No abstract

Feline odontoclastic resorptive lesions (FORL) were first recognized and histologically differentiated from caries in the 1920s [1,2]. Some anecdotal reports describing caries-like lesions at the cervical region of feline teeth followed in the 1950s and 1960s, until two microscopic studies in the 1970s again revealed that FORL were not caries but a type of tooth resorption [3,4]. A recent study showed that cats with FORL have a significantly lower urine specific gravity and significantly higher serum concentration of 25-hydroxyvitamin D (25OHD) compared with cats without FORL [5], indicating that multiple tooth resorption in domestic cats could be the manifestation of some systemic insult rather than a local cause. In this article, the histologic and radiographic appearance of FORL and certain other peculiarities of feline teeth are reviewed. An attempt is then made to compare these findings with changes of the periodontium induced by administration of excess vitamin D or vitamin D metabolites in experimental animals. Histologic and radiographic features of feline odontoclastic resorptive lesionsTooth resorption is caused by odontoclasts. Their precursors derive from hematopoietic stem cells of bone marrow or spleen and migrate from blood vessels of the alveolar bone or periodontal ligament toward the external root

AIMTo compare the effectiveness and safety of vonoprazan-based therapy with proton pump inhibitor (PPI)-based therapies to treat Helicobacter pylori (H. pylori).METHODSWe retrospectively analysed data from first-line (vonoprazan or PPI with 200 mg clarithromycin and 750 mg amoxicillin twice daily for 7 d) (n = 1353) and second-line (vonoprazan or PPI with 250 mg metronidazole and 750 mg amoxicillin twice daily for 7 d) (n = 261) eradication treatments for H. pylori -positive patients with associated gastrointestinal diseases from April 2014 to December 2015 at Hattori Clinic, Japan. The primary endpoint was the eradication rate, which was assessed with a full analysis set. The secondary endpoints were adverse events and related factors.RESULTSAfter the first-line treatments, the eradication rates for vonoprazan, esomeprazol, rabeprazole, and lansoprazole were 87.9% (95%CI: 84.9%-90.5%), 71.6% (95%CI: 67.5%-75.5%), 62.9% (95%CI: 52.0%-72.9%), and 57.3% (95%CI: 50.4%-64.1%), respectively. The vonoprazan eradication rate was significantly higher than that of the PPIs (P < 0.01). Interestingly, smoking did not affect the H. pylori eradication rate in the vonoprazan group (P = 0.34), whereas it decreased the rates in the PPI groups (P = 0.013). The incidence of adverse events in the vonoprazan group was not different from the PPI group (P = 0.054), although the vonoprazan group exhibited a wider range of adverse events. Vonoprazan-based triple therapy was highly effective as a second-line treatment, with an eradication rate similar to that of PPI-based therapy.CONCLUSIONVonoprazan might be superior to PPIs in first-line H. pylori therapy, particularly for smokers. However, caution is required due to possible adverse events.

Background and Aim Proton pump inhibitors and vonoprazan (a potassium-competitive acid blocker) are recommended as first-line treatments for gastroesophageal reflux disease (GERD). However, few reports have investigated the onset of action of these agents for GERD symptom relief. The present study compared the symptom relief of esomeprazole with that of vonoprazan via monitoring self-reported GERD symptoms after treatment initiation. Methods This was a prospective, multicenter, randomized, open-label, parallel group, comparative clinical study between esomeprazole (20 mg/day) and vonoprazan (20 mg/day) administered for 4 weeks to patients with GERD symptoms. Patients who had scores ≥ 8 on the Gastroesophageal Reflux Disease Questionnaire (GerdQ) were defined as having GERD and enrolled in this study. Sixty patients were randomly assigned to either the esomeprazole group ( n = 30) or the vonoprazan group ( n = 30). Treatment response rates in each drug group were evaluated according to the GerdQ. The Frequency Scale for the Symptoms of GERD (FSSG) scores from the 1st day after treatment initiation and the Global Overall Symptom (GOS) scale scores during treatment were also evaluated. Results At 4 weeks, the treatment response rates for symptom relief according to the GerdQ were 88.0% in the esomeprazole group and 81.8% in the vonoprazan group. The GOS scales, which reflect the impact of GERD symptoms, were similar for both groups. The FSSG scores decreased from the 1st to the 14th day in both groups. Conclusions There were no substantial differences in the symptom relief between the two groups at any time point in this short-term study.

Abnormal extrusion of canine teeth is often noted in middle-aged and geriatric domestic cats. The same age group of cats also is commonly affected by tooth resorption (TR). This study explored the relationship between these two phenomena of unknown etiology. Using digital radiography, the distance between the alveolar margin (AM) and cementoenamel junction (CEJ), referred to as the AM-CEJ distance, was measured in clinically and radiographically healthy maxillary canine teeth of 24 TR-affected and 29 TR-free cats. The mean AM-CEJ distance of maxillary canine teeth of cats with and cats without TR was 2.68-mm and 2.22-mm, respectively. An analysis of covariance adjusting for age revealed a significant correlation (p = 0.02) between tooth extrusion and TR. Extrusion of the maxillary canine teeth became clinically apparent when an AM-CEJ distance of 2.5-mm or greater was evident in the absence of horizontal or vertical alveolar bone loss. Based on this criterion, 15 of 24 cats with TR (63.0 %) exhibited extrusion of maxillary canine teeth, compared to 9 of 29 cats without TR (31.0 %). Four extruded and five non-extruded maxillary canine teeth were evaluated histologically. Cementum of extruded teeth was significantly thicker compared to that of non-extruded teeth. Four of 4 canine teeth with extrusion (100 %) showed histological evidence of resorption, compared to 1 of 5 canine teeth without extrusion (20.0 %). These results suggest that tooth extrusion is linked to or may be caused by similar factors responsible for the development of TR.