Engineered polymer nanoparticles as artificial chaperones facilitating the selective refolding of denatured enzymes.

Molecular chaperones assist in protein refolding by selectively binding to proteins in their nonnative states. Despite progress in creating artificial chaperones, these designs often have a limited range of substrates they can work with. In this paper, we present molecularly imprinted flexible polymer nanoparticles (nanoMIPs) designed as customizable biomimetic chaperones. We used model proteins such as cytochrome c, laccase, and lipase to screen polymeric monomers and identify the most effective formulations, offering tunable charge and hydrophobic properties. Utilizing a dispersed phase imprinting approach, we employed magnetic beads modified with destabilized whole-protein as solid-phase templates. This process involves medium exchange facilitated by magnetic pulldowns, resulting in the synthesis of nanoMIPs featuring imprinted sites that effectively mimic chaperone cavities. These nanoMIPs were able to selectively refold denatured enzymes, achieving up to 86.7% recovery of their activity, significantly outperforming control samples. Mechanistic studies confirmed that nanoMIPs preferentially bind denatured rather than native enzymes, mimicking natural chaperone interactions. Multifaceted analyses support the functionality of nanoMIPs, which emulate the protective roles of chaperones by selectively engaging with denatured proteins to inhibit aggregation and facilitate refolding. This approach shows promise for widespread use in protein recovery within biocatalysis and biomedicine.

Intravascular ultrasound-guided drug-coated balloon angioplasty for femoropopliteal artery disease: a clinical trial.

BACKGROUND AND AIMS: Drug-coated balloons (DCBs) have demonstrated favourable outcomes following endovascular therapy for femoropopliteal artery (FPA) disease. However, uncertainty remains whether the use of intravascular ultrasound (IVUS) can improve the outcomes of DCBs. METHODS: This prospective, multicentre, randomized trial, conducted at seven centres in South Korea, compared the outcomes of IVUS-guided vs. angiography-guided angioplasty for treating FPA disease with DCBs. Patients were assigned to receive IVUS-guided (n = 119) or angiography-guided (n = 118) angioplasty using DCBs. The primary endpoint was 12-month primary patency. RESULTS: Between May 2016 and August 2022, 237 patients were enrolled and 204 (86.0%) completed the trial (median follow-up; 363 days). The IVUS guidance group showed significantly higher primary patency [83.8% vs. 70.1%; cumulative difference 19.6% (95% confidence interval 6.8 to 32.3); P = .01] and increased freedom from clinically driven target lesion revascularization [92.4% vs. 83.0%; difference 11.6% (95% confidence interval 3.1 to 20.1); P = .02], sustained clinical improvement (89.1% vs. 76.3%, P = .01), and haemodynamic improvement (82.4% vs. 66.9%, P = .01) at 12 months compared with the angiography guidance group. The IVUS group utilized larger balloon diameters and pressures for pre-dilation, more frequent post-dilation, and higher pressures for post-dilation, resulting in a greater post-procedural minimum lumen diameter (3.90 ± 0.59 vs. 3.71 ± 0.73 mm, P = .03). CONCLUSIONS: Intravascular ultrasound guidance significantly improved the outcomes of DCBs for FPA disease in terms of primary patency, freedom from clinically driven target lesion revascularization, and sustained clinical and haemodynamic improvement at 12 months. These benefits may be attributed to IVUS-guided optimization of the lesion before and after DCB treatment.

Hypophysitis and central nervous system involvement in association with Sjögren's syndrome along with hypoparathyroidism: a case report.

BACKGROUND: Patients with autoimmune diseases can develop multiple autoimmune diseases over a long period of time, and the presence of more than one autoimmune disease in a single patient is defined as polyautoimmunity. Polyautoimmunity may be clinical evidence that autoimmune diseases share similar immunological mechanisms. CASE PRESENTATION: We report a 30-year-old woman with a unique combination of autoimmune diseases predominantly affecting the central nervous system, with hypoparathyroidism, hypophysitis, medulla involvement, and pons and temporal lobe involvement associated with primary Sjögren's syndrome (pSS), occurring independently over a long period. The patient who had a history of muscle cramps and one seizure incident, presented with vomiting and blurred vision. She was diagnosed with hypophysitis and hypoparathyroidism with calcifications in the basal ganglia and cerebellum. She recovered after four months of corticosteroid treatment for hypophysitis and was started on treatment for hypoparathyroidism. Eight months later, she developed vomiting, hiccups, vertigo, and ataxia with a focal lesion in the medulla. She recovered with immunosuppressive treatment for 2 years. Fifty-eight months after the onset of hypophysitis, she developed diplopia and dry mouth and eyes. MRI showed infiltrative lesions in the left pons and left temporal lobe. Based on positive anti-Sjögren's syndrome-related antigen A antibodies and low unstimulated whole salivary flow rate, pSS was diagnosed. She received corticosteroids and continued mycophenolate mofetil treatment with recovery of neurological symptoms. CONCLUSION: This case highlights the need for long-term follow-up to detect autoimmune disease processes involving various organs.

