Dentistry

Objectives: Alhough typically prescribed in oncology, bisphosphonates (BPs) are also employed in rheumatology, particularly for the treatment of osteoporosis, sometimes resulting in complications, such as osteonecrosis of the jaw. Because of different opinions between rheumatologists and dentists on BP use, this study aimed to assess the views of dentists regarding administration of BPs in rheumatology. Methods: A questionnaire was sent to 880 dentists from the Auvergne region of France to determine their views on BP treatment. Results: We obtained 382 (43.4%) responses and analysed 376 (58.7% men). In total, 156 (41.5%) of the responders analysed had attended an in-service training course (ISTC) on the topic. A total of 237 (63.0%) systematically inquired as to whether their patients were undergoing BP treatment; this proportion was higher among those who had been practicing for fewer than 10 years (P < 0.004). For patients receiving BPs, 84.5% of practitioners felt ill at ease about performing dental surgery (n = 318) and 11% felt ill at ease about performing nonsurgical dental care (n = 41); 67% stated that their practice differed depending on the method of BP administration (per os or intravenously). Overall, 53.7% of practitioners felt uncomfortable when asked by a rheumatologist whether a given patient's dental status permitted prescription of BP (n = 202). This proportion was higher among those who had never attended an ISTC (62.6% vs. 50.7%; P < 0.03). Conclusions: Dentists feel ill at ease providing dental surgery to patients receiving BPs. Closer collaboration and better information-sharing between rheumatologists and dentists is necessary to facilitate the administration of BPs in rheumatology.

Objectives: Alhough typically prescribed in oncology, bisphosphonates (BPs) are also employed in rheumatology, particularly for the treatment of osteoporosis, sometimes resulting in complications, such as osteonecrosis of the jaw. Because of different opinions between rheumatologists and dentists on BP use, this study aimed to assess the views of dentists regarding administration of BPs in rheumatology. Methods: A questionnaire was sent to 880 dentists from the Auvergne region of France to determine their views on BP treatment. Results: We obtained 382 (43.4%) responses and analysed 376 (58.7% men). In total, 156 (41.5%) of the responders analysed had attended an in-service training course (ISTC) on the topic. A total of 237 (63.0%) systematically inquired as to whether their patients were undergoing BP treatment; this proportion was higher among those who had been practicing for fewer than 10 years (P < 0.004). For patients receiving BPs, 84.5% of practitioners felt ill at ease about performing dental surgery (n = 318) and 11% felt ill at ease about performing nonsurgical dental care (n = 41); 67% stated that their practice differed depending on the method of BP administration (per os or intravenously). Overall, 53.7% of practitioners felt uncomfortable when asked by a rheumatologist whether a given patient's dental status permitted prescription of BP (n = 202). This proportion was higher among those who had never attended an ISTC (62.6% vs. 50.7%; P < 0.03). Conclusions: Dentists feel ill at ease providing dental surgery to patients receiving BPs. Closer collaboration and better information-sharing between rheumatologists and dentists is necessary to facilitate the administration of BPs in rheumatology.

Working group Jacky SAMSON Vianney DESCROIX Jacques-Henri TORRES Patrick BLANCHARD Marie-Anne BOULDOUYRE Jean-Hugues CATHERINE Bruno COURRIER Sarah COUSTY Eric DENES Christophe DESCHAUMES Jean-Christophe FRICAIN Frédéric LECOMTE Nicolas MAILHAC Dominique MUSTER Jean SIBILIA Michel VEYRAC (Stomatology, Geneva) Chairman (Odontology, Paris) Rapporteur (Stomatology, Montpellier) Coordinator (Stomatology, Maisons-Laffitte) (Internal medicine, Paris) (Odontology, Marseille) (Odontology, Paris) (Odontology, Toulouse) (Infectious diseases, Limoges) (Odontology, Clermont-Ferrand) (Odontology, Bordeaux) (Infectious diseases, Lorient) (Odontology, Autun) (Stomatology, Strasbourg) (Rheumatology, Strasbourg) (Gastrointestinal disorders, Montpellier)

The purpose of this study was to evaluate dental laboratory technicians' abilities to match shades using a light-corrective device under conventional laboratory conditions. The variables measured were years experience, gender, and light source. Materials and Methods: A 14-item shade-matching quiz (SMQ) was field-tested and deemed adequate. Information included age, gender, number of years experience, and Ishihara's Colour-Blindness Assessment. Forty-two dental technicians from five northeast Ohio laboratories were invited to participate. The SMQ was administered twice: under the lighting conditions in the individual laboratories (SMQ-Lab) and with a light-corrective source (SMQ-LC). For each item, the technicians were to select the matching Vita shade tab from five preselected shade tabs. SMQ scores equaled the number of correct matches. Statistical analysis included calculation of means, standard deviations, correlation coefficients, and independent and paired t-tests. Significance was set at p ≤ 0.05. Results: Twenty male and 20 female technicians participated. None were colordeficient. The SMQ scores were significantly higher with the light-corrective device than under laboratory lighting: 12.0 ± 1.9 and 10.0 ± 2.0, respectively (p < 0.001). There were no significant correlations between years experience and SMQ scores, nor were there differences between scores by gender. In general, the Vita C shades were least likely to be matched. Conclusions: Within the limitations of this study, dental technicians' shade-matching abilities were better with a light-corrective device than under the conventional laboratory lighting conditions. Gender and experience were not factors in matching shades. The Vita C shades were least likely to be matched.

