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Developments in the field of allergy in 2017 through the eyes of Clinical and Experimental Allergy

Summary

In this article, we described the development in the field of allergy as described by Clinical and Experimental Allergy in 2017. Experimental models of allergic disease, basic mechanisms, clinical mechanisms, allergens, asthma and rhinitis and clinical allergy are all covered.

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Best of the Other Journals

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Forthcoming Meetings

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Cover Image

The cover image is based on the Original Article Monocytes accumulate in the airways of children with fatal asthma by Ibon Eguíluz‐Gracia et al, DOI: https://doi.org/10.1111/cea.13265.

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Effect of periodontal treatment on Aggregatibacter actinomycetemcomitans (Aa) colonization and serum IgG levels against Aa serotypes and Omp29 of aggressive periodontitis patients

Abstract

Objective

To evaluate the effect of the periodontal treatment on A. actinomycetemcomitans (Aa) JP2 clone, and the IgG serum levels against its outer membrane protein (Omp29) and Aa serotypes in aggressive periodontitis (AgP).

Subjects and Methods

Seventeen patients with generalized (GAgP), 10 with localized (LAgP) and 10 healthy controls were included. AgP participants were submitted to periodontal treatment – scaling and root planing plus antibiotics (SRP+A). Periodontal parameters, e.g. probing depth [PD] and clinical attachment loss [CAL]), were evaluated at baseline and at 1‐year. Serum IgG against Omp29 and serotypes a, b and c were determined by ELISA. The levels of Aa JP2 clone were determined in subgingival biofilm samples by qPCR.

Results

Periodontal treatment resulted in significant reductions of PD, CAL, and IgG levels against Omp29, serotypes b and c. After therapy, IgG levels against Aa serotypes, as well as the levels of the JP2 clone in AgP became similar to controls. The reduction in JP2 clone count was correlated with a reduction of PD and IgG response against Omp29.

Conclusion

SRP+A decreased IgG levels response against Omp29 and Aa serotypes involved in the disease (b and c), while the serum‐response increased against tne commensal serotype (a), similar to what occurs in periodontally healthy individuals.

This article is protected by copyright. All rights reserved.

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NTN1 gene was risk to NSCLO among Han Chinese Population

Abstract

Objective

Genome wide association studies (GWAS) found NTN1, NOG and the region between CREBBP and ADCY9 were risks to non‐syndromic cleft lip with or without cleft palate (NSCL/P). However, the association of single nucleotide polymorphisms (SNPs) in these genes with NSCL/P in Western China is unknown.

Subjects and Methods

We selected seven SNPs in NTN1, NOG and between CREBBP and ADCY9, then performed transmission disequilibrium test (TDT), parent‐of‐origin effect and sliding window haplotype analysis to test the associations among 302 NSCL/P case‐parent trios from Western Han Chinese.

Results

We found allele G at rs4791774 in NTN1 was significantly over‐transmitted among non‐syndromic cleft lip only (NSCLO) (P=0.0067, OR=1.79, 95%CI: 1.17‐2.74); rs4791774 and rs9915089 tightly linked with each other among NSCL/P (D'=0.87, r²=0.67) and haplotypes carrying the risk allele G at rs4791774 were always found to be over‐transmitted from parents to cases. Motif analysis indicated that allele G at rs4791774 could greatly alter the affinity of Myc_disc7, so allele G at rs4791774 in NTN1 might modulate C‐MYC transcription to participate in the etiology of NSCLO.

Conclusions

Our study suggested allele G at rs4791774 in NTN1 gene is risk for NSCLO, which could greatly increase the risk to have a baby with cleft.

This article is protected by copyright. All rights reserved.

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Protective Role of α2‐Macroglobulin against Jaw Osteoradionecrosis in a Preclinical Rat Model

Abstract

Objective

We have previously demonstrated the effect of alpha‐2‐macroglobulin (α2M) in the remediation of radiation‐induced cellular damage. Here, we investigated the protective effects of α2M in a preclinical rat model of jaw osteoradionecrosis (ORN).

Methods

Eighteen rats were divided randomly into three groups: the control group, the radiation therapy (RT) alone group, and the radiated mandibles pretreated with α2M (α2M + RT) group. One month after radiation, all left molar teeth were extracted. After another three months, the animals were sacrificed and body weight, histopathology, microcomputed tomography and immunofluorescence were evaluated in all groups.

Results

The RT group showed serious alopecia, bone exposure, inflammation, necrosis, fibrosis, and absence of new bone formation within the socket. The α2M + RT group exhibited less alopecia than the RT group and slight inflammation and fibrosis in the bone marrow cavity. The cortical bone was similar to normal bone tissue. Interestingly, compared with RT group, serum superoxide dismutase levels in the α2M + RT group increased at the 1^th day (p= 0.037), 14^th day (p= 0.012), while reactive oxygen species levels clearly decreased at the 1^th day (p< 0.001), 14^th day (p= 0.007), and 28^th day (p= 0.013).

Conclusions

A clinically translational model of jaw ORN was successfully established and the application of α2M prior to radiation protected the bone from being injured by the radiation, possibly related to oxidative stress.

This article is protected by copyright. All rights reserved.