Channelled versus nonchannelled Macintosh videolaryngoscope blades in patients with a cervical collar: a randomized controlled noninferiority trial.

PURPOSE: Channelled blades have the advantage of avoiding stylet use and potential airway injury during videolaryngoscopic intubation. Nevertheless, the effectiveness of channelled Macintosh-type blades has not yet been fully established. We sought to assess the utility of channelled Macintosh-type blades for videolaryngoscopic intubation under cervical spine immobilization. METHODS: We conducted a randomized controlled noninferiority trial in neurosurgical patients with a difficult airway simulated by a cervical collar. Videolaryngoscopic intubation with a reinforced tracheal tube was performed using a channelled Macintosh-type blade without a stylet (channelled group, n = 130) or a nonchannelled Macintosh-type blade with a stylet (nonchannelled group, n = 131). The primary outcome was intubation success rate. Secondary outcomes included time to intubation and incidence or severity of intubation-related complications (subglottic, lingual, and dental injuries; bleeding; sore throat; and hoarseness). RESULTS: The initial intubation success rate was 98% and 99% in the channelled and nonchannelled groups, respectively, showing the noninferiority of the channelled group (difference in proportions -0.8%; 95% confidence interval [CI], -4.8% to 2.9%; predefined noninferiority margin, -5%; P = 0.62). Fewer participants in the channelled group had subglottic injuries than in the nonchannelled group (32% [32/100] vs 57% [54/95]; difference in proportions, -25%; 95% CI, -39% to -11%; P < 0.001). There were no significant differences between the two groups in the overall intubation success rate, time to intubation, and incidence or severity of other intubation-related complications. CONCLUSIONS: For videolaryngoscopic intubation in patients with a cervical collar, channelled Macintosh-type blades are an alternative to nonchannelled Macintosh-type blades, with a noninferior initial intubation success rate and a lower incidence of subglottic injury. STUDY REGISTRATION: CRIS.nih.go.kr ( KCT0005186 ); first submitted 29 June 2020.

RéSUMé: OBJECTIF: Les lames avec canal ont l'avantage de ne pas nécessiter l'utilisation d'un stylet et d'ainsi éviter les lésions potentielles des voies aériennes lors de l'intubation vidéolaryngoscopique. Néanmoins, l'efficacité des lames avec canal de type Macintosh n'a pas encore été pleinement établie. Nous avons cherché à évaluer l'utilité des lames avec canal de type Macintosh pour l'intubation vidéolaryngoscopique lorsque le rachis cervical était immobilisé. MéTHODE: Nous avons mené une étude randomisée contrôlée de non-infériorité chez des patient·es de neurochirurgie présentant des voies aériennes difficiles simulées par le port d'un collier cervical. L'intubation vidéolaryngoscopique avec une sonde trachéale renforcée a été réalisée à l'aide d'une lame Macintosh avec canal sans stylet (groupe avec canal, n = 130) ou d'une lame Macintosh sans canal avec stylet (groupe sans canal, n = 131). Le critère d'évaluation principal était le taux de réussite de l'intubation. Les critères d'évaluation secondaires comprenaient le temps d'intubation et l'incidence ou la gravité des complications liées à l'intubation (lésions sous-glottiques, linguales et dentaires, saignements, maux de gorge et enrouement). RéSULTATS: Le taux de réussite initial de l'intubation était de 98 % et 99 % dans les groupes avec et sans canal, respectivement, montrant la non-infériorité du groupe lame avec canal (différence de proportions −0,8 %; intervalle de confiance [IC] à 95 %, −4,8 % à 2,9 %; marge de non-infériorité prédéfinie, −5 %; P = 0,62). Les lésions sous-glottiques ont été moins nombreuses dans le groupe avec canal que dans le groupe sans canal (32 % [32/100] vs 57 % [54/95]; différence de proportions, −25 %; IC 95 %, −39 % à −11 %; P < 0,001). Il n'y avait pas de différences significatives entre les deux groupes en matière de taux global de réussite de l'intubation, de temps d'intubation et d'incidence ou de gravité des autres complications liées à l'intubation. CONCLUSION: Pour l'intubation vidéolaryngoscopique des patient·es portant un collier cervical, les lames avec canal de type Macintosh constituent une alternative aux lames sans canal de type Macintosh, avec un taux de réussite d'intubation initial non inférieur et une incidence plus faible de lésions sous-glottiques. ENREGISTREMENT DE L'éTUDE: CRIS.nih.go.kr ( KCT0005186 ); première soumission le 29 juin 2020.

