Biological Activities of Citrus-Derived Extracellular Vesicles on Human Cells: The Role of Preservation.

Extracellular vesicles (EVs) have been identified as important mediators for cell-to-cell communication. Citrus-based EVs in particular offer an excellent platform for nutraceutical delivery systems, as their endemic cargo includes micronutrients (e.g., ascorbic acid), which contribute to their antioxidant capacity. Despite being extensively investigated as to their therapeutic and diagnostic potential, their cargo is inherently unstable and thus directly affected by their storage and preservation. In this study, EVs were isolated from citrus fruit using tangential flow filtration and evaluated for their physicochemical characteristics, antioxidant activity and effects on human cells. To assess how their isolation and preservation methods affect these properties, the EVs were tested immediately after isolation (from fresh and freeze-thawed juices) or following freeze-drying. A measurable biological effect of cryoprotection on citrus-derived EVs was evident, whether during or after isolation. This was more pronounced in the cell-based assays, ranging from -4% to +32% in human skin fibroblast proliferation. Nevertheless, the effects on human cancer cells varied depending on the cell line. Although these results should be considered preliminary observations, subject to further investigation, it is safe to state that any type of preservation is expected to impact the EVs' biological activity.

Retentive force variations in three polyamide and a polyetheretherketone denture attachments for implant-supported overdentures: An in vitro study.

STATEMENT OF PROBLEM: The loss in the retentive capability of implant-supported overdenture attachments has been related to the wear of the retentive inserts. Wear of the abutment coating material when following the replacement period for the retentive inserts requires investigation. PURPOSE: The purpose of this in vitro study was to compare the changes in retentive force of 3 polyamide and a polyetheretherketone denture attachments under repeated insertion and removal cycles in wet conditions while following their manufacturers' replacement time recommendations. MATERIAL AND METHODS: Four different denture attachments (LOCKiT, OT-Equator, Ball attachment, and Novaloc) with their retentive inserts were tested. Four implants were embedded into individual acrylic resin blocks, and 10 abutments for each attachment were used. Forty metal housings with their retentive inserts were attached to polyamide screws with autopolymerizing acrylic resin. A customized universal testing machine was used to simulate insertion and removal cycles. The specimens were mounted on a second universal testing machine at 0, 540, 2700, and 5400 cycles, and the maximum retentive force was recorded. The retentive inserts for LOCKiT (light retention), OT-Equator (soft retention), and Ball attachment (soft retention) were replaced every 540 cycles, while the Novaloc (medium retention) attachments were never replaced. All the abutments were weighed with a precision scale at 0, 2700, and 5400 cycles. The surface of every abutment was examined under a stereomicroscope at ×10 magnification. Data were analyzed with descriptive statistics. Two-way repeated measures ANOVA was used to compare the mean retentive force and mean abutment mass of all groups and time evaluation points. Bonferroni corrections were made to adjust for multiple tests (α=.05). RESULTS: The mean retention loss for LOCKiT was 12.6% after 6 months and 45.0% after 5 years of simulated use. The mean retention loss for OT-Equator was 16.0% after 6 months and 50.1% after 5 years of simulated use. The mean retention loss for Ball attachment was 15.3% after 6 months and 39.1% after 5 years of simulated use. The mean retention loss for Novaloc was 31.0% after 6 months and 59.1% after 5 years of simulated use. The mean abutment mass difference was statistically significant (P<.05) for LOCKiT and Ball attachment but not statistically significant (P>.05) for OT-Equator and Novaloc at baseline, 2.5 years, and 5 years. CONCLUSIONS: All tested attachments recorded retention loss under the experimental conditions, even when their manufacturers' recommendations for replacement time for the retentive inserts were followed. Patients should be aware that implant abutments should be replaced after a recommended period since their surfaces also change over time.

A rare case of poorly differentiated mixed neuroendocrine-nonneuroendocrine tumor of the caecum with long term survival: A case report.