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Development and validation of mathematical models for testing antifungal activity of different essential oils against Candida species

Publication date: Available online 1 December 2018

Source: Archives of Oral Biology

Author(s): Mirjana Perić, Katarina Rajković, Aleksandra Milić Lemić, Rade Živković, Valentina Arsić Arsenijević

Abstract

Objective

The upward trend in using plant materials introduced essential oils (EOs) as a valuable, novel, bioactive antifungal agent and as an alternative to standard treatment protocol of denture stomatitis caused by Candida species. Therefore, the aim was to evaluate the antifungal activity of different EOs and to present the response surface methodology (RSM) and artificial neural network (ANN) as possible tools for optimizing and predicting EOs antifungal activity.

Methods

Minimum inhibitory concentration (MIC) and Minimum fungicidal concentration (MFC) of the EOs against 3 species Candida spp. (C. albicans, C. tropicalis, C. glabrata) isolated in patients with DS were determined, together with optimization and prediction based on non-terpene and terpene content in EOs, using two mathematical models RSM and ANN-GA.

Results

The highest concentrations of EO M. alternifolia inhibited (1.6 – 2.8 μg/ml) and fungicided (3.5 – 6.0 μg/ml) all three investigated Candida spp. while the lowest concentrations of EO C. limon inhibited (0.2 – 0.5 μg/ml) and fungicided (0.6 - 1.1 μg/ml).Among the three types of Candida, C. glabrata was the most sensitive. The RSM modelling proved that MICs and MFCs statistically depend on non-terpene and terpene content in different EOs (<0.0001). Both models showed that a citrus oil (EO C. limon) with 89% content of terpenes and limonene as major constituent was more antifungal efficient.

Conclusions

The investigated EOs showed a broad spectrum of anticandidal activity, also confirmed using the RSM and ANN-GA models. Since EOs can be cytotoxic in higher concentrations, models may be used for qualitative and quantitative dosage predictions of the antifungal activity of EOs.

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Effects of Lactobacillus salivarius WB21 combined with green tea catechins on dental caries, periodontitis, and oral malodor

Publication date: Available online 30 November 2018

Source: Archives of Oral Biology

Author(s): Takuya Higuchi, Nao Suzuki, Seigo Nakaya, Sami Omagari, Masahiro Yoneda, Takashi Hanioka, Takao Hirofuji

Abstract

Objective

To evaluate the combined use ofLactobacillus salivarius WB21 and (–)-epigallocatechin gallate (EGCg) for oral health maintenance.

Design

The effects ofL. salivarius WB21 on growth of Streptococcus mutans, the insoluble glucan produced by S. mutans, and on growth of Porphyromonas gingivalis were evaluated in vitro. In addition, the susceptibility of five oral pathogenic bacteria and L. salivarius WB21 to EGCg, the inhibiting effect of EGCg on methyl mercaptan, and the effects of L. salivarius WB21 and EGCg in combination on growth of P. gingivalis were examined.

Results

Lactobacillus salivarius WB21 showed concentration-dependent inhibition of the growth of S. mutans. Addition of L. salivarius WB21 inhibited production of the insoluble glucan by S. mutans (p < 0.001). A filtrate of L. salivarius WB21 culture solution inhibited growth of P. gingivalis (p < 0.001 vs. control), and this effect was enhanced when it was used in combination with EGCg (p < 0.001 vs. the addition of L. salivarius WB21). In addition, EGCg directly inhibited methyl mercaptan in a concentration-dependent manner (p < 0.001). Concerning bacterial susceptibility to EGCg, growth of P. gingivalis, Prevotella intermedia, and Fusobacterium nucleatum was inhibited at 2.5 mg/mL of EGCg, while that of L. salivarius WB21 was inhibited at 25 mg/mL EGCg.

Conclusions

Our results imply thatL. salivarius WB21 may be useful for controlling dental caries, periodontitis, and oral malodor. In addition, the effects of L. salivarius WB21 on periodontitis and oral malodor may be synergistically enhanced by use in combination with EGCg.

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Assessment of Permanent Selective His Bundle Pacing in Left Ventricular Synchronization Using 3-D Speckle Tracking Echocardiography

Publication date: Available online 1 December 2018

Source: Ultrasound in Medicine & Biology

Author(s): Jiaojiao Tang, Silin Chen, Lie Liu, Hongtao Liao, Xianzhang Zhan, Shulin Wu, Yuanhong Liang, Oudi Chen, Chunying Lin, Qianhuan Zhang, Huiqiang Wei, Dongli Chen

Abstract

The study described here aimed to evaluate left ventricular (LV) systolic mechanical synchronization during permanent selective His bundle pacing (SHBP) using 3-D speckle-tracking echocardiography post-operatively and 6 mo after pacemaker implantation in 62 patients randomly assigned to SHBP (n = 32) or right ventricular apical pacing (RVAP, n = 30). A standard apex four-chamber view was exposed and was transformed into full-volume mode under 3-D echocardiography. Three-dimensional speckle-tracking echocardiography was analyzed offline. The primary endpoint was LV mechanical synchronization post-operatively and during the 6-mo follow-up. Significant LV dyssynchrony was detected while evaluating the maximum time difference and standard deviation of 16-segment systolic time to peak 3-D strain at 1 wk and 6 mo. The pacing thresholds were significantly higher in the SHBP than in the RVAP group throughout follow-up. The R-wave amplitude was significantly lower in the SHBP group than with RVAP. The pacing parameters during SHBP were as stable as during conventional RVAP during the mid-term follow-up. In conclusion, 3-D speckle-tracking echocardiography is feasible and provides a more convenient method for evaluating LV synchrony.

