The Efficacy of Anterior Capsulotomy and Basal Capsulectomy Adherent to Expanded Scalp Flap During Alopecia Reconstruction in Pediatric Burned Patients.

BACKGROUND: Scalp expansion is an optimal treatment for alopecia resulting from burn injuries, especially in the pediatric population through providing highly vascularized adjacent local tissues with optimal hair density, color matching, texture, and hair-bearing characteristics. The aim of this study was to evaluate the efficacy of anterior capsulotomy and basal capsulectomy adherent to expanded scalp flap during alopecia reconstruction with scalp expansion in pediatric burned patients. METHODS: The study was conducted on 127 patients with an age range of 5 to 19 years who presented with postburn alopecia accompanied by hairline loss. The patients were divided into 2 groups: group I consisted of 58 patients who were operated on using conventional technique, and group II consisted of 69 patients who were operated using modified technique including basal capsulectomy on the skull side and anterior capsulotomy on the expanded scalp flap. RESULTS: The Hairdex, a validated questionnaire of Hair-Specific Health-Related Quality of Life measures, showed that percentage of satisfaction concerning outcomes was 91.50%, psychological well-being was 95%, and self-confidence was 84.30% in group II, compared with 63%, 55.70%, and 66.20%, respectively, in group I. This significant values had a great positive effect on patient satisfaction, changing child's behavior and self-confidence. CONCLUSION: Although physiological background of tissue expansion is the same, proper flap design with anterior capsulotomy on flap undersurface and basal capsulectomy on the skull side improve results of the traditional method significantly and minimize the complication rate. These surgical modifications provide maximum benefits from expanded tissue, with restoration of the hairline and a uniform hair direction. LEVEL OF EVIDENCE: Level III, case-control study.

Radiographic Assessment of Three-implant-retained Mandibular Overdentures: A Clinical Study of Alveolar Bone Height Changes (Randomized Clinical Trial).

AIM: To evaluate the residual alveolar ridge bone height changes regarding the impact of the block-out spacer used during the pick-up procedures of implant-assisted mandibular complete overdentures. MATERIALS AND METHODS: This study was a randomized clinical trial conducted on 18 patients. All patients received three mandibular dental implants with definitive locator attachments which were directly picked up with two different techniques. Patients were classified randomly without any bias into two equal groups (Group I block-out spacer) and (Group II without block-out spacer). Over a year, the digital radiographic technique with new technique of reference points was employed to evaluate the changes in the residual alveolar ridge bone heights. The data were statistically analyzed to test the significance difference between groups. RESULTS: Concerning the residual alveolar ridge resorption RRR, group I exhibited a significantly higher RRR than group II. CONCLUSION: In terms of residual alveolar ridge preservation, not using the block-out spacer was more beneficial than using it. CLINICAL SIGNIFICANCE: Alveolar bone heights can be affected by the use of block-out spacer during pick-up procedure within accepted physiologic values. The removal of the block-out spacer could be more beneficial with respect to the preservation of the residual alveolar ridge. How to cite this article: Mohammed REL, Askar OM, El-Waseef FAE, et al. Radiographic Assessment of Three-implant-retained Mandibular Overdentures: A Clinical Study of Alveolar Bone Height Changes (Randomized Clinical Trial). J Contemp Dent Pract 2023;24(11):847-852.

Study on prevalence and bacterial etiology of mastitis, and effects of subclinical mastitis and stage of lactation on SCC in dairy goats in Egypt.