A 59-year-old woman presented with flushing attacks accompanied by tachycardia and hypotension, which lasted approximately 30 to 60 minutes, underwent 18 years ago a gastrointestinal tumor resection. The histologic examination revealed a poorly differentiated mixed neuroendocrine/adenocarcinoma located in the caecum with regional metastases. Postoperatively, the patient received combined chemotherapy of 5-fluorouracil with interferon for six months and since has remained asymptomatic. Her examination revealed positivity for chromogranin A (CgA) and a-Fetoprotein (aFP) (580 ng/24 h, normal range 27-94, and 10 IU/mL, normal range 0-6, respectively). Urinary 5-hydroxy indole acetic acid excretion was remarkably high (41.8 mg/24 h, normal range 2-10 mg/24 h). An abdominal Magnetic Resonance Imaging scan revealed multiple focal loci in the liver whose histological examination revealed a carcinoid tumor confirmed by an Octreoscan. Additional uptake was noted on the right shoulder and the right sternum-clavicle joint confirmed by Tc-99m MDP scan. The patient received somatostatin analogue therapy followed by long-acting release octreotide analogue therapy (30 mg/month) showing a partial improvement of relevant biomarkers. Two years later, carcinoid syndrome symptoms reappeared and due to the tumors expression of somatostatin receptors the patient received peptide receptor radionuclide therapy with 177Lu-DOTATATE that resulted in both clinical and biochemical improvements.

Tooth preservation vs. extraction and implant placement in periodontally compromised patients: A systematic review and analysis of studies.

PURPOSE: The aim of this systematic review was to identify studies with a minimum of 5-years follow-up, reporting on the management of periodontally compromised teeth with either extraction and subsequent implant placement or teeth preservation with conventional periodontal treatment and application of regenerative procedures. The outcomes of these two approaches, based on clinical and radiographic data and the incidence of tooth- and implant-loss, were also investigated. MATERIAL AND METHODS: A systematic search for studies reporting on clinical and radiographic outcomes of periodontal treatment or replacement of periodontally compromised teeth with implants was conducted in 3 electronic databases, followed by a hand-search in 8 journals. Only randomized controlled trials (RCTs), cohort studies, and case series with prospective design were included. RESULTS: The initial search resulted in 1080 papers. After the first two screenings, 24 publications were selected for inclusion in this systematic review. The treatment protocols for the teeth preservation group contained nonsurgical and/or surgical periodontal treatment with or without regeneration procedures. The implant studies included extraction of periodontally involved teeth and implant placement with or without bone and soft tissue augmentation, followed by restoration with fixed dental prostheses (FDPs). Survival rates ranged between 81.8% and 100% in the tooth retention group, and between 94.8% and 100% in the implant group. In the extraction group, no complications were reported for 76.09% of the implants. Similarly, no complications were reported for 86.83% of the tooth retention group. The lack of standardized comparable studies prohibited conduction of a metaanalysis. CONCLUSION: Both treatment approaches, treatment of periodontally compromised teeth, or tooth extraction followed by implant placement, present high survival rates. The application of bone regeneration techniques improves the long-term prognosis of periodontally involved teeth. Hence, treatment of periodontally involved teeth with subsequent application of a rigorous maintenance protocol can be a viable alternative for a number of years, before proceeding to extraction and replacement with dental implants. More well-designed randomized controlled trials are needed in order to draw definite conclusions on the subject.

The Effect of Pituitary Gland Disorders on Glucose Metabolism: From Pathophysiology to Management.

This review aims to explore, present, and discuss disorders of glucose metabolism implicated in pituitary gland diseases, the appropriate interventions, as well as the therapeutic challenges that may arise. Pituitary pathologies may dysregulate glucose homeostasis, as both the excess and deficiency of various pituitary hormones can affect glucose metabolism. Increased circulating levels of growth hormone, glucocorticoids or prolactin have been shown to mainly provoke hyperglycemic states, while hypopituitarism can be associated with both hyperglycemia and hypoglycemia. Addressing the primary cause of these disorders with the use of surgery, medical treatment or radiotherapy forms the cornerstone of current management strategies. Physicians should bear in mind that some such medications have an unfavorable effect on glucose metabolism too. When unsuccessful, or until the appropriate treatment of the underlying pituitary problem, the addition of established antidiabetic therapies might prove useful. Further studies aiming to discover more accurate and effective drug preparations in combination with optimal lifestyle management models will contribute to achieving a more successful glycemic control in these patients.