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On the Relationship between Dynamic Contrast-Enhanced Ultrasound Parameters and the Underlying Vascular Architecture Extracted from Acoustic Angiography

Publication date: Available online 30 November 2018

Source: Ultrasound in Medicine & Biology

Author(s): Anastasiia Panfilova, Sarah E. Shelton, Cristina Caresio, Ruud J.G. van Sloun, Filippo Molinari, Hessel Wijkstra, Paul A. Dayton, Massimo Mischi

Abstract

Dynamic contrast-enhanced ultrasound (DCE-US) has been proposed as a powerful tool for cancer diagnosis by estimation of perfusion and dispersion parameters reflecting angiogenic vascular changes. This work was aimed at identifying which vascular features are reflected by the estimated perfusion and dispersion parameters through comparison with acoustic angiography (AA). AA is a high-resolution technique that allows quantification of vascular morphology. Three-dimensional AA and 2-D DCE-US bolus acquisitions were used to monitor the growth of fibrosarcoma tumors in nine rats. AA-derived vascular properties were analyzed along with DCE-US perfusion and dispersion to investigate the differences between tumor and control and their evolution in time. AA-derived microvascular density and DCE-US perfusion exhibited good agreement, confirmed by their spatial distributions. No vascular feature was correlated with dispersion. Yet, dispersion provided better cancer classification than perfusion. We therefore hypothesize that dispersion characterizes vessels that are smaller than those visible with AA.

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Switched CD21–/low B cells with an antigen-presenting phenotype in the infant thymus

Publication date: Available online 30 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Christina Lundqvist, Alessandro Camponeschi, Marcella Visentini, Esbjörn Telemo, Olov Ekwall, Inga-Lill Mårtensson

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Sublingual allergen immunotherapy with a liquid birch pollen product in seasonal allergic rhinoconjunctivitis with/without asthma*

Publication date: Available online 30 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Oliver Pfaar, Claus Bachert, Piotr Kuna, Peter Panzner, Mária Džupinová, Ludger Klimek, Maroesja J. van Nimwegen, Johan D. Boot, Donghui Yu, Dirk Jan E. Opstelten, Pieter-Jan de Kam

Abstract

Background

Sublingual allergen immunotherapy (SLIT) has been demonstrated to be both clinical efficacious and safe. However, in line with the current regulatory guidance from the European Medicines Agency, allergen immunotherapy (AIT) products must demonstrate their efficacy and safety in pivotal, phase III trials for registration.

Objective

To investigate the efficacy and safety of sublingual high-dose liquid birch pollen extract (40,000 AUN/ml) in birch pollen allergic adult patients.

Methods

A randomized, double-blind, placebo-controlled, parallel-group, multicenter trial was conducted in 406 adult patients with moderate to severe birch pollen induced allergic rhinoconjunctivitis with or without mild to moderate controlled asthma. Treatment was started 3-6 months prior to the birch pollen season and was continued during the season in 40 clinical study centers in 5 European countries. For primary endpoint assessment the recommended combined symptom and medication score (CSMS) of the European Academy of Allergy and Clinical Immunology (EAACI) was used. Secondary endpoints included Quality of Life assessments, immunological parameter and safety.

Results

The primary efficacy results demonstrate a significant (p< 0.0001) and clinically relevant (32%) reduction in the CSMS compared to placebo after 3-6 months of SLIT. Significant better rhinoconjunctivitis quality of life scores (p<0.0001) and patients' own overall assessment of their health status: visual analogue scale (EQ-VAS; p=0.0025) were also demonstrated. In total, a good safety profile of SLIT was observed.

Conclusion

This study confirmed clinical efficacy as well as safety of a sublingual liquid birch pollen extract in birch pollen allergic adult patients in a pivotal phase III trial. (EudraCT: 2013-005550-30; ClinicalTrials.gov: NCT02231307).

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Interferon-lambda1 enhances Staphylococcus aureus clearance in healthy nasal mucosa, not in nasal polyps

Publication date: Available online 30 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Feng Lan, Hua Zhong, Nan Zhang, Sebastian L. Johnston, Weiping Wen, Nikos Papadopoulos, Luo Zhang, Claus Bachert

Abstract

Background

Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by a Th2-skewed inflammation and an increased colonization by Staphylococcus aureus (S. aureus). Interferon-lambda 1(IFN-λ1) is known for its antiviral activity, there is little information on its anti-bacterial role.

Objective

To determine the expression and release of IFN-λ1 from healthy and CRSwNP nasal mucosal tissue upon exposure to S. aureus and assess its potential role in anti-bacterial defense mechanisms.

Methods

Healthy and CRSwNP nasal tissues were exposed to S. aureus and assessed the expression of IFN-λ1 and MUC5AC and MUC5B. THP1 derived macrophages incubated with or without IFN-λ1 were assessed for uptake and killing of S. aureus and expression of lysosomal-associated membrane protein 1 (LAMP1) and intracellular reactive oxidase substrate (ROS), IFN-λ1 receptor IL-28R and Janus kinase (JAK)/signal transducer and activator of transcription (STAT) 1 pathway by immunofluorescence staining.

