Abstract Introduction: Nosocomial infections caused by Pseudomonas aeruginosa producing carbapenemases represent an important cause of morbidity and mortality among immunosuppressed patients. The aim of our study was to detect the production of metallo-carbapenemases (MBLs) by phenotypic methods and to detect the presence of the MBLs encoding genes (blaIMP and blaVIM) by PCR in P. aeruginosa strains isolated from hospitalized patients to the Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca. Material and methods: Between September 2014-February 2015, we tested thirty-eight P. aeruginosa strains resistant to carbapenems according to CLSI 2014 breakpoints, determined by Vitek ® 2(BioMérieux),isolated from various clinical specimens. Phenotypic detection of the MBLs production was performed using the KPC/MBL Confirmation kit (ROSCO ® ) and the MBL Etest ® IP/IPI (BioMérieux). We used the PCR method for detecting MBLs encoding genes: blaIMP, blaVIM. Results: The strains were obtained from surgery (55.3%), ICU (15.8%) and gastroenterology wards (28.9%), isolated from pus (25.8%), tracheal secretion (22.7%), bile (13.6%), sputum (10.6%), blood (10.6%), other secretions (16.7%). These strains were resistant to multiple classes of antibiotics. By ROSCO ® method 28/38 strains (73.7%) were positive with imipenem ± dipicolinic acid (DPA) and 22/38 (57.9%) with meropenem ± DPA. Etest ® waspositive for the 28/38 strains (73.7%). 11 strains (28.9%) were positive for KPC with the screening method. We identified: 6 blaIMP+ (15.8%), 2 (5.3%) blaVIM+ and 4 blaIMP+/blaVIM+ strains (10.5%). Conclusion: Both genes encoding MBL were found, alone or in combination. The increasing level of carbapenem resistance of these strains impose their routine testing to detect MBL.
Patients with disabilities have a higher prevalence of caries and dental erosions than general population. This particularity may be assessed by the study of microcrystallization of saliva. We investigated the oral liquid microcrystallization in children with gastroesophageal reflux disease (GERD), a condition associated with dental erosions.54 children have been clinically examined: 27 children suffering from GERD with ages between 13 and 15, were included in the study group, and 27 healthy children - the control group. The study of crystallographic changes of the oral liquid was performed using the method developed by Shatohina, Razumov SN, Shabalin VN (2006) with the scanning electron microscope VEGA TESCAN TS 5130 MM.The degree of microcrystalization of the oral liquid in children with GERD was considerably reduced, (1.73±0.11 points) and was lower than in children in the control group (3.22±0.16 points) (p<0.01, RR=2). The degree of microcrystallization of oral liquid in children with GERD was 1.86 times lower than in healthy children. This was correlated with the duration of gastroesophageal reflux.The study of structural particularities of dehydrated droplet of oral liquid in children with GERD has elucidated a number of markers of the changes produced in the oral cavity. These can be used in the screening research in prevention of caries and dental erosions.
15 at% Mg-doped ZrO2 ceramic material was synthesized by solid-state reaction at 1600 ºC.Particle size analysis of raw materials mixture depicts the formation of a narrow particle size distribution (PSD) with a mean particle size of about 56 nm.The structural analysis confirms that the assynthesized Mg-doped ZrO2 product is of pure tetragonal phase (t-ZrO2) with a crystallite size of 55.76 nm.The UV-VIS diffuse reflectance spectrum (DRS) showed a maximum %R at 550 nm and the estimated optical bandgap was about 3.83 eV.The morphology of the sample examined by scanning electron microscopy (SEM) shows interconnected grains in the sintered ceramics.Moreover, EDX analyses confirm the presence of Mg, Zr, and O, with a homogenous distribution throughout the sample.
The loss of teeth is largely caused by supporting tissue damage, because of bacterial invasion from the infected root canals. Sixty patients with periapical lesions (PLs) of endodontic origin were included in the study. Clinical and radiological examination was performed. Periapical radiographs were analyzed by two independent observers to determine the size and severity of PLs, using Periapical Index (PAI) scores. The tissue samples collected by periapical curettage during apicoectomy or after dental extractions by alveolar curettage were histologically and immunohistochemically analyzed. The PLs were histologically diagnosed as: periapical granulomas (PGs), granulomas with cystic potential and radicular cysts (RCs) with various degrees of inflammation. Capillary density was evaluated using the angiogenic index after immunohistochemical staining with CD34 monoclonal antibody. A statistically significant correlation was observed between PAI scores and the size of the lesions. 68.33% of cases were PGs, 18.33% PGs with cystic potential and 18.33% RCs with different degrees of inflammation. Seventy-five percent PLs had an angiogenic index 1 and 25% had an angiogenic index 2. Statistically significant differences were obtained between the angiogenic index and lesion size (p<0.05). Capillary density within PLs did not influence the severity scores of lesions detected on radiographs. The angiogenic index appeared not to be associated with the histological lesion type and the intensity of inflammation, but was more likely correlated with the degree of granulation tissue maturation and the size of PLs.
