Grażyna Wilk

Tomographic Evaluation of Reparative Dentin Formation after Direct Pulp Capping with Ca(OH)2, MTA, Biodentine, and Dentin Bonding System in Human Teeth

INTRODUCTION New materials can increase the efficiency of pulp capping through the formation of a complete reparative dentin bridge with no toxic effects. The present study involved tomographic evaluations of reparative dentin bridge formation after direct pulp capping with calcium hydroxide, mineral trioxide aggregate (MTA), Biodentine (Septodont, Saint Maur des Fossés, France), and Single Bond Universal (3M ESPE, Seefeld, Germany) in human teeth. METHODS Forty-four caries-free, intact, human third molars scheduled for extraction were subjected to mechanical pulp exposure and assigned to 1 of 4 experimental groups depending on the pulp capping agent used: calcium hydroxide, MTA, Biodentine, or Single Bond Universal. After 6 weeks, the teeth were extracted and processed for cone-beam computed tomographic imaging and histologic examination. Tomographic data, including the density and volume of formed reparative dentin bridges, were evaluated using a scoring system. RESULTS The reparative dentin formed in the calcium hydroxide, MTA, and Biodentine groups was significantly superior to that formed in the Single Bond Universal group in terms of thickness and volume. The dentin bridges in the Biodentine group showed the highest average and maximum volumes. The mean density of dentin bridges was the highest in the MTA group and the lowest in the Single Bond Universal group. CONCLUSIONS The volume of reparative dentin bridges formed after direct pulp capping is dependent on the material used. Biodentine and MTA resulted in the formation of bridges with a significantly higher average volume compared with Single Bond Universal, and cone-beam computed tomographic imaging allowed for the identification of the location of dentin bridges.

Effect of primary correction of nasal septal deformity in complete unilateral cleft lip and palate on the craniofacial morphology

PURPOSE To assess the long-term effect of primary correction of the nasal septum during lip repair in unilateral complete cleft lip and palate on the craniofacial morphology. MATERIAL, SUBJECTS, METHODS The study material consisted of 54 lateral cephalograms made at the ages 7-22, including 28 cephalograms of patients from a study group (aged 7-14 years) after a primary correction of the nasal septum during lip closure and 26 cephalograms of patients from a control group (aged 12-22 years) operated on without septal correction. All cephalograms have been analysed with regard to skeletal, dental and soft-tissue relationships. Data distribution has been checked using Shapiro-Wilk test (α = 0.05). Student t-test was used to compare values of normal distribution and for the latter - Mann-Whitney test. RESULTS The comparison of all cephalometric values between the study and control groups revealed a statistically significant (α = 0.05) difference only for H (p = 0.0267), 1+: NB angle (p = 0.0175) and 1+: NA (mm) (p = 0.0249). Each of the three cephalometric measurements mentioned were greater in the study than in the control group. CONCLUSION No negative effect from the primary nasal septum correction on maxillary development could be found in the study group.

Screening with magnetic resonance imaging, mammography and ultrasound in women at average and intermediate risk of breast cancer

BackgroundThe addition of MRI to mammography and ultrasound for breast cancer screening has been shown to improve screening sensitivity for high risk women, but there is little data to date for women at average or intermediate risk.MethodsTwo thousand nine hundred and ninety-five women, aged 40 to 65 years with no previous history of breast cancer were enrolled in a screening program, which consisted of two rounds of MRI, ultrasound and mammography, one year apart. Three hundred and fifty-six women had a CHEK2 mutation, 370 women had a first-degree relative with breast cancer (and no CHEK2 mutation) and 2269 women had neither risk factor. Subjects were followed for breast cancer for three years from the second screening examination.ResultsTwenty-seven invasive epithelial cancers, one angiosarcoma and six cases of DCIS were identified over the four-year period. Of the 27 invasive cancers, 20 were screen-detected, 2 were interval cancers, and five cancers were identified in the second or third follow-up year (i.e., after the end of the screening period). For invasive cancer, the sensitivity of MRI was 86%, the sensitivity of ultrasound was 59% and the sensitivity of mammography was 50%. The number of biopsies incurred by MRI (n = 156) was greater than the number incurred by mammography (n = 35) or ultrasound (n = 57). Of the 19 invasive cancers detected by MRI, 17 (89%) were also detected by ultrasound or mammography.ConclusionsIn terms of sensitivity, MRI is slightly better than the combination of mammography and ultrasound for screening of women at average or intermediate risk of breast cancer. However, because of additional costs incurred by MRI screening, and the small gain in sensitivity, MRI screening is probably not warranted outside of high-risk populations.