Purpose: The purpose of this investigation was to assess the level of consensus regarding the definition of centric relation and its clinical use in 7 US dental schools. Materials and Methods: The preclinical and clinical faculty in the departments of prosthodontics, operative, and general dentistry (n ‫؍‬ 137) at 7 dental schools and a convenience sample of fourth year students (n ‫؍‬ 150) at the same schools were invited to complete 2-page surveys regarding the definitions and use of centric relation at their institutions. The faculty and student survey included 6 commonly used centric relation definitions from the 1994 Glossary of Prosthodontic Terms, and provided space for writing in definitions not listed on the form. The participants were asked to identify which definition was used at their school. Results: Return rate was 85% for faculty and 75% for students. Both faculty and students identified a low level of consensus regarding the definition and clinical use of centric relation at their dental school. Numerous definitions are in use at each institution. Extramural practice participation and the number of years since dental school graduation were variables associated with the faculty's choice of definition. The faculty who did not participate in an extramural practice chose older definitions. Dental educators graduating before 1975 selected either the oldest or the most recent centric relation definition, whereas the more recent graduates frequently selected the newer definitions. There were no statistical differences between prosthodontic specialists and nonspecialists in choice of definitions. Three courses identified by the students as having the most influence on their understanding of centric relation were preclinical removable prosthodontics, preclinical occlusion, and clinical removable prosthodontics. The results of this survey suggest that the controversy will continue, because to date there is no consensus regarding the definition of centric relation within the 7 dental schools surveyed.

atients' anxiety and fearrelated behaviors not only are difficult to manage but also can affect dental treatment, compliance and oral health. Allaying apprehension may be especially difficult if a patient's qualms and avoidance of treatment are not simply based on a phobia, but are associated with actual painful experiences encountered during dental visits. Unfortunately, many dental treatments performed without anesthesia, such as nonsurgical periodontal procedures, can be painful. Periodontitis, a chronic inflammatory disease affecting the gingiva, periodontal ligament and bone around the teeth, is characterized by bone resorption, apical migration of the attachment and subsequent periodontal pocket formation. Scaling and root planing (SRP) is an essential component of successful periodontal therapy. Because SRP can be painful, 9,10 patients undergoing it may need local anesthesia or other methods of pain control such as cognitive behavioral treatment, 11 administration of nitrous oxide 12 or intravenous administration of sedatives. Clinicians also have used

AimTo evaluate the efficacy of different screening protocols for undiagnosed hyperglycaemia in a Research Network of Dental Clinics coordinated by the Spanish Society of Periodontology (SEPA).Material and MethodsA total of 1143 patients were included in the study. Participants filled a questionnaire considering diabetes risk factors (FINDRISC) and received a periodontal screening examination. Patients with a slightly elevated score according to the Findrisc (≥7), received a point‐of‐care HbA1c and were eventually referred to their physician for confirmatory diagnosis. Receiver Operating Characteristic (ROC) curves were used to assess the performance of various predictive models with confirmed hyperglycaemia as outcome.ResultsFrom this population, 97 (8.5%) were finally diagnosed of diabetes (n = 28; 2.5%) or prediabetes (n = 69; 6.0%). When only including the results from the FINDRISC questionnaire, the model reported an area under the curve (AUC) of 0.866 (95% confidence interval ‐...

En los ultimos anos se ha observado un aumento en la incidencia de la peri-implantitis y en consecuencia, un aumento en la investigacion sobre esta patologia y sobre los factores que influyen en su aparicion. En este estudio, queremos valorar la posible influencia de la altura del pilar protesico en los implantes tipo Bone Level sobre la futura perdida osea marginal. Para ello, realizaremos un estudio retrospectivo midiendo la distancia entre la cresta osea y el hombro del implante en radiografias periapicales. Las mediciones seran realizadas por un unico examinador calibrado, se realizara estadistica descriptiva y utilizaremos el test t de Student para comparar dos medias para muestras independientes.

ObjectivesThe aim of this RCT was to assess radiographically the effect of abutment height and depth of placement of platform‐switched implants on interproximal peri‐implant bone loss (IPBL) in patients with thin peri‐implant mucosa.Material and MethodsThirty‐three patients received one prosthesis supported by two implants replacing at least two adjacent missing teeth (66 implants). Patients were randomly allocated and implant insertion depth adapted to abutment height groups (3 mm height group the implants were placed 2 mm subcrestally; 1 mm height group, equicrestally). Clinical and radiological measurements were performed at 3, 6 and 12 months after surgery. Interproximal bone‐level changes were compared between treatment groups using repeated measures mixed ANOVA. The association between IPBL and categorical variables was also analyzed.ResultsThe mean IPBL in 1 mm abutment group was 0.76 ± 0.79 mm at 3 months, 0.92 ± 0.88 mm at 6 months, and 0.95 ± 0.88 mm at 12 months, while in...

The aim of this randomized clinical trial was to compare the effect on the interproximal implant bone loss (IBL) of two different heights (1 and 3 mm) of definitive abutments placed at bone level implants with a platform switched design. Twenty-two patients received forty-four implants (6.5-10 mm length and 3.5-4 mm diameter) to replace at least two adjacent missing teeth, one bridge set to each patient-two implants per bridge. Patients were randomly allocated, and two different abutment heights, 1 and 3 mm using only one abutment height per bridge, were used. Clinical and radiological measurements were performed at 3 and 6 months after surgery. Interproximal bone level changes were compared between treatment groups. The association between IBL and categorical variables (history of periodontitis, smoking, implant location, implant diameter, implant length, insertion torque, width of keratinized mucosa, bone density, gingival biotype and antagonist) was also performed. At 3 months, i...

