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Purpose Bisphosphonate related osteonecrosis of the jaw (BRONJ) is an adverse drug reaction consisting of progressive bone destruction in the maxillofacial region of patients under current or previous treatment with a bisphosphonate. Autologous platelet concentrates (APC) demonstrated to enhance bone and soft tissue healing in oral surgery procedures. The present systematic review aimed at evaluating if APC may improve treatment and prevention of BRONJ in patients under bisphosphonate therapy. Methods MEDLINE, Scopus and Cochrane databases were searched using terms like bisphosphonates, osteonecrosis, BRONJ, platelet concentrate, PRP, PRF, PRGF. No language, publication date and study design limitation was set. A hand search of the bibliographies of identified articles was also performed. The primary outcome was recurrence/onset of BRONJ after oral surgery procedures. Results Eighteen studies were included, reporting on 362 patients undergoing oral surgery in combination with APC. The adjunct of APC in BRONJ treatment significantly reduced osteonecrosis recurrence with respect to control. APC was associated with a lower BRONJ incidence after tooth extraction, though not significant. Heterogeneity was found regarding bisphosphonate type, clinical indication, treatment duration, triggering factors, study design, follow-up duration, type of APC, outcomes adopted to evaluate treatment success. Conclusion Though the results of this review must be cautiously interpreted, due to the low evidence level of the studies included, and the limited sample size, they are suggestive of possible benefits of APC when associated with surgical procedures for treatment or prevention of BRONJ. To confirm such indication, prospective comparative studies with a large sample size are urgently needed. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The purpose of this systematic review was to investigate if the use of magnification devices in endodontics is associated with the improvement of clinical and radiographic outcomes. Data: The treatment success as determined by clinical and radiographic evaluation after 1-year follow-up was the main outcome. The main search terms used alone or in combination were: endodontic treatment, endodontic therapy, endodontic surgery, apicoectomy, periapical surgery, microscope, endoscope, loupes, magnification devices. Sources: The authors searched MEDLINE, Embase, Cochrane Oral Health Specialized Register, Cochrane Central Register of Controlled Trials for articles published up to September 2009 plus hand-searching of relevant journals and reference list of pertinent reviews and included studies. Study selection: Prospective clinical trials comparing endodontic therapy performed with or without using magnification devices, as well as trials comparing two or more magnification devices for endodontic therapy were considered. Conclusions: Three prospective studies were included, all dealing with endodontic surgery. No significant difference in outcomes was found among patients treated using magnifying loupes, surgical microscope or endoscope. Similarly, no difference was found with or without using the endoscope. No comparative study on magnification devices was found regarding orthograde endodontic treatment. The type of magnification device per se can only minimally affect the treatment outcome. Well-designed randomized trials should be performed to determine the true difference in treatment outcomes when using a magnification device in both orthograde and surgical endodontic treatment, if any exist. [Copyright &y& Elsevier]

Bacteria identification inside the dental tissue is a complex procedure requiring specific protocols. This study aimed to compare two classical Gram staining methods with a new staining method proposed by the authors to detect Gram-positive and Gram-negative bacteria in dental histological samples of human dentin. Ten human teeth, extracted because of various pathologies, were decalcified, dehydrated, and paraffin-embedded. Then, approximately 100 serial sections of 4 µm thickness were made per sample. The serial sections were placed on glass slides and were stained according to Brown-Brenn, Brown-Hopps, and a proposed modification of Brown-Brenn staining. Both ATCC strains, smeared on glass slides, were stained following each method's instructions used in histological samples. From a qualitative evaluation, the Brown-Brenn method resulted in better staining of Gram-positive bacteria, while the authors' proposed staining technique was more oriented towards Gram-negative bacteria. On the other hand, the Brown-Hopps showed quite a balance in detecting Gram-positive and Gram-negative bacteria. Unlike the Brown-Brenn stain, the other two protocols showed better stainability of Gram-negative microorganisms in bacterial-smeared samples. All staining techniques evaluated in this article can identify bacteria, but the outcome can change according to the staining procedure used. • G&S stain by changing the differentiation method could enhance Gram – bacteria identification in paraffin embeddend samples. [ABSTRACT FROM AUTHOR]

Hair analysis for the assessment of cannabis active use from passive consumption may be failed when performed by the sole detection of compounds present in plant material as well as in cannabis smoke like Δ-9-tetrahydrocannabinol (THC), cannabidiol (CBD), and cannabinol (CBN). For this reason, the determination of 11-nor-9-carboxy-Δ-9-tetrahydrocannabinol (THC-COOH) has been proposed by the Society of Hair Testing (SoHT) in order to prove active cannabis consumption. The identification of THC-COOH in hair will continue to be complicated by its acidic nature and the critical low concentration due to the preferential incorporation of basic compounds into hair shaft. Alternatively, 11-OH-THC may be considered as a complementary marker for THC administration. Our recent study reported an accurate validated procedure for THC, CBD, CBN and 11-OH-THC in hair, based on a GC/MS-MS method in electron ionization mode. However, unlike THC-COOH, a cut-off level for 11-OH-THC in hair has not been fixed yet. For this reason, the aim of this study is to propose a concentration value for 11-OH-THC in hair analysis in order to discriminate between chronic use and external contamination. Receiver operating characteristics (ROC) analysis was applied for cut-off evaluation after 11-OH-THC quantification in a pool of 672 THC-positive hair samples. Results have shown a concentration range between 0.01-5.34 ng/mg for THC (mean 0.34 ng/mg, median 0.12), 0.00-19.2 pg/mg for THC-COOH (mean 0.72 pg/mg, median 0.19 pg/mg) and 0.01-13.33 ng/mg for 11-OH-THC (mean 1.09 ng/mg, median 0.51 ng/mg) for scalp hair and between 0.03-6.32 ng/mg for THC (mean 0.82 ng/mg, median 0.30), 0.00-42.1 pg/mg for THC-COOH (mean 2.70 pg/mg, median 1.08 pg/mg) and 0.00-7.88 ng/mg for 11-OH-THC (mean 1.70 ng/mg, median 0.89 ng/mg) for body hair. Considering these experimental data collected in our laboratory, we propose a cut-off level of 0.5 for scalp and body hair, as indicative of cannabis active consumption. The ROC curve AUCs for 11-OH-THC were 0.873 and 0.884 in 590 scalp hair and 82 body hair samples, respectively. The comparison of the results for THC-COOH (control method) and 11-OH-THC (test method) was also made by means of the Cohen's kappa statistics providing a good agreement according to both Landis & Koch and Fleiss scales. Additionally, we suggest that the detection of both THC-COOH and 11-OH-THC should be mandatory in order to prove active intake and exclude false positive results from external contamination. [ABSTRACT FROM AUTHOR]