Randomized controlled multi-centre study comparing shorter dental implants (6 mm) to longer dental implants (11-15 mm) in combination with sinus floor elevation procedures: 10-year data.

AIM: To compare implant survival and complication rates between shorter and standard-length implants with sinus augmentation and restored with single crowns, at 10 years of loading. MATERIALS AND METHODS: One-hundred and one patients (137 implants) with a ridge height of 5-7 mm in the posterior maxilla were randomly assigned to two treatment modalities: shorter implants (6 mm) (group short [GS]) or standard-length implants (11-15 mm) with sinus grafting (group graft [GG]). Following the insertion of final restorations, patients were regularly recalled for up to 10 years. Assessed outcomes encompassed implant survival, marginal bone levels (MBLs), biological and technical parameters and patient-reported outcome measures (OHIP-49 = Oral Health Impact Profile). Non-parametric statistical analysis was used to analyse the data. RESULTS: For the 5- to 10-year follow-up period, 77 patients with 105 implants (GS: 36 patients/48 implants; GG: 41/57) were available for re-examination (drop-out rate 21%). Implant survival rates at the patient level were 96.0% (GS; 2 failures) and 100% (GG) (inter-group p = .24). Median MBLs amounted to 0.00 mm (min 0.00; max 3.25; GS) and 0.00 mm (min 0.00; max 4.55; GG) (inter-group p = .73). Technical complications predominantly occurred within the first 5 years (inter-group p > .05). Peri-implantitis rates were 4.2% (GS) and 13.3% (GG) (intergroup p = .37). Median OHIP-49 scores were 7.00 (0.00; 39.00; GS) and 9.00 (0.00; 196; GG) (inter-group p = .61) at 10 years. CONCLUSIONS: Based on similar 10-year implant survival rates, reduced patient morbidity and lower costs, the use of shorter dental implants might well serve as an alternative treatment concept to longer implants placed in conjunction with sinus grafting for patients with a limited ridge height in the posterior maxilla. Study register: https://clinicaltrials.gov/ct2/show/NCT01030523.

Computer-Guided Immediate Full-Arch Implant Reconstruction of the Mandible in Severe Periodontally Compromised Patients: Three-Dimensional Analysis of Bone Volume Changes.

PURPOSE: Comprehensive rehabilitation in patients with severe periodontal destruction may require the use of dental implants. The primary aim of this study was to evaluate bone volume changes in periodontally compromised patients over a 12-month follow-up period after immediate full-arch implant reconstruction of the mandible. The secondary aim was to evaluate the repeatability of 3D bone volume change measurement methods around dental implants. The null hypothesis was that bone volume would decrease in the first year after delivery of the definitive prosthetic reconstruction. MATERIALS AND METHODS: This retrospective study analyzed CBCT scans of 16 patients before and after computer-guided immediate full-arch implant reconstruction of the mandible. The bone volume change in the mandibular body and around the implants and the peri-implant bone area in coronal and axial cross sections were calculated. RESULTS: The average bone gain for the mandibular body was 3.3% ± 1.8%. The average bone volume increase in the peri-implant area was 23.2% ± 16.7%. The interobserver and intraobserver ICC values for 3D measurements were high (> 0.85). CONCLUSION: The null hypothesis was rejected. Both mandibular body and peri-implant surroundings undergo bone remodeling in the form of bone gain over 12 months after immediate implantation.

Diagnosis, Early Care, and Treatment of Hallermann-Streiff Syndrome: A Review of the Literature.

Hallermann-Streiff syndrome is a rare congenital disorder characterized by a wide spectrum of craniofacial abnormalities. A review of the available literature reveals that only approximately 200 cases of the disease have been reported worldwide. For this article, we performed a literature review as a basis for a proposed scheme for early care and treatment. A comprehensive database search was carried out with the use of Medline (PubMed), ISI Web of Science, and ScienceDirect/Scopus. Of the 551 studies initially found, an evaluation using inclusion and exclusion criteria ultimately resulted in a total of 33 articles. Most of the articles are case reports, and only approximately 20% of these articles include treatment options. We propose an early care and treatment schedule based on the presented symptoms. [Pediatr Ann. 2021;50(5):e227-e231.].