In this 3-year follow-up study, peri-implant bone loss at bone-level implants was evaluated with two definitive abutment heights: 1 mm and 2.5 mm. Peri-implant bone loss was defined as the distance between the implant shoulder and the first bone-to-implant contact from the time of loading to the 36-month follow-up, estimated using periapical radiographs. The bone loss was increased at the time of follow-up, to 1.30 mm (95% confidence interval [CI]: 0.70-1.89 mm; SD = 1.89) and 0.33 mm (95% CI: 0.11-0.55; SD = 0.59) at 36 months in short and long abutments, respectively. Placement of short abutments induced higher peri-implant bone loss at bone-level implants during a peri-implant recall program.

ObjectiveThe aim of this study was to evaluate the soft tissue histomorphometric composition around implant abutments comparing two different materials, titanium (Ti) and zirconia (ZrO2).Material and methodsTwelve implants were placed at bone level in the mandible of six beagle dogs (one in each side). At the same day of surgery one titanium abutment was screwed to the implant in one side (control group) and a zirconia abutment was screwed in the contralateral side. Nine months after implant/abutments placement, animals were sacrificed for histological analysis. Descriptive analysis was calculated for each variable and Wilcoxon test was applied to evaluate histomorphometric variables.ResultsAt the end of the study the soft tissue dimension at Ti and ZrO2 were similar in all counterparts: biological width, the length of the barrier epithelium, length of the connective tissue, and the percentage of collagen fibers density. However, the percentage of blood vessels was higher for the Ti...

Objectives For many years, tumor development has been viewed as a cell-autonomous process; however, today we know that the tumor microenvironment (TME) and especially cancer-associated fibroblasts (CAFs) significantly contribute to tumor progression. Caveolin-1 (Cav-1) is a scaffolding protein which is involved in several cancer-associated processes as important component of the caveolae. Our goal was to shed light on the expression of the two different isoforms of Cav-1 in normal fibroblasts (NFs) and CAFs of patients with oral squamous cell carcinoma (OSCC). Materials and methods Fibroblasts from normal mucosa and CAFs were isolated and propagated in vitro. Gene expression of the different Cav-1 isoforms was assessed via quantitative real-time PCR (qPCR) and supplemented by protein expression analysis. Results We could show that the Cav-1β isoform is more highly expressed in NFs and CAFs compared to Cav-1α. Furthermore, the different Cav-1 isoforms tended to be differently express...

Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact—the dimensions of oral health‐related quality of life—capture dental patients’ oral health problems worldwide and regardless of whether the patient currently suffers from oral diseases or intends to prevent them in the future. Using scores for these dimensions, the project Mapping Oral Disease Impact with a Common Metric (MOM) aims to provide four‐dimensional oral health impact information across oral diseases and settings. In this article, project authors summarize MOM’s findings and provide recommendations about how to improve standardized oral health impact assessment. Project MOM’s systematic reviews identified four‐dimensional impact information for 189 adult and 22 pediatric patient populations that were contained in 170 publications. A typical functional, pain‐related, aesthetical, and psychosocial impact (on a 0‐8 impact metric based on two items with a response format 0 = never, 1 = hardly ever, 2 ...

Pain in the oro‐facial region is one of the most common reasons for patients to seek dental treatment. Oral health‐related quality of life (OHRQoL) can be affected not only by pain, but also by other oral disorders. Four main dimensions, Oral Function, Orofacial Pain, Orofacial Appearance and Psychosocial Impact, have been suggested to cover different areas of OHRQoL. The aim of this systematic review was to map the impact of oro‐facial pain conditions on the Orofacial Pain dimension of OHRQoL (PROSPERO registration: CRD42017064033). Studies were included if they reported Oral Health Impact Profile (OHIP) mean or median domain scores for patients with odontogenic pain, oral mucosal pain/burning mouth syndrome (BMS), third molar extractions or temporomandibular disorders (TMD). A search in PubMed (MEDLINE), EMBASE, Cochrane, CINAHL and PsycINFO on 8 June 2017, updated 14 January 2019, combined with a hand search identified 2104 articles. After screening of abstracts, 1607 articles we...

ObjectivesFor jaw functional limitations measured by the Jaw Functional Limitation Scale (JFLS), (a) determining prevalence in the Swedish general adult population, (b) investigating the influence of demographic factors and self‐reported dental status and (c) deriving normative values.MethodsA random sample of the general adult population in Sweden was approached (response rate: 46%, N = 1,372). Prevalence was determined for the JFLS summary score and individual items. The influence of age, gender and dental status was investigated with regression analyses and normative values presented.ResultsThe JFLS median score was 0, and all items had prevalences ≤30%. Age and gender did not influence jaw functional limitations but dental status did. Normative JFLS scores were 1, 9 and 28 for the 7th, 8th and 9th deciles, respectively. In dental status‐stratified norms, 9th deciles were 20, 43 and 100, for subjects with natural teeth only, removable and complete dentures, respectively.Conclusio...