Avian mud nest architecture by self-secreted saliva.

Mud nests built by swallows (Hirundinidae) and phoebes (Sayornis) are stable granular piles attached to cliffs, walls, or ceilings. Although these birds have been observed to mix saliva with incohesive mud granules, how such biopolymer solutions provide the nest with sufficient strength to support the weight of the residents as well as its own remains elusive. Here, we elucidate the mechanism of strong granular cohesion by the viscoelastic paste of bird saliva through a combination of theoretical analysis and experimental measurements in both natural and artificial nests. Our mathematical model considering the mechanics of mud nest construction allows us to explain the biological observation that all mud-nesting bird species should be lightweight.

Retrieval of cement-retained zirconia implant-supported crowns with an Er,Cr:YSGG laser.

STATEMENT OF PROBLEM: Cement-retained implant-supported crowns can be challenging to retrieve from the abutment once technical or biological issues arise. Removal traditionally requires sectioning the crown with rotary instruments, which causes irreversible damage to the crown and potential damage to the periodontal apparatus stabilizing the implant. PURPOSE: The purpose of this in vitro study was to evaluate an erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser as a minimally invasive alternative for the retrieval of zirconia implant-supported crowns from titanium abutments. Time, temperature, and structural changes to the crown after retrieval were assessed. Appropriate laser parameters were established for this method of crown retrieval. MATERIAL AND METHODS: Twenty zirconia crowns were milled for a maxillary left second premolar based on a CAD-CAM implant analog cast. Ten of these crowns were cemented with a noneugenol zinc oxide dental cement (group Temp) (n=10). The remaining 10 were cemented with a self-adhesive universal resin cement (group Resin) (n=10). Er,Cr:YSGG laser irradiation was performed with the Waterlase iPlus for 1-minute cycles. An attempt was made to remove the crown with a mechanical instrument after each cycle. A type K thermocouple continuously recorded temperature at the level of the abutment. For statistical comparison of decementation time and temperature, the Mann-Whitney test was used (α=.05). Scanning electron microscopy of the nonirradiated and the irradiated crowns was used for analysis of structural and dimensional changes. RESULTS: A significant difference (P<.001) was found in the time ±standard deviation required to retrieve the crowns between group Temp (02:40 ±00:18 minutes:seconds) and group Resin (05:26 ±00:36 minutes:seconds). A significant difference (P<.001) was found in the mean ±standard deviation temperature recorded between group Temp (24.0 ±1.19 °C) and group Resin (25.7 ±0.66 °C). No structural changes to crowns were observed after irradiation. CONCLUSIONS: Retrieval of cement-retained zirconia implant-supported crowns with an Er,Cr:YSGG laser is safe and efficient. Crowns luted with zinc oxide dental cement were retrieved significantly faster while maintaining a significantly lower average temperature than those luted with resin cement. Laser irradiation for decementation did not cause structural changes to zirconia implant-supported crowns.

Complete mouth rehabilitation in a patient with condylar fracture malunion: A clinical report.

Mandibular condyle fracture malunion and tooth loss can cause functional and esthetic problems. A patient with restricted mouth opening associated with muscle atrophy required prosthetic rehabilitation. Since the remaining teeth had a poor prognosis and the patient had difficulty adapting to the interim denture, complete mouth rehabilitation with implants was chosen. The implants were placed by using nerve lateralization and an autogenous bone graft. Prosthetic rehabilitation combines digital diagnosis and conventional prosthetic restorations. The definitive prosthesis was fabricated to ensure adequate oral hygiene and functional adaptation of the orofacial structures. Treatment resulted in stable masticatory function, occlusion, and esthetics and restored the function of the atrophied lips and restricted mouth opening.