Results

S. aureus infection increased IFN-λ1 expression in healthy nasal tissue, not in CRSwNP tissue. IFN-λ1 (10 ng/ml) significantly decreased the number of S. aureus colony-forming units in healthy control tissue, but not in CRSwNP tissue, and upregulated MUC5AC and MUC5B expression in control tissues upon S. aureus infection. IFN-λ1 stimulation increased intracellular killing of S. aureus in THP1 derived macrophages and substantially increased LAMP1, IL-28R, ROS and STAT signaling in macrophages incubated with S. aureus. All of these effects were attenuated by blocking IL-28R and ROS activities.

Conclusions

IFN-λ1 favors the clearance of S. aureus in healthy nasal mucosa, and enhances antibacterial function of macrophages via IFN-λ1-IL-28R-ROS-JAK-STAT signaling pathways.

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Obesity and severe asthma

Publication date: Available online 1 December 2018

Source: Allergology International

Author(s): Hiroki Tashiro, Stephanie A. Shore

Abstract

Obesity is an important global health issue for both children and adults. Obesity increases the prevalence and incidence of asthma and also increases the risk for severe asthma. Here we describe the features of severe asthma phenotypes for which obesity is a defining characteristic, including steroid resistance, airway inflammation, and co-morbidities. We also review current concepts regarding the mechanistic basis for the impact of obesity in severe asthma, including possible roles for vitamin D deficiency, systemic inflammation, and the microbiome. Finally, we describe data indicating a role for diet, weight loss, and exercise in the treatment of severe asthma with obesity. Better understanding of the mechanistic basis for the role of obesity in severe asthma could lead to new therapeutic options for this population.

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The South Asian Facial Anthropometric Profile: A Systematic Review

Publication date: Available online 30 November 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Maria Raveendran

Summary

Purpose

Craniofacial anatomy, as measured by facial anthropometric data, varies significantly between races. South Asia, comprised of eight countries, represents a large proportion of the global population and is the fastest-growing region of the world. This systematic review presents the facial anthropometric data collected for populations from this region.

Materials and Methods

This systematic review was conducted in accordance with PRISMA guidelines. A systematic review of the literature was conducted by an electronic search of the MEDLINE and Cochran databases, returning 1675 articles. Bibliographies of accepted articles were screened to identify further eligible studies.

Results

A total of 12 articles were considered eligible for the systematic review. Two studies were conducted in Bangladesh, 7 in India, and 3 in Nepal. No facial anthropometric data were found for populations from Afghanistan, Bhutan, Maldives, Pakistan, or Sri Lanka. Qualitative and quantitative parameters from the 12 studies were extracted.

Conclusion

There is a paucity of facial anthropometric data for South Asian populations. As South Asia has a significant prevalence of craniofacial anomalies and a burgeoning cosmetic facial surgery market, it is in the interest of both the craniofacial surgeon and the South Asian patient to collect baseline facial anthropometric data for this population.

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Semiautomatic device for in vitro/ experimental bone perforation in dental implant research

Publication date: Available online 30 November 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Marco Antônio da Costa Borges, Rogério Margonar, Maciel Antônio Spinelli, Indira Moraes Gomes Cavalcanti, Guilherme José Pimentel Lopes de Oliveira, Thallita Pereira Queiroz

Abstract

Purpose

The present study presents a semiautomatic device developed to perform in vitro experiments using surgical drills for assisting dental implant research. It was built to perform tests independent of human direct contact, and contains an adjustable toolholder for engaging different types of implant contra angle hand pieces, in which different drills can be adapted. The researcher is able to make a range of adjustments on the machine, such as controlling the drilling force and depth.

Materials and methods

The device was tested on samples of both synthetic and natural bone with type I density, and a sequence of drills selected to perform the perforations. Drilling time and perforation force exerted during drilling were evaluated, as both parameters are required to be standardized.

Results

It was observed that the drilling performed using the device was uniform using both types of bone, although the drilling time for the synthetic bone was higher. All perforations were exactly on the spot previously determined, and without variations in drill angulations. The perforation force was higher for the lance pilot drill for both bone types, and the natural bone required a higher axial force than the synthetic bone.

Conclusion

Thus, we consider this device trustable to perform standardized analysis and provide accurate results. It can be used for tests performed in universities and companies that develop dental implant materials and products.

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Comparison of the effects of cement removal from zirconia and titanium abutments: An in vitro study

Publication date: Available online 1 December 2018

Source: The Journal of Prosthetic Dentistry

Author(s): Ankur Dahiya, Nadim Z. Baba, Mathew T. Kattadiyil, Charles J. Goodacre, Akshita Mann

Abstract

Statement of problem

Excess cement around dental implants is a significant cause of peri-implant inflammation. Research has focused on approaches to cement removal, the type of cement used, and the different instruments used for cement removal with titanium abutments. However, data comparing zirconia with titanium abutments are lacking.

Purpose

The purpose of this in vitro study was to compare the effectiveness of excess cement removal from zirconia and titanium custom abutments using an explorer and to compare the effects of cement removal on the abutment surfaces.

