Ecologic, Geoclimatic, and Genomic Factors Modulating Plague Epidemics in Primary Natural Focus, Brazil.

Plague is a deadly zoonosis that still poses a threat in many regions of the world. We combined epidemiologic, host, and vector surveillance data collected during 1961-1980 from the Araripe Plateau focus in northeastern Brazil with ecologic, geoclimatic, and Yersinia pestis genomic information to elucidate how these factors interplay in plague activity. We identified well-delimited plague hotspots showing elevated plague risk in low-altitude areas near the foothills of the plateau's concave sectors. Those locations exhibited distinct precipitation and vegetation coverage patterns compared with the surrounding areas. We noted a seasonal effect on plague activity, and human cases linearly correlated with precipitation and rodent and flea Y. pestis positivity rates. Genomic characterization of Y. pestis strains revealed a foundational strain capable of evolving into distinct genetic variants, each linked to temporally and spatially constrained plague outbreaks. These data could identify risk areas and improve surveillance in other plague foci within the Caatinga biome.

Mechanical stability of posterior implant-supported monolithic zirconia cantilever on titanium-base abutments. An in vitro study.

PURPOSE: Investigate survival and technical complications of two-unit posterior implant-supported cantilever made of monolithic zirconia on titanium-base abutments (Zr-TiB) vs. porcelain-fused-to-metal on castable gold abutments (PFM-GA) using two different implant connections, internal butt-joint (IBJ) and internal conical (IC). MATERIALS AND METHODS: Forty-eight implants (4.3 mm diameter) were divided into four groups (n = 12) to support 2-unit mandibular premolar cantilevers with two different materials (Zr-TiB vs. PFM-GA) and two connection types (IBJ vs. IC). Tested groups were as follows: (1) IBJ/Zr-TiB; (2) IBJ/PFM-GA; (3) IC/Zr-TiB; and (4) IC/PFM-GA. Specimens were thermomechanical aged (1,200,000 cycles, 98 N, 5-55°C) with occlusal axial load on the pontic. Catastrophic and non-catastrophic events were registered, and removal torque values measured before and after aging. Specimens surviving aging were subjected to loading until failure. Survival, total complication rates, torque loss (%), and bending moments were calculated. RESULTS: From 48 specimens, 38 survived aging. Survival rates significantly varied from 16.7% (IC/PFM-GA) to 100% (IBJ/Zr-TiB; IBJ/PFM-GA; IC/Zr-TiB) (p < .01). Internal conical connection revealed significantly higher torque loss (IC/ZrTiB - 67%) compared to internal butt-joint (IBJ/Zr-TiB - 44%; IBJ/PFM-GA - 46%) (p < .01). Bending moments were higher in internal butt-joint connections than in internal conical (p < .05). CONCLUSION AND CLINICAL IMPLICATIONS: Two-unit posterior implant-supported cantilever FDPs replacing mandibular premolars composed of monolithic zirconia on titanium-base abutments demonstrated higher mechanical stability compared to porcelain-fused-to-metal on castable gold abutments in this in vitro study. The internal conical connection combined with porcelain-fused-to-metal on gold abutments revealed a high number of failures; therefore, their clinical use may be considered cautiously for this indication.

Material and abutment selection for CAD/CAM implant-supported fixed dental prostheses in partially edentulous patients - A narrative review.