Enhancing scanning accuracy of digital implant scans: A systematic review on application methods of scan bodies.

STATEMENT OF PROBLEM: Scan bodies play a crucial role in the accuracy of digital implant scans by serving as implant-positioning transfer devices. Previous literature has demonstrated the effects of scan body characteristics on the accuracy of digital implant scans. However, the optimal application methods of scan bodies to enhance scanning accuracy remain unclear. PURPOSE: The purpose of this systematic review was to determine the optimal application methods of scan bodies to enhance the accuracy of digital implant scans. MATERIAL AND METHODS: An electronic search was conducted by using the PubMed (MEDLINE), Web of Science, Cochrane Library, and Embase databases from November 2018 to 2023. Relevant references from the included studies were further screened manually for eligibility. Following the population, intervention, comparison, and outcome (PICO) criteria, a research question focused on identifying the optimal application method for effectively using scan bodies to enhance scanning accuracy was developed. Specific inclusion criteria involved in vitro and in vivo studies. The Checklist for Reporting In Vitro Studies (CRIS) guidelines were followed and the assessment of the risk of bias in the included studies was conducted. RESULTS: Sixteen articles that met the eligibility criteria were included in this systematic review. Two studies investigated the effect of scan body bevel orientation on the accuracy of digital implant scans, and 3 examined the impact of tightening torque on scan bodies. Among the studies focusing on completely edentulous arches, 5 recommended the use of auxiliary geometric devices on the dental arch to enhance scanning accuracy. However, 2 studies reported no improvements in accuracy after splinting scan bodies with thread. CONCLUSIONS: Different techniques for applying scan bodies, such as configuring bevel orientation, adjusting tightening torque, and attaching auxiliary geometric devices, influence the accuracy of digital implant scans. For scanning completely edentulous arches, attaching auxiliary devices to scan bodies to cover the edentulous ridge effectively enhances scanning accuracy.

Analyzing the accuracy of a cross-mounting technique utilizing digitized interocclusal records.

PURPOSE: To compare the accuracy of a partially digital cross-mounting workflow of direct scans of interocclusal records to a conventional workflow by analyzing the deviations of sequentially cross-mounted casts. MATERIALS AND METHODS: A set of reference casts, comprising maxillary and mandibular full-arch prepared casts and interim prostheses, was articulated, mounted, and scanned to generate four reference casts for cross-mounting. In the conventional approach, 15 sets of these four casts were printed. Polyvinylsiloxane (PVS) records were made using the reference casts and utilized for sequential cross-mounting. In the partially digital group, the same PVS interocclusal records were scanned and used for digital cross-mounting via design software. The mean deviations of both groups from the reference cast were analyzed using a 3D inspection software program. Statistical tests, including paired t-test and analysis of variance (ANOVA), were conducted to compare the average discrepancies between the two groups and to evaluate discrepancies in the anterior and posterior regions (α = 0.05). RESULTS: The range of discrepancies was similar in both the conventional and partially digital groups. The final set of related casts had a mean deviation of 201.58 ± 136.98 mm in the conventional workflow and 248.69 ± 164.71 mm in the partially digital workflow. No statistically significant difference was found between conventional and partially digital groups (p = 0.091). Error propagation was examined by comparing discrepancies at each step within the cross-mounting process. In the conventional group, no significant difference was found (p = 0.148), but a significant difference was found among groups in the partially digital group at each step of sequential mounting (p < 0.001). A significant difference was observed between anterior and posterior deviations in the partially digital group (p < 0.001), but not in the conventional group (p = 0.143). CONCLUSIONS: The study reveals that there is no statistically significant difference between conventional and partially digital cross-mounting workflows. However, within the partially digital group, a significant difference in deviation emerges across cross-mounting steps, with increased deviation in the anterior region.

Metabolic engineering of Corynebacterium glutamicum for the high-level production of valerolactam, a nylon-5 monomer.

