Isokinetic thigh muscles strength in semi-professional athletics: A one season prospective cohort study

Introduction: Continuous evaluations of athletes, including strength testing, can help control performance improvement or facilitate the restoration of normality after an injury. The aim of the present study was to prospectively determine the peak torque (PT), angle at which PT is achieved, and functional ratios of flexors and extensors thigh muscles during one season. Material and methods Thirty semi-professional male athletes competing in long jumping (n = 10), javelin throwing (n = 10), and sprinting (n = 10) participated. PT was evaluated in relation to limb length; the angle at which PT was achieved was obtained from the force-curve displayed in the isokinetic dynamometer; functional ratios were calculated by dividing concentric hamstring strength by eccentric quadriceps strength (flexor ratio) or vice-versa for the extensor ratio. Assessment was performed at 60º/s and 300º/s. Results Significant variations were seen for both extensor and flexor PTs at different stages of the season, with moderate to large effect sizes observed (effect size (d) = 0.49–0.93). Functional ratios and the angle at which peak torque was achieved remained stable throughout the season. Conclusions Thigh muscle strength is unstable throughout a track and field season, coaches or medical staff should consider these findings when programming training sessions or rehabilitating an athlete. (AU)

Influence of different drilling protocols and bone density on the insertion torque of dental implants

Background: The insertion torque of dental implants will depend on a combination of different factors such as bone density, the design of the implant and the drilling protocol used. However, it is not clear how the interaction of these factors affects the final insertion torque and which drilling protocol should be used in each clinical situation. The aim of this work is to analyse the influence of bone density, implant diameter and implant length on the insertion torque using different drilling protocols. Material and methods: An experimental study was carried out in which the maximum insertion torque was measured, in standardised polyurethane blocks (Sawbones Europe AB) of four densities, for M12 Oxtein dental implants (Oxtein, Spain) with diameters of 3.5, 4.0, 4.5 and 5mm, and lengths of 8.5mm, 11.5mm and 14.5mm. All these measurements were carried out following four drilling protocols, a standard protocol, adding a bone tap, cortical drill or conical drill. In this way, a total of 576 samples were obtained. For the statistical analysis, the table of confidence intervals, mean, standard deviation and covariance was carried out, in total and grouped by the parameters used. Results: The insertion torque for D1 bone obtained very high levels, reaching 77 6.95 N/cm, these values improved with the use of conical drills. In D2 bone, the mean torque obtained was 37.89± 13.70N/cm, with values within the standard. In D3 and D4 bone significantly low torques were obtained with values of 14.97± 4.40N/cm and 9.88± 4.16N/cm (p>0.001) respectively. Conclusions: In D1 bone, conical drills must be incorporated in drilling to avoid excessive torque, while in D3 and D4 bone, these would be contraindicated, as they drastically decrease the insertion torque, which may compromise the treatment. (AU)

Impact of implant thread design on insertion torque and osseointegration: a preclinical model

Background: Successful osseointegration of endosteal dental implants has been attributed to implant design, including the macro-, micro- and nano- geometric properties. Based on current literature pertaining to implant design, the resultant cellular and bone healing response is unknown when the thread thickness of the implants is increased, resulting in an increased contact area in implants designed with healing chambers. The aim of this study was to evaluate the effect of two implant designs with different thread profiles on the osseointegration parameters and implant stability at 3- and 6-weeks in vivo using a well-established preclinical dog model.Material and methods: A total of 48 type V Ti alloy implants were divided in two groups according to their thread design (D1= +0.1x/mm and D2= +0.15x/mm) and placed in an interpolated fashion into the radii of six beagles. Insertion torque was measured at time of placement, radii were extracted for histological processing following 3- and 6-week healing intervals. Histologic and histomorphometric analyses were performed in terms of bone to implant contact (%BIC) and bone area fraction occupancy within implant threads (%BAFO). Statistical analyses were performed through a linear mixed model with fixed factors of time and implant thread design.Results: Surface roughness analysis demonstrated no significant differences in Sa and Sq between D1 and D2 implant designs, which confirmed that both implant designs were homogenous except for their respective thread profiles. For insertion torque, statistically significant lower values were recorded for D1 in comparison to D2 (59.6 ± 11.1 and 78.9 ± 10.1 N⋅cm, respectively). Furthermore, there were no significant differences with respect to histological analysis and histomorphometric parameters, between D1 and D2 at both time points.(AU)