Restorative material selection has become increasingly challenging due to the speed of new developments in the field of dental material science. The present narrative review gives an overview of the current indications for implant abutments and restoration materials for provisional and definitive implant-supported fixed dental prostheses in partially edentulous patients. For single implant restorations, titanium base abutments for crowns are suggested as an alternative to the conventional stock- and customized abutments made out of metal or zirconia. They combine the mechanical stability of a metallic connection with the esthetic potential of ceramics. For multiple-unit restorations, conical titanium bases especially designed for bridges are recommended, to compensate for deviating implant insertion axes and angulations. Even though titanium base abutments with different geometries and heights are available, certain clinical scenarios still benefit from customized titanium abutments. Indications for the definitive material in fixed implant restorations depend on the region of tooth replacement. In the posterior (not esthetically critical) zone, ceramics such as zirconia (3-5-Ymol%) and lithium-disilicate are recommended to be used in a monolithic fashion. In the anterior sector, ceramic restorations may be buccally micro-veneered for an optimal esthetic appearance. Lithium-disilicate is only recommended for single-crowns, while zirconia (3-5-Ymol%) is also recommended for multiple-unit and cantilever restorations. Attention must be given to the specific mechanical properties of different types of zirconia, as some feature reduced mechanical strengths and are therefore not indicated for all regions and restoration span lengths. Metal-ceramics remain an option, especially for cantilever restorations.

Influence of sterilization on the retention forces of lithium disilicate and polymer-infiltrated ceramic-network crowns bonded to titanium base abutments: An in-vitro study.

OBJECTIVES: The aim of this study was to evaluate the effect of sterilization on the retention forces of lithium disilicate (LD) and polymer-infiltrated ceramic network (PICN) crowns bonded to titanium base (Ti-base) abutments. MATERIALS AND METHODS: Forty LD and 40 PICN crowns were milled and then bonded to 80 Ti-bases with two resin composite cements: Multilink Hybrid Abutment (mh) and Panavia V5 (pv) for a total of 8 groups (n = 10). Half of the specimens (test) underwent an autoclaving protocol (pressure 1.1 bar, 121°C, 20.5 min) and the other half not (control). Restorations were screw-retained to implants, and retention forces (N) were measured with a pull-off testing machine. The surfaces of the Ti-bases and the crowns were inspected for the analysis of the integrity of the marginal bonding interface and failure mode. Student's t-test, chi-square test, and univariate linear regression model were performed to analyze the data (α = 0.05). RESULTS: The mean pull-off retention forces ranged from 487.7 ± 73.4 N to 742.2 ± 150.3 N. Sterilized groups showed statistically significant overall higher maximum retention forces (p < .05), except for one combination (LD + mh). Sterilization led to an increased presence of marginal gaps and deformities compared to no-sterilization (p < .001), while no statistically significant relationship was found between failure mode and sterilization (p > .05). CONCLUSIONS: Sterilization may have a beneficial effect on the retention forces of LD and PICN crowns bonded to titanium base abutments, although it may negatively influence the integrity of the marginal bonding interface.

The influence of titanium-base abutment geometry and height on mechanical stability of implant-supported single crowns.

AIM: This study aimed to investigate the influence of titanium base (ti-base) abutment macro- and micro-geometry on the mechanical stability of polymer-infiltrated ceramic network (PICN) screw-retained implant-supported single crowns (iSCs). MATERIALS AND METHODS: Twelve specimens per group were used, comprising six different implant/ti-base abutment combinations restored with PICN iSCs: Nb-T (gingival height [GH]: 1.5 mm, prosthetic height [PH]: 4.3 mm), CC (GH: 0.8 mm, PH: 4.3 mm), CC-P (GH: 0.8 mm, PH: 7 mm), Nb-V (GH: 1.5 mm, PH: 6 mm), St (GH: 1.5 mm, PH: 5.5 mm), and Th (GH: 0.5 mm, PH: 9 mm). The specimens underwent thermo-mechanical aging, and those that survived were subsequently subjected to static loading until failure. The data were analyzed using a one-way ANOVA test followed by Tukey post hoc test (α = .05). RESULTS: All specimens survived thermo-mechanical aging without complications, namely, visible cracks, debonding, or screw loosening. Th group demonstrated the highest strength values among all the groups, with significant differences compared to Nb-T (p < .05), CC (p < .001), and St (p < .001). Additionally, CC-P group exhibited significantly superior fracture strength results compared to CC (p < .05) and St (p < .05). CONCLUSION: The choice of ti-base, particularly prosthetic height, had a significant influence on fracture resistance of PICN iSCs. Nevertheless, the height or geometrical features of the ti-base did not exhibit a significant influence on the mechanical behavior of the iSC/ti-base assembly under thermomechanical loading, as all specimens withstood the aging without complication or failure.