In Egypt, inadequate information on prevalence and epidemiology of caprine mastitis is available. This study was designed to investigate prevalence and etiological agents of caprine mastitis and assess the efficacy of somatic cell count (SCC) as marker of subclinical mastitis (SCM) in dairy goats. This study was carried out on 249 randomly selected lactating goats in different lactation stages and examined clinically. Of these animals, 477 milk samples were aseptically collected and screened for bacterial carriage. SCC was assessed in 234 apparently normal milk samples, and SCC ≥ 106 cells/ml was indicator for SCM. Prevalence of clinical mastitis (CM) was 33.73% and 16.87% at animal and udder-half levels, respectively. SCM was 52.56% in the apparently healthy halves. Culture results proved single infection in 49.69% of samples, mixed infection in 23.9% of samples, and 26.41% of samples were negative. Coagulase negative staphylococci (CNS) were the most predominant bacteria (58.75%), then Staphylococcus aureus (S. aureus) (24.375%), and Streptococci (1.875%) were the least. No significant difference was recorded between mean of SCC in bacteriologically positive and negative samples, neither in those with SCC ≤ 106 nor with SCC ≥ 106 cells/ml both in middle and late lactation stages. Besides, the percentage of animals harboring SCC ≥ 106 cells/ml and negative for bacteriology in late lactation stage was 3 times (28.57%) more than in midlactation (9.3%). We can assume that SCC is not proper indicator for intra-mammary inflammation (IMI) in goats, and bacteriological examination remains more efficient, despites being time consuming and expensive.

Strains Around Abutment Teeth with Different Attachments Used for Implant-Assisted Distal Extension Partial Overdentures: An In Vitro Study.

PURPOSE: The aim of this study was to evaluate and compare strain around abutment teeth with different attachments used for implant-assisted distal extension partial overdentures (IADEPODs). MATERIALS AND METHODS: A mandibular Kennedy class I acrylic model (remaining teeth from first premolar to first premolar) was constructed. A conventional partial denture was constructed over the model (control, group 1). Two laboratory implants were then placed bilaterally in the first molar areas parallel to each other and perpendicular to the residual ridge. Three additional experimental partial overdentures (PODs) were constructed and connected to the implants using ball (group 2), magnetic (group 3), and Locator (group 4) attachments. Three linear strain gauges were bonded buccal, lingual, and distal to the first premolar abutment tooth at the right (loading) and the left (nonloading) sides. For each group, a universal testing device was used to apply a unilateral vertical static load (50 N) on the first molar area, and the strain was recorded using a multichannel digital strainometer. RESULTS: Significant differences between groups and between sites of strain gauges were detected. Strains recorded for all groups were compressive (negative) in nature. Group 1 demonstrated the highest strain, followed by group 3 and group 4; group 2 recorded the lowest strain. For group 2, the highest strain was recoded at the lingual nonloading side. For group 1, group 3, and group 4, the highest strain was recorded at the buccal loading side. CONCLUSION: Within the limitation of the present study, ball attachments used to retain IADEPODs to the implants were associated with lower strains around abutment teeth than Locator and magnetic attachments. The highest strain was recorded with conventional partial dentures.

A comparison of mandibular denture base deformation with different impression techniques for implant overdentures.

PURPOSE: This study aimed to evaluate mandibular denture base deformation along with three impression techniques used for implant-retained overdenture. MATERIALS AND METHODS: Ten edentulous patients (five men and five women) received two implants in the canine region of the mandible and three duplicate mandibular overdentures which were constructed with mucostatic, selective pressure, and definitive pressure impression techniques. Ball abutments and respective gold matrices were used to connect the overdentures to the implants. Six linear strain gauges were bonded to the lingual polished surface of each duplicate overdenture at midline and implant areas to measure strain during maximal clenching and gum chewing. RESULTS: The strains recorded at midline were compressive while strains at implant areas were tensile. Clenching recorded significant higher strain when compared with gum chewing for all techniques. The mucostatic technique recorded the highest strain and the definite pressure technique recorded the lowest. There was no significant difference between the strain recorded with mucostatic technique and that registered with selective pressure technique. The highest strain was recorded at the level of ball abutment's top with the mucostatic technique during clenching. CONCLUSION AND RECOMMENDATION: Definite pressure impression technique for implant-retained mandibular overdenture is associated with minimal denture deformation during function when compared with mucostatic and selective pressure techniques. Reinforcement of the denture base over the implants may be recommended to increase resistance of fracture when mucostatic or selective pressure impression technique is used.

Scanning electron microscopy observations of osseointegration failures of dental implants that support mandibular overdentures.

