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Biomedical subjects

L Montebugnoli

Publications and source records attributed to L Montebugnoli.

At least 37 records · Page 2Linked to original sources
PubMed1999

A rapid test for the visual detection of anti-hepatitis C virus antibodies in whole blood.

A rapid test for the visual detection of anti-HCV antibodies in whole blood was evaluated in its accuracy when compared with EIA method. The rapid test was performed blind on 50 HCV EIA-positive (adsorbance greater than 3.0) and on 50 HCV EIA-negative samples. Each whole blood sample was 1:20, 1:50 and 1:100 diluted with saline solution for a total of 400 samples. Results showed a sensitivity of 100% when whole blood was tested, 96% when 1:20 diluted blood was tested, 30% when 1:50 diluted blood was tested and 4% when 1:100 diluted blood was tested. The specificity gave also better results and only one false-positive was found in all samples tested. The test took less than 3 min and only a mechanical pipette was required. In conclusion, the HCV Ab rapid test showed a very high accuracy and could be very useful for the detection of HCV-positive subjects in situations where rapid results are required or technical expertise is limited.

Case-Control Studies↗
PubMed1999

Vasovagal syncope in heart transplant patients during dental surgery.

The pathogenesis of vasovagal syncope during emotional stress is controversial. Several authors have postulated that the vasodepressor response in humans may be initiated by C-fiber mechanoreceptors situated in the heart and connected via cardiac vagal afferents to the medullary center for cardiovascular control. It has been argued that heart transplant patients cannot show any vasovagal reaction because the donor heart is transplanted completely deprived of any vagal or sympathetic innervation. In this report, however, 3 episodes of vasovagal syncope are documented in 3 heart transplant patients undergoing periodontal surgery. During vasovagal syncope in each of these patients, a dramatic fall in systolic blood pressure (from 137 +/- 5 mmHg to 76 +/- 3.6 mmHg) was detected, but, in contrast to what is observable in normal subjects, the heart rate did not show any relevant change (from 96.7 +/- 4.5 beats per minute to 102.6 +/- 7.6 beats per minute). These unexpected findings emphasize the marginal role of the heart on the pathogenesis of the vasovagal syncope and underline the fact that a vasovagal reaction can develop even in the absence of the bradycardia that is the primary symptom usually reported in the literature.

Adult↗
PubMed1999

Effect of air, dentin and resin-based composite thickness on light intensity reduction.

PURPOSE: To evaluate the effect of air, dentin and resin-based composite thickness on light intensity reduction. MATERIALS AND METHODS: Two different light-units were used in the study. Light intensity was measured using a curing radiometer. RESULTS: There was an exponential decrease in light intensity with distance. The light-intensity value at a specific distance from the tip during passage through a specific dental material was calculated. Both composite and dentin caused a dramatic reduction in light intensity rate, e.g. 2.0 mm of composite are sufficient to reduce the light-intensity to 6% of its initial value.

Air↗
PubMed1999

Cyclosporin A effects on extra oral connective tissue in heart transplanted patients.

Gingival overgrowth (GO) is an adverse side-effect of Cyclosporin A (CsA) therapy. There is wide evidence that fibroblasts are the primary cellular influence on GO and it has been hypothesised that people developing GO have fibroblasts with an abnormal susceptibility to CsA. The purpose of the study was to analyse, on a macroscopic scale, the Cyclosporin effects on soft connective tissues in order to show whether subjects with an abnormal gingival connective reaction to Cyclosporin may have macroscopic signs of a similar reaction in connective tissues other than oral cavity. Twenty-two heart transplanted patients were enrolled in the study. All patients had been on a CsA-based immunosuppression regimen for at least six months (33.2 +/- 20.5). Hyperplastic Index (HI) was considered as the periodontal parameter relating to GO. Macroscopic evidence of the residual cicatrix following thoracotomy (P1) and connective tissue hyperproduction in the subclavian region conditioning the difficulty in probing the vein during myocardial biopsies (P2) were considered as the parameters relating to extraoral cicatricial activity. Both non parametric statistical analysis (Mann Whitney U-test, linear correlation by Spearman) and parametric analysis (Student t-test) were used to investigate the relationship between HI (dependent variable) and P1, P2 (independent variables). Results failed to demonstrate any significant correlation between gingival overgrowth and cicatricial tissue hyperproduction in sites other than the oral cavity. We conclude that the hyperproduction of collagen leading to GO in a certain percentage of subjects treated with CsA is a reaction limited to the oral cavity and not a consequence of a systemic fibroblastic hyperactivity. Our data suggest that the collagen disregulation at gingival level may be a consequence of a local perturbation whose aetiological factors are however still not known.

Adult↗
PubMed1998

Contamination of the turbine air chamber: a risk of cross infection.