Randomized controlled multicentre study comparing short dental implants (6 mm) versus longer dental implants (11-15 mm) in combination with sinus floor elevation procedures: 5-Year data.

AIM: To compare the implant survival rate between short dental implants and standard length implants placed in combination with bone grafting at 5 years of loading. METHODS: This multicentre study enrolled 101 patients (137 implants) with a posterior maxillary bone height of 5-7 mm. Patients randomly received either short implants (6 mm; GS) or long implants (11-15 mm) with sinus grafting (GG). Six months later, implants were loaded with single crowns and patients re-examined at 1, 3 and 5 years of loading. Outcomes included: implant survival, marginal bone levels (MBLs), biological and technical parameters and patient-reported outcome measures (OHIP-49 = Oral Health Impact Profile). Statistical analysis was performed using a non-parametric approach. RESULTS: At 5 years, 90 patients (124 implants; GS: 60; GG: 64) were re-examined (drop-out rate 10%). Patient-level implant survival rates were 98.5% (GS; 1 implant failure) and 100% (GG; p = 0.49). Mean MBLs were 0.54 mm ± 0.87 (GS) and 0.46 mm ± 1.00 (GG; p = 0.34). Biological and technical parameters were not significantly different (p > 0.05). Median overall OHIP-49 scores improved significantly up to 5 years in both groups (GS: p = 0.03; GG: p = 0.00; intergroup comparison p = 0.11). CONCLUSIONS: Both treatment modalities were suitable for implant therapy in the atrophied posterior maxilla revealing no differences in terms of survival rates, marginal bone levels (changes), patient-reported outcomes and technical/biological complications.

OPEN-SOURCE SOFTWARE IN DENTISTRY: A SYSTEMATIC REVIEW.

OBJECTIVES: Technological development and the need for electronic health records management resulted in the need for a computer with dedicated, commercial software in daily dental practice. The alternative for commercial software may be open-source solutions. Therefore, this study reviewed the current literature on the availability and use of open-source software (OSS) in dentistry. METHODS: A comprehensive database search was performed on February 1, 2017. Only articles published in peer-reviewed journals with a focus on the use or description of OSS were retrieved. The level of evidence, according to Oxford EBM Centre Levels of Evidence Scale was classified for all studies. Experimental studies underwent additional quality reporting assessment. RESULTS: The screening and evaluation process resulted in twenty-one studies from 1,940 articles found, with 10 of them being experimental studies. None of the articles provided level 1 evidence, and only one study was considered high quality following quality assessment. Twenty-six different OSS programs were described in the included studies of which ten were used for image visualization, five were used for healthcare records management, four were used for educations processes, one was used for remote consultation and simulation, and six were used for general purposes. CONCLUSIONS: Our analysis revealed that the dental literature on OSS consists of scarce, incomplete, and methodologically low quality information.

Short dental implants (6 mm) versus long dental implants (11-15 mm) in combination with sinus floor elevation procedures: 3-year results from a multicentre, randomized, controlled clinical trial.

AIM: To test whether the use of short dental implants (6 mm) results in an implant survival rate similar to that with longer implants (11-15 mm) in combination with sinus grafting. METHODS: This multicentre study enrolled 101 patients with partial edentulism in the posterior maxilla and a remaining bone height of 5-7 mm. Included patients were randomly assigned to receive short implants (6 mm; GS/group short) or long implants (11-15 mm) simultaneously with sinus grafting (GG/group graft). Six months after implant placement (IP), implants were loaded with single crowns (PR) and patients were re-examined yearly thereafter. Assessed outcomes included: implant survival, marginal bone level changes (MBL), probing pocket depth (PPD), bleeding on probing (BoP) and plaque accumulation (PCR) during 3 years of loading as well as recording of any adverse effects. In addition to descriptive statistics, statistical analysis has been performed for the two treatment modalities using a non-parametric approach. RESULTS: In 101 patients, 137 implants were placed. At the 3-year follow-up (FU-3), 94 patients with 129 implants were re-examined. The implant survival rate was 100% in both groups. MBL at FU-3 was 0.45 mm (GG) and 0.44 mm (GS) (p > 0.05). A statistically significant loss of MBL was observed in both GG (-0.43 ± 0.58 mm) and GS (-0.44 ± 0.56 mm) from IP to FU-3, and from PR to FU-3 in GG (-0.25 ± 0.58 mm) but not in GS (-0.1 ± 0.54 mm). PCR and BoP at FU-3 did not show any difference between the groups but for PPD (p = 0.035). CONCLUSIONS: Within the limitations of this study, implants with a length of 6 mm as well as longer implants in combination with a lateral sinus lift may be considered as a treatment option provided a residual ridge height of 5-7 mm in the atrophied posterior maxilla is present.