Epitranscriptome machinery in Trypanosomatids: New players on the table?

Trypanosoma and Leishmania parasites cause devastating tropical diseases resulting in serious global health consequences. These organisms have complex life cycles with mammalian hosts and insect vectors. The parasites must, therefore, survive in different environments, demanding rapid physiological and metabolic changes. These responses depend upon regulation of gene expression, which primarily occurs posttranscriptionally. Altering the composition or conformation of RNA through nucleotide modifications is one posttranscriptional mechanism of regulating RNA fate and function, and modifications including N6-methyladenosine (m6A), N1-methyladenosine (m1A), N5-methylcytidine (m5C), N4-acetylcytidine (ac4C), and pseudouridine (Ψ), dynamically regulate RNA stability and translation in diverse organisms. Little is known about RNA modifications and their machinery in Trypanosomatids, but we hypothesize that they regulate parasite gene expression and are vital for survival. Here, we identified Trypanosomatid homologs for writers of m1A, m5C, ac4C, and Ψ and analyze their evolutionary relationships. We systematically review the evidence for their functions and assess their potential use as therapeutic targets. This work provides new insights into the roles of these proteins in Trypanosomatid parasite biology and treatment of the diseases they cause and illustrates that Trypanosomatids provide an excellent model system to study RNA modifications, their molecular, cellular, and biological consequences, and their regulation and interplay.

Community-based assessment of marine resources contamination after a large-scale oil spill.

As of August 2019, several oil slicks reached the Brazilian coast, compromising local ecosystems and the economy of coastal communities. In this context, this study aimed to assess seafood quality at the Canavieiras Extractive Reserve (RESEX), located in the state of Bahia, Northeastern Brazil, by determining polycyclic aromatic hydrocarbons (PAHs) concentrations in local biota following the oil spill. It was designed and carried out in a participatory manner, involving RESEX fishers, shellfish and crab gatherers and managers, as well as university researchers. A total of 72 biota samples were analyzed, and the sum of the 16 priority USEPA PAHs ranged from less than the limit of detection to 30.81 ng g-1 (w.w.). When also considering alkylated compounds, concentrations ranged from 3.53 to 360.75 ng g-1 (w.w.). No sample contained PAHs concentrations suggestive of human consumption risks. No difference in PAHs concentrations between the six studied areas and regarding different biota feeding habits were observed. Higher PAHs concentrations were generally noted in molluscs, as these organisms do not have enzyme systems capable of metabolizing these compounds. This initiative demonstrated the feasibility of participatory construction resulting in a study concerning valued species to local communities, ensuring a contribution to local fishing and marketing activities.

Long-term outcomes of maxillary single-tooth implants in relation to timing protocols of implant placement and loading: Systematic review and meta-analysis.

OBJECTIVES: The aim of the present systematic literature review was to determine whether long-term treatment results with single-tooth implants may differ depending on the timing of implant placement in relation to tooth extraction (immediate IP/early EP/delayed DP) and the timing of prosthetic loading (immediate IL/early EL/delayed DL). MATERIAL AND METHODS: Electronic and manual searches were performed to identify studies reporting on long-term results (survival rate and/or marginal bone resorption after ≥3 years) of maxillary single-tooth implants in the aesthetic zone using defined placement and loading protocols. Comparative trials were subjected to meta-analyses whilst data from single-arm studies were pooled to evaluate differences between timing protocols. RESULTS: A total of 7 controlled trials were considered for meta-analyses: immediate loading was compared to delayed loading in 3 studies on immediate placement (IPIL vs. IPDL, p = .306) and in 2 studies on delayed placement (DPIL vs. DPDL, p = 1.000) whilst 2 studies compared early versus delayed placement with delayed loading (EPDL vs. DPDL, p = .600), however, without significant differences. Pooled data analysis of 29 studies (965 implants) did not show differences between timing of placement or loading as well as marginal bone remodelling. No impact of the one abutment - one time concept, flap design and simultaneous bone or soft tissue augmentation could be established. CONCLUSIONS: Insufficient data are available for meta-analytic comparison of all combinations of implant placement and loading protocols.

