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AIM: To analyse the effect of post-core, and cement materials and thickness of the cement lute on the stress in post-core systems under ultrasonic vibration at different frequencies and amplitudes using three-dimensional finite element analysis. METHODOLOGY: Eight three-dimensional finite element models of a maxillary central incisor with post-cores were established. Two post-core materials (Au and Ni-Cr alloys), two cements (glass ionomer (GI) and zinc phosphate (ZP)) and two cement layer thicknesses (50 and 150 µm) were considered. Vibration loads were applied near the neck on the buccal side of the core at frequencies of 10-40 kHz and amplitudes of 10-50 µm. The maximum shear stress of the cement layer and maximum principal stress of the roots and their distributions were investigated. RESULTS: The stresses on cements and roots increased with an increase in the frequency and amplitude of the vibration load and elastic modulus of the cements, and decreased with increasing thickness of the cement layer and elastic modulus of the post-core. Maximum cement stress was observed on the contralateral upper part of the loading side, whereas the maximum root stress was found on the ferrule where the load was applied. CONCLUSIONS: In this simulated model, the frequency and amplitude of ultrasound needed to remove a post-core were positively related to the elastic modulus of the post-core and thickness of the cement layer and negatively related to the elastic modulus of the cements.
Assuntos
Técnica para Retentor Intrarradicular , Ondas Ultrassônicas , Cimentos Dentários , Análise do Estresse Dentário , Análise de Elementos Finitos , Teste de Materiais , Cimentos de Resina , Estresse MecânicoRESUMO
In recent years, several drugs have become relatively easy to obtain with the rapid development of the economy and improvement in people's living standards. However, pathogenic bacteria have evolved strains that are resistant to certain drugs, such as antibiotics. Peptides are generally considered to be safe, have high tolerance to drugs, and are easy to manufacture. However, peptides are easily decomposed in complex biological environments. To solve this problem, many studies have modified peptides on the surface of nanomaterials to increase their functionality, biocompatibility, and stability. Meanwhile, nanomaterials have exhibited good absorption of near-infrared (NIR) light. When the NIR laser is focused on nanomaterials, photons are absorbed and the energy of the photons is converted into heat. Low-toxicity NRC03 peptide-conjugated dopamine/nano-reduced-graphene oxide (NRC03-DA/nRGO) nanomaterials are synthesized in this study for antibacterial testing using photothermal technology. The strains used in this study were Gram-positive Staphylococcus aureus (S. aureus). Our results indicated that the synthesized NRC03-DA/nRGO exhibits good absorption of NIR light and high photothermal conversion efficiency. Moreover, the synthesized NRC03-DA/nRGO inhibits the growth and survival of S. aureus. When the NRC03 peptide is modified on the surface of DA/nRGO, its biological stability is improved and the photothermal effect generated by NIR light produces additive effects, thereby indicating potential antibacterial applications.
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Antibacterianos/farmacologia , Dopamina/química , Grafite/química , Nanoestruturas/química , Peptídeos/química , Staphylococcus aureus/efeitos dos fármacos , Antibacterianos/química , Materiais Biocompatíveis/síntese química , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Humanos , Raios InfravermelhosRESUMO
AIM: To profile miRNA expression between inflamed and healthy human dental pulp tissues and to investigate how the upregulation of miR-223-3p in the inflamed pulp tissue regulates odontoblast differentiation and regeneration. METHODOLOGY: Microarray analysis was used to identify differences in miRNA expression patterns between healthy and inflamed pulp tissue. The results were validated using quantitative real-time PCR. To determine the effect of miR-223-3p on odontoblast differentiation, miR-223-3p was overexpressed in human dental pulp stem cells (DPSCs), which were cultured in mineralizing induction medium (to induce odontoblast differentiation). To identify the target genes of miR-223-3p, an SABiosciences Human Osteogenesis PCR Array, combined with bioinformatics, was used. Furthermore, a dual-luciferase reporter assay and a small interfering RNA (siRNA) experiment were used to confirm the relationship between miR-223-3p and its target gene. Statistical analysis was performed using the Student's t-test or one-way analysis of variance (anova); P < 0.05 was considered statistically significant. RESULTS: Seventy-nine miRNAs were significantly differentially expressed (fold change >2.0; P < 0.05) between the two tissues. In particular, miR-223-3p was markedly upregulated in inflamed dental pulp. Overexpression of miR-223-3p in DPSCs significantly increased the protein levels of dentine sialophosphoprotein (DSPP) and dentine matrix protein 1 (DMP-1) (P < 0.05). However, the SMAD family member 3 (SMAD3) protein level was significantly lower than in control DPSCs (P < 0.05). Bioinformatics and the dual-luciferase assay reporter assay indicated that Smad3 was a potential target of miR-223-3p. Knockdown of Smad3 in DPSCs subjected to mineralization induction resulted in detection of DSPP and DMP-1 earlier than in control DPSCs, and it increased the protein level of alkaline phosphatase (ALP), thereby promoting odontoblast differentiation. CONCLUSIONS: miR-223-3p is implicated in the regulation of odontoblast differentiation, which may be involved in the process of pulpitis repair.
