Spinopelvic mobility and acetabular component position for total hip arthroplasty.

AIMS: Posterior tilt of the pelvis with sitting provides biological acetabular opening. Our goal was to study the post-operative interaction of skeletal mobility and sagittal acetabular component position. MATERIALS AND METHODS: This was a radiographic study of 160 hips (151 patients) who prospectively had lateral spinopelvic hip radiographs for skeletal and implant measurements. Intra-operative acetabular component position was determined according to the pre-operative spinal mobility. Sagittal implant measurements of ante-inclination and sacral acetabular angle were used as surrogate measurements for the risk of impingement, and intra-operative acetabular component angles were compared with these. RESULTS: Post-operatively, ante-inclination and sacral acetabular angles were within normal range in 133 hips (83.1%). A total of seven hips (4.4%) had pathological imbalance and were biologically or surgically fused hips. In all, 23 of 24 hips had pre-operative dangerous spinal imbalance corrected. CONCLUSIONS: In all, 145 of 160 hips (90%) were considered safe from impingement. Patients with highest risk are those with biological or surgical spinal fusion; patients with dangerous spinal imbalance can be safe with correct acetabular component position. The clinical relevance of the study is that it correlates acetabular component position to spinal pelvic mobility which provides guidelines for total hip arthroplasty. Cite this article: Bone Joint J 2017;99-B(1 Supple A):37-45.

Redemption of a perforated furcation with a multidisciplinary treatment approach.

A long-standing lesion associated with an undetected perforation of the furca in a mandibular molar was successfully managed using a multidisciplinary treatment approach. The sequence of therapeutic procedures involved conventional endodontic retreatment, an initial orthograde sealing of the perforation, guided tissue regeneration, and a subsequent orthograde resealing of the perforation with Ketac-Endo and Intermediate Restorative Material.

Free gingival grafts. Current indications and techniques.

The free gingival graft is a simple, predictable technique for increasing the zone of attached gingiva. Dentists interested in performing minor surgical procedures should include the free gingival graft in their armamentarium. Indications and contraindications have been established, but the decision regarding the adequacy of the attached gingiva remains one of clinical judgment. The clinician must evaluate several variables, including the width of the attached gingiva, the patient's age, recession history, oral hygiene practices, teeth involved, and dental records. In the opinion of the authors, the free gingival graft usually should not be used in areas of inadequate attached gingiva when root coverage is indicated. Other techniques are more predictable and yield a more esthetic result.

Crown lengthening: a surgical flap approach.

In many instances it is not possible to place a restoration margin without encroaching on the periodontal attachment apparatus. A surgical crown-lengthening procedure can provide a good solution to this common clinical problem. This article discusses indication and contraindication for surgical crown-lengthening procedures and presents an appropriate surgical technique.

High pressure liquid chromatographic determination of furazolidone in turkey tissue.

A high pressure liquid chromatographic method for determining furazolidone in turkey tissue has been developed. Tissues are ground with methanol and centrifuged. For lower levels of furazolidone, 2--40 ppb, the supernate is evaporated to dryness and redissolved before it is injected onto the liquid chromatographic column. Using a reverse phase column and an ultraviolet absorption detector set at 365 nm, the assay is linear over the concentration range 2--400 ppb with a coefficient of variation of less than 4%. Average recovery from fortified tissues was 96% with a coefficient of variation of 6% at the 50--400 ppb level, and 105% with a coefficient of variation of 11% at the 2--40 ppb level.

Crevicular fluid elastase levels in relation to periodontitis and metabolic control of diabetes.

The purpose of this study was to investigate the associations between gingival crevicular fluid (GCF) elastase levels, clinical measures of periodontal status, and metabolic control of diabetes in insulin dependent (type 1) diabetes (IDDM) and non-insulin dependent (type 2) diabetes (NIDDM) patients. Sixty patients were recruited from the Diabetes Center at the University of California in San Francisco. Thirty subjects were type 1 diabetics and 30 subjects were type 2 diabetics. Metabolic control was evaluated by glycosylatted hemoglobin (HbA1c) levels. Demographic information was obtained using a structured interview with the subjects. Clinical measurements and GCF samples were taken from the mesio-buccal surfaces of 2 premolars and 2 molars from the most diseased sextant. GCF elastase was determined by measurement of p-Nitroanalide resulting from hydrolysis of elastase specific peptide. Crevicular fluid elastase levels were significantly correlated with gingival index, bleeding index, probing depth and attachment level in both type 1 and type 2 diabetes groups (0.01

Longitudinal evaluation of GCF MMP-3 and TIMP-1 levels as prognostic factors for progression of periodontitis.

BACKGROUND: To determine whether matrix metalloproteinase-3 (MMP-3) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in gingival crevicular fluid (GCF) could serve as prognostic factors for the progression of periodontitis, we monitored GCF MMP-3 and TIMP-1 and periodontal status of selected sites in 40 medically healthy subjects over a 6-month period. METHOD: Clinical measurements including gingival index (GI), plaque index, bleeding on probing, suppuration, probing depth (PD), attachment loss (AL), and GCF samples were taken from 2 healthy sites (including sites with gingival recession, GI=0 PD < or =3 mm; AL < or =2 mm) and 2 periodontitis sites (GI > or =1; PD > or =5 mm; AL > or =3 mm) of each patient at baseline, 3-month and 6-month visits by means of sterile paper strips. GCF levels of MMP-3 and TIMP-1 were determined by sandwich ELISA assays. RESULTS: The mean amounts of MMP-3 and TIMP-1 in diseased sites were significantly higher than in healthy sites (p<0.0001). Significantly higher GCF levels of MMP-3 and TIMP-1 were found at progressing sites than in nonprogressing periodontitis sites (0.001 or =2 mm loss of attachment during 6- month study period. GCF levels of MMP-3 were highly correlated with clinical measurements taken at baseline, 3-month and 6-month visits (p<0.001). TIMP-1 levels were only moderately correlated with probing depth and attachment level (p<0.01). Step-wise multiple regression analysis was performed to construct models for the prediction of probing depth and attachment loss increases. The most parsimonious regression models which had the best R2 values included the following variables and accounted for the indicated % of variability. The regression model for the prediction of probing depth increase included MMP-3, smoking pack-years, TIMP-1 and accounted for 53% of the variability. The best model for the prediction of attachment loss increase included MMP-3, smoking pack-years, age, TIMP-1 and explained 59% of the variability. CONCLUSION: These data indicate that sites with high GCF levels of MMP-3 and TIMP-1 are at significantly greater risk for progression of periodontitis.

Angiotensin-II increases cytoplasmic calcium, cell number and total DNA for human periodontal ligamental cells in vitro.

The identification and the development of potential growth factors for the cells of the periodontal ligament is an important and novel stratagem for the regeneration of tissue destroyed by periodontal pathogens. The problem is that growth factors are difficult to synthesize, very immunogenic and expensive. The purpose of our study was to determine if angiotensin-II, a naturally occurring octo-peptide with growth-factor like properties in cardiac muscle, could also stimulate cultured human periodontal ligament cells. If angiotensin-II does have growth factor properties, then it should be able to increase cytoplasmic calcium (a secondary messenger associated with mitogenesis) and to increase fibroblast proliferation. Fura-2 fluorescence and aequorin photometry were used to follow changes in cytoplasmic calcium. Cytometry and total amount of DNA were used to measure proliferation evoked by angiotensin-II. We found that angiotensin-II increased cytoplasmic calcium, the total amount of DNA and cell number, suggesting that angiotensin-II has mitogenic properties for cells isolated from human periodontal ligament.