Material and methods

Implant analogs were placed in a cast in the position of the 2 maxillary central incisors. After creating similar emergence profiles for both the implant abutments, 18 zirconia and titanium custom abutments were fabricated with 1-mm subgingival finish lines on the facial and interproximal areas and an equigingival finish line on the palatal side. The crowns were cemented with zinc oxide-eugenol cement, and a steel explorer was used to remove the excess cement. All abutments were analyzed under a scanning electron microscope for cement remnants and scratches.

Results

The mean surface area of cement remnants on the zirconia abutments was 778 ±113 μm², and for titanium abutments, it was 1123 ±252 μm², which in terms of the mean percentage area was 3.27% of the total surface area of zirconia and 4.71% of titanium abutments. Only a few abutments from each group showed scratches, and no deep scratches or gouges were observed.

Conclusions

Zirconia and titanium abutments had statistically similar cement remnants. Scratches were observed on only a few specimens.

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Antagonist enamel wear of tooth-supported monolithic zirconia posterior crowns in vivo: A systematic review

Publication date: Available online 1 December 2018

Source: The Journal of Prosthetic Dentistry

Author(s): Min Gou, Helin Chen, Jian Kang, Hang Wang

Abstract

Statement of problem

An assessment of the evidence for the antagonist enamel wear of tooth-supported monolithic zirconia posterior crowns is lacking.

Purpose

The purpose of this systematic review was to identify and summarize clinical studies related to the antagonist enamel wear of tooth-supported monolithic zirconia posterior crowns.

Material and methods

PubMed, Embase, and Cochrane library searches were performed and complemented by manual searches from database inception to December 25, 2017, for title and abstract analysis.

Results

Initially, 198 articles were obtained through database searches. Twenty-one articles were selected for full-text analysis, and 5 studies met the inclusion criteria. Because of the heterogeneity in design, surface treatment, measurement methods, and wear parameters, a meta-analysis was not possible. The selected studies were analyzed regarding the antagonist natural enamel wear of zirconia, measurement methods, and surface treatment. The results of the antagonist enamel wear varied widely, which made comparing them scientifically with absolute values difficult.

Conclusions

This review indicated that the antagonist enamel wear of zirconia was similar to or more than that of natural teeth but less than that of metal-ceramics. Additional properly designed, longer follow-up clinical trials with larger sample sizes are needed to evaluate the antagonist enamel wear of monolithic zirconia crowns in vivo.

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Marginal and internal fit of CAD-CAM inlay/onlay restorations: A systematic review of in vitro studies

Publication date: Available online 1 December 2018

Source: The Journal of Prosthetic Dentistry

Author(s): Alexis Goujat, Hazem Abouelleil, Pierre Colon, Christophe Jeannin, Nelly Pradelle, Dominique Seux, Brigitte Grosgogeat

Abstract

Statement of problem

Different parameters can influence the adaptation of computer-assisted design and computer-assisted manufacturing (CAD-CAM) inlay/onlay restorations. However, systematic reviews to identify and discuss these parameters are lacking.

Purpose

The purpose of this systematic review was to summarize the scientific literature investigating all parameters that can influence both the marginal and internal adaptation of CAD-CAM inlay/onlay restorations.

Material and methods

An electronic search was conducted by 2 independent reviewers for studies published in English between January 1, 2007 and September 20, 2017 on the PubMed/MEDLINE, Scopus, and Web of Science databases and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Factors investigated in the selected articles included the type of CAD-CAM system, virtual space parameters, version of the software, type of block, luting procedure, type of restoration, sample size and aging procedure, evaluation method, and number of measurement points per specimen.

Results

A total of 162 articles were identified, of which 23 articles met the inclusion criteria. Nine studies investigated adaptation with different restorative materials, 2 evaluated adaptation according to the type of preparation design, 9 compared adaptation before/after thermomechanical loading, and 2 before/after cementation, 1 study investigated marginal adaptation based on whether the optical scan was made intraorally or extraorally, 1 compared adaptation with 5 and 3 axis CAM systems, and 1 assessed adaptation with 4 different intraoral scanners. The risk of bias was high for 7, medium for 15, and low for 1 of the studies reviewed. The high level of heterogeneity across the studies excluded meta-analysis.

Conclusions

Most of the studies reported clinically acceptable values for marginal adaptation. The performance of a CAD-CAM system is influenced by the type of restorative material. A nonretentive cavity preparation exhibited better adaptation than a retentive preparation. Most studies showed that thermomechanical loading affected the quality of marginal adaptation. Cementation increased marginal discrepancies. No statistically significant difference was found for marginal fit of onlays between intraoral and extraoral optical scans using a stone die. The number of milling axes, the type of digital camera, and the region measured were statistically significant in relation to marginal/internal adaptation. Values of adaptation recorded failed to reproduce the preestablished spacer parameters in the software. Clarification is needed concerning adaptation according to the type of preparation design, the type of material, the choice of intrinsic parameters for the CAD process, the type and shape of milling instruments, and the behavior of the material during milling. Adaptation of CAD-CAM inlay/onlays should be evaluated under clinical conditions.