Valerolactam (VL) is an important precursor chemical for nylon-5 and nylon 6,5. It has been produced by petroleum-based route involving harsh reaction conditions and generating toxic wastes. Here, we report the complete biosynthesis of VL by metabolically engineered Corynebacterium glutamicum overproducing L-lysine. The pathway comprising L-lysine monooxygenase (davB) and 5-aminovaleramide amidohydrolase (davA) from Pseudomonas putida, and ß-alanine CoA transferase (act) from Clostridium propionicum was introduced into the C. glutamicum GA16 strain. To increase the VL flux, competitive pathways predicted from sRNA knockdown target screening were deleted. This engineered C. glutamicum strain produced VL as a major product, but still secreted significant amount of its precursor, 5-aminovaleric acid (5AVA). To circumvent this problem, putative 5AVA transporter genes were screened and engineered in the genome, thereby reuptaking 5AVA excreted. Also, multiple copies of the act gene were integrated into the genome to strengthen the conversion of 5AVA to VL. The final VL10 (pVL1) strain was constructed by enhancing glucose uptake system, which produced 9.68 g/L of VL in flask culture. Fed-batch fermentation of the VL10 (pVL1) strain produced 76.1 g/L of VL from glucose with the yield and productivity of 0.28 g/g and 0.99 g/L/h, respectively, showcasing a high potential for bio-based production of VL from renewable resources.

Prolonged patency of fully covered self-expandable metal stents with an externally anchored plastic stent in distal malignant biliary obstruction.

BACKGROUND : Fully covered self-expandable metal stents (FCSEMSs) are widely used for endoscopic treatment of distal malignant biliary obstruction (dMBO). We aimed to assess the efficacy of anchoring an external plastic stent to an FCSEMS in dMBO. METHODS : A multicenter retrospective cohort study was performed in patients with dMBO to compare stent patency between FCSEMSs and FCSEMSs with an externally anchored plastic stent (EPS). For external anchoring, a 7-Fr double-pigtail plastic stent (DPPS) was placed first in the bile duct, then an FCSEMS was deployed side-by-side. RESULTS : Among a total of 185 patients, 65 had an FCSEMS alone and 120 had an FCSEMS with an EPS. The median stent patency was significantly longer in the FCSEMS with an EPS group than in the FCSEMS only group (342 vs. 240 days; P = 0.04). The rate of stent migration was significantly lower in the FCSEMS with an EPS group than in the FCSEMS only group (10.8 % vs. 27.7 %; P = 0.01). There were no significant differences in the rates of stent occlusion and adverse events between the two groups. CONCLUSIONS : A novel and simple technique of anchoring an external plastic stent may decrease the risk of FCSEMS migration and prolong stent patency, without significantly increasing the adverse events rate in dMBO.

Clinical implication by differential analytical performances of serum free light chain quantitation analysis using fully automated analyzers.

OBJECTIVES: Free light chain (FLC) is used for the diagnosis and prediction with regard to the progression risk of plasma cell disorders and Freelite reagent using the SPAplus analyzer (The Binding Site) has been one of the widely used option. However, N Latex FLC reagent with the Atellica CH 930 analyzer (Siemens Healthineers) has shown the advantages of automation and high throughput. We aimed to evaluated clinical implication by differential analytical performances of two assays. METHODS: A total of 322 serum samples were collected from 193 patients requested for FLC analysis including 131 multiple myeloma patients. The precision, linearity, dilution recovery of N Latex FLC assay was evaluated. We compared the two assays and analyzed the monomer-dimer pattern for discrepant results. RESULTS: The precision, linearity, and dilution recovery performance was appropriate for the routine use in clinical laboratories. Despite the good correlation within normal range, proportional bias up-to 170% was observed in samples with high concentrations especially for lambda. The higher value samples with N Latex FLC assay contained more monomer forms than controls. All opposite changes of FLC burden by the N Latex FLC assay proved to present concordant dynamic changes when assessed by serum protein electrophoresis. CONCLUSIONS: Clinical laboratories should be aware of the inter-assay variability of FLC quantitative measurements using different platforms, especially for high concentrations of both kappa and lambda measurements, possibly due to monomer/dimer ratio diversity. Clinical interpretations for multiple myeloma disease status might not be dramatically affected only when the same assay is utilized during follow-up periods.

Effect of preoperative patient education and simulated mouth breathing training on opioid requirements in the post-anesthesia care unit after nasal surgery: a randomized controlled study.