Evaluating temperature increase during the polymerization of dental acrylic resin materials used for the direct fabrication of anterior deprogramming devices.

STATEMENT OF PROBLEM: The polymerization of acrylic resin materials used for the direct fabrication of anterior deprogramming devices results in a temperature increase because of the exothermic reaction. This heat release might cause thermal trauma to the pulp, compromising the tooth's vitality. PURPOSE: The purpose of this in vitro study was to compare the temperature increase and the timing of the maximum temperature recording obtained inside the pulp chamber of a maxillary central incisor during the polymerization of different resins materials used for the direct fabrication of anterior deprogramming devices. MATERIAL AND METHODS: The exothermic reaction was examined during the polymerization of 4 different polymethyl methacrylate resin products: Pattern Resin LS; GC America, DuraLay inlay pattern resin; Reliance Dental, Kallocryl CPGM red; Speiko, and mega-Model Resin NF; Megadental. A polymeric matrix was fabricated to simulate the anterior deprogramming device. A freshly extracted intact maxillary central incisor was fixed in an acrylic resin mold, and a thermal probe was inserted into the pulp chamber to transmit the temperature recordings. The resin materials were mixed as per the manufacturer's instructions and an equal volume of each was inserted into the plastic matrix, which was then positioned on the tooth. The temperature increase and the time needed to obtain the maximum temperature were recorded. The temperature and time recordings were performed initially for the intact tooth and repeated after the tooth was prepared for a metal-ceramic restoration. The data were analyzed with descriptive statistics, 1-way analysis of variance, and the Tukey Honestly Significant Difference tests (α=.05). RESULTS: In accordance with the 1-way ANOVA, there was a statistically significant difference both in temperature increase (F [7,72] = 3.72, P=.002) and in the recorded time (F [7,72] = 160.80, P<.001). The mean temperature inside the pulp chamber ranged from 40.1 °C for the Pattern Resin LS to 41.4 °C for the DuraLay inlay pattern resin material. The mean time recordings ranged from 133 seconds for the Kallocryl CPGM red material to 266 seconds for the DuraLay inlay pattern resin material. CONCLUSIONS: The Pattern Resin LS revealed the lowest exothermic reaction (P<.05) when compared with the other materials tested in this study, whereas Kallocryl CPGM red had the shortest time increase without being statistically significantly different.

Comparative Study of Dimensional Stability and Detail Reproduction of Reformulated and Nonreformulated Elastomeric Impression Materials.

PURPOSE: To evaluate the dimensional stability and the detail reproduction of five current elastomeric impression materials in vitro. MATERIALS AND METHODS: The materials examined were: 3 different polyether impression materials, a vinyl polysiloxane impression material, and a vinyl polyether silicone impression material. All impression materials were of a medium viscosity. One stainless steel die was fabricated according to the ANSI/ADA specification no.19 criteria. Twenty impressions of this die were made for each material. Dimensional accuracy and surface detail were evaluated 24 hours after making the impressions using a measuring microscope. The data were analyzed using Welch's analysis of variance, Games-Howell Post-Hoc, and the Pearson's chi-square tests (α = 0.05). RESULTS: Statistical differences were observed in the mean percent dimensional stability (F [4,47] = 39, p < 0.001) of the tested impression materials. The highest dimensional change was recorded for the vinyl polysiloxane impression material, with a mean percent value of -0.09 ± 0.02% (p < 0.001). The lowest dimensional change was recorded for the Monophase polyether material with a mean percent value of -0.03 ± 0.01% (p < 0.038). The best surface detail reproduction results were obtained using the Monophase polyether material (90% acceptable impressions), with no significant differences (χ² [4] = 3.86, p = 0.483) observed between the Monophase and the rest impression materials. CONCLUSIONS: All materials exhibited acceptable dimensional stability, well below the ANSI/ADA specification no.19 standard of ≤0.5% dimensional change. All impression materials demonstrated acceptable surface detail reproduction with no significant differences between them.