Aims. The aim of this experimental study is to assess the bone healing phenomenon produced in the presence of several dental materials: a polycarboxylate cement, a glass-ionomer cement, a composite resin and MTA (mineral trioxide aggregate) based cement. Methods. The biocompatibility of four root-end fillings materials, used in periapical surgery was investigated after intra-osseous implantation of the materials in rats’ calvaria. Tissue reaction was studied at 2, 4, 6, 8, 10 and 12 weeks after implantation. We took into consideration the presence of inflammatory cells (polymorphonuclear leukocytes, macrophages, plasma cells, lymphocytes and giant cells) and classified the aspects of the histological samples according to the following scale: 0 - no inflammation, 1 – mild, isolated inflammation, 2 - moderate, localized inflammatory reaction, 3 - severe, diffuse and intense inflammatory reaction.Results. The inflammatory reaction was present at the six intervals for all the tested materials, but at 12 week interval, the reaction was minimal in all cases. Also, a dissolution reaction was observed for all the materials, less intense for glass-ionomer cement and polycarboxilate cement.Conclusions. At the end of the experimental period, glass-ionomer cement and polycarboxilate cement suffered a lesser dissolution reaction as compared to the second group of tested materials.
Introduction Dental erosion (DE) is defined as a progressive, irreversible loss of dental hard tissues due to a chemical process, without bacterial involvement, and is not directly associated with mechanical or traumatic factors or with dental caries (Bamise et al 2008, Imfeld 1996). Anyway, the mechanism of DE induces fragile surfaces of dental tissues, increasing tooth wear by mechanical mechanism (Lasserre 2003). A multifactorial condition, with higher prevalence in the recent decades (Lussi 2006, 2012) DE is caused by the presence of acidic source which may be either of intrinsic origin or extrinsic source or a combination of both (Barron et al 2003; Lussi et al 2008, 2012). Prolonged contact between extrinsic or intrinsic acids with tooth surfaces determinate the dissolution of mineralized teeth structures. Critical pH of the enamel is 5.5. According to Lussi, pH of the acid is less important than contact duration (Lussi 2006). Although, the critical pH below which enamel dissolves is not constant, but it is rather inversely proportional to the concentrations of calcium and phosphate in saliva (Dawes 2003). The most devastating acid is gastric juice, which contains hydrochloric acid and low concentrations of calcium and phosphate and has a pH of less than 2 thus having great potential to cause DE. An enamel surface eroded by acidic attacks cannot be remineralized because there is no suitable matrix for crystal growth (Dawes 2003). DE produced by acidic exposure, typically progresses very slow over a period of years. The DE is a slowly progressive process, with periods of activity and inactivity ranging from a minimal loss of surface enamel to the partial and complete exposure of dentine. A variety of extrinsic and intrinsic factors are associated with DE. Extrinsic factors include most commonly dietary acids (citrus fruits, acidic drinks and foods), environment (industrial chemicals-sulfuric, nitric and chromic acid exposure, chlorinated pools) and medication in particular, the use of vitamin C tablets, non steroidal anti-inflammatory or some asthma drugs. Intrinsic factors of DE are acids of gastric origin regurgitated into esophagus and oral cavity and come in contact direct with the teeth in different pathological conditions: gastro-esophageal reflux disease (GERD), regurgitation, excessive vomiting related to eating disorders such as anorexia nervosa or bulimia, chronic vomiting during pregnancy, drug’s effects and alcoholism (Bartlett et al 2011, 2013; Dawes et al 1995). Abstract. Introduction: The occurrence of dental erosion (DE) involves the prolonged contact of acids of extrinsic and intrinsic origin with the tooth tissues, without intervention of pathogenic bacteria. Gastro esophageal reflux disease (GERD) is one of the most common disorder of digestive tract causing several extra-esophageal manifestations including impacting the hard dental structures. Objective: We investigate the distribution/severity and the relationships of DE with associated factors in patients from two French medical centers involved in an international AUF project: Digestive Diseases Institute, University of Nantes and Faculty of Dentistry Victor Segalen, University of Bordeaux. Material and method: A total of 119 patients comprising 77 (64.7%) female and 42 (35.3%) male, mean age 43.81± 14.42 years were included in the study. Two questionnaires regarding alimentary habits, lifestyle, general and digestive diseases and medications associated that favor the occurrence of DE and gastro-esophageal reflux were completed. Oral examination to quantify the severity of DE was done using the Basic Erosive Wear Examination Index. Buccal (B), palatal/ lingual (P /L) and occlusal (O) / incisal (I) surfaces are examined and the highest score was recorded. Results: DE scores were higher on the palatal/ lingual and incisal surfaces of the anterior teeth and the palatal/lingual and occlusal surfaces of the posterior teeth in patients with GERD. No statistically differences were found between DE scores and age, gender, diet or medications. Conclusion: The most affected surfaces by DE in the presence of GERD were the palatal/ lingual and incisal surfaces of the anterior teeth and the palatal/lingual and occlusal surfaces of the posterior teeth.