Assuntos
Polpa Dentária , MicroRNAs , Diferenciação Celular , Células Cultivadas , Humanos , Inflamação , Odontoblastos , Proteína Smad3 , Células-TroncoRESUMO
OBJECTIVE: To establish a 3D printing system for bone tissue engineering scaffold fabrication based on the principle of fused deposition modeling, and to evaluate the controllability over macro and micro structure precision of polylactide (PLA) and polycaprolactone (PCL) scaffolds. METHODS: The system was composed of the elements mixture-I bioprinter and its supporting slicing software which generated printing control code in the G code file format. With a diameter of 0.3 mm, the nozzle of the bioprinter was controlled by a triaxial stepper motor and extruded melting material. In this study, a 10 mm×10 mm×2 mm cuboid CAD model was designed in the image ware software and saved as STL file. The file was imported into the slicing software and the internal structure was designed in a pattern of cuboid pore uniform distribution, with a layer thickness of 0.2 mm. Then the data were exported as Gcode file and ready for printing. Both polylactic acid (PLA) and polycaprolactone (PCL) filaments were used to print the cuboid parts and each material was printed 10 times repeatedly. After natural cooling, the PLA and PCL scaffolds were removed from the platform and the macro dimensions of each one were measured using a vernier caliper. Three scaffolds of each material were randomly selected and scanned by a 3D measurement laser microscope. Measurements of thediameter of struts and the size of pores both in the interlayer overlapping area and non-interlayer overlapping area were taken. RESULTS: The pores in the printed PLA and PCL scaffolds were regular and interconnected. The printed PLA scaffolds were 9.950 (0.020) mm long, 9.950 (0.003) mm wide and 1.970 (0.023) mm high, while the PCL scaffolds were 9.845 (0.025) mm long, 9.845 (0.045) mm wide and 1.950 (0.043) mm high. The struts of both the PLA and PCL parts became wider inthe interlayer overlapping area, and the former was more obvious. The difference between the designed size and the printed size was greatest in the pore size of the PLA scaffolds in interlayer overlapping area [(274.09 ± 8.35) µm)], which was 26.91 µm. However, it satisfied the requirements for research application. CONCLUSION: The self-established 3D printing system for bone tissue engineering scaffold can be used to print PLA and PCL porous scaffolds. The controllability of this system over macro and micro structure can meet the precision requirements for research application.
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Impressão Tridimensional , Engenharia Tecidual , Alicerces Teciduais , Osso e Ossos , Poliésteres , PorosidadeRESUMO
Gingival fibromatosis (GF) is a condition characterized by a progressive, normal colored enlargement of the gingiva caused by an increase in the size of submucosal connective tissue. Both familial and idiopathic variants of the condition exist. The authors present a case report of a 38-year-old African American man who presented with an impressive overgrowth of the maxillary and mandibular gingivae, subsequently diagnosed as idiopathic GF. In this report, the authors will review the etiologies, treatment, and clinical and histological findings of GF, review similar cases found in the literature, and discuss the differential diagnosis for diffuse gingival enlargements.