Effect of orthodontic debonding and residual adhesive removal on 3D enamel microroughness.

BACKGROUND: Termination of fixed orthodontic treatment is associated with bracket debonding and residual adhesive removal. These procedures increase enamel roughness to a degree that should depend on the tool used. Enamel roughening may be associated with bacterial retention and staining. However, a very limited data exists on the alteration of 3D enamel roughness resulting from the use of different tools for orthodontic clean-up. AIMS: 1. To perform a precise assessment of 3D enamel surface roughness resulting from residual adhesive removal following orthodontic debonding molar tubes. 2. To compare enamel surfaces resulting from the use of tungsten carbide bur, a one-step polisher and finisher and Adhesive Residue Remover. MATERIAL AND METHODS: Buccal surfaces of forty-five extracted human third molars were analysed using a confocal laser microscope at the magnification of 1080× and 3D roughness parameters were calculated. After 20 s etching, molar tubes were bonded, the teeth were stored in 0.9% saline solution for 24 hours and debonded. Residual adhesive was removed using in fifteen specimen each: a twelve-fluted tungsten carbide bur, a one-step finisher and polisher and Adhesive Residue Remover. Then, surface roughness analysis was repeated. Data normality was assessed using Shapiro-Wilk test. Analysis of variance (ANOVA) was used to compare between variables of normal distribution and for the latter-Kruskal-Wallis test. RESULTS: Sa (arithmetical mean height) was significantly different between the groups (p = 0, 01326); the smoothest and most repeatable surfaces were achieved using Adhesive Residue Remover. Similarly, Sq (root mean square height of the scale-limited surface) had the lowest and most homogenous values for Adhesive Residue Remover (p = 0, 01108). Sz (maximum height of the scale-limited surface) was statistically different between the groups (p = 0, 0327), however no statistically significant differences were found concerning Ssk (skewness of the scale-limited surface). DISCUSSION: Confocal laser microscopy allowed 3D surface analysis of enamel surface, avoiding the limitations of contact profilometry. Tungsten carbide burs are the most popular adhesive removing tools, however, the results of the present study indicate, that a one step polisher and finisher as well as Adhesive Residue Remover are less detrimental to the enamel. This is in agreement with a recent study based on direct 3D scanning enamel surface. It proved, that a one-step finisher and polisher as well as Adhesive Residue Remover are characterized by a similar effectiveness in removing residual remnants as tungsten carbide bur, but they remove significantly less enamel. CONCLUSION: Orthodontic debonding and removal of adhesive remnants increases enamel roughness. The smoothest surfaces were achieved using Adhesive Residue Remover, and the roughest using tungsten carbide bur.

Three-Dimensional Cephalometric Analysis of Orbital Morphology Modification for Midface Correction Surgery.

OBJECTIVES: The aim of this study was to create an evidence-based three-dimensional cephalometric analysis of orbits in order to perform time-efficient measurements of postoperative orbital morphology changes. MATERIALS AND METHODS: The authors used 23 (11 bilateral and 1 unilateral) anatomical landmarks. Based on these, 6 planes, 12 angular and 16 linear measurements were determined. A three dimensional analysis was performed twice by two observers on pre and post-operative computed tomography scans of six patients who had undergone midface advancement. The mean, minimal and maximal difference, as well as standard deviation (SD) and intraclass correlation coefficient (ICC) for the inter- and intra-observer landmark selection reliability were calculated. Additionally, the mean, minimal, maximal difference and standard deviation between pre- and post-operative angular and linear measurements were calculated to examine a connection between the established measurements and any morphological change. RESULTS: The inter and intra-examiner accuracy of all landmarks for three axes was >0.9 ICC. Despite excellent inter and intra-examiner agreement (<2.49 mm ± 2.05 mm SD) for the landmark selection, linear and angular measurements showed a mismatch, the mean SD for angular measurements was found to be 8.2° and the linear 3.04 mm. DISCUSSION: The possible causes of linear and angular measurement discrepancies are discussed and the future direction for the development of three-dimensional cephalometric analysis of orbits proposed.