Endocrine approach in the treatment of obesity: Is there any space for the adiponectin action?

Adiponectin is a hormone secreted by adipose tissue, exerting many positive effects in the human body. Its action has been widely studied, placing it into the metabolic health beneficial products of the adipose tissue. Nevertheless, adiponectin has been shown to exert some extra beneficial non metabolic actions, as well. Adiponectin levels can be related to reduced incidence of cancer in obese patients. Moreover, adiponectin has been shown to be implicated in the positive fertility outcomes of women. Some new studies have also indicated that adiponectin has a potential effect in the control of appetite, which raises a question, whether adiponectin could be accredited to be useful in the endocrine evaluation of obesity. Could these additional non-metabolic actions prove its helpfulness?

Influence of Preparation Depth and Design on Stress Distribution in Maxillary Central Incisors Restored with Ceramic Veneers: A 3D Finite Element Analysis.

PURPOSE: To evaluate the influence of different preparation designs and depths on the stress field developed in maxillary central incisors restored with veneers made with different ceramic materials using finite element analysis (FEA). MATERIALS AND METHODS: A linear static three-dimensional finite element analysis model was used with the aid of reverse engineering to develop digital models of maxillary central incisors restored with ceramic veneers, according to two different preparation depths (thin vs deep) and two different preparation designs (feather edge vs butt joint). Three ceramic systems were tested: (i) feldspathic porcelain, (ii) heat pressed glass ceramic IPS Empress 2 (Ivoclar Vivadent AG), and (iii) heat pressed glass ceramic IPS e.max-Press (Ivoclar Vivadent AG). Each model was subjected to a compressive force of 200N applied to the palatal surface 2 mm below the incisal edge. The longitudinal axis of the restored tooth formed an angle of 130o with the direction of the force. The biomechanical behavior of the different models was examined according to the von Mises stress criterion. Statistical analysis was performed using nonparametric confidence interval estimation using bootstrapping. RESULTS: The maximum observed stress values were calculated and found to be similar between prepared and intact teeth. The cervical margin of the veneers displayed the highest von Mises stress values. Irrespectively of the depth and preparation design, the biggest von Mises stress values were observed at the veneer structures with the following order: (i) IPS Empress 2, (ii) IPS e.max-Press, (iii) feldspathic (p = 0.001). Preparation depth resulted in statistically significant differences (p = 0.001) in the stress distribution in the majority of tested structures. As the preparation depth was increased, the stresses within the veneer structure and the tooth structures were decreased. No statistically significant differences were detected in the stresses among the different restored models, when the preparation design was considered. CONCLUSIONS: This FEA study suggests that ceramic veneers could restore the biomechanical behavior of prepared central incisors and made it similar of that of an intact tooth. Regardless of the preparation depth and design and the ceramic system used, the cervical margin of ceramic veneers presents the highest von Mises stress values. When feldspathic porcelain was compared with lithium disilicate (IPS e.max Press), the latter displayed the lowest transfer of stresses to dental tissues. An increase in preparation depth resulted in a statistically significant stress decrease in both the veneer and the tooth.

Association Between Increased Concavity of Maxillary Labial Alveolar Bone and Decreased Labial Cortical Bone Thickness: A Cone Beam Computed Tomography Aided Retrospective Cohort Study.