Assuntos
Fibromatose Gengival/patologia , Adulto , Humanos , MasculinoRESUMO
AIM: To investigate the in vitro effects of TNF-α and IL-1ß on the osteogenic/dentinogenic differentiation of stem cells from the apical papilla (SCAP). METHODOLOGY: SCAPs treated with 10 ng mL(-1) TNF-α and/or 5 ng mL(-1) IL-1ß were defined as the treatment groups, with untreated cells defined as the control group. Cell proliferation was measured using the MTT assay and cell cycle analysis. Cells in all of the groups were cultured in the osteogenic/dentinogenic differentiation medium and processed for analysis at days 3, 7 and 14. The Alizarin Red S assay, alkaline phosphatase staining and real-time PCR were used to evaluate the differentiation capacity. Differences between the treatment groups and the control groups were analysed statistically using one-way anova and Dunnett's post-test. RESULTS: Compared with the control group, the treated SCAPs were associated with a significantly greater proliferation activity at days 3 and 5 but reduced proliferation at day 9 (P < 0.05). Significantly lower calcium deposition and ALP activity were observed in the treatment groups at day 14 (P < 0.05), as well as reduced ALP, DSPP and DMP-1 expression levels (P < 0.05); however, treated SCAPs had significantly higher levels of DSPP and DMP-1 at day 7 (P < 0.05). In the control group, the ALP, DSPP and DMP-1 expression levels increased significantly from day 3 to day 14 (P < 0.05), but the treatment groups were not associated with increased expression from day 7 to day 14 (P > 0.05). CONCLUSIONS: The pro-inflammatory cytokines TNF-α and IL-1ß inhibited mineralization and osteogenic-/dentinogenic-related gene expression in SCAPs in vitro after long-term culturing. However, these cytokines induced cell proliferation and mineralization in short-term culture probably as a protective response. These findings help to elucidate the impact of inflammation on tooth development.
Assuntos
Diferenciação Celular/efeitos dos fármacos , Papila Dentária/citologia , Interleucina-1beta/fisiologia , Fator de Necrose Tumoral alfa/farmacologia , Papila Dentária/metabolismo , Expressão Gênica , Humanos , Técnicas In VitroRESUMO
AIMS: To identify the contributions of various mechanical factors related to cast posts in a root filled tooth by integration of finite element analysis and the Taguchi method. The investigated factors included post-length (Post-L), post-diameter (Post-D), ferrule height (Ferrule-H) and periodontal bone loss (Bone-H). METHODOLOGY: Three-dimensional finite element models of a mandibular premolar were developed to simulate a root filled tooth. For each investigated factor, three levels and values were selected, and based on a Taguchi orthogonal array, nine models were established. An inclination load of 100 N was applied on the buccal cusp tip, and the dentine peak von Mises stress was used as the evaluation index. RESULTS: Among the four investigated factors, Bone-H was the predominant mechanical factor, with a contribution of more than 97%. Among the other three controllable factors of post-design, Post-D was the primary contributing factor and was almost five times more substantial than the least contributing factor, Ferrule-H. CONCLUSION: Bone-H was the predominant factor influencing the stress of the dentine on a post-restored root filled tooth, followed by the Post-D, Post-L and Ferrule-H. For patients with severe periodontal bone loss, a large post-diameter is essential for endodontic post-restoration treatment.
Assuntos
Dente Pré-Molar/cirurgia , Análise do Estresse Dentário/métodos , Técnica para Retentor Intrarradicular , Tratamento do Canal Radicular , Análise de Elementos Finitos , Humanos , Mandíbula , Tratamento do Canal Radicular/métodosRESUMO
Recent evidence has determined a phenotypic and functional heterogeneity for macrophage populations. This plasticity of macrophage function has been related to specific properties of subsets (M1 and M2) of these cells in inflammation, adaptive immune responses and resolution of tissue destructive processes. This investigation hypothesized that targeted alterations in the distribution of macrophage phenotypes in aged individuals, and with periodontitis would be skewed towards M1 inflammatory macrophages in gingival tissues. The study used a non-human primate model to evaluate gene expression profiles as footprints of macrophage variation in healthy and periodontitis gingival tissues from animals 3-23 years of age and in periodontitis tissues in adult and aged animals. Significant increases in multiple genes reflecting overall increases in macrophage activities were observed in healthy aged tissues, and were significantly increased in periodontitis tissues from both adults and aged animals. Generally, gene expression patterns for M2 macrophages were similar in healthy young, adolescent and adult tissues. However, modest increases were noted in healthy aged tissues, similar to those seen in periodontitis tissues from both age groups. M1 macrophage gene transcription patterns increased significantly over the age range in healthy tissues, with multiple genes (e.g. CCL13, CCL19, CCR7 and TLR4) significantly increased in aged animals. Additionally, gene expression patterns for M1 macrophages were significantly increased in adult health versus periodontitis and aged healthy versus periodontitis. The findings supported a significant increase in macrophages with aging and in periodontitis. The primary increases in both healthy aged tissues and, particularly periodontitis tissues appeared in the M1 phenotype.