AIM: : Investigating possible failure causes of mandibular implants after their immediate loading with an overdenture retained with bilateral bar attachments, using scanning electron microscope. PATIENTS AND METHODS: Twenty edentulous male patients were included in the present study. Each patient had 2 fixtures inserted in the canine and the first molar areas on each side of the mandible. After abutments screwing, the 2 fixtures on the same side were splinted with a bar, and immediately loaded with an overdenture. Implants mobility was assessed on weekly basis. Failed implants were removed, and examined by scanning electron microscope. RESULTS: The failed implants, removed after 4 weeks of treatment, showed an intimate contact of mineralized and osteoid tissues with dense collagen-rich matrix in the apical third of implants. Furthermore, newly developed bone was observed at the same area in implants removed after 7 weeks. However, there was no evidence of such growth at the middle and/or cervical thirds in either case. CONCLUSION: Lack of osseointegration at the middle and cervical thirds of the root could be a possible cause of implant failure. Early loading by an overdenture retained with bilateral bars is considered a major contributing factor to incomplete osseointegration of the supporting implants.

Corrigendum to "The development of coronaphobia scale and psychometric effect among UAE people" [Heliyon 8(10) (October 2022) e10875].

[This corrects the article DOI: 10.1016/j.heliyon.2022.e10875.].

The Influence of Piper sarmentosum Extract on Growth Performance, Intestinal Barrier Function, and Metabolism of Growing Chickens.

In the poultry industry, there is an urgent need to evaluate and introduce natural, effective, and safe alternatives for synthetic antibiotics, which have been banned in most countries. The present study aimed to investigate the effects of dietary supplementation with Piper sarmentosum extract (PSE) on the growth performance, intestinal barrier function, and metabolism of growing chickens. A total of 400 seven-day-old female chicks were randomly assigned to four dietary treatments, each of which consisted of five replicates and twenty birds each. The four experimental treatments were fed a basal diet containing 0, 100, 200, and 300 mg PSE/kg (BC, PSE1, PSE2, and PSE3 groups), respectively. The experiment lasted for 28 days. The results showed that dietary supplementation with PSE had no significant effects on the final body weight, average daily gain (ADG), average daily feed intake (ADFI), and the ratio of ADFI to ADG (F/G) (p > 0.05). Compared with the BC group, dietary supplementation with 200-300 mg/kg PSE increased the villus height in the jejunum and ileum of chickens (p < 0.05). The PSE-treated groups significantly increased the mRNA expression of Occludin, ZO-1, and Claudin-1 in the ileal mucosa of chickens (p < 0.05). In addition, a significant decrease in ileal TNF-α and IL-8 mRNA expression (p < 0.05) and a significant increase in IL-22 (p < 0.05) were observed in the PSE2 treatment compared to the BC group. Additionally, three gut metabolites (i.e., citrate, isocitrate, and spermine) showed significant differences among treatments (p < 0.05) and were involved in the tricarboxylic acid (TCA) cycle, the transfer of acetyl groups into mitochondria, and spermidine and spermine biosynthesis, respectively. In conclusion, the findings obtained here indicate that supplemental PSE can enhance the anti-inflammatory capacity and intestinal mucosal barrier function of chickens.

Marginal bone loss adjacent to conventional and immediate loaded two implants supporting a ball-retained mandibular overdenture: a 3-year randomized clinical trial.