Mechanical stability and technical outcomes of monolithic CAD/CAM fabricated abutment-crowns supported by titanium bases: An in vitro study.

OBJECTIVES: To evaluate mechanical stability (survival and complication rates) and bending moments of different all-ceramic monolithic restorations bonded to titanium bases (hybrid abutment-crowns) or to customized titanium abutments compared to porcelain-fused-to-metal crowns (PFM) after thermo-mechanical aging. MATERIAL AND METHODS: Sixty conical connection implants (4.3 mm-diameter) were divided in five groups (n = 12): PFM using gold abutment (GAbut-PFM), lithium disilicate crown bonded to customized titanium abutment (TAbut+LDS), lithium disilicate abutment-crown bonded to titanium base (TiBase+LDS), zirconia abutment-crown bonded to titanium base (TiBase+ZR), polymer-infiltrated ceramic-network (PICN) abutment-crown bonded to titanium base (TiBase+PICN). Simultaneous thermocycling (5°-55°C) and chewing simulation (1,200,000-cycles, 49 N, 1.67 Hz) were applied. Catastrophic and non-catastrophic events were evaluated under light microscope, and survival and complication rates were calculated. Specimens that survived aging were loaded until failure and bending moments were calculated. RESULTS: Survival rates after aging were 100% (TAbut+LDS, TiBase+LDS), 91.7% (GA-PFM), 66.7% (TiBase+ZR) and 58.3% (TiBase+PICN) and differed among the groups (p = .006). Non-catastrophic events as screw loosening (GA-PFM) and loss of retention or micro-/macro-movement (TiBase groups) were observed. Complication rates varied among the groups (p < .001). TiBase+PICN had lower bending moment than all the other groups (p < .001). CONCLUSIONS: Hybrid abutment-crowns made of lithium disilicate can be an alternative to PFM-based restorations, although concerns regarding the bonded interface between the titanium base and abutment-crown can be raised. PICN and zirconia may not be recommended due to its inferior mechanical and bonding outcomes, respectively. Titanium customized abutment with bonded lithium disilicate crown appears to be the most stable combination.

Does the timing of implant placement and loading influence biological outcomes of implant-supported multiple-unit fixed dental prosthesis-A systematic review with meta-analyses.

OBJECTIVE: To investigate the impact of timing of implant placement and loading on implant survival and biological outcomes of multiple-unit implant-supported fixed dental prosthesis (FDPs). MATERIAL AND METHODS: A literature search was performed by three independent reviewers for studies reporting on ≥10 patients with FPDs supported by ≥two implants over ≥3 years of follow-up. Data were analyzed on implant survival and biological complications as primary outcomes and biological events, including changes in peri-implant marginal bone level (MBL), probing depth, soft-tissue level, and health condition as secondary outcomes. RESULTS: 7002 titles were identified, 360 full-texts were screened, and 14 studies were included. These comprised 6 randomized controlled studies (RCTs), 5 cohort studies, and 3 case series with identifiable implant placement and loading protocols in five of 09 possible combinations. All groups but one (IPIL) showed implant survival rates >90%. A meta-analysis based on 3 RCTs found no differences in survival rate between DPIL and DPDL (p = .227). CONCLUSIONS: High survival rates for all studied implant placement and loading combinations were shown for FPDs over ≥3 years of follow-up. When a delayed implant placement protocol is applied, immediate or delayed loading demonstrated similar survival rates. The heterogeneity of the data did not allow to draw any further conclusions on the occurrence of biological complications related to timing of implant placement/loading.

Peri-implantitis: Summary and consensus statements of group 3. The 6th EAO Consensus Conference 2021.