Supernumerary teeth (ST) are uncommon alterations of development that may appear in either of the dental arches and that are frequently associated with syndromes such as cleidocranial dysplasia and Gardner syndrome. Multiple ST in individuals with no other disease or syndrome are very rare. In view of this situation, correct diagnosis, treatment and evaluation of ST with the use of appropriate imaging techniques are highly important. This case report presents radiographic images of a nonsyndromic 12-year-old female patient who presented with 14 supernumerary teeth and was treated under general anesthesia, with the extraction of all ST in a single surgical intervention. During the postoperative period, the patient did not complain of pain nor did she present any signs or symptoms of infection. During late follow-up period, due to difficulty in traction of the maxillary right canine and mandibular left first premolar towards the dental arch, it was necessary to extract these teeth und...

This study presents the experimental results of the shear strength of reinforced concrete (RC) "real" beams extracted from an old RC building in Rome, built in 1929. The concrete strength is very small as in the case of many existing old RC structures. These results about "real" beams are innovative in the literature because the beams are usually built purposely to be retrofitted and tested. The data presented in this paper improve the literature database giving original data about the measured concrete strength variation along the beams, the stiffness, the deflections, and the strengths of the beams before and after retrofitting, and the Carbon FRP U-Strips strains. The shear strengths of these "real" beams, together with the ones obtained in other experimental studies, are in good agreement with the predicted strengths by design code equations.

Objective: The objective of this retrospective longitudinal study was to evaluate short-and long-term results of the application of the Liou Alt-RAMEC (alternate rapid maxillary expansion and constriction) technique, a late orthopedic maxillary protraction technique, with intraoral anchorage, in patients with cleft. Materials and Methods: Twenty-six patients with unilateral cleft lip and palate (UCLP) were consecutively treated with the Alt-RAMEC technique. The average age of the patients was 11.7 years (10.3-13.2 years) before protraction and 18.3 years (17.4-21.1 years) at long-term follow-up. A sample of nontreated patients with UCLP was used as a control group. It was matched for sex, skeletal class III, and age (11.3 years). The control sample had records at the end of growth (18.7 years). The sagittal advancement of A-point, after the application of the technique, was 5.7 (2.17) mm. Some mandibular dentoalveolar and positional adaptation was noted. The position of the maxilla was stable in the long term. On the other hand, the UCLP control group showed hardly any growth at the maxillary level during the long-term follow-up period. Our results showed that the Alt-RAMEC technique, performed at the correct time, with a double-hinged expander, followed by class III spring or elastic traction, 24 hours per day, allows for satisfactory maxillary protraction, with, at this stage, apparently stable long-term results. Nevertheless, as only 50% of the patients had long-term follow-up data, we are still unable to predict the percentage of patients which will not eventually need orthognathic surgery.

Aim.dComparison of the long-term follow-up until the completion of growth of two homogeneous samples of children affected by hemifacial microsomia (HFM), one treated by mandibular distraction osteogenesis (DO) in the deciduous or early mixed dentition, the other not subjected to any treatment until adulthood. Material.dFourteen patients affected by vertically severe type I or II HFM were operated at an average age of 5.9 years with an average follow-up of 11.2 years. They were compared to a sample of eight patients who were never treated until the completion of growth. Methods.dMandibular vertical changes were measured on panoramic radiographs taken at different time points. Ratios between affected and non affected ramal heights were calculated and compared. Results.dIn the DO sample, after correction, mandibular vertical changes showed a gradual return of the asymmetry with growth in all patients. The ratio in the non treated sample was unchanged between the initial and the long term panoramic x-rays. Conclusion.dThe facial proportions of HFM patients are maintained, when not treated, throughout growth. The same proportions return to their original asymmetry after DO. Even though short term aesthetic and psychological advantages of distraction osteogenesis are well accepted, early surgery should only be applied after careful patient selection and honest clarification of the long term recurrence by genetically guided craniofacial growth pattern (Fig ). The authors present a compelling prospective comparison of the long-term growth patterns of 2 groups of children with hemifacial microsomia, one that has been treated with distraction osteogenesis and another that has not been treated. The patient groups were similar, and vertical lengthening of the ramus was achieved with distraction in the treatment group. The main outcome measure was the ratio of the ramus height on the affected versus the unaffected side. The authors report that after complete correction of the ratio during distraction, that 16% ± 17% of the vertical correction obtained by distraction was lost at the end of the first year and 75% ± 11% of the vertical correction was lost after 5 years. At the final follow-up after growth was completed (>10 years after distraction) the ratio of ramus height was virtually unchanged from the predistraction ratio. This is well illustrated in Fig 2 . The ratio of ramus height was also constant in the untreated group. The authors were able to achieve significant vertical lengthening of the ramus with distraction osteogenesis, but the results were short lived, and the asymmetric ratios recurred when growth was complete. These patients may benefit

Prospective, longitudinal, clinical long-term follow-up study of a homogeneous sample of children affected by hemifacial microsomia and treated by mandibular distraction osteogenesis. Material: Eight patients affected by types I and II hemifacial microsomia were operated on at an average age of 5.6 years with an average follow-up of 5.8 years. Methods: Vertical changes were measured on postero-anterior cephalometric and panoramic radiographs taken sequentially. Results: Angular changes of the infraorbital and nasal floor planes were not significant, showing that distraction osteogenesis starting after 5 years of age did not influence the maxillary skeletal base. Occlusal (plane) cant was reduced by 71 on average following distraction osteogenesis, showing good dentoalveolar plasticity. Mandibular vertical changes showed a gradual return of the asymmetry, with growth in all patients (the ratio between affected and non-affected rami returned by 77% of the correction obtained by means of distraction 5 years postoperatively). Conclusion: Although aesthetic and psychological advantages of distraction osteogenesis are well accepted it should only be applied after careful patient selection and honest explanation of the long-term recurrence by genetically determined craniofacial growth patterns. r 2005 European Association for Cranio-Maxillofacial Surgery