Unilateral and bilateral isokinetic knee strength indices in professional soccer players / Índices de fuerza isocinética unilateral y bilateral de rodilla en jugadores profesionales de futbol

INTRODUCTION: The maximum isokinetic torque is one of the most commonly applied methods to assess the muscle strength of the lower extremities in soccer. Knee force indices have been used extensively to identify possible risk factors for injuries such as torn hamstring muscles or rupture of the anterior cruciate ligament. There are previous studies that describe the isokinetic profile in different populations and there are few in Latin American population. The objective of this study is to describe the isokinetic profile and strength indices in a population of soccer players from a professional Mexican team. METHODOLOGY: This is an observational, retrospective, analytical study. The maximum torque was measured with an angular velocity of 60°/s in 375 professional soccer players from 1st, 2nd and 3rd division from 2010 to 2015 in the Department of Sports Medicine and Rehabilitation of the "Dr. José Eleuterio González" University Hospital, Monterrey Nuevo León, Mexico. RESULTS: The results obtained were general, clinimetry and isokinetic parameters. The maximum torque was cataloged by group in injured and non-injured players according to the division: 1st (n = 142), 2nd (n = 86) and 3rd (n = 147). From these, the isokinetic strength indices of each of the players were obtained, observing anthropometric differences, in the unilateral and bilateral knee indices, between each category, and even more so in players with injuries. It is important to have isokinetic parameters and identify at-risk players according to their category as this will provide reference data for future assessments of professional soccer players and they can be used to categorize muscle function as normal or at risk of injury

INTRODUCCIÓN: El torque máximo isocinético es uno de los métodos más comúnmente aplicados para evaluar la fuerza muscular de las extremidades inferiores en el futbol. Se han empleado índices de fuerza de la rodilla extensivamente para identificar posibles factores de riesgo para lesiones como desgarros de la musculatura isquiotibial o la ruptura del ligamento cruzado anterior. Hay estudios previos que describen el perfil isocinético en distintas poblaciones y hay pocas en población latinoamericana. El objetivo de este estudio es describir el perfil isocinético y los índices de fuerza en una población de jugadores de soccer de un equipo profesional mexicano. METODOLOGÍA: Es un estudio observacional, retrospectivo y analítico. Se midió el torque máximo con una velocidad angular de 60°/s en 375 futbolistas profesionales de 1°, 2° y 3° división del 2010 al 2015 en el Departamento de Medicina del Deporte y Rehabilitación del Hospital Universitario "Dr. José Eleuterio González", Monterrey Nuevo León, México. RESULTADOS: Los resultados recabados fueron generales, clinimetria y parámetros isocinéticos. Los torques máximos fueron catalogados por grupo en jugadores lesionados y no lesionados de acuerdo a la división: 1°(n = 142), 2° (n = 86) y 3° (n = 147). A partir de estos se obtuvieron los índices de fuerza isocinética de cada uno de los jugadores existiendo diferencias antropométricas, en los índices unilateral y bilateral de rodilla, entre cada categoría, y más aún en jugadores con lesiones. Es importante tener parámetros isocinéticos e identificar jugadores en riesgo según su categoría ya que esto aportar datos de referencia para futuras valoraciones en los jugadores profesionales de soccer y pueden ser utilizados para categorizar la función muscular como normal o con riesgo de lesión

Repeatability of the resonance frequency analysis values in implants with a new technology