Effect of Immunosuppressive Therapy on Proteinogram in Rats.

BACKGROUND It has been observed that the use of immunosuppressive drugs in patients after transplantation of vascularized organs may be associated with changes in the concentration of certain fractions of plasma proteins. The concentration of these proteins was correlated with an increased risk of occurrence of stage 3 chronic kidney disease (CKD). This article examines the effect of the most commonly used immunosuppressive drugs on the concentration of plasma proteins in Wistar rats. MATERIAL AND METHODS The study involved 36 rats grouped according to the immunosuppressive regimen used (tacrolimus, mycophenolate mofetil, cyclosporine A, rapamycin, and prednisone). The rats in all study groups were treated with a 3-drug protocol for 6 months. The treatment dose was adjusted based on available data in the literature. No drugs were administered to the control group. The rats were sacrificed and blood samples collected to determine the concentration of plasma proteins using electrophoresis technique. RESULTS Statistically significant differences were observed between protein concentrations within the studied groups. The differences related to the proteins with masses of 195 kDa, 170 kDa, 103 kDa, and 58 kDa. CONCLUSIONS (1) Immunosuppressive drugs caused changes in the proteinogram of plasma proteins. (2) The strongest effect on rat plasma proteins was exerted by a regimen based on rapamycin. Intermediate, weak, and weakest effects were observed in regimens based on cyclosporine A, tacrolimus, and mycophenolate mofetil, respectively.

Wegener's granulomatosis and pyoderma gangrenosum--rare causes of facial ulcerations.

BACKGROUND: Pyoderma gangrenosum (PG) is caused by immune system dysfunction, and particularly improper functioning of neutrophils. At least half of all PG patients also suffer from autoimmunological diseases, one of which is Wegener granulomatosis (WG). The purpose of this article was to compare cases of patients with WG and PG in terms of their clinical course, histopathology, and applied treatment. In both, histopathological features are not fully distinct. Data from microbiological and immunological evaluation and clinical presentation are required to establish the diagnosis. We also present the case of a patient with WG and deep facial skin lesions not responding to standard treatment. METHODS: Systematic review of the literature in PubMed using the search terms "Wegener granulomatosis AND Pyoderma gangrenosum" and case report. RESULTS: The finding of 22 reports in the literature (PubMed) suggests that it is a rare phenomenon. This study revealed a similar rate of comorbidity of WG and PG in both genders and an increased incidence of both diseases after the age of 50. Among skin lesions there was a dominance of ulceration, most often deep and painful, covering a large area with the presence of advanced necrosis and destruction of the surrounding tissue. The most common location proved to be the cervical-cephalic area. The most popular treatment included steroids with cyclophosphamide. DISCUSSION: The rarity of the coexistence of these two diseases results in a lack of effective therapy. In such cases sulfone derivatives are still effective and provide an alternative to standard immunosuppression methods. Hyperbaric therapy and plasmapheresis can also play an important complementary role.

Does Immunosuppressive Therapy Affect Markers of Kidney Damage?