Summary Objective/Design/Setting This retrospective study sought voluntary participation from leading cleft centres from Europe and Brazil regarding core outcome measures. The results of this study would inform the debate on core outcome consensus pertaining to the European Reference Network for rare diseases (ERN CRANIO) and achieve a core outcome set for cleft care providers worldwide. Intervention/Method Five orofacial cleft (OFC) disciplines were identified, within which all of the International Consortium of Health Outcomes Measurement (ICHOM) outcomes fall. One questionnaire was designed for each discipline and comprised 1. the relevant ICHOM’s outcomes within that discipline, and 2. a series of questions targeted to clinicians. What core outcomes are currently measured and when, did these align with the ICHOM minimum, if not how did they differ, and would they recommend modified or additional outcomes?. Results For some disciplines participants agreed with the ICHOM minimums ...

Objective: Nasal stigma in patients with bilateral cleft lip and palate (BCLP) are a short columella and a flattened nasal tip. Design: The aim of this study was to evaluate the aesthetics of adolescents with BCLP, operated with a modified Cutting primary columella lengthening technique, associated to a modified Grayson orthopedic nasoalveolar molding (NAM). Setting and Patients: 72 BCLP patients were operated with this approach. Standardized photographic records were taken every 2 years. A group of 23 patients between 12 and 13 years of age was compared through normalized photogrammetry to a matched control of 23 noncleft adolescents. Results: Nasal protrusion and length of the columella were very close to normal. On the other hand, nasolabial angle and interalar width were still excessively wide compared to the noncleft sample. Conclusions: NAM and primary columella lengthening in BCLP has allowed to avoid traditional secondary columella lengthening at 5 to 6 years of age and give...

We evaluated the correlation between the skeletal facial advancement through Le Fort III osteotomy and the modification of polysomnographic values in syndromic patients with sleep respiratory disorders affected by craniofacial synostosis. Methods: We selected a sample of 17 patients affected by mild to severe OSAS. All patients underwent a Le Fort III osteotomy. In five cases we used the "classical technique" and in 12 cases distraction osteogenesis. Sleep respiratory disorders were evaluated by pre-op and post-op polysomnography. All patients had pre-op and post-op cephalometric records. Results: The average midface advancement was 16 mm (10-28 mm) measured at A point. The average pre-op polysomnographic records were: ODI 28.6 (8-75), AHI 23.2 (8-50). The average post-op polysomnographic records were: ODI 3.88 (0.3-7), AHI 4.14 (0.2-3). In one tracheostomized patient we removed the tracheostomy and one patient with CPAP stopped the treatment. Conclusions: The respiratory disorders in syndromic patients with midfacial hypoplasia have different clinical manifestation: from snoring to acute respiratory distress requiring tracheostomy. Our study demonstrates an improvement of polysomnographic values in all patients, with a shift from severe to mild OSAS or even a complete resolution.

Objectives: To examine the presence and morphologic characteristics of bifid mandibular canals (BMCs) and retromolar foramens (RFs) using cone beam CT (CBCT) and to determine their visualization on panoramic radiographs (PANs). Methods: A sample of 225 CBCT examinations was analysed for the presence of BMCs, as well as length, height, diameter and angle. The diameter of the RF was also determined. Subsequently, corresponding PANs were analysed to determine whether the BMCs and RFs were visible or not. Results: The BMCs were observed on CBCT in 83 out of the 225 patients (36.8%). With respect to gender, statistically significant differences were found in the number of BMCs. There were also significant differences in anatomical characteristics of the types of BMCs. Only 37.8% of the BMCs and 32.5% of the RFs identified on CBCT were also visible on PANs. The diameter had a significant effect on the capability of PANs to visualize BMCs and RFs (B 5 0.791, p 5 0.035; B 5 1.900, p 5 0.017, respectively). Conclusions: PANs are unable to sufficiently identify BMCs and RFs. The diameter of these anatomical landmarks represents a relevant factor for visualization on PANs. Pre-operative images using only PANs may lead to underestimation of the presence of BMCs and to surgical complications and anaesthetic failures, which could have been avoided. For true determination of BMCs, a CBCT device should be considered better than a PAN.

Extractions are routinely performed in orthodontics to gain space for teeth alignment. Crowded, malaligned, and overlapped teeth make it difficult for the dental surgeon to engage the beaks of the extraction forceps on the concerned tooth for extraction. An improper grip often leads to complications of instrument slippage, crown fracture, and more commonly, luxation of adjacent teeth. This article aims to help with atraumatic orthodontic extractions and reduce such complications. This case report examines an interproximal reduction technique using standard grit, taper, flat-end diamond bur (Mani TF-20, ISO 171/014, Mani, Inc., Tochigi, Japan) for the tooth to be extracted to create enough space for proper placement of the forceps and to prevent injury to adjacent structures. It can be useful for orthodontic extractions or other cases of tooth extractions with inadequate access.

