 canals are often present in maxillary second molars, being individuated in nearly half cases. This possibility and the presence of an indipendent apex make the research of MB2 canals mandatory during the endodontic treatment

Neoadjuvant eribulin mesylate following anthracycline and taxane in triple negative breast cancer: Results from the HOPE study

Background Eribulin mesylate (E) is indicated for metastatic breast cancer patients previously treated with anthracycline and taxane. We argued that E could also benefit patients eligible for neoadjuvant chemotherapy. Methods Patients with primary triple negative breast cancer 2 cm received doxorubicin 60 mg/m2 and paclitaxel 200 mg/m2 x 4 cycles (AT) followed by E 1.4 mg/m2 x 4 cycles. Primary endpoint was pathological complete response (pCR) rate; secondary and explorative endpoints included clinical/metabolic response rates and safety, and biomarker analysis, respectively. Using a two-stage Simon design, 43 patients were to be included provided that 4 of 13 patients had achieved pCR in the first stage of the study. Results In stage I of the study 13 women were enrolled, median age 43 years, tumor size 2–5 cm in 9/13 (69%), positive nodal status in 8/13 (61%). Main grade 3 adverse event was neutropenia (related to AT and E in 4 and 2 cases, respectively). AT followed by E induced clinical complete + partial responses in 11/13 patients (85%), pCR in 3/13 (23%). Median measurements of maximum standardized uptake value (SUVmax) resulted 13, 3, and 1.9 at baseline, after AT and E, respectively. Complete metabolic response (CMR) occurred after AT and after E in 2 and 3 cases, respectively. Notably, 2 of the 5 (40%) patients with CMR achieved pCR at surgery. Immunostaining of paired pre-/post-treatment tumor specimens showed a reduction of β-catenin, CyclinD1, Zeb-1, and c-myc expression, in the absence of N-cadherin modulation. The study was interrupted at stage I due to the lack of the required patients with pCR. Conclusions Despite the early study closure, preoperative E following AT showed clinical and biological activity in triple negative breast cancer patients. Furthermore, the modulation of β-catenin pathway core proteins, supposedly outside the domain of epithelial–mesenchymal transition, claims for further investigation. Trial registration EU Clinical Trial Register, EudraCT number 2012-004956-12

Combination of letrozole, metronomic cyclophosphamide and sorafenib is well-tolerated and shows activity in patients with primary breast cancer

PURPOSE: To assess whether the combination of letrozole, metronomic cyclophosphamide and sorafenib (LCS) is well tolerated and shows activity in primary breast cancer (BC). METHODS:Thirteen oestrogen receptor-positive, postmenopausal, T2-4, N0-1 BC patients received the LCS combination for 6 months. In these patients we examined the pharmacokinetics of sorafenib and cyclophosphamide, toxicity of the regimen, the clinical response to therapy and changes in the levels of biologically relevant biomarkers. RESULTS:Adequate plasma concentrations of sorafenib were achieved in patients when it was dosed in combination with L+C. The mean plasma concentrations of C were consistently lower following administration of LCS, compared with administration of L+C only. The most common drug-related grade 3/4 adverse events were skin rash (69.3%), hand-foot skin reaction (69.3%) and diarrhoea (46.1%). According to RECIST Criteria, a clinical complete response was observed in 6 of 13 patients. A significant reduction in tumour size, evaluated with MRI, was also observed between baseline and 14 days of treatment in all 13 patients (P=0.005). A significant reduction in SUV uptake, measured by (18)FDG-PET/CT, was observed in all patients between baseline and 30 days of treatment (P=0.015) and between baseline and definitive surgery (P=0.0002). Using modified CT Criteria, a response was demonstrated in 8 out of 10 evaluable patients at 30 days and in 11 out of 13 evaluable patients at the definitive surgery. A significant reduction in Ki67 expression was observed in all patients at day 14 compared with baseline (P<0.00001) and in 9 out of 13 patients at the definitive surgery compared with baseline (P<0.03). There was also a significant suppression of CD31 and VEGF-A expression in response to treatment (P=0.01 and P=0.007, respectively).CONCLUSIONS:The LCS combination is feasible and tolerable. The tumour response and target biomarker modulation indicate that the combination is clinically and biologically active