BACKGROUND: Markers currently used to detect kidney damage are effective in both early (KIM-1, NGAL) and late (MCP-1, MMP, TIMP) stages of renal tubular damage, indicating the progression of chronic kidney disease. Immunosuppressive drugs may damage the transplanted organ through their direct toxic effects and by contributing to the development of chronic fibrosis and tubular atrophy. The aim of this study was to determine if immunosuppressive drugs per se affect the concentration of kidney damage markers, by using concentrations and doses of immunosuppressive within therapeutic, not toxic, levels in rat blood. MATERIAL AND METHODS: The study involved 36 rats grouped according to the immunosuppressive regimen used (tacrolimus, mycophenolate mofetil, cyclosporin A, rapamycin, and prednisone). The rats were treated with a 3-drug protocol for 6 months. No drugs were administered to the control group. The blood samples were collected to determine the concentration of kidney damage markers by using enzyme-linked immunosorbent assay (ELISA). RESULTS: 1. In the groups receiving regimens based on cyclosporin A (CyA), significantly higher concentrations of KIM-1 in plasma was observed compared to cases not treated with drugs. 2. The use of tacrolimus was associated with increased concentrations of MCP-1 in plasma and rapamycin was associated with decreased concentrations of MCP-1 in plasma. 3. Rapamycin induces an unfavorable, profibrotic imbalance between metalloproteinase-9 and its inhibitor, TIMP-1. CONCLUSIONS: Commonly used immunosuppressive drugs influence the concentration of blood markers of kidney damage. This fact should be taken into account when analyzing the association between the concentration of these markers and pathological processes occurring in the transplanted kidney.

Effect of methylprednisolone, hyaluronic acid and pioglitazone on histological remodeling of temporomandibular joint cartilage in rabbits affected by drug-induced osteoarthritis.

BACKGROUND: The aims of this study were to assess the anti-degenerative effects of pioglitazone and to compare these effects with those of methylprednisolone and hyaluronic acid on drug-induced osteoarthritis in rabbits' temporomandibular joint cartilage. MATERIAL AND METHODS: The experiment was conducted on 40 Californian white rabbits. Degenerative changes were induced by intra-articular injections of papain. Subsequently, all of the animals were randomly assigned to one of four groups: 1) a control group that received no medications; 2) a group treated with 4 intra-articular injections of 2 mg (0.2 ml) of hyaluronic acid at weekly intervals; 3) a group treated with 4 intra-articular injections of 2 mg (0.1 ml) of methylprednisolone at weekly intervals; 4) a group administered pioglitazone orally in daily doses of 2 mg/kg of body weight. Four weeks after the beginning of drug administration, the rabbits were sacrificed. Sagittal sections of the intra-articular cartilage (discs) and mandibular condyles were stained with hematoxylin and eosin by the PAS technique and with van Gieson's solution. Histologic examinations, as well as cartilage thickness and number of cell layers measurements, were performed. RESULTS: Histologic assessment in cases of arthritis-associated pathologies revealed that changes occurred most frequently in the control group and least frequently in the pioglitazone group. There were no differences in the histological structures of the intra-articular discs. Cartilage thickness measurements demonstrated the thinnest cartilage in group 2 and the thickest in group 3. Analysis of cell layer numbers showed the most numerous layers in the pioglitazone group and the least in the control group. CONCLUSION: Pioglitazone and hyaluronic acid showed anti-degenerative properties compared to methylprednisolone in an animal model.

Surgical extraction of impacted teeth in elderly patients. A retrospective analysis of perioperative complications - the experience of a single institution.

OBJECTIVE: The aim of this retrospective study was to investigate the most frequent complications and assess their overall rate associated with the surgical extraction of impacted teeth in an elderly patient population. BACKGROUND: Oral health needs of the elders are often associated with surgical procedures for the creation of appropriate conditions for any further prosthetic treatment. One such process is the removal of severely decayed, fractured or impacted teeth detrimental to the fit or appearance of dentures. While broken and decayed teeth leave little doubt for their removal, impacted teeth divide opinion, some extreme regarding their prophylactic removal and the appropriate age for the procedure. MATERIAL AND METHODS: Material was selected from the archives of an Out-Patient Dental Surgery Clinic of the Regional Centre of Dentistry in Szczecin, from 2002 to 2013. The database was independently screened by two investigators according to inclusion and exclusion criteria. After selection process, all included records were screened using a data extraction form to obtain the necessary data. RESULTS: The total number of impacted teeth was 73, of which 29% were partially impacted. The overall complication rate was 24.6%. The most common complications were as follows: haematoma, nerve disturbances and local infections. CONCLUSION: Surgical extraction in patients above 60 years of age is fraught with a high risk of possible complications.