Most studies in faculty development focus on assessing participant satisfaction rather than documenting change. The purpose of this study was to explore the possible short-term outcomes of a faculty development initiative. The research question that guided our study was: How does a faculty development seminar influence change in participants' instructional beliefs? An analysis of participant's (n = 7) learning journals showed that they experienced increased confidence using an expanded repertoire of teaching methods and models. Five of the participants demonstrated their ability to promote critical thinking during their PowerPoint presentations illustrating their integration of new information and simultaneous behavioral change. To develop a knowledge base beyond assessing participant satisfaction, researchers may need to relinquish casual assumptions and conceptualize how different modes of inquiry might yield untapped outcomes.

The aim of this study was to explore the effectiveness of a professional development initiative using organisational change research studies to frame the inquiry. Two faculty groups and two student groups participated in a total of four focus group interviews to ascertain their perceptions of a new model of pre-clinical dental education. Using a grounded theory approach, the findings showed that there were individual, structural and resource-related issues that advanced and restricted the successful implementation of the initiative. The exchange of ideas and the development of critical thinking skills, the use of modelling in multidisciplinary clinics, and just in time consultation were benefits of the programme, while its reliance on attaining competencies to determine student skill development and continual issues with patient allocation and a sufficient pool of patients were drawbacks. The findings suggest that inviting those involved in the professional development initiative into an investigation of their instructional practices while trying out new ideas in action is key to the processes of institutionalising change and engendering professional development growth.

Motivation is a frequently studied topic in various areas of sports scientific research studies such as education, business, exercise and so on. Specifically, motivation is a device that describes why some people choose to participate in various activities, try harder, and persist longer than others. Motivation is important psychological variable in sports and its need to achieve high level of competition. The current study was carried out to investigate the effects of gender differences on achievement motivation of university badminton players. The study was based on interuniversity level players who participated in north zone interuniversity badminton tournament held at Aligarh Muslim University, Aligarh India. Sports Achievement Motivation Test (SAMT) developed by M.L. Kamlesh was used to collect the data. t-test was applied to test the hypotheses. The result of the study showed that there was no difference between male and female badminton players on achievement motivation.

NF is a rare, but rapidly spreading fatal infection of polymicrobial origin. While sparing skin and muscles, NF initially causes necrosis of superficial fascia and subcutaneous tissue. With the progression of disease, skin and muscles also become necrosed due to thrombosis of the feeding vessels. 1,2 NF rarely involves the head and neck area. But literature shows that recently, NF of head and neck is becoming more common with more atypical locations like eyelids, periorbital region, scalp and ear. 3 -5

Inverted papilloma is a rare benign tumor of nasal cavity and paranasal sinuses. Although it is included in category of benign tumors, it has strong potential for local destruction, high recurrence rate and increased tendency towards malignancy. In this report, we present a case of an uncommon bilateral inverted papilloma of nasal cavities and paranasal sinuses.

ObjectivesAlthough platelet‐rich plasma (PRP) has been proposed as a therapeutic tool to enhance wound repair, the cellular and molecular mechanisms stimulated by this agent are still not completely understood. The present study was designed to characterize the effects of PRP and platelet‐poor plasma (PPP) supernatants on cell responses involved in gingival tissue repair.MethodsWe studied the response of human gingival fibroblasts (HGF) to PRP and PPP fractions on: matrix contraction, cell migration, myofibroblastic differentiation, production of matrix components and proteolytic enzymes. PRP and PPP were obtained from donors using a commercial kit. Matrix contraction was evaluated by means of collagen lattices in the presence of matrix metalloproteinase (MMP) and actin polymerization inhibitors. The production of matrix molecules and proteinases was assessed through Western‐blot. RhoA activity was evaluated through a pull‐down assay. Actin distribution and focal adhesions were asse...

A 34-yr-old male suffered multiple trauma in a road traf®c accident. He required right thoracotomy and laparotomy to control exanguinating haemorrhage, and received 93 u blood and blood products. Intraoperatively, he developed severe systemic in¯ammatory response syndrome (SIRS) with coagulopathy and respiratory failure. At the end of the procedure, the mean arterial pressure (MAP) was 40 mm Hg, arterial blood gas analysis showed a pH of 6.9, Pa CO 2 12 kPa, and Pa O 2 4.5 kPa, and his core temperature was 29°C. There was established disseminated intravascular coagulation. The decision was made to stabilize the patient on venovenous extracorporeal membrane oxygenation (ECMO) only 10 h after the accident, in spite of the high risk of haemorrhage. The patient was stabilized within 60 min and transferred to the intensive care unit. He was weaned off ECMO after 51 h. He had no haemorrhagic complications, spent 3 weeks in the intensive care unit, and has made a good recovery.

AimTo test whether an equine bone substitute block used for guided bone regeneration (GBR) of peri‐implant defects renders different results from bovine block or particulated bone substitutes regarding the dimensions of the augmented ridge and the amount of new bone.Material and methodsMandibular premolars and molars were extracted in eight dogs. After 4 months, four semi‐saddle bone defects were created in each mandible and one titanium implant was inserted into every site. Bone augmentation by GBR was attempted using the following randomly assigned modalities: (i) particulated deproteinized bovine bone mineral (DBBM) + a collagen membrane (CM), (ii) block DBBM + CM, (iii) equine bone substitute block + CM, and (iv) empty controls. After 4 months, one central and two lateral sections of each site were prepared. Descriptive histological and histomorphometrical assessments were performed evaluating the augmented area (AA) within the former bone defect, the area of mineralized tissue ...