Background: Assess the reliability (by means of reproducibility and repeatability) of the PenguinRFA system, analyse the ISQ values of different implant types and correlate the ISQ with the insertion torque during the placement of the implant. Material and Methods: 120 rough surface implants were placed in bovine bone (type II and III). The implants were divided into groups, according to its design. Once the implants were in place, the exact insertion torque was registered. Then, primary stability was measured by means of the resonance frequency analysis with the PenguinRFA and the Osstell ISQ devices. In each implant two transducers of each device were used. Three measurements were obtained with each transducer. Results: The mean ISQ (implant stability quotient) of the whole sample is 67,70 ± 5,51. The Intraclass Correlation Coefficient (ICC) is 0,933 and 0,944 for transducers 1 and 2 respectively. The reproducibility is 0,906. The mean insertion torque is 24,54 ± 8,96N. The correlation between the ISQ and the insertion torque is 0,507 p < 0,000 (MultiPeg 1) and 0,468 p < 0,000 (MultiPeg 2) for bone type II and 0,533 p < 0,801 (MultiPeg 1) and 0,193 p < 0,140 (MultiPeg 2) for bone type III

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Implant insertion torque value in immediate loading: A retrospective study

Background: The aim of this study is to verify if the Insertion Torque Value (ITV) of 32 Ncm for immediate loading protocol (ILP), as indicated by literature, is still, with the advance in implant research, a real significant cut-off for long-term implant survival. Material and Methods: In this retrospective study, data from 224 patients that during three years of clinical practice, were submitted to the insertion of 322 implants with immediate loading protocol, have been recorded, pooled and analyzed. Data were organized based on Insertion Torque Value (ITV): > 32 Ncm (CG) and < 32 Ncm (LTG) and two different groups of equal sample size, 161 implants each, were distinguished. Crestal bone reabsorption, and the implant failure rate were evaluated after 2-years of follow-up. Results: The bone reabsorption in LTG (0.49 ± 0.11 mm ) was significantly greater than CG (0.22 ± 0.04 mm), p<0.001. However, the survival rate after 2-years of follow-up was quite high and similar for both groups: 96.89% for LTG and 97.52% for CG and no statistically significant differences have been found among the two groups for the implant failure rate (p = 0.455).The Odds Ratio (OR) of implant failure was of 1.258 (95% CI 0.332, 4.772), but results were not statistical significant, p = 0.740. Conclusions: The present study showed that although implants with ITV> 32 Ncm are still characterized by a lower crestal bone resorption, there are no statistically significant differences among the two groups for what con-cerning the failure rate during the 2 years of follow-up and OR. These results permit us to suppose that the cut-off of ITV >32 Ncm for immediate loading implants, could be reduced to inferior values. However further studies are necessary to indicate precise clinical guidelines

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Efecto de la fatiga en el ratio isquiotibiales: cuádriceps. Revisión sistemática / The influence of fatigue in hamstrings:quadriceps ratio. A systematic review

Las lesiones deportivas conforman la principal causa por la que el proceso de entrenamiento se ve interrumpido total o parcialmente. Entre los diferentes tipos de lesión que pueden darse en cualquier disciplina deportiva, las lesiones musculares, y más especialmente las que se producen en la musculatura isquiotibial, son las más recurrentes. En este sentido, uno de los indicadores más fiables para cuantificar la descompensación muscular que produce esta lesión es el ratio isquiotibiales: cuádriceps, del cual se diferencian dos tipos: ratio convencional y ratio funcional. El objetivo de esta revisión fue buscar en la literatura científica cómo afecta la fatiga a los valores de ambos ratios que indican el riesgo de sufrir una lesión muscular. Se realizó una búsqueda electrónica en diferentes bases de datos, y un total de trece artículos publicados hasta el 19 de Mayo de 2015 fueron incluidos en el análisis bajo las palabras clave «Hamstrings», "Quadriceps", "Isokinetic", "Peak torque" y "Fatigue". Los estudios analizados revelaron un importante descenso en los valores de ambos ratios, en especial del funcional, tras la realización de diferentes protocolos de fatiga, sobretodo en aquellos que eran más específicos. Este descenso de los valores del ratio se traduce en un mayor riesgo de sufrir una lesión muscular. Además, el descenso en ambos ratios se producía por una disminución en los valores de fuerza de los isquiotibiales, especialmente durante su fase excéntrica. Por tanto, los resultados obtenidos sugieren la implantación de estrategias de prevención enfocadas al retraso de la aparición de la fatiga, especialmente en la musculatura isquiotibial, y en el fortalecimiento de la misma durante la fase excéntrica del movimiento