Three-dimensional analysis of enamel surface alteration resulting from orthodontic clean-up -comparison of three different tools.

BACKGROUND: The present study aimed at 3D analysis of adhesive remnants and enamel loss following the debonding of orthodontic molar tubes and orthodontic clean-up to assess the effectiveness and safety of One-Step Finisher and Polisher and Adhesive Residue Remover in comparison to tungsten carbide bur. MATERIALS AND METHODS: Thirty human molars were bonded with chemical-cure orthodontic adhesive (Unite, 3M, USA), stored 24 h in 0.9 % saline solution, debonded and cleaned using three methods (Three groups of ten): tungsten carbide bur (Dentaurum, Pforzheim, Germany), one-step finisher and polisher (One gloss, Shofu Dental, Kyoto, Japan) and Adhesive Residue Remover (Dentaurum, Pforzheim, Germany). Direct 3D scanning in blue-light technology to the nearest 2 µm was performed before etching and after adhesive removal. Adhesive remnant height and volume as well as enamel loss depth and volume were calculated. An index of effectiveness and safety was proposed and calculated for every tool; adhesive remnant volume and duplicated enamel lost volume were divided by a sum of multiplicands. Comparisons using parametric ANOVA or nonparametric ANOVA rank Kruskal-Wallis tests were used to compare between tools for adhesive remnant height and volume, enamel loss depth and volume as well as for the proposed index. RESULTS: No statistically significant differences in the volume (p = 0.35) or mean height (p = 0.24) of adhesive remnants were found (ANOVA rank Kruskal-Wallis test) between the groups of teeth cleaned using different tools. Mean volume of enamel loss was 2.159 mm(3) for tungsten carbide bur, 1.366 mm(3) for Shofu One Gloss and 0.659 mm(3) for Adhesive Residue Remover - (F = 2.816, p = 0.0078). A comparison of the proposed new index between tools revealed highly statistically significant differences (p = 0.0081), supporting the best value for Adhesive Residue Remover and the worst - for tungsten carbide bur. CONCLUSIONS: The evaluated tools were all characterized by similar effectiveness. The most destructive tool with regards to enamel was the tungsten carbide bur, and the least was Adhesive Residue Removal.

Three-Dimensional Eyeball and Orbit Volume Modification After LeFort III Midface Distraction.

The aim of our study was to evaluate orbital volume modification with LeFort III midface distraction in patients with craniosynostosis and its influence on eyeball volume and axial diameter modification. Orbital volume was assessed by the semiautomatic segmentation method based on deformable surface models and on 3-dimensional (3D) interaction with haptics. The eyeball volumes and diameters were automatically calculated after manual segmentation of computed tomographic scans with 3D slicer software. The mean, minimal, and maximal differences as well as the standard deviation and intraclass correlation coefficient (ICC) for intraobserver and interobserver measurements reliability were calculated. The Wilcoxon signed rank test was used to compare measured values before and after surgery. P < 0.05 was considered statistically significant. Intraobserver and interobserver ICC for haptic-aided semiautomatic orbital volume measurements were 0.98 and 0.99, respectively. The intraobserver and interobserver ICC values for manual segmentation of the eyeball volume were 0.87 and 0.86, respectively. The orbital volume increased significantly after surgery: 30.32% (mean, 5.96  mL) for the left orbit and 31.04% (mean, 6.31  mL) for the right orbit. The mean increase in eyeball volume was 12.3%. The mean increases in the eyeball axial dimensions were 7.3%, 9.3%, and 4.4% for the X-, Y-, and Z-axes, respectively. The Wilcoxon signed rank test showed that preoperative and postoperative eyeball volumes, as well as the diameters along the X- and Y-axes, were statistically significant. Midface distraction in patients with syndromic craniostenosis results in a significant increase (P < 0.05) in the orbit and eyeball volumes. The 2 methods (haptic-aided semiautomatic segmentation and manual 3D slicer segmentation) are reproducible techniques for orbit and eyeball volume measurements.

The influence of immunosuppressants on the morphology, proliferating cell nuclear antigen (PCNA) and apoptosis in the rat ventral prostate.