Assuntos
Envelhecimento/genética , Gengiva/metabolismo , Macrófagos/metabolismo , Periodontite/genética , Transcriptoma , Fatores Etários , Envelhecimento/imunologia , Animais , Modelos Animais de Doenças , Feminino , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Gengiva/imunologia , Gengiva/patologia , Macaca mulatta , Ativação de Macrófagos/genética , Ativação de Macrófagos/imunologia , Macrófagos/imunologia , Masculino , Periodontite/imunologiaRESUMO
OBJECTIVES: Membrane materials have been widely used for guided bone regeneration (GBR). However, due to bio-functional limitation of the current membranes, the ideal resorbable membrane that can stimulate bone regeneration has yet to be developed. This study seeks to investigate the effects of a strontium hydroxyapatite (SrHA)-containing membrane for GBR. MATERIAL AND METHODS: Strontium hydroxyapatite powder was synthesized and mixed with gelatin solution to the final concentration of 10 mg/ml (Sr10) and 20 mg/ml (Sr20). Approximately 100-µm-thick membranes were fabricated, and the mechanical properties and strontium ion release pattern were analyzed. Rat bone marrow stromal cell (BMSC) responses were investigated in vitro. Bilaterial rat calvarial defects were used in vivo to compare the SrHA membranes against commercially available collagen membranes and evaluated radiologically and histologically. RESULTS: Strontium hydroxyapatite membranes exhibited higher elasticity and strength than the collagen membrane, and slow strontium ion release was also confirmed. No BMSC cytotoxicity was found on the SrHA membranes, and the alkaline phosphatase positively stained area was significantly greater than the collagen membrane at earlier time point. At 4 weeks, both micro-CT and histological analyses revealed that the Sr20 group yielded significantly greater bone formation. CONCLUSIONS: The SrHA-containing membrane developed in this study was found to be a biocompatible material that can stimulate BMSC differentiation as well as bone regeneration and maturation in rat calvarial defects at early time point compared with collagen membrane. The best result was observed in Sr20 group, which can be potentially effective for GBR.
Assuntos
Materiais Biocompatíveis/farmacologia , Regeneração Óssea/efeitos dos fármacos , Regeneração Tecidual Guiada/métodos , Hidroxiapatitas/farmacologia , Células-Tronco Mesenquimais/efeitos dos fármacos , Crânio/cirurgia , Estrôncio/farmacologia , Implantes Absorvíveis , Animais , Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular , Colágeno/farmacologia , Elasticidade , Masculino , Membranas Artificiais , Microscopia Eletrônica de Varredura , Ratos , Ratos Wistar , Crânio/diagnóstico por imagem , Propriedades de Superfície , Microtomografia por Raio-XRESUMO
The sagittal split ramus osteotomy (SSRO) carries potential risks and complications. A double-blind, split-mouth, randomized clinical trial was performed, involving 30 patients undergoing mandibular setback. Advanced platelet-rich fibrin (A-PRF) was applied to one side, and the other side served as a control. The volume of postoperative drainage over 24 h was recorded. At 1, 2, and 5 days, and 3 months postsurgery, nerve recovery was assessed using the two-point discrimination test (TPD), while pain was evaluated using a visual analogue scale (VAS pain). Facial swelling was evaluated by taking linear measurements from facial reference points at the same time intervals. In the treatment group, the 24-hour drainage volume was lower (P = 0.011), pain was better on day 5 (P = 0.011), and TPD was better on day 2 (P = 0.011), day 5 (P = 0.007), and 3 months postoperatively (P = 0.020) than in the control group. There was also less facial swelling in the treatment group when compared to the baseline of 3 months postoperative (day 1, P = 0.012; day 2, P = 0.001; day 5, P = 0.011). The difference in bone mineral density (HU) at 3 months between the treatment group (469.7 ± 134.2) and the control group (348.3 ± 127.2) was statistically significant (P = 0.011), in favour of the treatment group. A-PRF may reduce postoperative complications such as neurosensory disturbance of the inferior alveolar nerve, pain, swelling, and drainage while enhancing bone healing in the osteotomy gap following SSRO. TRIAL REGISTRATION: The study was registered with the Chinese Clinical Trial Register (ChiCTR2200064534).