OBJECTIVES: The aim of this study was to evaluate and compare marginal bone loss and clinical outcomes of conventionally and immediately loaded two implants supporting a ball-retained mandibular overdenture. MATERIALS AND METHODS: Thirty six completely edentulous patients (22 males and 14 females) were randomly assigned into two groups. Each patient received two implants in the canine area of the mandible after a minimal flap reflection. Implants were loaded by mandibular overdentures either 3 months (conventional loading group) or the same day (immediate loading group) after implant placement. Ball attachments were used to retain all overdentures to the implants. Vertical and horizontal alveolar bone losses were evaluated in both groups 1 and 3 years after implant placement using multislice computed tomography, which allow evaluation of peri-implant buccal and lingual alveolar bone. Plaque scores, gingival scores, probing depths and periotest values (PTVs) were evaluated at 4 months (baseline), 1 and 3 years after implant placement. Clinical and radiographic evaluations were performed at distal, labial, mesial and lingual peri-implant sites. RESULTS: After 3 years of follow-up period, the immediate loading group recorded significant vertical bone loss at distal and labial sites than the conventional loading group and no significant differences in horizontal bone loss between groups were observed. Probing depth at distal and labial sites in the immediate loading group were higher than the conventional loading group, while plaque scores, gingival scores and PTVs showed no significant differences between the two groups. A low level of positive correlation between plaque scores, gingival scores, probing depths and vertical bone loss was noted. CONCLUSION: Immediately loaded two implants supporting a ball-retained mandibular overdenture are associated with more marginal bone resorption and increased probing depths when compared with conventionally loaded implants after 3 years. The bone resorption and probing depths at distal and labial sites are significantly higher than those at mesial and lingual sites. Clinical outcomes do not differ significantly between loading protocols.

The nutritional effect of Moringa oleifera fresh leaves as feed supplement on Rhode Island Red hen egg production and quality.

This study aimed to evaluate the potential of Moringa oleifera fresh leaves (MOL) as feed supplement on the performance and egg quality of Rhode Island Red (RIR) hens under the tropical conditions of Yucatan, Mexico. Forty-eight RIR hens were allocated in 12 floor pen replicates each with four birds. Thereafter, the replicates were divided into three groups which were corresponded to ad libitum feed (control), ad libitum feed supplemented with MOL T1 (AL + MOL) and restricted feed amount (20% lower than control) with MOL T2 (RCD + MOL), respectively. T1 (AL + MOL) had higher egg laying rate (71.4% versus 66.6%), higher daily egg mass production (45.4 versus 41.9 g/day), lower feed intake (121.3 versus 127.5 g/day) and better feed conversion ratio (2.8 versus 3.2 g feed:g egg) versus control. T2 / (RCD + MOL) had lower values of body weight, egg laying rate, egg weight and egg mass, and recorded better feed conversion ratio than the control group. The control group recorded a higher percentage of pecked eggs versus T1 and T2 (6.5% versus 1.2% and 2.0 %). Similar intake of MOL (3.1 and 3.4 g DM/day) was recorded in T1 (AL + MOL) and T2 (RCD + MOL). Yolk color was improved significantly in T1 (AL + MOL) than both control and T2 (RCD + MOL), while T2 (RCD + MOL) had eggs with lower yolk and higher albumen percentages than the other two ad libitum groups. The results suggest that MOL could be used successfully as sustainable tropical feed resource for RIR hens.

The role of cytokine gene single nucleotide polymorphism in the development of recurrent acute otitis media.

The study aimed at examining the role of single nucleotide polymorphism (SNP) of cytokine genes in the development of recurrent acute otitis media (AOM) among children. Single nucleotide polymorphism of IFN-, IL-6, IL-10, TNF-α, and TGF-ß1, were analyzed by the polymerase chain reaction with sequence-specific primers (PCR-SSP) in 82 children with recurrent AOM and compared with a similar control group. There was a significant higher incidence of IL-10 polymorphisms (loci -592, -819 and -1082) in children with recurrent AOM (P=0.0137, 0.0137 and 0.0072, respectively). However, there was no significant difference in the distribution of other cytokine genotypes between the two study groups. Among the 5 studied cytokine genes, only IL-10 loci showed significant correlation to the development of recurrent AOM.

Comparison of Histidine rich glycoprotein, a novel biomarker for sepsis, with traditional biomarkers in adult ICU patients.