AIM: Analysis of the impact of immunosuppressants on apoptosis and PCNA in the rat ventral prostate. METHOD: The studies were performed on 48 male Wistar rats. The animals were divided into a control group and 7 experimental groups. For 6 months, the rats were administered drugs such as: rapamycin (Rapa), cyclosporin A (CsA), tacrolimus (Tac), mycophenolate mofetil (MMF) and glucocorticosteroids (GS). During section of the rats, prostate ventral lobes were obtained. Morphological evaluation (HE, PAS), TUNEL assay, PCNA expression analysis and quantitative image computer analysis were performed. RESULTS: The highest percentage of apoptosis in epithelial cells was observed in groups which received two combinations of drugs: (V) CsA, MMF, GS and (VII) Tac, MMF, GS. A much lower percentage of apoptotic epithelial cells was found in the groups where the treatment schemes included rapamycin throughout the duration of the study. Interestingly, the conversion of the treatment to rapamycin caused a significant reduction of apoptosis in epithelial cells as well as in proliferation in both epithelial and stromal cells. CONCLUSIONS: On one hand, the obtained results may explain the anticancer activity of rapamycin in reducing the proliferation of epithelial cells, and on the other hand the adverse effect of rapamycin in the form of reduced regeneration of these cells. Taking into account the prostate in isolation from other organs/systems, the dosage scheme with Rapa, Tac and GS would appear to be the most favorable, due to the smallest morphological changes.

Maxillary sinus septa prevalence and morphology: computed tomography based analysis / Prevalencia y morfología del septo del seno maxilar: análisis basado en estudios de tomografía computadorizada

The aim of this study was to examine the prevalence, location and morphology of maxillary sinus septa, and in particular sagittally orientated forms, which cannot be visualized by classic 2D x-rays. Thereby authors would like to provide information about the potential patient group, to be referred for the computed tomography scan before sinus lift procedure. The analysis was based on 216 computed tomography archival images. The exclusion criterion was occurrence of any suspected pathology in the maxillary region. The septa prevalence that was investigated in computed tomography was high (49%) with the mean height of 5.44 mm. The incidence of sagittally orientated septa as a challenge in 2D x-rays was 10%, with the second molar region as the most frequent location. Based on the obtained results and radiation safety principles, the authors suggest that orthopantomogram x-ray may be a sufficient ancillary radiological examination before beginning preimplant surgical procedure in the area of the maxillary sinus.

El objetivo de este estudio fue determinar la prevalencia, ubicación y morfología del septo del seno maxilar, y en particular de las formas orientadas sagitalmente, que no pueden ser visualizadas con el uso de equipos convencionales de Rayos X en dos dimensiones. De esta manera, se busca ofrecer información sobre el grupo potencial de pacientes, que serán sometidos a estudios de tomografía computarizada antes de la elevación del seno maxilar. El análisis se basó en 216 imágenes de archivo de tomografía computarizada. El criterio de exclusión fue la presencia de cualquier sospecha de patología en la región maxilar. La prevalencia de septos hallados en tomografía computarizada fue alta (49%) con una altura media de 5,44 mm. La incidencia de septos orientados sagitalmente, encontrados en estudios de Rayos X 2D fue del 10%, siendo la localización más frecuente la región del segundo molar. De acuerdo a los resultados obtenidos y respetando los principios de seguridad radiológica, los autores sugieren que la ortopantomografía de rayos X puede ser un examen radiológico suficiente antes de comenzar el procedimiento quirúrgico de implante en el área del seno maxilar.

The effect of immunosuppressive therapy on renal cell apoptosis in native rat kidneys.