In the present work, we evaluated (a) the influx of contaminating fluid into the air chamber when a high-speed turbine stops rotating, (b) the significance of a series of variables (type of handpiece and dental unit, shape of the bur, number of stops set on the turbine) which condition it, and (c) the time required to expel the contaminating fluid from the turbine head. Results showed that contamination takes place every time the turbine stops rotating with the bur in contact with an external fluid. The main variable affecting the influx of contaminating fluid into the air chamber of the turbine head was represented by the shape of the bur (F=54.9; p<0.01). Another significant variable was the type of handpiece and dental unit (F=7.3; p<0.01). The number of stops set on the turbine was irrelevant (F=0.03; p=n.s.). The expulsion of the contaminant from the turbine head showed 2 different exponential rates: a very rapid-elimination phase within 30 s and a slow-elimination phase between 60 and 300 s. In order to remove over 99% of the contaminant from the air chamber, a turbine had to run for more than 4-7 min depending on the type of the handpiece. In conclusion, data from the present study suggest that a significant cross-infection potential exists with high-speed handpieces whenever they are only externally scrubbed and disinfected so the internal cleaning and sterilization between patients is mandatory. The practice of flushing by running the turbines between patients should be discouraged.

Air↗
PubMed1996

Cyclosporin-A-induced gingival overgrowth in heart transplant patients. A cross-sectional study.

The incidence of gingival overgrowth secondary to the administration of cyclosporine A (CsA) is widely reported in renal transplant recipients, while there is no information about periodontal conditions in heart transplant patients. In the present cross-sectional investigation the relationship between clinical periodontal conditions and pharmacological profiles of CsA was determined in 39 patients (31 male and 8 female, aged 18-63 years, mean 45.6 +/- 15.2 years) who possessed their 6 upper and 6 lower anterior teeth. All patients had been on a CsA-based immunosoppression regimen for at least 6 months (6-101, mean 39.3 +/- 30.1). 2 periodontal parameters (recorded on the 12 anterior teeth only) relating to gingival overgrowth were considered: hyperplastic index and % of sites with probing depth > 3 mm. These parameters were always recorded by the same observer at first appointment and 2 months after an oral hygiene programme. Both non parametric statistical analysis (Kruskal-Wallis one-way analysis by rank, Wicoxon signed rank-test and Mann Whitney U-test) and parametric analysis (stepwise multiple regression analysis, one-sample and two-sample t-test) were used to investigate the relationship between the periodontal parameters (dependent variables) and a series of independent variables: age, sex, plaque index (PI), gingival index (GI), CsA dose, CsA blood level, duration of therapy (months since allograft). Results failed to demonstrate any significant correlation between gingival overgrowth and age, sex, CsA dose or CsA blood level, PI. A positive significant correlation was found between periodontal conditions and GI and a significant inverse correlation between periodontal conditions and duration of therapy, suggesting that the relation between CsA therapy and gingival overgrowth in heart-transplant patients could be time-related and the negative influence of the drug on the periodontal status could spontaneously decrease over time.

Adolescent↗
PubMed1994

Extraction of impacted third molars. A longitudinal prospective study on factors that affect postoperative recovery.

A longitudinal prospective trial was carried out on 146 patients to evaluate which factors can have an effect on postoperative recovery after extraction of impacted third molars or wisdom teeth. The following factors were considered: (1) age, (2) sex, (3) smoking habits, (4) use of the birth control pill, (5) previous history of pericoronitis, (6) degree of difficulty of the extraction, (7) expertise of the surgeon, (8) length of surgery, and (9) antibiotic prophylaxis. The following results were obtained and statistically significant differences were noted with respect to the pain in the context of (1) sex-males noted more pain on the 1st and 3rd days (p < 0.05) compared with females; (2) expertise of the surgeon--patients treated by surgeons with considerable or average expertise reported less pain on the first and third days (p < 0.05) compared with patients treated by surgeons with little expertise; and (3) age--a direct correlation was noted between age and pain (p < 0.05).

Adult↗
PubMed1994

Influence of dental glove type on the penetration of liquid through experimental perforation: a spectrophotometric analysis.

This study was made to assess whether the physical structure or the commercial make of a glove has any influence on the penetration of liquid through perforations in the glove during work. A comparison was made between three types of gloves (10 for each brand name and type): vinyl (Peha Fit, Paul Hartmann), latex (without ASTM certification), and Biogel D (Regent Dental Division) for a total of 30 gloves. Of the 10 gloves for each type, five were worn tightly adhering to the operator's hand and five were worn relatively loosely. Holes of a predetermined size (0.40 mm) were made in each glove on the index, middle, and ring fingers, for a total of 90 holes. A randomized preprogrammed list ensured a perfect balance of the three variables: type of glove, adherence to the hand, and fingers having holes. The amount of liquid that penetrated the gloves through the holes was determined by placing the gloved hand in a tank containing a colored substance for 3 minutes and then analyzing the colored substance that had penetrated the glove with an ultraviolet (UV) spectrophotometer. The results clearly showed that the amount of liquid that penetrated through the holes varied significantly (p < 0.001) according to the type of glove tested. The mean quantity of liquid penetrating the vinyl gloves (6.24 microL) was approximately five times higher than that of the latex gloves (1.20 microL), and 100 times higher than that of the Biogel D gloves (0.05 microL). The statistical differences between the three types of gloves were even more significant in the cases in which the glove adhered closely to the hand (12.44 microL in vinyl, 2.37 microL in latex, and 0.09 microL in Biogel D), whereas no significant difference was found when the gloves were loose (0.03 microL in vinyl, 0.04 microL in latex, and 0.00 microL in Biogel D).