Sepsis is a major public healthcare problem. It remains a significant cause of morbidity and mortality in intensive care units (ICU) all over the world. A lifesaving early specific diagnosis and treatment is a challenge as no gold standard technique exists that can alone allow a rapid and reliable diagnosis of sepsis. Histidine-rich glycoprotein (HRG) is a promising new biomarker of sepsis that can contribute to enhance current sepsis diagnostic tools. The current study aimed to evaluate HRG as a diagnostic biomarker for sepsis compared to the conventionally used biomarkers, procalcitonin (PCT) and C-reactive protein (CRP). The study included 67 participants classified into 3 groups: Control (n=19), systemic inflammatory response syndrome (SIRS) patients (n=24) and sepsis patients (n=24). Serum HRG, CRP and PCT levels were measured by ELISA techniques. HRG level was significantly reduced in sepsis patients compared with SIRS patients (P < 0.001) and controls (P < 0.001) with overall statistically significant differences between the three groups (P < 0.001). Serum levels of the 3 biomarkers revealed increased PCT level in SIRS and sepsis groups, (P=0.002 and p < 0.001 respectively), CRP level significantly increased in sepsis (P < 0.001) but not in SIRS patients (P=0.525). The area under the curve (AUC) value was 0.988 for HRG, 0.966 for PCT and 0.859 for CRP respectively. The sensitivity, specificity, PPV and NPV for diagnosis of HRG were 95.8%, 93%, 88.5%, and 97.6%, respectively. In conclusion, HRG could be a good indicator for sepsis, that can discriminate sepsis and SIRS patients in ICU.

Esthetic restoration of progressive hemifacial atrophy (Parry-Romberg disease) by free fat grafting using computerized-assisted mapping.

BACKGROUND: This study aimed to evaluate the use of fat grafting enriched with platelet-rich plasma through a computerized-assisted mapping for esthetic restoration in progressive hemifacial atrophy (Parry-Romberg disease). METHODS: This prospective study was conducted on 53 patients presented by Parry-Romberg disease and was corrected by facial fat grafting (FFG) enriched with platelet-rich plasma (PRP). A computerized software program was used to design a detailed map to achieve clinical symmetry with fat grafting application, as the anatomical subunits direct 3-dimensional volumetric symmetric, and compartments direct isolated recipient-specific grafting. Also, volumetric asymmetry was assessed through outlines of facial contour, projection, and proportions for both sides and comparing the mirror image of unaffected side as a template. RESULTS: Objective ultrasound and photogrammetric measurements showed a significant improvement in facial symmetry postoperatively compared to preoperative (P < 0.05), with no significant differences between 12 and 18 months after surgery. The FACE-Q score regarding comparison before surgery and 18 months after surgery showed a statistically significant improvement in all modules (P < 0.001) with overall satisfaction concerning outcome of 82.7 ± 0.8. CONCLUSION: Enriched fat grafting with platelet-rich plasma (PRP) is a good alternative to reconstruct soft tissue defects for patients with progressive hemifacial atrophy (Parry-Romberg disease) with a minimally invasive approach and low complications. It provides volumetric replacement, enhancement of skin texture, and improvement of hyperpigmentation with restoration of facial contour for an esthetic pleasing appearance. Isolated replacement in accordance with the anatomical facial subunits and fat compartments allows three-dimensional reconstruction and maximizes fat retention.

Prevalence and molecular characterization of foodborne and human-derived Salmonella strains for resistance to critically important antibiotics.