AIM: To analyse the impact of the most commonly used immunosuppressive drugs on the occurrence of apoptosis in the native kidneys of Wistar rats. METHOD: The study involved 36 rats. the animals being grouped according to the immunosuppressive regimen used (tacrolimus, mycophenolate mofetil, cyclosporine A, rapamycin and prednisone). The rats in all study groups were treated with a 3-drug protocol for 6 months. The medication dose was adjusted based on available literature data. No drugs were administered to the control group. The rats were then killed. Autopsies of all animals were performed and the kidneys were isolated for histopathology (HE + PAS). To assess cell apoptosis the TUNEL reaction was performed. Blood trough levels of immunosuppressive drugs as well as the parameters of peripheral blood were determined. RESULTS: 1. In rats treated with cyclosporine A distal nephron tubules were characterised by more pronounced apoptosis. 2. In tacrolimus-treated rats a lower intensity of apoptosis was found in the distal tubules. 3. In rapamycin-treated rats the apoptosis was inhibited both in the distal and proximal nephron tubules. 4. In MMF treated rats intense apoptosis was observed in the proximal nephron tubules. 5. There were no significant changes in renal histopathology (HE + PAS). CONCLUSIONS: The apoptosis in nephron tubules caused by immunosuppressive therapy is not accompanied by any histopathological changes (eg fibrosis, inflammation, tubular atrophy, vacuolation of the tubular cells) in light microscopy.

Effects of immunosuppressive treatment on protein expression in rat kidney.

The structural proteins of renal tubular epithelial cells may become a target for the toxic metabolites of immunosuppressants. These metabolites can modify the properties of the proteins, thereby affecting cell function, which is a possible explanation for the mechanism of immunosuppressive agents' toxicity. In our study, we evaluated the effect of two immunosuppressive strategies on protein expression in the kidneys of Wistar rats. Fragments of the rat kidneys were homogenized after cooling in liquid nitrogen and then dissolved in lysis buffer. The protein concentration in the samples was determined using a protein assay kit, and the proteins were separated by two-dimensional electrophoresis. The obtained gels were then stained with Coomassie Brilliant Blue, and their images were analyzed to evaluate differences in protein expression. Identification of selected proteins was then performed using mass spectrometry. We found that the immunosuppressive drugs used in popular regimens induce a series of changes in protein expression in target organs. The expression of proteins involved in drug, glucose, amino acid, and lipid metabolism was pronounced. However, to a lesser extent, we also observed changes in nuclear, structural, and transport proteins' synthesis. Very slight differences were observed between the group receiving cyclosporine, mycophenolate mofetil, and glucocorticoids (CMG) and the control group. In contrast, compared to the control group, animals receiving tacrolimus, mycophenolate mofetil, and glucocorticoids (TMG) exhibited higher expression of proteins responsible for renal drug metabolism and lower expression levels of cytoplasmic actin and the major urinary protein. In the TMG group, we observed higher expression of proteins responsible for drug metabolism and a decrease in the expression of respiratory chain enzymes (thioredoxin-2) and markers of distal renal tubular damage (heart fatty acid-binding protein) compared to expression in the CMG group. The consequences of the reported changes in protein expression require further study.

Three-dimensional quantitative analysis of adhesive remnants and enamel loss resulting from debonding orthodontic molar tubes.

AIMS: Presenting a new method for direct, quantitative analysis of enamel surface. Measurement of adhesive remnants and enamel loss resulting from debonding molar tubes. MATERIAL AND METHODS: Buccal surfaces of fifteen extracted human molars were directly scanned with an optic blue-light 3D scanner to the nearest 2 µm. After 20 s etching molar tubes were bonded and after 24 h storing in 0.9% saline - debonded. Then 3D scanning was repeated. Superimposition and comparison were proceeded and shape alterations of the entire objects were analyzed using specialized computer software. Residual adhesive heights as well as enamel loss depths have been obtained for the entire buccal surfaces. Residual adhesive volume and enamel loss volume have been calculated for every tooth. RESULTS: The maximum height of adhesive remaining on enamel surface was 0.76 mm and the volume on particular teeth ranged from 0.047 mm3 to 4.16 mm3. The median adhesive remnant volume was 0.988 mm3. Mean depths of enamel loss for particular teeth ranged from 0.0076 mm to 0.0416 mm. Highest maximum depth of enamel loss was 0.207 mm. Median volume of enamel loss was 0.104 mm3 and maximum volume was 1.484 mm3. CONCLUSIONS: Blue-light 3D scanning is able to provide direct precise scans of the enamel surface, which can be superimposed in order to calculate shape alterations. Debonding molar tubes leaves a certain amount of adhesive remnants on the enamel, however the interface fracture pattern varies for particular teeth and areas of enamel loss are present as well.