PURPOSE: To assess whether an increased concavity of maxillary labial alveolar bone is related to labial thickness of cortical bone in that area and to the presence of extraoral manifestations in the philtrum. MATERIALS AND METHODS: Cone beam computed tomography images along with intra- and extraoral photographic images of 50 Caucasian female patients, age range 18 to 65 years (mean: 37 years), previously evaluated for implant treatment were assessed by three experienced prosthodontists. Patients were divided into two groups (A and B), according to the presence or absence of a horizontal groove at the philtrum area. Mann-Whitney U test (α = 0.05) was performed to reveal any statistical differences regarding the angle of the maxillary labial concavity and the labial thickness of the alveolar cortical bone between the two groups. RESULTS: The mean angle of the maxillary concavity in group A was 127.76° while in group B it was 137.12°. The mean thickness of the labial cortical wall of the dental, interdental, and edentulous areas of the 8 anterior teeth for group A were: 0.41 mm, 0.61 mm, and 0.46 mm, respectively; and for group B were: 0.52 mm, 0.72 mm, and 0.56 mm, respectively. The Mann-Whitney U test (α = 0.05) revealed a statistically significant difference for both the angle (p = 0.008) but not for the thickness of the bone (p = 0.062). CONCLUSIONS: According to the results of this study an increased maxillary labial concavity was associated with reduced thickness of the labial cortical wall and the presence of a horizontal groove at the philtrum area.

In Vitro Assessment of Retention and Resistance Failure Loads of Teeth Restored with a Complete Coverage Restoration and Different Core Materials.

PURPOSE: To investigate in vitro the retention and the resistance form, as well as the failure modes of maxillary premolars restored with cast metal crowns and different core materials. MATERIALS AND METHODS: Sixty human extracted maxillary premolars were selected according to their size and were embedded in PMMA resin blocks. After removing a part of their clinical crowns, the teeth were randomly divided into 3 groups of 20 teeth and were either left unrestored, or they were restored with amalgam or composite resin. All teeth were prepared for a cast metal complete coverage restoration. The restorations were cemented on the prepared teeth with a resin-modified glass ionomer luting agent (GC Fuji Plus). All specimens were subjected to static loading at 1 mm/min by a universal testing machine, until failure. Half the specimens of each group were subjected to tensile loading along the long axis of the teeth. The other half were subjected to compressive loading at a 30° angle. Failure loads and failure modes for each tooth were recorded. The statistical analysis included descriptive statistics, one-way ANOVA, and Tukey's HSD test. RESULTS: One-way ANOVA revealed statistically significant differences among the 3 tested groups (p < 0.05) for both tests. The group of teeth with no core material presented the highest failure loads for both the tensile and the compressive loading tests, with mean loads of 381.02 Ν and 741.21 Ν, respectively. Mean tensile and compressive failure loads for the amalgam group were 277.34 Ν and 584.75 Ν, while the composite resin group presented the lowest tensile and compressive failure values, which were 250.77 Ν and 465.78 Ν, respectively. The compression loading test resulted in the same failure mode for all specimens, which included unfavorable fracture of the teeth in combination with detachment of the cast metal complete coverage restorations. The tensile loading test resulted in different failure modes between the groups that used a core material and the group with no core material. CONCLUSIONS: Teeth that lost more than half of their coronal structure presented better retention and resistance form if no core material was used, provided that a minimum of 2-mm axial wall height was present at the missing part. Teeth that have lost more than half of their coronal structure and were restored with amalgam core presented better retention and resistance form than those restored with composite resin. Catastrophic fractures, extending to the root, were associated with compression forces but not with tensile forces.

Complications and survival rates of inlays and onlays vs complete coverage restorations: A systematic review and analysis of studies.

OBJECTIVE: The aim of this study was to identify if different types of indirect restorations used for single teeth had different biological and technical complications, as well as survival rates. METHOD: An electronic search was performed in various electronic databases to identify articles, published between 1980 and 2017. The search terms were categorised into 4 groups: inlay, onlay, inlay/onlay and crown. Manual searches of published full-text articles and related reviews were also performed. RESULTS: A total number of 2849 papers were retrieved initially. After a detailed assessment for eligibility, 9 studies were selected for inclusion. The heterogeneity of the studies did allow neither a meta-analysis nor any meaningful comparison between types of restorations or materials. Only some pooling was performed for representative reasons. The mean survival rate of inlays was 90.89%, while for onlays and crowns it was 93.50% and 95.38%, respectively. For the fourth study group, consisting of both inlays and onlays, the survival rate was found to be 99.43%. Statistical analysis demonstrated caries to be the main biological complication for all types of restorations, followed by a root and/or tooth fracture incidence (11.34%) and endodontic incidence. Ceramic fractures represented the most common technical complication, followed by loss of retention and porcelain chipping. CONCLUSION: The 5-year survival rate for crowns and inlays/onlays is very high, exceeding 90%. An association between the kind of complications and different types of restorations could not be established. Nevertheless, a relatively high failure rate due to caries and ceramic fractures was noted.