BACKGROUND: A simulated education, prior to surgery about postoperative nasal stuffiness and ease of breathing through the mouth may help patients tolerate discomfort after nasal surgery. This study aimed to investigate the effect of preoperative simulated education on immediate postoperative opioid requirements in patients undergoing elective nasal surgery. METHODS: This randomized controlled trial of 110 patients undergoing nasal surgery randomly allocated patients into either a control (group C) or an education group (group E). One day before surgery, patients in group E were intensively trained to breathe through the mouth by using a nasal clip, with informative explanations about inevitable nasal obstruction and discomfort following surgery. Patients in group C were provided with routine preoperative information. Total intravenous anesthesia (TIVA) with propofol and remifentanil was used for anesthesia. No further opioid was used for analgesia intraoperatively. The primary outcome was index opioid (fentanyl) requirements at the post-anesthesia recovery unit (PACU). Secondary outcomes were emergence agitation, pain scores at the PACU, and postoperative recovery using the Quality of Recovery-15 (QoR15-K). RESULTS: The rate of opioid use in the PACU was 51.0% in the group E and 39.6% in the group C (p = 0.242). Additional request for analgesics other than index opioid was not different between the groups. Emergence agitation, postoperative pain severity, and QoR15-K scores were comparable between the groups. CONCLUSION: Preoperative education with simulated mouth breathing in patients undergoing nasal surgery did not reduce opioid requirements. TRIAL REGISTRATION: KCT0006264; 16/09/2021; Clinical Research Information Services ( https://cris.nih.go.kr ).

Vascular Anatomy for the Prevention of Sublingual Hematomas: Life-Threatening Complication of Genioplasty.

After genioplasty, the occurrence of bleeding is rare; however, rapid enlargement or displacement of the tongue secondary to lingual or sublingual hematoma can lead to life-threatening airway obstruction, necessitating prompt recognition, and immediate management. Therefore, the investigators aimed to evaluate the underlying etiologies of sublingual hematoma and relevant anatomy to facilitate early recognition of the initial presentation of these hematomas and appropriate management. The authors conducted a literature review on cases of delayed sublingual hematoma after genioplasty. The authors also report a case of delayed hematoma after performing genioplasty. The anatomical structures involved with the development of rare and serious hematomas therein are the sublingual and submental arteries, which are located in the sublingual area, rendering them susceptible to injury during genioplasty. The results of this study suggest that submental artery ligation should be performed for proper management of airway obstruction, if symptoms of sublingual bleeding are observed during the surgical procedure. If there is continuous bleeding despite the submental artery ligation, sublingual artery ligation should be performed.

Increased Immunoglobulin Gamma-3 Chain C in the Serum, Saliva, and Urine of Patients with Systemic Lupus Erythematosus.

Immunoglobulin gamma-3 chain C (IGHG3) levels have been detected in the blood and tissue of patients with systemic lupus erythematosus (SLE). This study aims to assess its clinical value by measuring and comparing levels of IGHG3 in different body fluids in patients with SLE. The levels of IGHG3 in saliva, serum, and urine from 181 patients with SLE and 99 healthy controls were measured and analyzed. In patients with SLE and healthy controls, salivary IGHG3 levels were 3078.9 ± 2473.8 and 1413.6 ± 1075.3 ng/mL, serum IGHG3 levels were 478.1 ± 160.9 and 364.4 ± 97.9 µg/mL, and urine IGHG3 levels were 64.0 ± 74.5 and 27.1 ± 16.2 ng/mL, respectively (all p < 0.001). Salivary IGHG3 was correlated with ESR (correlation coefficient [r], 0.173; p = 0.024). Serum IGHG3 was correlated with leukocyte count (r, -0.219; p = 0.003), lymphocyte count (r, 0.22; p = 0.03), anti-dsDNA antibody positivity (r, 0.22; p = 0.003), and C3 levels (r, -0.23; p = 0.002). Urinary IGHG3 was correlated with hemoglobin level (r, -0.183; p = 0.021), ESR (r, 0.204; p = 0.01), anti-dsDNA antibody positivity (r, 0.262; p = 0.001), C3 levels (r, -0.202; p = 0.011), and SLE disease activity index (r, 0.332; p = 0.01). Urinary IGHG3 was higher in patients with nephritis than in those without (119.5 ± 110.0 vs. 49.8 ± 54.4 ng/mL; p < 0.01). IGHG3 was increased in the saliva, serum, and urine of patients with SLE. While salivary IGHG3 was not identified to be specific to SLE disease activity, serum IGHG3 showed correlations with clinical characteristics. Urinary IGHG3 levels were associated with disease activity and renal involvement in SLE.