Sport injuries are considered the main cause of cessation of training process, either completely or partially. Among the different types of injuries that may be produced in any sport disciplines, muscular injuries, and more specifically hamstring injuries, are the most common. For that matter the best indicator for evaluating the muscular risk of this kind of injury produced by a muscular imbalance is the hamstrings: quadriceps ratio, of which two types can be distinguished: functional ratio and conventional ratio. The aim of this study was to search in scientific literature how the fatigue presents an influence in the values of both conventional and functional hamstrings:quadriceps ratio as an injury risk indicator. An electronic search of different databases was carried out and a total of thirteen studies publicated until 19th May 2015 were included in this review. The following keywords were employed: «Hamstrings», «quadriceps», «Isokinetic», “Peak torque» and «Fatigue». Analysed studies showed a significant decrease of both ratios values, but especially functional ratio, after the fatigue protocols application. Besides, a greater decrease of both ratios were noticed when protocols were more specific. This fact means a greatest risk of muscular injury. In addition, the fall in both ratios levels were produced by a decrease in hamstings strength values, in particular during the eccentric phase of movement. Hence, our results suggest that it would be important to develop an injury prevention strategy focused on delay fatigue, specially in hamstrings, as much as possible and improve hamstrings strength during the eccentric phase of movement

Relation between bone density and primary implant stability

Aims: This study aims to relate bone density in Hounsfield units (Hu) with the primary implant stability measured by insertion torque (Ncm) and resonance frequency analysis (ISQ).Materials and Methods: Ten patients were included in this study. A total of 54 implant sites were provided from 10 computerized tomography scans. The computerized tomography scan was used for the preoperative evaluation of bone density for each patient. The bone mean density around planned implants was determined with Physioplanet TM software. Bone quality according resistance to drilling, insertion torque and resonance frequency measurements were recorded. Results: A statistically significant relationship was observed between bone quality density and location with ISQvalues. Conclusions: This research demonstrates a strong relationship between the bone density values from computerized tomography and the location in the maxillaries. A correlation exists between bone quality, according to the Lekholm & Zarb classification, and Hu computerized tomography values. The primary implant stability measuredwith resonance frequency analysis depends on bone density values, bone quality and implant location (AU)

Torque de desinserción y propiedades fisico-químicas de implantes dentales grabados con ácidos fluorhídrico y nítrico. Estudio experimental en perros Beagle / Removal torque and physico-chemical characteristics of dental implants etched with hydrofluoric and nitric acid. An experimental study in Beagle dogs

Objetivo: Estudiar la composición, características superficiales y respuesta al torque de desinserción de una superficie implantaria tratada inicialmente con ácido fluorhídrico y posterior pasivado con ácidos fluorhídrico y nítrico.Diseño del estudio: En una primera fase, se seleccionaron 12 implantes en los que se estudiaron las características fisico-químicas mediante mediciones de energía dispersa de rayos X (EDS), microscopio electrónico de barrido y análisis de XPS (espectrometría de fotoelectrones). Asimismo, se colocaron 24 implantes –doce de 8 mm y doce de 10 mm de longitud-, en seis perros beagle, en los que tras un período de reposo, se procedió a la retirada de 12 implantes a las seis semanas y los 12 restantes a las doce semanas, mediante un calibrador de torque Gauge TonichiR modelo BGT150CN-S -con un rango de registro de fuerza de 0 a 150 Ncm.Resultados: El análisis de la composición química superficial mediante EDS sólo mostró la presencia de titanio en las superficies grabadas. En el análisis mediante XPS, al igual que sucede con las superficies de otros implantes dentales, aparecieron trazas de otros elementos presentes en la superficie, fundamentalmente de carbono.La morfología de la superficie tras el doble grabado con ácido, permitió observar la rugosidad creada por el ataque ácido, con una morfología bastante homogénea. Los valores de rugosidad obtenidos fueron superiores al micrómetro.Los valores medios encontrados para el torque de desinserción, a las seis semanas, fueron de 79,7 Ncm para los implantes de 8 mm de longitud y 115 Ncm para los implantes de 10 mm. A las doce semanas, estos valores incrementaron hasta 101,2 Ncm para los implantes de 8 mm y 139,7 Ncm para los implantes de 10 mm de longitud.Conclusiones: El grabado con ácido fluorhídrico y nítrico, posee características superficiales óptimas y comparables al de otras superficies. Los valores de torque de desinserción abren la posibilidad para su aplicación en clínica humana para procedimientos de carga precoz o inmediata