The effect of rigid and non-rigid connections between implants and teeth on biological and technical complications: a systematic review and a meta-analysis.

OBJECTIVE: To assess survival, as well as technical and biological complication rates of partial fixed dental prostheses (FDPs) supported by implants and teeth. METHOD: An electronic Medline search was conducted to identify articles, published in dental journals from January 1980 to August 2015, reporting on partial FDPs supported by implants and teeth. The search terms were categorized into four groups comprising the PICO question. Manual searches of published full-text articles and related reviews were also performed. RESULTS: The initial database search produced 3587 relevant titles. Three hundred and eighty-six articles were retrieved for abstract review, while 39 articles were selected for full-text review. A total of 10 studies were selected for inclusion. Overall survival rate for implants ranged between 90% and 100%, after follow-up periods with a mean range of 18-120 months. The survival of the abutment teeth was 94.1-100%, while the prostheses survival was 85-100% for the same time period. The most frequent complications were "periapical lesions" (11.53%). The most frequent technical complication was "porcelain occlusal fracture" (16.6%), followed by "screw loosening" (15%). According to the meta-analysis, no intrusion was noted on the rigid connection group, while five teeth (8.19%) were intruded in the non-rigid connection group [95% CI (0.013-0.151)]. CONCLUSION: The tooth-implant FDP seems to be a possible alternative to an implant-supported FDP. There is limited evidence that rigid connection between teeth and implants presents better results when compared with the non-rigid one. The major drawback of non-rigidly connected FDPs is tooth intrusion.

IoT Contextual Factors on Healthcare.

With the emergence of the Internet of Things, new services in healthcare will be available and existing systems will be integrated in the IoT framework, providing automated medical supervision and efficient medical treatment. Context awareness plays a critical role in realizing the vision of the IoT, providing rich contextual information that can help the system act more efficiently. Since context in healthcare has its unique characteristics, it is necessary to define an appropriate context aware framework for healthcare IoT applications. We identify this context as perceived in healthcare applications and describe the context aware procedures. We also present an architecture that connects the sensors that measure biometric data with the sensory networks of the environment and the various IoT middleware that reside in the geographical area. Finally, we discuss the challenges for the realization of this vision.

In vitro assessment of retention and resistance failure loads of two preparation designs for maxillary anterior teeth.

STATEMENT OF PROBLEM: Parallel labiolingual walls and the preservation of the cingulum in anterior tooth preparations have been advocated. However, their contribution to retention and resistance form has not been evaluated. PURPOSE: The purpose of this in vitro study was to evaluate the retention and resistance failure loads of 2 preparation designs for maxillary anterior teeth. MATERIAL AND METHODS: Forty metal restorations were fabricated and paired with 40 cobalt-chromium prepared tooth analogs. Twenty of the specimens had parallel buccolingual walls at the cervical part (group PBLW; the control group), whereas the remaining 20 had converging buccolingual walls (group CBLW; the experimental group). The restorations were cemented to the tooth analogs with a resin-modified glass ionomer luting agent. Ten specimens from each group were subjected to tensile loading with a universal testing machine; the rest were subjected to compression loading until failure. Descriptive statistics and the independent t test (α=.05) were used to determine the effect of failure loads in the tested groups. RESULTS: The independent t test revealed statistically significant differences between the tested groups in tensile loading (P<.001) and in compressive loading (P<.001). The PBLW group presented a higher tensile failure load than the CBLW. On the contrary, the PBLW group presented a smaller compression failure load than the CBLW. CONCLUSIONS: Parallelism of the buccolingual axial walls in anterior maxillary teeth increased the retention form but decreased the resistance form.