OBJECTIVE: To evaluate the influence of implant and prosthetic components on peri-implant tissue health. A further aim was to evaluate peri-implant soft-tissue changes following surgical peri-implantitis treatment. MATERIALS AND METHODS: Group discussions based on two systematic reviews (SR) and one critical review (CR) addressed (i) the influence of implant material and surface characteristics on the incidence and progression of peri-implantitis, (ii) implant and restorative design elements and the associated risk for peri-implant diseases, and (iii) peri-implant soft-tissue level changes and patient-reported outcomes following peri-implantitis treatment. Consensus statements, clinical recommendations, and implications for future research were discussed within the group and approved during plenary sessions. RESULTS: Data from preclinical in vivo studies demonstrated significantly greater radiographic bone loss and increased area of inflammatory infiltrate at modified compared to non-modified surface implants. Limited clinical data did not show differences between modified and non-modified implant surfaces in incidence or progression of peri-implantitis (SR). There is some evidence that restricted accessibility for oral hygiene and an emergence angle of >30 combined with a convex emergence profile of the abutment/prosthesis are associated with an increased risk for peri-implantitis (CR). Reconstructive therapy for peri-implantitis resulted in significantly less soft-tissue recession, when compared with access flap. Implantoplasty or the adjunctive use of a barrier membrane had no influence on the extent of peri-implant mucosal recession following peri-implantitis treatment (SR). CONCLUSIONS: Prosthesis overcontouring and impaired access to oral hygiene procedures increases risk for peri-implantitis. When indicated, reconstructive peri-implantitis treatment may facilitate the maintenance of post-operative peri-implant soft-tissue levels.

Effect of airborne-particle abrasion of a titanium base abutment on the stability of the bonded interface and retention forces of crowns after artificial aging.

STATEMENT OF PROBLEM: Published data have shown that a mechanical surface treatment of titanium surfaces increases bonding potential. However, most of the studies are based on shear or tensile tests performed on flat-surfaced specimens and do not take into consideration the retention given by the titanium base (ti-base) axial walls and the thermomechanical loading seen in a clinical setting. PURPOSE: The purpose of this in vitro study was to evaluate the influence of different airborne-particle abrasion (APA) methods of the ti-base surface on the stability of the bonded interface and retention forces between these titanium bases and lithium disilicate crowns after thermomechanical aging. MATERIAL AND METHODS: Sixty internal connection implants (Conelog) were restored with lithium disilicate crowns and bonded to the corresponding ti-bases (Conelog). The ti-bases were divided into 4 groups (n=15), 3 experimental groups applying different APA methods, 30-µm silica-modified Al2O3 particles (CoJet) (30-SiO-AlO), 50-µm Al2O3 (Cobra Aluoxyd) (50-AlO), 110-µm silica-modified Al2O3 particles (Rocatec Plus) (110-SiO-AlO), and 1 control group (NoT). Ti-bases were airborne-particle abraded (10 seconds, 0.25 MPa at a 10-mm distance) under standardized conditions in a custom-made APA device. All crowns were cemented with a resin cement (Multilink Hybrid Abutment). After aging (1 200 000 cycles, 49 N, 1.67 Hz; 5 °C-55 °C, 120 seconds), all specimens were assessed for the presence of bond failures by optical microscopy (×50). The retention forces (N) were tested by using a pull-off test (0.5mm/min). Modes of failure were classified (Type 1, 2, or 3). An additional ti-base representing each group was prepared for surface roughness (µm) calculation (Ra, Rc, Rz) with a noncontact laser profilometer, and representative scanning electron microscope (SEM) images were recorded (×1000). Chi-squared tests were performed to analyze the bonded interface failure and modes of failure, and a Kruskal-Wallis test was selected to evaluate retention force values (α=.05). RESULTS: The percentages of bonding failure after aging were 73.3% (NoT), 40% (30-SiO-AlO), 6.7% (50-AlO), and 40% (110-SiO-AlO). The stability of the bonded interface was influenced by the APA method applied (P<.05). Mean ±standard deviation retention force values varied from 206.3 ±86.3 N (NoT) to 420 ±139.5 N (50-AlO), and the differences between these 2 groups were significant (P<.05). Modes of failure were predominantly Type 2 (30-SiO-AlO; 50-AlO; 110-SiO-AlO) and Type 3 (NoT). CONCLUSIONS: Airborne-particle abrasion of the titanium surface increased the bond stability and retention forces between the ti-base and the respective crown. The use of 50-µm Al2O3 provided the most stable bonded interface among the different treatments.