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Combined use of a facial scanner and an intraoral scanner to acquire a digital scan for the fabrication of an orbital prosthesis

Publication date: Available online 30 November 2018

Source: The Journal of Prosthetic Dentistry

Author(s): Huan Liu, Shizhu Bai, Xiaonan Yu, Yimin Zhao

Abstract

For a patient with a unilateral orbital defect, an esthetic orbital prosthesis plays an essential role in enhancing quality of life. This technique describes the combined use of a facial scanner and an intraoral scanner to acquire the digital scan for the design and fabrication of an orbital prosthesis. The method results in an esthetic prosthesis with accurate skin texture reproduction.

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Effect of titanium tetrafluoride addition on the physicochemical and antibacterial properties of Biodentine as intraorfice barrier

Publication date: Available online 1 December 2018

Source: Dental Materials

Author(s): Shaymaa E. Elsaka, Amr M. Elnaghy, Ayman Mandorah, Alaa H. Elshazli

Abstract

Objective

To evaluate the influence of titanium tetrafluoride (TiF₄) incorporation on the physicochemical and antibacterial properties of Biodentine (BD; Septodont, Saint Maur des Faussés, France) as an intraorfice barrier material.

Methods

Three different proportions of TiF₄ powder were used with BD; 1 wt%, 2 wt%, and 3 wt%; respectively. BD without TiF₄ addition was used as the control group. The setting time (ST) was determined using Gillmore needle apparatus. Diametral tensile strength (DTS) and fracture resistance were measured in a universal testing machine. Solubility was assessed using mass variation after 7 days water storage. The hardness test was conducted using Vickers microhardness tester. The antibacterial activity was assessed using direct contact test against Enterococcus faecalis. Radiopacity was assessed and expressed in thickness of aluminum. Surface topography and elemental composition of modified BD were also assessed. The pH of soaking water was measured up to 168 h. Data of tested properties were analyzed using one-way analysis of variance, the paired t-test, two-way repeated measures analysis of variance, and Tukey post hoc tests (P < 0.05).

Results

BD-incorporating 2 wt% TiF₄ revealed the highest surface microhardness, DTS, and fracture resistance compared with the unmodified group (P < 0.001). Higher concentrations of TiF₄ (3 wt%) compromised the solubility and prolonged the ST of BD (P < 0.05). Bacterial growth of BD-incorporating TiF₄ was significantly reduced when compared with the control group (P < 0.05). The tested materials induced alkalization of the soaking water that decreased with time.

Significance

Biodentine-incorporating TiF₄ (1 wt% and 2 wt%) is a promising intraorfice barrier material with enhanced physicochemical and antibacterial properties.

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Transdentinal cytotoxicity and macrophage phenotype of a novel quaternary ammonium silane cavity disinfectant

Publication date: Available online 30 November 2018

Source: Dental Materials

Author(s): U. Daood, C.K.Y. Yiu

Abstract

Objective

To evaluate the transdentinal cytotoxicity and macrophage phenotype response to a novel quaternary ammonium silane (QAS) cavity disinfectant.

Methods

NIH 3T3 mouse fibroblasts were cultured in Dulbecco's Modified Eagle's Medium and incubated for 3 days. The cells (3 × 10⁴) were seeded on the pulpal side of dentine discs and the occlusal side of the discs were treated with different cavity disinfectants: Group 1: de-ionized water (control); Group 2: 2% chlorhexidine (CHX); Group 3: 2% QAS; Group 4: 5% QAS, and Group 5: 10% QAS. Cell morphology of NIH 3T3 cells was examined using scanning electron microscopy (SEM) and cell viability was assessed using Trypan blue assay. The eluates were collected and applied on cells seeded in 24-well plates. The total protein production, alkaline phosphatase activity and deposition of mineralized nodules were evaluated after 7 and 14 days. Immunofluorescence staining was performed on the samples with primary antibodies of CD68+, CD80+, and CD163+ assessing the macrophage M1/M2 phenotypes. The macrophages were imaged using a confocal scanning light microscope with an excitation wavelength of 488 nm.

Results

No significant difference in cell viability (p < 0.0001), total protein production (p < 0.01) and mineralized nodule production (p < 0.05) was found between 2% QAS and the control, which was significantly higher than 2% CHX, 5% and 10% QAS after 14 days. Alkaline phosphatase production of 2% QAS was significantly lower than the control (p < 0.001), but higher than 2% CHX at 14 days. The M1/M2 macrophage ratio was also significantly lower in the 2% and 10% QAS groups (p < 0.05) compared to the control and 2% CHX groups.

Significance

The 2% QAS cavity disinfectant does not have cytotoxic effects on 3T3 NIH mouse fibroblast cells and the predominance of the anti-inflammatory phenotype after its application may stimulate healing and tissue repair.

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Novel in vitro comparative model of osteogenic and inflammatory cell response to dental implants

Publication date: Available online 30 November 2018

Source: Dental Materials

Author(s): Kelly M. Hotchkiss, Kegan T. Sowers, Rene Olivares-Navarrete

Abstract

Objectives

Roughened dental implants promote mesenchymal stem cell (MSCs) osteoblastic differentiation, and hydrophilic modifications induce anti-inflammatory macrophages activation. While the effect of different surface modifications on osseointegration of commercial dental implants have been compared in vivo and clinically, the initial cellular response to these modifications often overlooked. We aimed to characterize the macrophage inflammatory response and MSC osteogenesis across different commercially available implants in vitro.