Analysis of Variance↗
PubMed1993

Tranexamic acid as a mouthwash in anticoagulant-treated patients undergoing oral surgery. An alternative method to discontinuing anticoagulant therapy.

A double-blind randomized study was carried out to evaluate the clinical hemostatic effect of tranexamic acid mouthwash after dental extraction in 30 patients who received anticoagulant agents. Surgery was performed with a reduction in the level of anticoagulant therapy in the control group and with no change in the level of anticoagulant therapy in the group who received the tranexamic acid. After the extraction the surgical field was irrigated with a 5% solution of tranexamic acid in the group of 15 patients whose anticoagulant treatment had not been discontinued and with a placebo solution in the group of 15 patients for whom the anticoagulant therapy was reduced. Patients were instructed to rinse their mouths with 10 ml of the assigned solution for 2 minutes four times a day for 7 days. There was no significant difference between the two treatment groups in the bleeding incidence after oral surgery. We conclude that the anticoagulant treatment does not need to be withdrawn before oral surgery provided that local antifibrinolytic therapy is instituted.

Anticoagulants↗
PubMed1993

Circulatory dynamics during dental operations in patients with heart transplants.

Twelve patients with heart transplants and who needed dental operations were studied. At the same time, a group of normal subjects was enrolled as control. Blood pressure and heart rate were recorded in all subjects when they sat in the chair, after 5 minutes of relaxation, 5 minutes after administration of local anesthetic, and immediately after each dental extraction or curettage. No statistically significant difference was found between the values recorded during the different situations and the basal values in transplanted patients. Conversely, in the normal subjects, the values recorded when they sat in the chair, at the end of curettage, and at the end of dental extractions were significantly different from the basal values. The slight and dulled cardiovascular reaction to stress in patients with heart transplants suggests that the management of these patients is relatively uncomplicated and certainly easier than treatment of subjects with heart disease.

Adult↗
PubMed1992

Clinical significance of holes in gloves for dental use: a spectrophotometric analysis.

The aim of this study on latex dental gloves was to establish whether there is any relationship between faults that are detected by filling with water and the entry of liquid into the gloves during use. Twenty-four gloves of different sizes were examined. Large and small holes randomly distributed on the index, middle, and ring fingers, were made in the gloves. The gloves were filled with water and squeezed to detect the amount of water escaping. A mass spectrophotometer was used with the same gloves to quantify the entry of an aqueous solution of potassium bichromate during work. The filling method was effective for revealing all faults in gloves, but it was not able to determine whether there would be fluid entry through the holes during work. While the size of the holes was not predictive for the amount of liquid entering the glove, adherence of the glove to the hand was. Holes of the same size allowed a greater entry of contaminated liquid in adherent gloves than in looser ones.

Dentists↗
PubMed1991

[Pain induced changes in circulatory dynamics].

In the present research data about cardiovascular changes induced by pain during a dental extraction are shown. A painful dental extraction causes blood pressure and heart rate changes significantly higher with respect to a painless dental extraction.

Blood Pressure↗
PubMed1991

[Solitary cyst of the jaws].

A clinical case of solitary cyst of jaws has been presented. The diagnosis of this pathology with only objective and radiological examination is not always easy. The Authors suggest the need to execute explorative operation.

Adolescent↗
PubMed1991

[Patients on anticoagulant therapy. Interpretation of a new test].

In the present study a new test for the monitoring the efficacy of anticoagulant therapy in patients at risk of cardiovascular thrombosis has been described. The dentist approach to anticoagulant-treated patients undergoing oral surgery has been evaluated.

Anticoagulants↗
PubMed1991

A new approach to quantify cardiovascular response in dentistry.

Essential hypertension, which is common in dentists, has been attributed to mental stress but the importance of working conditions has not been evaluated. The pressor and forearm circulatory response to correct and incorrect working position during dental practice has been evaluated in 10 normotensive dentists and compared with the effects of mental stress. Mental stress elicited a significant increase in blood pressure not observed during correct dental practice despite a comparable forearm vasodilatation during both tests. Conversely incorrect working position, significantly raised blood pressure to an extent comparable to what observed during mental stress but with only a transitory and rapidly abolished forearm vasodilatation. The recordings of blood pressure or peripheral hemodynamic changes per se did not allow to discriminate between a specific response to mental stress and dental practice which, were clearly differentiated by the analysis of combined pressor and hemodynamic measurements. We conclude that odontoiatric practice carried out in an incorrect working position is able to elicit either an increase in blood pressure or abnormalities in peripheral vascular response which may contribute to the high occurrence of systemic hypertension in dentists. The evaluation of peripheral hemodynamic profile during working conditions seems to provide a useful method for a better understanding of the pattern of cardiovascular involvement in dentistry.

Adult↗