Effect of saliva contamination and artificial aging on different primer/cement systems bonded to zirconia.

STATEMENT OF PROBLEM: Saliva contamination has been shown to decrease bonding to zirconia. Adopting a less contamination-sensitive cement system may be an alternative to decontamination. PURPOSE: The purpose of this in vitro study was to assess the ability of different primer/cement systems to promote a durable bond to zirconia after saliva contamination. MATERIAL AND METHODS: Zirconia blocks (Lava Plus) (N=320) were airborne-particle abraded (50 µm Al2O3) and divided into 32 experimental groups (n=10) according to the variables in the study: saliva contamination; primer/cement system (Panavia SA [PSA]; RelyX Unicem 2 [RU2]; Bifix SE [BSE]; Panavia F2.0 [PF2]; Scotchbond Universal + RelyX Ultimate [SBU+RXU]; Futurabond M+ + Bifix QM [FBM+BQM]; All-Bond Universal + Duo-link [ABU+DL]; Z-Prime Plus + Duo-link [ZPP+DL]; and aging period (72 hours; 30 days with 10 000 thermocycles at 5°C to 55°C). After half of the blocks had been contaminated with fresh human saliva for 10 minutes, rinsed with water, and air-dried, each primer/cement was applied. Polymerized composite resin disks were then placed over the cement, and the resin cement was light-polymerized for 20 seconds each at 2 opposite margins. After the aging time, the specimens were tested in shear (1 mm/min). The failure mode was classified as adhesive, cohesive, or mixed. Statistical analysis of the shear bond strength (SBS) data was performed with ANOVA followed by Tukey honest significant difference post hoc tests. Chi-square tests were used to analyze the failure mode data (α=.05). RESULTS: The mean SBS ranged between 4.2 and 34.5 MPa. Shear bond strength was influenced (P<.001) by all the factors studied (cement system, saliva contamination, aging time). SBU+RXU and FBM+BQM showed a higher mean SBS than those of the other experimental groups (P<.05) and were the only groups not affected by saliva contamination (P>.05). Failure was predominantly classified as adhesive. CONCLUSIONS: In general, saliva contamination and aging decreased bonding efficacy. Two systems, combining an application of a universal adhesive and a resin cement (SBU+RXU and FBM+BQM) were not affected by saliva contamination.

Monolithic zirconia multiple-unit implant reconstructions on titanium bonding bases.

The development of titanium bonding bases allows for the use of implant-supported monolithic reconstructions in a digital workflow. Different base configurations are available according to each clinical indication. In this case report, the selection of titanium bonding bases for crowns was considered for a multiple-unit fixed dental prosthesis (FDP).

Implant failure and clinical and radiographic outcomes after surgical treatment of peri-implantitis: A meta-analysis.