To assess the effect of immediate loading on ridge alterations following implants placed into fresh extraction sockets in a dog model. Six Beagle dogs were used. Four implants were placed into post-extraction sockets in the lower jaw immediately after the removal of premolars 3 and 4. In the control side, two implants remained without occlusal loading, and in the test side, they received an immediate prosthesis with occlusal contacts (involving implant sites). Extraction sockets without implants were used as a test in non-involved implant sites. Three months later, the dogs were sacrificed. Vertical distance from implant shoulder to bone crest (BC) was similar for both groups. BC at the buccal aspect was located 3.66 mm apical to the shoulder in the test group and 4.11 mm in the control group. This difference was not statistically significant. Buccal bone resorption was more pronounced in the premolar 3 area than in the premolar 4 area. In edentulous sites, the buccal bone crest was...

Blanco J, Liñares A, Villaverde G, Pérez J, Muñoz F: Flapless immediate implant placement with or without immediate loading. a histomorphometric study in beagle dog. J Clin Periodontol 2010; 37: 937–942. doi: 10.1111/j.1600‐051X.2010.01608.x.Objective: To assess the osseointegration process after flapless immediate implant placement with or without immediate loading.Material and Methods: This study was carried out on six beagle dogs. Four implants were placed in the lower jaw (two per side) in each dog immediately after tooth extraction (3rd and 4th premolars). Flapless immediate implant placement was performed in one hemimandible (control). The same procedure was carried out in the contra‐lateral side and immediate prosthesis was connected with occlusal contacts (test). After 3 months of healing, the dogs were sacrificed for histomorphometric analysis.Results: Twelve implants were placed in each group. None of the implants and prosthesis was lost. The percentage of bone‐to‐implant ...

Aim: To describe the histological and clinical outcomes of the use of a xenogeneic collagen matrix (CM) in combination with the coronally advanced flap (CAF) in the treatment of localized Miller class-I gingival recessions. Material and Methods: Gingival recession defects were surgically created on 12 minipigs. The defects were randomly treated with either the CAF procedure and the interposition of a CM (test) or the CAF alone (control). Clinical and histological outcomes at 1, 4 and 12 weeks were evaluated. Results: Histometrically, in the test group, there was a shorter junctional epithelial dimension [2.26 (SD 0.23) mm] compared with the control [2.79 (SD 0.77) mm]. On the contrary, the amount of newly formed cementum was larger in the test group [1.08 (SD 0.41) mm] than in the control group [0.75 (SD 0.25) mm], although the differences were not statistically significant. Conclusions: Both techniques rendered similar clinical outcomes, achieving complete root coverage at the end of the study. Nevertheless, the CM graft attained more tissue regeneration, characterized by a shorter epithelium and a larger new cementum formation. The use of a xenogeneic CM resulted in the incorporation of the xenograft within the adjacent host connective tissues in the absence of significant inflammation.

Objectives: The purpose of this investigation is to describe histologically the undisturbed healing of fresh extraction sockets when compared to immediate implant placement. Methods: In eight beagle dogs, after extraction of the 3P3 and 4P4, implants were inserted into the distal sockets of the premolars, while the mesial sockets were left to heal spontaneously. Each animal provided four socket sites (control) and four implant sites (test). After 6 weeks, animals were sacrificed and tissue blocks were dissected, prepared for ground sectioning. Results: The relative vertical buccal bone resorption in relation to the lingual bone was similar in both test and control groups. At immediate implant sites, however, the absolute buccal bone loss observed was 2.32 (SD 0.36) mm, what may indicate that while an apical shift of both the buccal and lingual bone crest occurred at the implant sites, this may not happen in naturally healing sockets. Conclusions: The results from this investigation showed that after tooth extraction the buccal socket wall underwent bone resorption at both test and control sites. This resorption appeared to be more pronounced at the implant sites, although the limitations of the histological evaluation method utilized preclude a definite conclusion.

por título "MARGINAL BONE AND SOFT TISSUE BEHAVIOR FOLLOWING PLATFORM SWITCHING ABUTMENT CONNECTION/DISCONNECTION -A DOG MODEL STUDY", realizada por el Licenciado en Odontología, CÉLIA FILIPA GONÇALVES COUTINHO ALVES, que cumple todos los requisitos esixidos no artigo 34 do regulamento de Estudos de doutoramento, e que como Director da mesma non incurre nas causas de abstención establecidas na lei 30/1992 para ser presentada y defendida ante el oportuno Tribunal para optar al Grado de Doctor en Odontología.

ObjectiveCrohn&#39;s disease is a chronic inflammatory process that has recently been associated with a higher risk of early implant failure. Herein we provide information on the impact of colitis on peri‐implant bone formation using preclinical models of chemically induced colitis.MethodsColitis was induced by intrarectal instillation of 2,4,6‐trinitro‐benzene‐sulfonic‐acid (TNBS). Colitis was also induced by feeding rats dextran‐sodium‐sulfate (DSS) in drinking water. One week after disease induction, titanium miniscrews were inserted into the tibia. Four weeks after implantation, peri‐implant bone volume per tissue volume (BV/TV) and bone‐to‐implant contacts (BIC) were determined by histomorphometric analysis.ResultsCortical histomorphometric parameters were similar in the control (n = 10), DSS (n = 10) and TNBS (n = 8) groups. Cortical BV/TV was 92.2 ± 3.7%, 92.0 ± 3.0% and 92.6 ± 2.7%. Cortical BIC was 81.3 ± 8.8%, 83.2 ± 8.4% and 84.0 ± 7.0%, respectively. No significant diffe...