Methods

Six commercially available rough implants [OsseoSpeed™ (Astra-Tech™, Implant A); Osseotite^® (Biomet 3i™, Implant B); TiUnite™ (Nobel-Biocare^®, Implant C); Ti-SLA^®, (Implant D), Roxolid^® (RXD-SLA, Implant E), RXD-SLActive^® (Implant F) (Straumann^®)] were examined. Macrophages and MSCs were seeded directly on implants and cultured in custom vials. mRNA and protein levels of pro- (IL1B, IL6, IL17A, CXCL10, TNFa) and anti- (IL4, IL10, TGFB1) inflammatory markers were measured after 24 and 48 h in macrophages. Osteoblastic differentiation of MSCs was assessed after seven days by alkaline phosphatase activity, osteocalcin, and angiogenic, osteogenic, and inflammatory markers by ELISA and qPCR (n = 6/variable, ANOVA, post hoc Tukey HSD with α = 0.05).

Results

Hydrophilic implant F induced the highest level of osteogenic factor released from MSCs and anti-inflammatory factors from macrophages with the lowest level of pro-inflammatory factors. Alternatively, implants A and C supported lower levels of osteogenesis and increased secretion of pro-inflammatory factors.

Significance

In this study, we successfully evaluated differences in cell response to commercially available clinical implants using an in vitro model. Data from this model suggest that not all surface modification procedures generate the same cell response.

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The acoustic correlates of quantity in Inari Saami

Publication date: January 2019

Source: Journal of Phonetics, Volume 72

Author(s): Helen Türk, Pärtel Lippus, Karl Pajusalu, Pire Teras

Abstract

This paper studies the phonetic realisation of the ternary length opposition of consonants in Inari Saami disyllabic feet focussing on the distinction between half-long and long geminates. Inari Saami is compared with other Saami and Finnic languages. Segmental durations, fundamental frequency and intensity are analysed. The results show a three-way distinction in consonant duration most robustly after a short stressed syllable vowel. In the case of a long stressed syllable vowel there is no difference between half-long and long geminates. In all of the analysed word structures, segments are inversely related to each other, as with an increase in consonant duration the durations of the surrounding vowels decrease. The fall in the fundamental frequency contour is less steep in words with a long geminate than in those with a short consonant or a half-long geminate. The intensity of the unstressed vowel decreases with the increasing quantity of the intervocalic consonant. The results indicate that the three-way quantity distinction in Inari Saami is primarily manifested by durational properties in a disyllabic foot, while fundamental frequency and intensity have a less important role.

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Distinct transcriptomic profiles of early-onset atopic dermatitis in blood and skin of pediatric patients

Publication date: Available online 1 December 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Patrick M. Brunner, Ariel Israel, Alexandra Leonard, Ana B. Pavel, Hyun Je Kim, Ning Zhang, Tali Czarnowicki, Krishna Patel, Morgan Murphrey, Kara Ramsey, Stephanie Rangel, Rema Zebda, Vinaya Soundararajan, Xiuzhong Zheng, Yeriel D. Estrada, Hui Xu, James G. Krueger, Amy S. Paller, Emma Guttman-Yassky

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SERPING1 mutation in a rare hereditary angioedema with skin blisters

Publication date: Available online 30 November 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Faradiba Sarquis Serpa, Camila Lopes Veronez, Fernanda Lugão Campinhos, Therezinha Ribeiro Moyses, João Bosco Pesquero

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Neutrophil to lymphocyte ratio is a novel independent predictor of severe exacerbation in asthma patients

Publication date: Available online 30 November 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Takao Mochimaru, Soichiro Ueda, Yusuke Suzuki, Koichiro Asano, Koichi Fukunaga

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Interview Techniques Utilized in Radiology Resident Selection—A Survey of the APDR

Publication date: Available online 1 December 2018

Source: Academic Radiology

Author(s): Claudia Kasales, Christine Peterson, Eric Gagnon

Rationale and Objectives

To evaluate interview techniques currently used in the selection of diagnostic radiology resident candidates and to identify factors influencing the use of alternative interview techniques.

Materials and Methods

An anonymous 25 question e-mail survey was provided to 319 active members of the Association of Program Directors in Radiology. The survey included questions on residency demographics, organization of resident applicant interviews, types of interview techniques utilized, scoring and ranking of applicants, and facets of the interview/application felt most important to the selection process. Statistical analysis was performed to identify factors associated with the use of alternative interview techniques.

Results

93.7% of responding programs use traditional interview techniques, with 92% using unblinded, unstructured interviews, 8% blinded, unstructured interviews. Structured interview questions were incorporated in 22%. Few programs used alternative techniques like the multiple mini-interview. None of the programs used written prompts during the interview, 3% used casual visual cognitive testing, 10% used panel interview techniques, and none used formal personality testing. For ranking candidates in the match, the most important facets considered were USMLE Step scores, performance on the interview, clinical course grades, and letters of reference. Factors associated with use of alternative techniques were domains associated with program size and number of faculty.

Conclusion

The majority of radiology training programs still rely upon the traditional unblinded interview technique. There is an opportunity for training programs to examine alternative techniques that reduce bias and may provide better insight into other aspects of the candidate that may not be as readily highlighted with the traditional, unblinded interview.