PURPOSE: To assess the implant failure rate and clinical and radiographic outcomes of implants affected by peri-implantitis that received surgical treatment. MATERIALS AND METHODS: A systematic search was conducted of three databases (PubMed, Embase and Cochrane Library) to identify studies that examined implant failure and biological outcomes after surgical peri-implantitis treatment, including ≥ 10 patients and reporting on a follow-up period of at least 12 months. Data and risk of bias were assessed qualitatively and quantitively. Surgical modalities were subdivided into reconstructive, non-reconstructive and combined. Meta-analyses were performed for implant failure, marginal bone level and probing pocket depth at 12 and 36 months with the respective subset of available data for each time and endpoint. RESULTS: A total of 45 studies with 3,463 treated implants were included in the quantitative evaluation. Meta-analyses revealed low implant failure rates of 1.2% (95% confidence interval 0.4%, -2.1%) and 4.2% (95% confidence interval 1.0%, -8.8%) at 12 and 36 months, respectively. No significant difference between the subgroups was observed at 12 months. At 36 months, reconstructive modalities showed a significantly lower implant failure rate (1.0%; 95% confidence interval 0.0%, 5.0%; P = 0.04, χ2(1) = 4.1) compared to non-reconstructive modalities (8.0%; 95% confidence interval 2.0%, 18.0%). The mean probing pocket depth was 3.71 mm (95% confidence interval 3.48, 3.94 mm) at 12 months and 3.63 mm (95% confidence interval 3.02, 4.24 mm) at 36 months. The mean marginal bone loss was 3.31 mm (95% confidence interval 2.89, 3.74 mm) at 12 months and 2.38 mm (95% confidence interval 1.01, 3.74 mm) at 36 months. No significant differences between the modalities were observed for bleeding on probing after either of these time points. Cumulative interventions during supportive therapy were reported in 9% of the studies. CONCLUSION: Surgical treatment of peri-implantitis results in a low implant failure rate in the short and medium term. No differences were noted between the different interventions with regard to failure rate. Surrogate therapeutic endpoints were improved after treatment, without significant differences between the different modalities. Therapeutic success and/or disease resolution and cumulative interventions during supportive therapy are seldom reported in the literature, but limited long-term outcomes are documented consistently.

Extended porcelain veneers in the maxillary anterior region. A retrospective study with an up to 27-year follow-up

AIM: The aim of the present retrospective study was to evaluate the long-term results, including technical and biologic outcomes, of maxillary extended porcelain veneers with an incisal edge thickness above 2 mm. MATERIALS AND METHODS: Patients treated with extended porcelain veneers performed by a single clinician at University of Geneva between 1990 and 2003 were identified and invited to an examination. Of the 37 identified patients, 10 patients with 50 veneers agreed to be examined and were included. A clinical examination was performed to assess survival rates as well as technical and biologic outcomes (modified United States Public Health Services criteria). Patient records were also reviewed to retrieve patient and reconstruction data and every complication event. Patient-reported outcome measures (PROMs) were evaluated using a visual analog scale to measure esthetic satisfaction, functional and phonetic comfort, masticatory improvement, tooth sensitivity, and acceptance of restoration replacement in case of failure. Data were descriptively analyzed, and Kaplan-Meier survival estimators were computed for survival rates and complication events. RESULTS: The survival rate of the veneers was 96% after a mean follow-up of 20.7 ± 3.7 years in function. The technical complication rate amounted to 30%, including two failures, nine repairable fractures, three cracks, and one displacement due to trauma. No cavitated caries lesions or endodontic complications were registered. PROMs were very high for esthetic satisfaction and phonetic comfort. CONCLUSIONS: Within the limitations of the present retrospective study, extended porcelain veneers appear to be a successful long-term treatment option in terms of clinical outcomes and patient satisfaction.

The influence of finishing line and luting material selection on the seating accuracy of CAD/CAM indirect composite restorations.