This study evaluated the inhibitory activity of copaiba oil (Copaifera officinalis against the cariogenic microorganism, Streptococcus mutans. For such purpose, a minimum inhibition concentration test of copaiba oil against S. mutans was performed, using the serial dilution in broth technique, with a negative control, a positive control (0.12% chlorhexidine) and a 10% copaíba oil solution as a test. A minimum bactericidal concentration test with tubes presenting microbial inhibition was also conduced. In the minimum inhibitory concentration test, copaiba oil showed inhibition of bacterial growth at all concentrations tested up to 0.78 µL/mL of the 10% copaiba oil solution in the broth. In addition, the negative control had no inhibition, and the 0.12% chlorhexidine solution was effective up to 6.25 µL/mL in the broth. Copaiba oil showed a bacteriostatic activity against S. mutans at low concentrations, and could be a an option of phytotherapic agent to be used against cariogenic bac...

Background: Some studies have investigated the possibility of incorporating silver nanoparticles (NAg) into dental materials to improve their antibacterial properties. However, the potential toxic effect of this material on pulp cells should be investigated in order to avoid additional damage to the pulp tissue. This study evaluated the cytotoxicity of conventional and resin-modified glass ionomer cements (GIC) with and without addition of NAg. Material and Methods: NAg were added to the materials at two different concentrations by weight: 0.1% and 0.2%. Specimens with standardized dimensions were prepared, immersed in 400 µL of culture medium and incubated at 37°C and 5% CO2 for 48 h to prepare GIC liquid extracts, which were then incubated in contact with cells for 48 h. Culture medium and 0.78% NAg solution were used as negative and positive controls, respectively. Cell viability was determined by MTT and Trypan Blue assays. ANOVA and the Tukey test (α=0.05) were used for statistical analyses. Results: Both tests revealed a significant decrease in cell viability in all groups of resin modified cements (p˂0.001). There were no statistically significant differences between groups with and without NAg (p˃0.05). The differences in cell viability between any group of conventional GIC and the negative control were not statistically significant (p>0.05). Conclusions: NAg did not affect the cytotoxicity of the GIC under evaluation.

To compare the effect of sealing dentinal caries [International Caries Detection and Assessment System (ICDAS) codes 4 and 5] by high viscosity glass ionomer cement (GIC) vs application of 38% silver diamine fluoride (SDF) in primary molars over a period of 6 months. Materials and method: This study was conducted over a period of 6 months and included 50 primary molars with active dentinal occlusal lesions, aged 3-5 years, having ICDAS codes 4 and 5. Children were randomly assigned to group I: SDF application (n = 27) or group II: high viscosity GIC treatment (n = 23). Lesions were assessed clinically for any progression of caries extent by using International Caries Diagnosis and Assessment System II, topography of lesion and radiographically by International Caries Classification and Management System (ICCMS) criteria after 6 months of intervention compared to baseline. Further, the evaluation of SDF-treated lesion status was by lesion texture and GIC restoration status was evaluated by caries-associated restorations and sealants (CARS) criteria. Results: After 6 months evaluation period, statistically significant, less progression of cases was observed in 7% of lesions after SDF application as compared to 39% in high-viscosity GIC group. Chairside time was statistically significant in between both the groups (p-value = 0.039). Techniques with minimal intervention, namely 38% SDF and high viscosity GIC for the occlusal surface cavity, appear to be effective in arresting the progress of dentinal caries in primary teeth. Clinical significance: Silver diamine fluoride (SDF) application stops the progression of dentinal lesions with less chairside time, being economical and can be used in patients of uncooperative behavior, including those with special healthcare needs.

Amac: Arastirma lomber disk hernili bireylerde fonksiyonel yetersizlik ve fiziksel aktivite duzeylerinin yasam kalitesi ile iliskisini belirlemek amaciyla yapildi. Gerec ve Yontem: Tanimlayici ve kesitsel turdeki bu arastirmaya Mart -Eylul 2017 tarihleri arasinda Turkiye&#39;nin bati bolgesindeki bir universite hastanesi beyin ve sinir cerrahisi klinigine lomber disk hernisi tanisi ile basvuran 132 birey dahil edildi. Arastirmanin verileri kisisel bilgi formu, visual analog skala (VAS), Uluslararasi Fiziksel Aktivite Anketi (IPAQ), Oswestry Fonksiyonel Yetersizlik Olcegi (ODI) ve SF-36 yasam kalitesi olcegi kullanilarak toplandi. Verilerin analizinde tanimlayici istatistikler, Mann Whitney U testi, Kruskal Wallis testi ve Spearman korelasyon analizi kullanildi. Bulgular: Arastirmaya katilan bireylerin yas ortalamasi 45,14±15,08 yil, %65,2&#39;si kadin, %40,9&#39;u fazla kiloludur. Olceklerden alinan puan ortalamalari VAS: 6,32±1,55, ODI: 29,75±11,08, SF-36 alt boyutlarindan fiziksel...