RESUMO
This investigation examined the cumulative survival rate of the implant-supported overdenture using two types of attachments in patients treated at Show Chwan Memorial Hospital Implant Center from 1992 to 2006. Fifty-one patients (30 men and 21 women) were treated with mandibular implant-supported overdentures. Attachment systems used were the Hader bar with bilateral, cast ERA attachments (Group A, 31 patients with 15 men and 16 women, 134 implants) and the Hader bar with bilateral, distal extension cantilevers (Group B, 20 patients with 15 men and 5 women, 85 implants). Two hundred and four implants remained at the end of the follow-up period. Among failed implants, 10 implants were in Group A (failure rate: 10/134 = 7·5%), whereas five implants were in Group B (failure rate: 5/85 = 5·9%). Sixty-six point seven per cent (10/15) of failed implants were placed in the distal anterior mandible, and 33·3% (5/15) were placed in the middle anterior mandible. Survival was also examined with respect to condition of the opposing arch. Patients wearing a maxillary removable partial denture had the highest implant failure rate (5/51 = 9·8%), whereas the failure rate of the maxillary complete denture group was only 5·7%. The most frequent need for maintenance was wear over patrix component of ERA or Hader clip (n = 56). Eight patients experienced connector fracture between ERA and Hader bar, and one experienced distal extension cantilever fracture. The implant-supported overdenture can be an effective and reliable alternative to the conventional complete mandibular denture. Fewer prosthetic complications were seen in overdentures retained with distal extension cantilever attachments.
Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante/instrumentação , Planejamento de Dentadura , Revestimento de Dentadura , Arcada Edêntula/reabilitação , Adulto , Idoso , Idoso de 80 Anos ou mais , Falha de Restauração Dentária , Feminino , Humanos , Masculino , Mandíbula , Maxila , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Charcot-Marie-Tooth disease (CMT1) is the most common form of inherited peripheral neuropathy. Although the disease is genetically heterogeneous, it has been demonstrated that the gene defect is the most frequent type (CMT1A) is the result of a partial duplication of band 17p11.2. Recent studies suggested that the peripheral hypomyelination syndrome in the trembler (Tr) mouse, a possible animal model for CMT1 disease, is associated with a point mutation in the peripheral myelin protein-22 gene (pmp-22). Expression of pmp-22 is particularly high in Schwann cells, and the protein is found in peripheral myelin. We now report that the human PMP-22 gene is contained within the CMT1A duplication. We therefore, suggest that increased dosage of the PMP-22 gene may be the cause of CMT1A neuropathy.
Assuntos
Doença de Charcot-Marie-Tooth/genética , Família Multigênica , Proteínas da Mielina/genética , Sequência de Bases , Doença de Charcot-Marie-Tooth/classificação , Mapeamento Cromossômico , Cromossomos Humanos Par 17 , DNA/genética , Feminino , Humanos , Masculino , Dados de Sequência Molecular , LinhagemRESUMO
Recombination between repeated sequences at various loci of the human genome are known to give rise to DNA rearrangements associated with many genetic disorders. Perhaps the most extensively characterized genomic region prone to rearrangement is 17p12, which is associated with the peripheral neuropathies, hereditary neuropathy with liability to pressure palsies (HNPP) and Charcot-Marie-Tooth disease type 1A (CMT1A;ref. 2). Homologous recombination between 24-kb flanking repeats, termed CMT1A-REPs, results in a 1.5-Mb deletion that is associated with HNPP, and the reciprocal duplication product is associated with CMT1A (ref. 2). Smith-Magenis syndrome (SMS) is a multiple congenital anomalies, mental retardation syndrome associated with a chromosome 17 microdeletion, del(17)(p11.2p11.2) (ref. 3,4). Most patients (>90%) carry deletions of the same genetic markers and define a common deletion. We report seven unrelated patients with de novo duplications of the same region deleted in SMS. A unique junction fragment, of the same apparent size, was identified in each patient by pulsed field gel electrophoresis (PFGE). Further molecular analyses suggest that the de novo17p11.2 duplication is preferentially paternal in origin, arises from unequal crossing over due to homologous recombination between flanking repeat gene clusters and probably represents the reciprocal recombination product of the SMS deletion. The clinical phenotype resulting from duplication [dup(17)(p11.2p11.2)] is milder than that associated with deficiency of this genomic region. This mechanism of reciprocal deletion and duplication via homologous recombination may not only pertain to the 17p11.2 region, but may also be common to other regions of the genome where interstitial microdeletion syndromes have been defined.
