Introduction: Overactive bladder (OAB) affects up to 10% of healthy children, with poorly understood mechanisms. Recent adult data implicate the urogenital microbiome in lower urinary tract symptoms. This pilot study explored the relationship between the urogenital microbiome and OAB in children. Methods: A prospective cohort study was conducted in children aged 5–11 years with OAB and age matched controls (2020–2023). Midstream voided urine samples were analyzed using standard urine culture and long-read, near full-length 16S rRNA gene sequencing with the Nanopore 16S Barcoding kit and MinION system. Results: Fifteen OAB patients and twelve controls were included, with similar ages (9.19±2.19 vs 8.35±2.92 years; p=0.386). Microbiome analysis was completed in 15 cases and 8 controls after exclusion of PCR negative samples. The most frequently detected bacteria were Campylobacter ureolyticus (32%), Ezakiella massiliensis (22%) and Peptoniphilus harei (20%). Alpha and beta diversity were both low, with no statistically significant differences between groups. Microbiome composition analysis showed a higher relative abundance of Gram-positive genera, including Streptococcus, Staphylococcus and Anaerococcus, in OAB patients compared with controls. Conclusion: This exploratory pilot study suggests qualitative urogenital microbiome differences in children with OAB, particularly a higher relative abundance of Gram-positive genera, despite no significant differences in diversity; larger studies are needed to confirm the clinical relevance of these hypothesis-generating findings.
Objective: Irrigation in regenerative endodontics must balance disinfection with preservation of the dentin matrix, whose matrix metalloproteinases (MMPs) may be exposed or degraded by irrigants. This study evaluated the effects of irrigation protocols on gelatinolytic activity and MMP-2 and MMP-9 immunolabeling in root dentin. Materials and Methods: In this randomized, examiner-blinded ex vivo study, thirty single-rooted teeth with standardized open apices were allocated to five protocols (n = 6): saline (G1); 1.5% sodium hypochlorite (NaOCl; G2); saline followed by 17% ethylenediaminetetraacetic acid (EDTA; G3); 1.5% NaOCl, saline, and EDTA (G4); or 2.5% NaOCl, saline, and EDTA (G5). Cervical, middle, and apical slices were analyzed by in situ zymography and immunofluorescence. Data were analyzed by two-way repeated-measures ANOVA with Tukey-adjusted comparisons (α = 0.05). Results: Irrigation protocol and root third affected all outcomes (p < 0.0001). Protocol-by-third interactions occurred for MMP-2 and MMP-9 (both p < 0.0001), but not gelatinolytic activity (p = 0.1619). Across root thirds, G3 showed the highest gelatinolytic activity (27.73 ± 1.74 pixels/µm²) and G2 the lowest (11.65 ± 0.62 pixels/µm²). Gelatinolytic activity was lower apically (16.02 ± 5.76 pixels/µm²) than cervically (19.79 ± 6.42) and in the middle third (18.48 ± 5.98). In the apical third, MMP-2 ranged from 27.88 ± 1.04 in G3 to 11.70 ± 0.94 pixels/µm² in G2, and MMP-9 from 24.63 ± 1.62 to 7.96 ± 1.04 pixels/µm², respectively. Conclusion: Irrigation protocols distinctly modulated the proteolytic profile of root dentin along the root. Whether these changes influence regenerative outcomes remains to be determined.
Tampon pulpotomy is an emerging modification of vital pulp therapy (VPT) in which a hydraulic calcium silicate cement (HCSC) is placed with controlled pressure over persistently bleeding vital pulp, allowing haemorrhage control to occur during biomaterial placement. This narrative review examines two related but distinct issues: the clinical significance of haemostasis time and the rationale and evidence for tampon pulpotomy. Evidence from conventional VPT suggests that prolonged haemostasis time alone may not reliably predict treatment failure, including recent prospective data showing favourable outcomes when haemostasis required up to 15 minutes. These findings, however, do not directly test cement placement during active bleeding. Direct tampon-specific evidence consists mainly of case reports and observational experience, while HCSCs provide a plausible biological and material basis through sealing, ion release, alkalinity, and mineralisation-related effects. Blood-material interactions and proposed tampon-specific effects on clot volume, intrapulpal pressure, microcirculation, inflammation, and angiogenesis require further study. Tampon pulpotomy therefore represents a testable procedural modification for persistent pulpal bleeding, and independent, standardised comparative studies are needed to define its safety, indications, mechanisms, and relative effectiveness.
Objectives: Managing hypersensitivity in molar incisor hypomineralization (MIH)-affected first permanent molars (FPMs) remains challenging. Silver fluoride (SF) combined with potassium iodide (KI) has been suggested to reduce sensitivity and improve clinical outcomes. This study aimed to evaluate whether the application of SF+KI prior to glass hybrid (GH) restorations provides additional benefit in reducing hypersensitivity and improving clinical performance in MIH-affected FPMs. Methods: This randomized split-mouth clinical trial included 34 children (8–13 years) with MIH-affected FPMs. A total of 82 FPMs were allocated to SF+KI+GH or GH alone. Hypersensitivity was assessed using the “Schiff Cold Air Sensitivity Scale” at baseline and at 1, 3, 6, and 12 months. Clinical performance was evaluated using modified USPHS criteria. Results: Hypersensitivity decreased markedly in both groups after treatment and remained minimal throughout follow-up, with no significant differences between groups (p>0.05). At 12 months, 90.6% (29/32) of the SF+KI+GH and 93.9% (31/33) of the GH restorations were clinically acceptable; three restorations in the SF+KI+GH group and two in the GH group were classified as unsatisfactory, with survival probabilities of 89.8% and 93.9%, respectively. Conclusion: Both protocols effectively reduced hypersensitivity and showed acceptable short-term clinical performance. SF+KI pretreatment did not provide additional benefit over GH alone within 12 months.
Objectives: To evaluate the effectiveness and safety of oral probiotic supplementation for the primary prevention of vulvovaginal infections and preterm birth in pregnant women. Methods: A systematic review (PROSPERO 1129806) of randomized, placebo-controlled studies evaluating oral probiotics in pregnant women was conducted using PubMed, Virtual Health Library, Scopus, Cochrane Library, Web of Science, and Embase databases (2002–2025). The studies published in English assessing probiotics for vulvovaginitis or preterm birth prevention were included. Results: Four primary prevention studies were included, all used oral probiotics containing Lactobacillus rhamnosus, and no severe adverse events were reported. One study demonstrated reduced abundance of Candida albicans and Candida glabrata and increased beneficial lactobacilli following probiotic use after antifungal treatment. However, none of the studies showed a statistically significant effect on vulvovaginitis or preterm birth. The largest study indicated a non-significant trend toward reduced preterm birth among women with asymptomatic intermediate bacterial vaginosis. Conclusions: Oral probiotics appear to be safe during pregnancy but are not effective as standalone therapy for vulvovaginitis. Combined approaches may provide benefit. Vaginal administration and specific species may offer greater efficacy. Further studies are needed, particularly regarding preterm birth prevention.