Aim of the study was to investigate compatively the compressive strength for three computer-aided design/computer-aided manufacturing (CAD/CAM) dental materials: glassceramic IPS Empress CAD (IvoclarVivadent), hybrid ceramic Cerasmart (GC) and polymer-reinforced graphene G-CAM (Graphenano Dental). Material and methods 45 samples consisted of the single-unit molar crowns fabricated by three CAD/CAM materials were cemented adhesively on 3D printed abutments (Asiga Dental Resin). The samples were divided into 3 groups (n=15) according to the crowns thickness; group 1 under the cusps/cervical margins - 0.6 mm/0.4 mm, group 2 - 1 mm/0.7 mm respectively, and group 3 - 1.5 mm/1 mm. Additionally, 20 cylindrical specimens fabricated by the three crowns and abutments material (n=5) were prepared by CAD/CAM technique. All samples and specimens were subjected to an axial compressive load by using a universal testing machine (Instron 3366-10kN, USA) until fracture. Results The compressive strength values were 1258 MPa for Empress CAD, 501.3 MPa for Cerasmart, 435 MPa for G-CAM and 360 MPa Asiga resin. G-CAM crowns exhibited a higher maximum compressive load (1701.5-2011.8N) than both Cerasmart (1295.4-1642.9N) and Empress CAD (494.3-597.5N). Conclusions The CAD/CAM crown materials presented different mechanical behavior; Empress CAD and Cerasmart presented a fragile behavior, with a high compressive strength when compared to G-CAM and Asiga resins.
Background and aim. Dental erosion (DE) represents a frequent condition in adults and the elderly. The gastroesophageal reflux disease (GERD) is considered an important endogenous factor causing dental erosions. The objective of this study was to assess the prevalence of DE in GERD patients and to establish the correlation between pathogenic intrinsic and extrinsic factors of DE and their relation to GERD.
Methods. A cross-sectional study was conducted on 263 patients (median age 43). Patients with heartburn were recruited in two countries with different prevalence of GERD. Patients were recruited from France (n=158, 60%) and Romania (n=105, 40%) including 163 females and 100 males. The Basic Erosive Wear Examination (BEWE) index for diagnosis and evaluation of dental erosion was used. Based on the value of BEWE score, each patient was included in a risk group for DE development (low risk: BEWE=3-8, medium risk: BEWE=9-13, high risk: BEWE ≥14). Patients filled a questionnaire regarding GERD symptoms, medications, life style. Salivary parameters (pH and buffering capacity) were also assessed and analyzed.
Results. DE was significantly more frequent and more severe in GERD subjects than in the non-GERD controls. Low salivary pH but not salivary buffering capacity was associated with BEWE scores. Buffering capacity however was significantly more altered in patients with BEWE score over 9 (medium DE) than in patients with mild DE (BEWE <9). Although extrinsic factors (consumption of citrus fruits, soda drinks) were associated with DE in GERD, there was no statistical correlation with the BEWE score. From the total of 263 patients, 229 (87.1%) presented BEWE score <9, and 34 (12.9%) presented BEWE ≥9. The DE was significantly associated with the presence of GERD (p<0.001). BEWE score >9 was more frequently present in GERD patients (30 patients: 21.3%) than in non GERD patients (4 patients: 3.3%). DE were more frequent in French subjects compared to Romanian subjects. Romanians had lower BEWE scores than the French.
Conclusions. DE is more frequent and more severe with GERD vs. non-GERD. DE in GERD is associated with extrinsic dietary factors like citrus fruits and soda drinks.
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