From ophthalmologist to dentist via radiology

Summary Background: The aim of this paper was to analyze the causes of orbital cellulitis in connection with covert dental changes as well as to establish the role of radiological procedures in the final diagnosis and further treatment of such cases. Material/Methods: Thirty-two patients, aged 25–56, 22 women and 10 men were diagnosed and treated between January 2007 and April 2011 at the Pomeranian Medical University in Szczecin. The patients were examined in the infirmary of the ophthalmological department due to unilateral blepharo-oedema, abrupt pain and vision disturbances; in 5 cases, body temperature increased up to 37.8°C was observed. Next, the patients underwent conventional X-ray examinations of the orbit to exclude any foreign bodies in the eyeball, as well as pantomographies to evaluate the dental status. Visible periapical or periodontal changes in dentition were analyzed with intraoral X-rays with the use of DIGORA System 2.1. Changes found in 3 patients on pantomograms and connected with iatrogenic procedures were further evaluated with CT (64 lines and 128 layers) in frontal, sagittal and axial projections. Orbital disorders were also diagnosed by an ophthalmologist and radiologist with Doppler ultrasound (US) examinations. A linear transducer of 7.5–10 MHz to observe the morphology and vascularity of the eyeball was applied. Results: Iatrogenic treatment was the cause of sinusitis and cellulitis in three cases: incorrectly implanted dental implant in one case, root of the 3rd molar pushed into the sinus in the second case, and communication between the maxillary alveolar process and the sinus after extraction in case of the third patient. Asymptomatic periapical osteolysis, periodontal disease or dead teeth were found in all cases. Diagnosis of orbital cellulitis of dental origin was determined on the basis of clinical, radiographic and ultrasound findings. Ophthalmologic and dental treatment was applied simultaneously. Conclusions: Co-operation between ophthalmologists, radiologists and dentists is necessary during the treatment of such orbital diseases.

Selenium as marker for cancer risk and prevention.

MARCIN LENER1*, KATARZYNA JAWORSKA1,3*, MAGDALENA MUSZYnSKA1,2, GRZEGORZ SUKIENNICKI1,2, KATARZYNA DURDA1, SATISH GUPTA1,3, ELŻBIETA ZŁOWOCKA-PERŁOWSKA1, JoZEF KŁADNY4, ANNA WIECHOWSKA-KOZŁOWSKA5, TOMASZ GRODZKI6, EWA JAWOROWSKA7, JAKUB LUBInSKI7, BARBARA GoRECKA-SZYLD8, GRAŻYNA WILK8, MIECZYSŁAW SULIKOWSKI9, TOMASZ HUZARSKI1, TOMASZ BYRSKI1, CEZARY CYBULSKI1, JACEK GRONWALD1, TADEUSZ DeBNIAK1, OLGIERD ASHURYK1, ALEKSANDRA TOŁOCZKO-GRABAREK1, ANNA JAKUBOWSKA1, ANTONI MORAWSKI10, JAN LUBInSKI1,2

Association between Asymptomatic Unilateral Internal Carotid Artery Stenosis and Electrophysiological Function of the Retina and Optic Nerve