Objective: To study the composition, surface characteristics and response to removal torque of an implant surface subjectedto hydrofluoric acid etching and posterior passivating with hydrofluoric and nitric acid.Study design: Twelve implants were initially selected and their physico-chemical characteristics were evaluated by means of energy-dispersive X-rays (EDS), scanning electron microscopy (SEM) and photoelectron spectroscopy (XPS). In addition, 24 implants – 12 measuring 8 mm and 12 measuring 10 mm in length – were implanted in 6 Beagle dogs. Twelve implants were removed after a recovery period of 6 weeks, followed by removal of the remaining 12 implants after 12 Medeweeks,using a torque calibrator (Gauge Tonichi® model BGT150CN-S) with a force registry range of 0-150 Ncm.Results: EDS analysis of the surface chemical composition only revealed the presence of titanium in the etched surfaces. In the same way as with the surfaces of other dental implants, XPS analysis revealed traces of other elements present in the surface, fundamentally carbon. Following dual acid etching, the surface showed the roughness resulting from acid action, with a morphology that proved to be quite homogeneous. The roughness values obtained exceeded 1 ìm. The mean removal torque values after 6 weeks were 79.7 Ncm for the 8 mm implants and 115 Ncm for the 10 mm implants. After 12 weeks, these values increased to 101.2 Ncm and 139.7 Ncm, respectively.Conclusions: Hydrofluoric and nitric acid etching affords optimum surface characteristics comparable to those of other surfaces. The recorded removal torque values raise the possibility of human clinical application for early or immediate loading procedures

Un método eficaz de tracción y enderezamiento de dientes incluidos / An effective method for traction and uprighting of impacted teeth

Presentamos un sistema de tratamiento que simplifica el tratamiento de dientes impactados al dividirlo en dos fases. En una primera fase de tracción utilizamos resortes seccionales de TMA. Esto permite conseguir la erupción del diente incluido aún antes de la colocación de la aparatología fija. En una segunda fase posterior se realiza el tratamiento convencional con aparatología fija. Contamos también en esta fase con la acción de resortes individuales de torque y enderezamiento que facilitan la colocación tridimensional más rápida y exacta del diente en su emplazamiento final, algo de especial utilidad en casos complejos. Es un sistema que nos ha permitido simplificar los tratamientos de dientes incluidos, caninos en especial por su alta frecuencia, convirtiéndolos en una rutina más dentro de nuestras consultas (AU)

Osteotomía sagital de rama para avance mandibular: ¿diseño Rossi o Dalpont, osteosíntesis con tornillos o con miniplacas? / Sagital split osteotomy for mandibular advancement: Rossi or Dal Pont design, screws or miniplate osteosynthesis?

La osteosíntesis de los avances mandibulares tra una osteotomía sagital de rama (OSR) se realiza de forma rutinaria mediante bicorticales o con miniplacas. Las modificaciones de la OSR que realiza Dal Pont a nivel bucal y lingual permiten una osteosíntesis con miniplacas. La modificación de Rossi y la fijación mediante tornillos bicorticacles origina una serie de ventajas sobre las modificaciones de Dal Pont y la osteosíntesis con miniplacas. Este artículo recoge las diferencias entre ambos diseños y sistemas de osteosíntesis con respecto a alteraciones neurosensoriales; defectos oseos visibles, gonion, aspectos psicológicos y cicatrices faciales, confort postoperatorio y oclusión, acceso y eficiencia, vasos faciales, riesgo de fractura de la cortical vestibular, necrosis aséptica de parte de la cortical vestibular, trauma dental, estructuras neurovasculares retromandibulares, trorque condilar, estabilidad, intubación y costes. El autor quiere presentar sus ideas y originar una discusión sobre el tema. (AU)