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Anormalidades Múltiplas/genética , Aberrações Cromossômicas , Cromossomos Humanos Par 17 , Deficiência Intelectual/genética , Recombinação Genética , Feminino , Genótipo , Humanos , Hibridização in Situ Fluorescente , Masculino , Linhagem , SíndromeRESUMO
This study was performed to evaluate the subjective and objective functional outcomes of patients who had undergone submandibular gland-sparing neck dissection. All data were obtained from patients treated in a single hospital. Seventy-seven patients who had undergone complete submandibular gland sparing (CSGS) were included in the study. Cancer prognosis items were recorded. The subjective outcomes included patient self-evaluation of mouth dryness and the evaluation of the presence of saliva secretion following the application of digital pressure. Saliva scintigraphy served as the objective test. Self-reported xerostomia was compared between the CSGS patients and a control group of patients who had undergone unilateral submandibular gland removal (USGR; n = 74). In the CSGS group, local recurrence occurred in 3.8% of the 80 cancer sites, and neck recurrence occurred in 5.9% of neck dissection sites. Regarding the subjective measurements, 7.0% of the CSGS patients reported xerostomia and 91.9% demonstrated saliva secretion by digital pressure. Scintigraphy revealed actively secreting glands, with 42.9% of them showing normal gland function; none of the patients had severe xerostomia. The relative risk of dry mouth was significantly higher in the USGR patients than in the CSGS patients (P < 0.001). Submandibular gland sparing during neck dissection was found to result in satisfactory saliva secretion, with a relatively small risk of local or neck recurrence.
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Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Xerostomia , Humanos , Esvaziamento Cervical , Carcinoma de Células Escamosas/cirurgia , Neoplasias Bucais/cirurgia , Glândulas Salivares , Xerostomia/etiologia , Glândula Submandibular/diagnóstico por imagem , Glândula Submandibular/cirurgiaRESUMO
The protection of open abdomen (OA) wound is a significant subject in the field of trauma surgery. The key technical challenge in the early stage of OA wound management involves promoting granulation tissue filling between intestinal segments, reducing intestinal wall abrasion, and preventing the development of enteroatmospheric fistulas (EAF). Hydrogels, characterized by their high water content and exceptional biocompatibility, serve as extracellular matrix-mimicking materials, and are extensively employed in various medical and healthcare applications. In this review, we discuss the application of hydrogel developed by natural biomaterials in OA wounds protection, taking into consideration the unique pathophysiological characteristics of the OA wounds. This review aims to provide valuable insights for the development of hydrogel materials for early-stage OA wound protection in future research.
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Cavidade Abdominal , Hidrogéis , Humanos , Hidrogéis/uso terapêutico , Cavidade Abdominal/cirurgia , Abdome/cirurgia , Materiais BiocompatíveisRESUMO
AIM: To report several types of response of immature permanent teeth with infected necrotic pulp tissue and either apical periodontitis or abscess to revascularization procedures. METHODOLOGY: Twenty immature permanent teeth with infected necrotic pulp tissue and either apical periodontitis or abscesses from 20 patients were included. The teeth were isolated with rubber dam, and pulp chambers was accessed through the crowns. The canals were gently irrigated with 5.25% sodium hypochlorite with minimal mechanical debridement. Calcium hydroxide was used as an inter-appointment intracanal medicament and placed into the coronal half of the canal space. After resolution of clinical signs and symptoms, bleeding was induced into the canal space from the periapical tissues using K-files. The coronal canal space was sealed with a mixture of mineral trioxide aggregate (MTA) and saline solution. The access cavity was filled with composite resin. These immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscesses were followed up from 6 to 26 months. RESULTS: Five types of responses of these immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures were observed: type 1, increased thickening of the canal walls and continued root maturation; type 2, no significant continuation of root development with the root apex becoming blunt and closed; type 3, continued root development with the apical foramen remaining open; type 4, severe calcification (obliteration) of the canal space; type 5, a hard tissue barrier formed in the canal between the coronal MTA plug and the root apex. CONCLUSIONS: Based on this case series, the outcome of continued root development was not as predictable as increased thickening of the canal walls in human immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess after revascularization procedures. Continued root development of revascularized immature permanent necrotic teeth depends on whether the Hertwig's epithelial root sheath survives in case of apical periodontitis/abscess. Severe pulp canal calcification (obliteration) by hard tissue formation might be a complication of internal replacement resorption or union between the intracanal hard tissue and the apical bone (ankylosis) in revascularized immature permanent necrotic teeth.