Purpose. This study was designed to assess retinal and optic nerve bioelectrical function in patients with unilateral asymptomatic but hemodynamically significant internal carotid artery stenosis (ICAS). Methods. Forty-two subjects with a diagnosis of unilateral ICAS and 34 controls were analyzed. Full-field electroretinogram (ERG), pattern electroretinogram (PERG), and pattern visual-evoked potentials, as well as optical coherence tomography and ophthalmological examination, were performed. Data analysis included eyes ipsilateral to ICAS (EIS) and eyes contralateral to ICAS (ECS). Results. Intraocular pressure was significantly decreased in EIS and ECS compared to that in the controls. In the macula, both the cube average thickness and cube volume values were significantly reduced both in EIS and ECS compared to those in the controls. Similarly, PERG P50 and N95 wave amplitudes were significantly smaller in EIS and ECS compared to those in the controls. The ERG rod b-wave and rod-cone a-wave amplitudes were decreased, and implicit times were significantly prolonged, whereas the OP wave index was reduced in EIS compared to that in the controls. No differences in IOP, OCT, or ERG and PERG parameters were identified between EIS and ECS. Conclusions. Our study demonstrated that retinal bioelectrical function is negatively affected by ICAS despite the absence of objective clinical signs and symptoms of ocular ischemia.

Selenium as a marker of cancer risk and of selection for control examinations in surveillance

Publication is summarization of existing data being results of literature review and our experience on usefulness of selenium as a diagnostic marker selection for control examinations in surveillance and as a marker of patients with high risk of cancers.

CHAPTER 22:Selenium and Cancer

Selenium is a trace element that is an essential component of many enzymes that play an important role in several major metabolic pathways and ameliorate environmental insult, including the antioxidant defense system, the immune system and functioning of the thyroid gland. There is a range of serum selenium levels associated, with the lowest rate of all causing mortality – the levels should be maintained at an optimal level and be neither too low nor too high. Selenium intake varies, largely based on the selenium content of food. The mean level of selenium in the population varies considerably between countries. Thus, for some countries selenium supplementation should be considered, whereas for others it could be contraindicated. Recent meta-analyses indicate unequivocally that selenium supplementation of people with low initial serum selenium levels decreases the incidence of cancer incidence by ∼35% and of cancer mortality by almost 50%. Additionally, it appears that in Se-deficient countries selenium levels may be a useful marker to select patients for cancer surveillance using for example computerized tomography for detection of the earliest stages of bronchial malignancy and colonoscopy for detection of the early stage colorectal cancer.

Relationship between Initial Lens Transparency and Ocular Circulation in Adolescents with Type-1 Diabetes Mellitus, Unstable Glycaemia and Lipid Parameters

Summary Background The aim of this study was to determine the relationships between lens opacity, vascular and lipid factors and retrobulbar blood flow parameters in type-1 diabetic (DM) adolescents. Material/Methods Glycated haemoglobin (HbA1c), total cholesterol (TCH), high- and low-density cholesterol, triglycerides (TG) and apolipoprotein B (ApoB) were determined in 28 patients with (DM-1) and without (DM-0) lens opacity and 18 controls. In the ophthalmic, central retinal (CRA) and temporal posterior ciliary (TPCA) arteries, the systolic (PSV), end-diastolic and mean blood flow velocities as well as pulsatility and resistance (RI) indices were measured. Results Ten (35.71%) diabetic patients exhibited lens opacification. Higher TG and TCH levels in the DM-1 group and HbA1c level in the DM-0 and DM-1 groups were observed (P≤0.05). Diabetic patients had lower PSV and higher RI within CRA and TPCA (P≤0.05). Significant correlations between biochemical and blood flow parameters were found. Conclusions Glycaemic and lipid factors may play a vasoconstrictive role in retrobulbar endotheliopathy.

Screening with Magnetic Resonance Imaging in women at low and intermediate risk of breast Cancer

Patients and Methods From 2008 to 2011, 2995 women, aged 40 to 65 years with no previous history of breast cancer were enrolled in a prospective screening trial consisting of two annual rounds of MRI, ultrasound and mammography. 356 women had a CHEK2 mutation, 458 women had a first-degree relative with breast cancer and 2269 women had neither risk factor. Subjects were followed for incident cancer for one year from the date of the second screening examination.