OBJECTIVES: This study aimed to assess the seating accuracy of resin composite CAD/CAM overlay restorations, employing various preparation designs and luting materials (pre-heated composite (HC) or resin cement (RC)). METHODS: A human molar's STL file was utilized to create 100 3D-printed resin tooth replicas, randomly distributed into 5 groups (n = 20) based on finishing line preparation designs: 1) Rounded shoulder above the dental equator - DE (SA); 2) Chamfer above the DE (CA); 3) Butt joint above the DE (BJ); 4) Rounded shoulder below the DE (SB); 5) Chamfer below the DE (CB). Digital impressions were acquired for all replicas, and restorations milled using Tetric CAD (Ivoclar Vivadent). The restorations were luted with HC (Tetric Prime, Ivoclar Vivadent) or RC (RelyX Universal, 3 M). Seating accuracy was evaluated through digital scans during try-in without any luting agent and post-cementation using a 3D analysis software (Geomagic wrap, 3D Systems). Data were statistically analyzed using Two-Way ANOVA (p < 0.05). RESULTS: The type of luting material (RC vs HC), preparation design, and their interactions significantly impacted 3D seating of the restorations (p < 0.001). HC exhibited higer volumetric increase than RC. BJ and CA designs consistently demonstrated superior seating accuracy, irrespective of the luting material used. CONCLUSIONS: The utilization of pre-heated composite resin could negatively influence the seating of overlay restorations, probably due to its higher viscosity when compared to the resin cement. However, when HC is selected as luting agent, preparation designs lacking internal angles are recommended for enhancing the precision of overlays seating.

Retention and Marginal Integrity of CAD/CAM Fabricated Crowns Adhesively Cemented to Titanium Base Abutments-Influence of Bonding System and Restorative Material.

PURPOSE: To assess the influence of the bonding system and restorative material on the marginal integrity and pull-off forces of monolithic all-ceramic crowns bonded to titanium base (ti-base) abutments. MATERIALS AND METHODS: A total of 108 ti-bases were sandblasted and divided into nine experimental groups (n = 12) according to the combination of crown material (polymer-infiltrated ceramic-network [PI], lithium-disilicate [LD], and zirconia [ZI]) and bonding system (Multilink Hybrid-Abutment [MH], Panavia V5 [PV], RelyX Ul5mate [RU]) with the respective primers. After bonding the crowns to the ti-base abutments, the restorations were screw-retained on implants and thermomechanically aged (1,200,000 cycles, 49 N, 1.67 Hz, 5 to 55°C). Marginal integrity and bonding failures were evaluated under a light microscope, and pull-off forces (N) were calculated. Chi-square tests for marginal integrity as well as one-way and two-way ANOVA statistical tests for pull-off forces were applied (a = .05). RESULTS: PI presented higher marginal integrity than LD (P = .023). Bonding system PV revealed higher marginal integrity than MH (P =.005) and RU (P =.029). Differences in pull-off forces were found between restorative material and resin cements (P < .001), with the highest values for ZI + RU (598 ± 192 N), PI + PV (545 ± 114 N), LD + MH (532 ± 116 N), and PI + RU (528 ± 81 N). Specimens with marginal integrity revealed higher pull-off forces than those with alteration (P = .006). Specimens presenting bonding failures (micromovements) showed lower pull-off forces than those without bonding failures (P < .001). CONCLUSIONS: The tested CAD/CAM materials show favorable bonding performances with different bonding systems, nevertheless for each restorative material a specific bonding system has to be recommended. Int J Prosthodont 2023;36:e88-e102.

Genomic Analysis of Yersinia pestis Strains from Brazil: Search for Virulence Factors and Association with Epidemiological Data.

Yersinia pestis, the etiological agent of the plague, is considered a genetically homogeneous species. Brazil is currently in a period of epidemiological silence but plague antibodies are still detected in sentinel animals, suggesting disease activity in the sylvatic cycle. The present study deployed an in silico approach to analyze virulence factors among 407 Brazilian genomes of Y. pestis belonging to the Fiocruz Collection (1966-1997). The pangenome analysis associated several known virulence factors of Y. pestis in clades according to the presence or absence of genes. Four main strain clades (C, E, G, and H) exhibited the absence of various virulence genes. Notably, clade G displayed the highest number of absent genes, while clade E showed a significant absence of genes related to the T6SS secretion system and clade H predominantly demonstrated the absence of plasmid-related genes. These results suggest attenuation of virulence in these strains over time. The cgMLST analysis associated genomic and epidemiological data highlighting evolutionary patterns related to the isolation years and outbreaks of Y. pestis in Brazil. Thus, the results contribute to the understanding of the genetic diversity and virulence within Y. pestis and the potential for utilizing genomic data in epidemiological investigations.