Influence of varying titanium base abutment heights on retention of zirconia restorations: An in vitro study.

STATEMENT OF PROBLEM: Implant manufacturers have introduced titanium base (Ti-Base) abutments with increased abutment heights, ostensibly, to increase the retention of the bonded restoration and to improve overall strength. However, evidence regarding the effects of increasing Ti-Base height on improving retention is lacking. PURPOSE: The purpose of this in vitro study was to evaluate the effect of different Ti-Base abutment heights on the retention of zirconia implant-supported crowns. MATERIAL AND METHODS: Thirty Ti-Base abutments of the same diameter and heights of 3.5 mm (n=10), 4.5 mm (n=10), and 5.5 mm (n=10), were used for testing. Zirconia restorations were cemented onto the Ti-Base abutments with a resin cement after treatment with a 10-methacryloyloxydecyl dihydrogen phosphate primer by a single operator using a positioning device. The zirconia-Ti-Base restorations were tightened to an implant analog embedded in an autopolymerizing resin block. The specimens were placed and tested in a universal testing machine for pull-out testing. Retention was measured by recording the force at load drop. Statistical analysis was performed using 1-way analysis of variance with the Tukey method for pairwise comparisons. RESULTS: The abutment height had a significant effect on retention (P=.010). Ti-Base abutments of 4.5 and 5.5 mm had significantly greater retention than Ti-Base abutments of 3.5 mm (P=.020, P=.040, respectively). However, Ti-Base abutments of 4.5 and 5.5 mm in height were statistically similar (P=.890). CONCLUSIONS: An increase in the height of Ti-Base abutments above the standard 3.5 mm height significantly improved the retention of the overlying restoration.

Accuracy of impression scan bodies for complete arch fixed implant-supported restorations.

STATEMENT OF PROBLEM: Despite the extensive studies on and comparisons of different implant impression techniques for completely edentulous patients, studies on novel techniques that combine conventional impression making with digital scanning are lacking. PURPOSE: The primary aim of this study was to compare the accuracy of the impression scan body technique with conventional impression making and digital scanning for a completely edentulous mandibular arch. The secondary aim was to assess the relationship between different implant angulations and interimplant distances in relation to the recording accuracy. MATERIAL AND METHODS: An edentulous mandibular definitive cast (control) was designed with 5 implants placed at different angles and interimplant distances. Three recording techniques were tested: a conventional impression with splinted copings (conventional) (n=15), an impression scan body technique where impression scan bodies were attached to the splinted impression copings in a conventional elastomeric impression and then digitally scanned with an extraoral scanner (n=15), and an intraoral digital scanning technique (digital) (n=15). For comparison, the definitive cast and the conventional impression stone casts were digitized into standard tessellation language (STL) datasets using the extraoral scanner. The 3-dimensional (3D) deviations between the 3 test groups and the control were calculated by superimposing the STL datasets. The 3D deviations from the control were compared by using the Kruskal-Wallis test followed by the Dunn post hoc test (α=.05). The Mann-Whitney test was used to investigate the effect of implant angulation and interimplant distance on impression accuracy (α=.05). RESULTS: The conventional splinted-coping impression technique showed a mean 3D deviation of 0.408 mm. The impression scan body and intraoral digital scan showed similar mean 3D deviations, 0.219 mm and 0.257 mm, respectively (P=.334). Both techniques showed significantly lower 3D deviations than the conventional technique (P<.001). Implants at an angle of 5 degrees and 10 degrees showed a statistically significant difference (P=.010) with mean 3D deviations of 0.340 mm and 0.396 mm, respectively. Implants with 5-mm and 10-mm interimplant distance showed a significant difference (P<.001) with mean 3D deviations of 0.301 mm and 0.423 mm, respectively. CONCLUSIONS: The impression scan body technique is comparable with intraoral digital scanning for a completely edentulous arch. Increased implant angulation and increased interimplant distance significantly reduced the accuracy of implant impression making or scanning.

A clinical comparison of sagittal condylar inclination and Bennett angle derived from a conventional electronic tracking device and an optical jaw tracking device.