The primary goals of this cross-sectional study were to screen various food/water, and human samples for the presence of Salmonella species, and to assess the phenotypic and genetic relationship between resistances found in food and human Salmonella isolates to critically important antibiotics. Between November 2019 and May 2021, 501 samples were randomly collected for Salmonella isolation and identification using standard culturing methods, biochemical, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and PCR techniques. Antimicrobial susceptibility testing was performed on confirmed Salmonella species, and PCR was used to investigate the genetic components that confer these resistance traits. Salmonella enterica subspecies enterica was confirmed in 35 (6.99%) of the samples (raw food = 23, ready-to-eat food/drink [REF/D] = 5, human = 7). Seventeen of them were antibiotic-resistant to at least one class, and eight were multidrug-resistant (MDR) isolates (raw food = 7, human = 1). All Salmonella isolates were susceptible to carbapenems, third- and fourth-generation cephalosporins and monobactam antibiotics. Resistance phenotypes to aminoglycosides (48.57%), ß-lactams (20%) and tetracycline (17.14%), as well as associated genes such as aadA, blaTEM , blaZ and tetA, as well as dfrA and sul1, were prevalent in Salmonella isolates. Colistin resistance genotype (mcr1) was detected in three (8.57%) isolates recovered from egg, cattle mince and rabbit meat, and the total incidence was 14.29% when two isolates exhibited resistance phenotypes were considered. Furthermore, four (11.43%) MDR isolates shared the blaTEM and blaZ genes, and one (2.86%) isolate contained three extended spectrum ß-lactams producing genes (ESBL), namely blaCTX , blaTEM and blaZ . The gyrA gene was expressed by one of three foodborne Salmonella isolates (8.57%) with ciprofloxacin resistance phenotypes. To the best of our knowledge, this is the first report from Egypt identifying colistin resistance in Salmonella enterica recovered from cattle minced meat and rabbit meat. Overall, the highest incidence rate of Salmonella enterica was found in cattle-derived products, and it was slightly more prevalent in RTE/D foods than in raw foods. Resistance to critical and clinically important antibiotics, particularly in Salmonella from RTE/D food, suggests that these antibiotics are being abused in the investigated area's veterinary field, and raises the potential of these isolates being transmitted to high-risk humans, which would be a serious problem. Future research using whole-genome sequencing is needed to clarify Salmonella resistance mechanisms to critically important antimicrobial agents or those exhibiting multidrug resistance.

Hand hygiene initiative: comparative study of pre- and postintervention outcomes.

BACKGROUND: Adequate hand hygiene is considered the most effective measure to reduce transmission of nosocomial pathogens. AIMS: To determine the effectiveness of infection control intervention to improve compliance with hand hygiene in the Emergency Department, Al-Leith General Hospital, Saudi Arabia, and evaluate bacterial load on hands as a possible indicator of improvement. METHODS: The study consisted of 3 phases: Phase I, measurement of basal hand hygiene compliance level; Phase II, multimodal hand hygiene educational programme was initiated; and Phase III, hand hygiene compliance level was measured again. Data were collected by direct observation of healthcare workers in the emergency department between October 2016 and March 2017, using the standardized World Health Organization method for direct observation, "Five Moments for Hand Hygiene". The intervention comprised health education sessions using direct personal contact. Hands of healthcare workers were sampled during Phases I and III by sterile bag method, and bacterial load was determined. RESULTS: A total of 1374 opportunities for hand hygiene were observed during the triphase study. Implementation of the interventional hand hygiene educational programme significantly improved compliance with hand hygiene guidelines from 30.7% to 45.5% (P < 0.01). Log10 bacterial load per hand dropped from 4.97 (standard deviation = 0.32) to 4.57 (0.47) (P < 0.05). CONCLUSIONS: Hand hygiene educational programmes were effective in improving compliance in the emergency department, and bacterial load on hands of healthcare workers could be used as an indicator of improvement in hand hygiene compliance.

Anatomically Based Optimization of Outcomes in Middle Eastern Rhinoplasy.

BACKGROUND: The predominant character in the Middle Eastern noses is the thick skin, weak cartilages, amorphous bulbous nasal tip, and high incidence of postoperative supra-tip swelling, compared with the Caucasian noses. The purpose of this study was to describe some anatomical findings and find techniques to improve outcomes in these patients. METHODS: This is retrospective study in 624 patients of Middle Eastern origin, where the characteristic anatomical findings are described and the surgical endeavors to combat their detrimental effect on the outcomes of rhinoplasty are explained. RESULTS: The results have shown that in these 624 patients, 365 patients had excellent results, 223 patients had average results, while 36 patients had poor results. CONCLUSION: The nasal shape depends on the skin (skin barring) or the cartilages (cartilage barring), or both (skin and cartilage sharing). Middle Eastern patients are toward the skin barring category with the lateral crus of the lower lateral cartilage very broad with a lateral fibrous attachment replacing the minor (sesamoid) cartilages leading to ill definition of the alae from the sides of the nose. Outcomes in these patients were improved by identification and release of these lateral attachment to improve the bulbous tip and define the alar subunit from the side of the nose. Cephalic rotation is achieved mainly by M-shaped excision of the inner lining of the vestibule and the caudal part of the septum. Other methods described to combat the strong skin memory and allow skin to configure after surgery.