Periodontal response to two different subgingival restorative margin designs: a 12-month randomized clinical trial.

OBJECTIVES: Subgingival margin placement is sometimes required due to different reasons and is often associated with adverse periodontal reactions. The purpose of this study was to determine if a single restoration with subgingival margin on a tooth, in the maxillary anterior zone, would affect its periodontal soft tissue parameters, and whether or not a deep chamfer preparation has a different influence in the periodontium when compared to a feather edge preparation. MATERIAL AND METHODS: Plaque and gingival indexes, periodontal probing depth, bleeding on probing, and patient's biotype were registered. One hundred six teeth were prepared with a deep chamfer, while 94 were prepared with a feather edge finishing line. Twelve months after the restoration delivery, the same parameters were evaluated. Repeated measure one-way analysis of variance (ANOVA) (α = 0.05) was used. RESULTS: A statistically significant difference between the baseline and the 12-month follow-up is present in regard to plaque index, gingival index, and periodontal probing depth, but no statistically significant difference between chamfer and feather edge finishing lines. There is a statistically significant difference between the baseline and the 12-month follow-up in regard to bleeding on probing. Feather edge preparation presents significantly more bleeding on probing and less gingival recession than the chamfer. CONCLUSIONS: Subgingival margins do influence the periodontal soft tissue response. Statistically significant difference exists between feather edge and chamfer finishing lines in regard to bleeding on probing and gingival recession. CLINICAL RELEVANCE: Subgingival margins should be carefully selected, especially when feather edge finishing line is utilized.

In prostate cancer, low adiponectin levels are not associated with insulin resistance.

PURPOSE: Adiponectin, an adipose tissue-derived hormone with insulin-sensitizing effect, has been inversely associated with several hormonally dependent malignancies. Prostate cancer is associated with low levels of adiponectin, which have been proposed as an independent risk factor for this malignancy. Aim of this study was to examine whether hypoadiponectinaemia in prostate is associated with insulin resistance. EXPERIMENTAL DESIGN: Plasma samples and covariate data in the context of a case-control study of 300 Greek men were evaluated including 75 patients with prostate cancer, 75 patients with benign prostatic hyperplasia (BPH) and 150 age-matched healthy controls. RESULTS: Patients with prostate cancer had significantly lower plasma adiponectin levels compared with the other two groups, that is BPH patients and healthy controls (7.4 ± 5 ng/mL vs. 11.5 ± 6.4 ng/mL and 12.8 ± 8 ng/mL, respectively). On the other hand, no statistically significant differences were found between patients with prostate cancer and the other two groups for both HOMA-IR and QUICKI (P-value = 0.551). As expected, in all three groups, the levels of adiponectin correlated negatively with HOMA-IR (rho = -0.214, P-value = 0.006), QUICKI (rho = 0.214, P-value = 0.006) and insulin levels (rho = 0.942, P-value < 0.001). CONCLUSION: In spite of what would have been expected from the relevant literature, our data suggest that the hypoadiponectinaemia in prostatic cancer does not appear to be associated with insulin resistance.

Conversion of an existing metal ceramic crown to an interim restoration and nonfunctional loading of a single implant in the maxillary esthetic zone: A clinical report.

Implant placement and immediate placement of an interim restoration can be a safe therapeutic approach with high survival rates. The technique is often used in the anterior esthetic area because of the better preservation of the periimplant soft tissue contours. Traditionally this procedure involves the fabrication of an acrylic resin implant-supported interim restoration. This clinical report describes the modification of an existing metal ceramic crown to be used as an implant-supported interim restoration for immediate nonfunctional loading to achieve an improved esthetic result and optimal support of the adjacent soft tissues.

Influence of thickness increase of intraoral autopolymerizing hard denture base liners on the temperature rise during the polymerization process.