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Normal axillary thickness thresholds as a metric for nutritional status of children

Publication date: Available online 1 December 2018

Source: Clinical Imaging

Author(s): Alissa L. Wall Kleinhenz, Jing Gao, Arzu Kovanlikaya, Daniel Rosenbaum, Daniela I. Guisado, Jonathan M. Rubin

Abstract

Introduction

Childhood pneumonia is a major cause of death in the 3rd world, and undernourishment increases the severity of the condition. We considered axillary thickness as a simple measurement to evaluate nutritional status that can be performed simultaneously with lung ultrasound. Our goal was to determine the distribution of axillary thickness in a cohort of children to determine a threshold for malnutrition.

Methods

Clinical databases were scanned to identify chest computed tomograms (CT) in children between the ages of 0 and 5 years with non-debilitating disease. The bilateral axillary thicknesses of the cohort were determined using equivalent width, and these measurements were segmented by age, sex, and laterality to determine cutoff thresholds. Data was evaluated using single factor analysis of variance (ANOVA) and 5th quantile analysis to determine the lower bound thresholds of axillary thickness.

Results

247 scans met inclusion criteria. ANOVA demonstrated no significant differences in the mean measurements in the 5 groups (p = 0.377). 95% confidence limits on the 5th quantile plots showed an axillary thickness of 1.5 cm was a reasonable threshold for malnutrition detection for all age groups and sexes except for males between 0 and 1 years old where a 1.1 cm threshold may be required.

Discussion

CT scans of the chests in a cohort of children without debilitating disease revealed a remarkably uniform axillary thickness threshold for malnutrition assessment of 1.5 cm. This suggests that there may be a threshold for nutritional assessment for children undergoing lung ultrasound scans for childhood pneumonia.

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Gastric wall fat halo sign in patients without intestinal disease

Publication date: Available online 30 November 2018

Source: Clinical Imaging

Author(s): Ali Kupeli, Gurkan Danisan, Mehmet Kocak, Ismaıl Taskent, Isa Gokturk Balcı, Eser Bulut

Abstract

Purpose

To investigate the relationship between gastric wall fat halo sign and visceral obesity with potentially associated diseases.

Materials and methods

Between September 2015 and April 2017, 90 patients with gastric wall fat halo signs and 130 controls were prospectively evaluated. Patient height, weight, body mass index (BMI), sex, age, subcutaneous fat area (SFA), visceral fat area (VFA), total fat area (TFA), percentage of visceral fat (VF%) and the presence of colic or ileal fat halo signs, hepatic steatosis and aortic calcified plaques were recorded for the two groups. Cut-off values for the VFA, TFA, and VF% were determined and the diagnostic efficacy was calculated using receiver operating characteristic (ROC) curve analysis.

Results

No significant differences were found in age, BMI and SFA, but the VFA, VF%, TFA and frequencies of colic or ileal fat halo signs, hepatic steatosis and aortic calcified plaques were significantly higher in the patient group. The areas under the ROC curve (AUCs) were 0.803, 0.770 and 0.596 for VFA, VF% and TFA, respectively. The diagnostic efficacies of VFA and VF% were significantly higher than those of the TFA.

Conclusion

Gastric wall fat halo signs may be observed in overweight people, especially those with increased VFA and VF%. Additionally, these signs are usually observed along with fat halo signs of the colon or terminal ileum. However, extensive studies are needed to clarify the relationship between gastric wall fat halo signs and type 2 diabetes, cardiovascular diseases and metabolic syndrome.

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Evaluation of a novel, patient-mounted system for CT-guided needle navigation—an ex vivo study

Abstract

Purpose

To describe the features of a novel patient-mounted system for CT-guided needle navigation, the Puncture Cube System (PCS), and to evaluate the accuracy and efficiency of the PCS by (a) applying numerical simulations and (b) by conducting punctures using the system in comparison to punctures using the free-hand method (FHM).

Methods

The PCS consists of a self-adhesive cube that is attached to the patient, with multiple through-holes in the upper and lower template plate and dedicated software that, using a computer vision algorithm, recognizes the cube in a planning scan. The target in the image dataset is connected by a line, here "virtual needle," which passes through the cube. For any chosen path of the virtual needle, the entry points for the needle into the cube are displayed by the software for the upper and lower template on-the-fly.

The possible exactness of the system was investigated by using numerical simulations. Next, 72 punctures were performed by 6 interventionists using a phantom to compare for accuracy, time requirement, and number of CT scans for punctures with the system to the FHM ex vivo (phantom study).

Results

The theoretical precision to arrive at targets increased with the distance of the target but remained low. The mean error for targets up to 20 cm below the lower plate was computed to be well below 0.5 mm, and the worst-case error stayed below 1.3 mm.

Compared to a conventional free-hand procedure, the use of the navigation system resulted in a statistically significantly improved accuracy (3.4 mm ± 2.3 mm versus FHM 4.9 mm ± 3.2 mm) and overall lower intervention time (168 s ± 28.5 s versus FHM 200 s ± 44.8 s). Furthermore, the number of CT scans was reduced to 2.3 versus FHM 2.8).

Conclusion

The PCS is a promising technique to improve accuracy and reduce intervention time in CT-guided needle navigations compared to the FHM.

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