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Apexificação/métodos , Necrose da Polpa Dentária/terapia , Abscesso Periapical/terapia , Periodontite Periapical/terapia , Adolescente , Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Criança , Resinas Compostas/química , Materiais Dentários/química , Calcificações da Polpa Dentária/patologia , Restauração Dentária Permanente/métodos , Dentina Secundária/anatomia & histologia , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Neovascularização Fisiológica/fisiologia , Odontogênese/fisiologia , Óxidos/uso terapêutico , Tecido Periapical/irrigação sanguínea , Materiais Restauradores do Canal Radicular/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/métodos , Silicatos/uso terapêutico , Hipoclorito de Sódio/uso terapêutico , Ápice Dentário/patologia , Raiz Dentária/patologia , Resultado do TratamentoRESUMO
Objective: To measure and analyze parameters of the three-dimensional (3D) model of the condylar movement envelope surface (ES) and provide a reference for the design of the temporomandibular prosthesis. Methods: Thirty-four healthy adults aged (25.4±2.8) years were recruited from the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology as subjects. There were 9 males and 25 females, most of them were university students and others outside the university have received undergraduate education or above. Condylar movement ES were obtained using the previous method on the 3D trajectory of condyle. The simulations of condylar movement were projected according to opening movements, protrusion movements, and lateral movements respectively. The total area of the ES and the area proportions of models formed by above different mandibular movements were measured and calculated. The adults' head and maxillofacial 3D models reconstructed by cone beam CT were registered with ES in Geomagic Studio. The inner and outer poles of the condyle, the corrective sagittal axis of the ES, and the median sagittal plane (MSP) were calibrated in registration models using Geomagic Studio, and the parameters were measured as follows: the anteroposterior and medialateral diameters of the condyle, the anteroposterior diameters and the transverse diameters (anterior, middle and posterior parts) of the ES, the angles between the corrective sagittal axis of the ES and MSP (ES-MSP). Pearson correlation analysis was performed by SPSS 24.0. Results: The total area of the ES was (760±133) mm2, the opening movement part accounted for (63.3±15.2)%, the protrusion movement part accounted for (14.9±9.6)%, the lateral movement part accounted for (21.8±13.3)%. Parameter measurements were as follows: mediolateral diameters of condyle was (19.8±2.3) mm; anteroposterior diameter of the ES was (21.2±3.1) mm, the transverse diameters (anterior, middle and posterior parts) of the ES were (20.6±2.4), (20.4±2.4), (22.0±2.6) mm, respectively; the transverse diameters of the ES were about 2 mm larger than that of the condyle. The angle between the corrective sagittal axis of ES and the MSP was 6.8°±6.2°. The coefficient of variation (CV) in these parameters showed: CV of the transverse diameters (anterior, middle and posterior parts) of the ES and mediolateral diameter of the condyle were 0.98, 0.99, 0.93, respectively (P<0.001). CV of aera of ES and mediolateral diameter of the condyle was 0.64 (P=0.002). CV of aera of ES and anteroposterior diameter of ES was 0.62 (P=0.004). Conclusions: The 3D envelope surface model formed by mandibular opening movements accounted for the largest proportion of the ES. The corrective sagittal axis of the ES was at an angle to the MSP, the transverse diameters (anterior, middle and posterior parts) of the ES were approximately 2 mm larger than the mediolateral diameter of the condyle, the transverse diameters (anterior, middle and posterior parts) of the ES were highly positively correlated with the mediolateral diameter of the condyle.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Côndilo Mandibular , Humanos , Adulto , Masculino , Feminino , Mandíbula , Movimento , Articulação TemporomandibularRESUMO