STATEMENT OF PROBLEM: Increasing the thickness of intraoral autopolymerizing hard denture base liners may result in a temperature rise and a burning sensation for patients. PURPOSE: The purpose of the study was to determine whether increasing the thickness of hard autopolymerizing reline resin increases the temperature of the basal seat area of a denture during the polymerization process. MATERIAL AND METHODS: Four polyethyl methacrylate and 1 polymethyl methacrylate autopolymerizing reline resin products of 3 different thicknesses were tested. A cobalt-chromium edentulous maxillary cast was used to obtain 150 stone casts, 50 for each thickness of 1, 2, and 3 mm (n=10). Polystyrene record bases were filled with the autopolymerizing reline resin mixture and placed on the cobalt-chromium cast, which was mounted on a reline index, to serve as denture substitutes. Two thermal probes were used to monitor the temperature rise, which was recorded at 30-second intervals until no further increase was noted. Collected data were subjected to a 2-way ANOVA and the Tukey honestly significant difference test (α=.05). RESULTS: The mean temperature increase for the chairside denture reline procedure ranged from 39.45°C for the 1-mm thickness to 46.10°C for the 3-mm thickness. The 2-way ANOVA found significant differences (P<.001) among the different reline resin materials and thicknesses tested. All materials produced an exothermic chemical reaction. An increase in thickness was always accompanied by an increased temperature. The Tukey honestly significant difference test found that the highest temperature increase for all 3 thicknesses occurred in the polymethyl methacrylate resin. CONCLUSIONS: The polymethyl methacrylate autopolymerizing hard denture base liner produced a significantly higher (P<.001) exothermic reaction than the other materials included in this study. One of the polyethyl methacrylate resins presented a higher exothermic reaction than the polymethyl methacrylate product at a 3-mm thickness, but the difference was not statistically significant. The polymethyl methacrylate resin presented the highest mean time to reach the maximum temperature for all 3 thicknesses.

Marginal adaptation of four inlay casting waxes on stone, titanium, and zirconia dies.

STATEMENT OF PROBLEM: Different inlay casting waxes do not produce copings with satisfactory marginal accuracy when used on different die materials. PURPOSE: The purpose of this study was to evaluate the marginal accuracy of 4 inlay casting waxes on stone dies and titanium and zirconia abutments and to correlate the findings with the degree of wetting between the die specimens and the inlay casting waxes. MATERIAL AND METHODS: The inlay casting waxes tested were Starwax (Dentaurum), Unterziehwachs (Bredent), SU Esthetic wax (Schuler), and Sculpturing wax (Renfert). The marginal opening of the waxes was measured with a stereomicroscope on high-strength stone dies and on titanium and zirconia abutments. Photographic images were obtained, and the mean marginal opening for each specimen was calculated. A total of 1440 measurements were made. Wetting between die materials and waxes was determined after fabricating stone, titanium, and zirconia rectangular specimens. A calibrated pipette was used to place a drop of molten wax onto each specimen. The contact angle was calculated with software after an image of each specimen had been made with a digital camera. Collected data were subjected to a 2-way analysis of variance (α=.05). Any association between marginal accuracy and wetting of different materials was found by using the Pearson correlation. RESULTS: The wax factor had a statistically significant effect both on the marginal discrepancy (F=158.31, P<.001) and contact angle values (F=68.09, P<.001). A statistically significant effect of the die material factor both on the marginal adaptation (F=503.47, P<.001) and contact angle values (F=585.02, P<.001) was detected. A significant correlation between the marginal accuracy and the contact angle values (Pearson=0.881, P=.01) was also found. CONCLUSIONS: Stone dies provided wax copings with the best marginal integrity, followed by titanium and zirconia abutments. Unterziehwachs (Bredent), wax produced the best marginal adaptation on different die materials. A significant correlation was found between the marginal accuracy and the contact angle values. As the contact angle value became smaller, the marginal accuracy improved. All combinations of waxes and stone and titanium dies presented a high wettability.