Clips vs Resilient Liners Used With Bilateral Posterior Prefabricated Bars for Retaining Four Implant-Supported Mandibular Overdentures.

The objective of this research was to clinically compare peri-implant tissue health of bar-clips vs silicone-resilient liners used with bilateral posterior bars for retaining 4 implant-supported mandibular overdentures. Thirty completely edentulous male patients (mean age, 65 years) were randomly assigned into 2 equal groups. Each patient received 4 implants in the canine and first molar regions of the mandible using a flapless surgical technique. Mandibular overdentures were immediately connected to the implants with bilateral prefabricated instant adjusting bars. According to the method of retention to the bar, 1 group was retained with clips (GI), whereas the other group was retained with a silicone-resilient soft liner (GII). Peri-implant tissue health was evaluated clinically in terms of plaque scores (MPI), bleeding scores (MBI), probing depth (PD), and implant stability (IS). MPI, MBI, and PD were measured at mesial, distal, buccal, and lingual surfaces of each implant. Evaluations were performed 2 weeks (T0), 6 months (T6), and 12 months (T12) after overdenture insertion. Implants of GI with clips demonstrated significant increase in plaque, bleeding, and PD scores compared with those of GII with silicone-resilient liner at all observation times. Implants in GI demonstrated a significant decrease in implant stability compared with those of GII at T6 and T12 anteriorly and at T12 posteriorly. Resilient liners are considered better than bar-clips when used with bilateral posterior bars for retaining implant-supported mandibular overdentures in terms of peri-implant soft tissue health. Bilateral posterior ready-made bars cannot be proposed as a promising design for supporting implant-assisted mandibular overdentures.

Study of non-organ-specific antibodies in children with genotype 4 chronic hepatitis C.

BACKGROUND/AIM: Adult studies established a relationship between hepatitis C virus (HCV) infection and the presence of non-organ-specific antibodies (NOSAs). Most studies were carried out on genotypes 1 and 2. Only a few studies addressed that issue in pediatrics. No studies have been carried out on autoimmunity and genotype 4 in children. We aim to investigate NOSAs in 80 Egyptian children with chronic HCV infection along with studying the underlying genotype of HCV, and correlating autoimmunity with the epidemiological, clinical, biochemical, and virological features. MATERIALS AND METHODS: HCV-RNA was assayed by the polymerase chain reaction and viral genotypes were determined. NOSAs were measured and liver biopsies were taken for histopathological examination. RESULTS: Genotype 4 was the only detected genotype in the included 80 patients. Anti-smooth muscle antibodies (ASMA) were the only detected antibodies in 32 (40%) patients, always with V specificity (vessels only) at titers ranging from 1:20 and 1:160. Anti-nuclear antibodies (ANA) and liver-kidney microsomal antibodies-1 (LKMA-1) were not detected in any of our patients. Epidemiologic and clinical features did not significantly differ between autoantibody-positive and -negative patients. Among biochemical features, significantly high levels of total bilirubin, albumin, immunoglobulins, alkaline phosphatase, and gamma-glutamyl transpeptidase were found in the antibody-positive group. CONCLUSION: Genotype 4 HCV is the prevailing genotype in Egyptian children with chronic HCV infection. A consistent proportion of these children with chronic HCV infection circulate non-organ-specific autoantibodies. The prevalence of ASMA and the absence of ANA and LKMA-1 might be related to the unique situation in Egypt with unique prevalence of genotype 4. More studies are warranted on larger pediatric population to validate these findings.