Valutazione al SEM di file endodontici dopo procedure di detersione

Il presente lavoro valuta la morfologia dei file endodontici dopo aver subito dievsre procedure di detersion

Assessment of colour modifications in two different composite resins induced by the influence of chlorhexidine mouthwashes and gels, with and without anti-staining properties: An in vitro study

Objectives: Chlorhexidine (CHX)-based products are the most effective chemical agents used in plaque control and oral disinfection. One of their side effects is tooth and restoration staining. For this reason, CHX products with anti-discolouration systems (ADS) have been developed. The aim of this in vitro study was to compare different CHX-based products (gel and mouthwash) with or without ADS in composite colour modification.Methods: Two hundred specimens were created, 100 of which were made of packable composite and 100 of flowable composite. After 24 h, colour coordinates (L*, a*, b*, C*, h degrees) were recorded using a spectrophotometer (T0). Then, all samples were subjected to a CHX/tea staining model and immersed in human saliva for 2 min. Composite specimens were divided in 10 groups (N = 20). Control groups (PC, FC) were soaked in distilled water and test groups (PG, PGads, FG, FGads, PM, PMads, FM and FMads) were immersed in CHX-based solutions or brushed with CHX gel. Then the cycle was repeated 6 times, and colour differences (Delta E-ab and Delta E-00) were finally calculated.Results: Through flowable composites, FC and FG showed the highest colour differences, respectively Delta E-ab = 3.48 +/- 1.0, Delta E-00 = 2.24 +/- 0.6 and Delta E-ab = 2.95 +/- 1.3, Delta E-00 = 1.53 +/- 0.6. In the composite groups instead, PM and PMads showed the highest colour differences, respectively Delta Eab = 2.78 +/- 1.3,Delta E00 = 1.94 +/- 0.8 and Delta E-ab = 2.71 +/- 1.4, Delta E-00 = 1.84 +/- 0.9.Conclusions: CHX-containing products are able to cause stains on restorative composite materials. Discolouration is more likely to occur in flowable composites than packable composites, and ADS-containing products cause fewer pigmentations than CHX products without ADS. Packable composites showed more staining after mouthwash treatment, whereas flowable composites underwent higher discolouration after treatment with gels

Rheumatic Manifestations in Autoimmune Liver Disease

Autoimmune liver diseases coexist with rheumatic disorders in approximately 30% of cases and may also share pathogenic mechanisms. Autoimmune liver diseases result from an immune-mediated injury of different tissues, with autoimmune hepatitis (AIH) targeting hepatocytes, and primary biliary cholangitis (PBC) and primary sclerosing cholangitis targeting cholangiocytes. Sjogren syndrome is diagnosed in 7% of AIH cases and serologic autoimmunity profiles are a common laboratory abnormality, particularly in the case of serum antimitochondrial (PBC) or anti\ue2\u80\u93liver kidney microsomal antibodies (AIH). Therapeutic strategies may overlap between rheumatic and autoimmune liver diseases and practitioners should be vigilant in managing bone loss

Effects of nucleating agents on diopside crystallization in new glass-ceramics for tile-glaze application

The effect of crystallization produced by addition of TiO2, ZrO2 and P2O5 oxides to glass-ceramic of the system CaO-MgO-SiO2 was studied using structural and thermal techniques. The devitrification process was independent of thermal treatment. X-ray diffraction studies performed on the glass-ceramic system indicated that diopside crystalline phase was more thermodynamically favourable than other phases. The effect of the nucleating agent depends on its nature: TiO2 decreased the activation energy while P2O5 and ZrO2 did not. SEM analysis of the doped glass-ceramics showed randomly distributed crystals with significant dimensional variations from those of the undoped system. All these formulations, showing a high crystallization rate, and a fast heating rate, can be used as tile glazes and/or tile-glaze components

In vitro and ex vivo studies on the antibacterial efficacy of sodium hypochlorite and two new generation endodontic irrigants, Tetraclean® and MTAD, in comparison with sodium hypochlorite.

The aim of this work was to compare the efficacy of two endodontic iorrigants of new generation, Tetraclean and MTAD. Their antimicrobial effectiveness was assessed by in vitro and in vivo studies. Sodium hypochlorite was included as standard reference irrigant