STATEMENT OF PROBLEM: The challenges of conventional methods to measure the sagittal condylar inclination and the Bennett angle include patient discomfort and an output of averaged values calculated on the arc of mandibular movement. Programming these average values into a mechanical or mathematically simulated articulator may introduce occlusal errors. PURPOSE: The purpose of this clinical study was to compare the sagittal condylar inclination and Bennett angle measurements derived from a conventional electronic tracking device and an optical tracking device. MATERIAL AND METHODS: Fifteen dentate participants with at least 12 occluding units, 25 years old and above, participated in the study. Each participant's mandibular movements were recorded by the 2 systems for different condylar guidance values. A conventional tracking device, the Cadiax Compact 2, and an optical tracking device, the MODJAW, were used for this study. Sagittal condylar inclination was measured at 3 mm and 5 mm using protrusive records and the values of the Bennett angle at 3 mm were measured using excursive records along the path traced by mandibular condyles. The Wilcoxon signed-rank test was used to analyze the paired data from the 2 methods. RESULTS: A significant difference was found between right (P=.007) and left sagittal condylar inclinations (P=.010) measured at 3 mm with the conventional and optical tracking devices. A significant difference was found between right (P=.015) and left sagittal condylar inclinations (P=.004) measured at 5 mm with the conventional and optical tracking devices. The right and left Bennett angles measured at 3 mm with the conventional and optical tracking devices were statistically different (P=.043 and P=.035 respectively). CONCLUSIONS: The sagittal condylar inclination and Bennett angle measured at different positions along the path of movement exhibited significant differences. The sagittal condylar inclination and Bennett angle values obtained from the conventional tracking device were generally significantly less than those derived from the optical tracking device.

Accuracy comparison of bilateral versus complete arch interocclusal registration scans for virtual articulation.

STATEMENT OF PROBLEM: Alternatives to the bilateral interocclusal registration scanning technique to improve virtual articulation have not been fully investigated. PURPOSE: The purpose of this in vitro study was to compare the accuracy of virtually articulating digital casts by using bilateral interocclusal registration scans versus a complete arch interocclusal scan. MATERIAL AND METHODS: A set of maxillary and mandibular reference casts were hand-articulated and mounted on an articulator. The mounted reference casts were scanned, and the maxillomandibular relationship record was scanned 15 times using 2 different scanning techniques, the bilateral interocclusal registration scan (BIRS) and complete arch interocclusal registration scan (CIRS), with an intraoral scanner. The generated files were transferred to a virtual articulator, and each set of scanned casts was articulated using BIRS and CIRS. The virtually articulated casts were saved as a set and transferred to a 3-dimensional (3D) analysis program. The scanned casts were set in the same coordinate system as the reference cast and overlaid on top of the reference cast for analysis. Two anterior and 2 posterior points were selected to determine points of comparison between the reference cast and test casts virtually articulated with BIRS and CIRS. The mean discrepancy between the 2 test groups and the anterior and posterior mean discrepancy within each group were tested for significance by using the Mann-Whitney U test (α=.05). RESULTS: A significant difference was found between the virtual articulation accuracy of BIRS and CIRS (P<.001). The mean deviation for BIRS was 0.053 ±0.051 mm and that for CIRS was 0.265 ±0.241 mm. Furthermore, significant differences were found between the anterior and posterior deviations in both BIRS (P=.020) and CIRS (P<.001). The mean deviation for BIRS was 0.034 ±0.026 mm in the anterior and 0.073 ±0.062 mm in the posterior. The mean deviation for CIRS was 0.146 ±0.108 mm anteriorly and 0.385 ±0.277 mm posteriorly. CONCLUSIONS: BIRS was more accurate than CIRS for virtual articulation. Moreover, the alignment accuracy of anterior and posterior sites for both BIRS and CIRS exhibited significant differences, with the anterior alignment exhibiting better accuracy in relation to the reference cast.

An analog-digital hybrid technique for immediate dentures with idealized border extensions.

In patients with severe tooth mobility, conventional impression making can be challenging because of the risk of accidental tooth extraction. Digital intraoral scanning avoids such a complication but does not capture optimal border extensions for a complete denture. This clinical report presents a combined digital and analog recording technique which allows the recording of optimal vestibular border extensions without the risk of tooth extraction.