This 24-mo randomized controlled trial was based on a double-blind parallel design, and it compared the effectiveness of 2 fluoride application protocols in arresting dentine caries in primary teeth. Three-year-old children with active dentine caries were recruited and randomly allocated to 2 treatment groups. Children in group A received a semiannual application of a 25% silver nitrate (AgNO3) solution followed by a commercially available varnish with 5% sodium fluoride (NaF) on the carious tooth surfaces. Children in group B received a semiannual application of a 25% AgNO3 solution followed by another commercially available varnish with 5% NaF containing functionalized tricalcium phosphate (fTCP). Carious tooth surfaces that were hard when probing were classified as arrested. Intention-to-treat analysis and a hierarchical generalized linear model were undertaken. A total of 408 children with 1,831 tooth surfaces with active dentine caries were recruited at baseline, and 356 children (87%) with 1,607 tooth surfaces (88%) were assessed after 24 mo. At the 24-mo evaluation, the mean (SD) number of arrested carious tooth surfaces per child were 1.8 (2.2) and 2.6 (3.3) for group A (without fTCP) and group B (with fTCP), respectively (P = 0.003). The arrest rates at the tooth surface level were 42% for group A and 57% for group B (P < 0.001). Results of the hierarchical generalized linear model indicated that protocol B (with fTCP) had a higher predicted probability (PP = 0.656) in arresting dentine caries than protocol A (without fTCP; PP = 0.500) when the carious lesions were on buccal/lingual surfaces, were on anterior teeth, had dental plaque coverage, and were in children from low-income families (P = 0.046). In conclusion, protocol B, which applied a 25% AgNO3 solution followed by a commercially available 5% NaF varnish with fTCP semiannually, is more effective in arresting dentine caries in primary teeth as compared with protocol A, which applied a 25% AgNO3 solution followed by another commercially available 5% NaF varnish without fTCP semiannually (ClinicalTrials.gov NCT03423797).
Assuntos
Cárie Dentária , Fluoreto de Sódio , Fosfatos de Cálcio , Cariostáticos , Criança , Pré-Escolar , Cárie Dentária/tratamento farmacológico , Cárie Dentária/prevenção & controle , Fluoretos Tópicos , HumanosRESUMO
Luminescent SiN-based multilayers were prepared in a plasma enhanced chemical vapor deposition system followed by subsequently laser crystallization of ultrathin amorphous Si-rich SiN sublayers. The cross-sectional TEM analysis reveals that grain size of Si nanocrystals embedded in the Si-rich SiN sublayers is independent of the laser fluence, while the grain density can be well controlled by the laser fluence. The devices containing the laser crystallized multilayers show a low turn-on voltage of 5 V and exhibit strong green light emission under both optical and electrical excitations. Moreover, the device after laser-irradiated at 554 mJ/cm(2) shows a significantly enhanced EL intensity as well as external quantum efficiency compared with the device without laser irradiation. The EL mechanism is suggested from the bipolar recombination of electron-hole pairs at Si nanocrystals. The improved performance of the devices was discussed.
Assuntos
Cristalização/métodos , Lasers , Iluminação/instrumentação , Medições Luminescentes/instrumentação , Membranas Artificiais , Semicondutores , Compostos de Silício/química , Desenho de Equipamento , Análise de Falha de Equipamento , Compostos de Silício/efeitos da radiaçãoRESUMO
Silver diamine fluoride (SDF) is used topically to prevent or arrest dental caries and has been tested clinically in toddlers to elderly adults. Following SDF application, small quantities of silver can be swallowed and absorbed. To monitor silver concentrations, pharmacokinetic studies can be performed. However, pharmacokinetic studies are time-consuming, resource intensive, and challenging to perform in young children. The objective of this study was to develop a physiologically based pharmacokinetic (PBPK) model to predict silver disposition in children. The PBPK model for silver was developed using Simcyp software (version 17.0) based on information obtained from literature sources. The predictive performance of the model was assessed by comparing the predicted PK profiles and parameters with the observed data from published rat and human data following intravenous or oral silver administration. The predicted silver concentrations were within 2-fold of observed blood and tissue silver concentrations in rats and within the 95% confidence interval of observed plasma silver concentrations in healthy human adults. The PBPK model was applied to the pediatric population by accounting for developmental physiological changes. For a given SDF dose, the simulated peak silver concentrations were 5.2-, 4.3-, 2.7-, and 1.3-fold higher in children aged 1 to 2, 2 to 4, 5 to 10, and 12 to 17 y, respectively, compared to adults. As silver is reportedly excreted in the bile, the half-life of silver was comparable in all ages and plasma and tissue silver concentrations were predicted to return to baseline levels within 2 wk after SDF application. The simulation in children suggests that conventional SDF application to teeth to prevent or arrest dental caries results in plasma and tissue silver concentrations lower than toxic concentrations. PBPK modeling offers a novel approach to studying dental exposures in younger children, where pharmacokinetic studies would be difficult to conduct.