Osteochondritis dissecans of the temporomandibular joint: a scoping review.

PURPOSE: To perform a scoping review to identify the available evidence regarding osteochondritis dissecans (OCD) of the temporomandibular joint (TMJ). METHODS: An electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: 'Temporomandibular Joint Disorders', 'Osteochondritis Dissecans', 'Joint Loose Bodies' and 'Temporomandibular Joint'. Full-text articles were obtained from the records after applying the inclusion/exclusion criteria. RESULTS: Ten articles were included in the analysis - six case reports, one case series, one retrospective study, one comparative study and one correlational study - with a total of 39 patients. The most frequently reported clinical presentation involved TMJ pain, locked jaw and articular noises (clicking and crepitus). The imaging methods used to identify OCD were radiographs, tomography, arthrography and magnetic resonance imaging. The reported imaging findings varied widely, but the most frequent were (single or multiple) calcified intra-articular loose bodies, signs of degenerative osseous changes, disc displacements, widening of the joint space and alterations in condylar morphology. Seven articles reported treatments (surgical or conservative), but the treatment outcome was not reported in all of the articles, which makes it difficult to make comparisons. CONCLUSION: OCD of the TMJ may present various non-specific clinical characteristics, and given the heterogeneous imaging findings, multiplanar images are required for an accurate diagnosis. Finally, the results do not allow recommending a standard treatment for OCD of the TMJ.

Displasia Cemento Ósea Florida: Reporte de un caso

La Displasia Cemento Ósea Florida corresponde a un tipo de lesión fibro ósea caracterizada por presentar un hueso trabecular con apariencia de tejido conectivo fibroso con áreas similares al cemento radicular. Afecta principalmente a mandíbula, a mujeres y a personas de etnia africana entre la cuarta a la quinta década. Posee crecimiento limitado, presentación de forma simétrica, bilateral y capacidad de afectar de uno a más cuadrantes. Tiene tres etapas de desarrollo, que se presentan con aspecto radiográfico diferente. En la primera etapa se aprecia un área radiolúcida, en la segunda etapa se visualizan radiopacidades circunscritas al área radiolúcida; y en la tercera etapa se observa una clara radiopacidad alrededor de la lesión. Para su correcto diagnóstico se necesita una cuidadosa correlación de los hallazgos clínicos, imagenológicos, de laboratorio e histopatológicos. Se presenta el caso de una paciente de género femenino de 70 años diagnosticada con Displasia Cemento Ósea Florida.

Florid Cemento-Osseous Dysplasia is a type of fibro-osseous lesion characterized by a trabecular bone with the appearance of fibrous connective tissue with areas similar to root cement. It mainly affects the jaw, women and people of African ethnicity between the fourth and fifth decades. It has limited growth, a symmetrical, bilateral presentation and the ability to affect one or more quadrants. It has three stages of development, with different radiographic appearance. The first stage shows a radiolucent area, the second stage shows radiopacities circumscribed to the radiolucent area; and in the third stage a clear radiopacity is observed around the lesion. For its correct diagnosis, a careful correlation of clinical, imaging, laboratory and histopathological findings is needed. The case of a 70-year-old female patient diagnosed with Florid Cemento-Osseous Dysplasia is presented.

Decellularized allografts as an alternative for reconstruction of large inferior alveolar nerve defects: a systematic review

Background: Inferior alveolar nerve (IAN) injuries are a clinical problem with devastating consequences, causing temporary or permanent paresthesia, significantly affecting the patient's quality of life. Despite morbidity, side effects and controversy regarding its results, autologous nerve grafting is still the main treatment for these type of lesions. However, due to advances in knowledge about nerve damage and with the aim of preventing the described problems of autografts, new treatment alternatives based on decellularized allografts have emerged. The aim of this systematic review was to evaluate the reported efficacy of decellularized allografts for the treatment of IAN damage. Material and methods: We performed a systematic search in Pubmed, Scopus and Web of Science databases following the PRISMA guidelines. Cohort studies, randomized or non-randomized clinical studies, prospective or retrospective studies, without age limits and language restriction that included human subjects who received decellularized allograft as treatment for IAN damage were included. Results: Six articles met the inclusion criteria and were included for data analysis. In all 6 articles, resolution of IAN damage was observed in more than 85% of patients after a 12-month follow-up period, and in 2 of them, complete resolution was observed in 100% of their patients at longer follow-ups. Conclusions: Decellularized allograft appears to be a promising alternative to resolve IAN lesions, without requiring a nerve autograft procedure. However, more randomized clinical trials are needed to validate adequate treatment modalities with decellularized allografts. (AU)

Diazotrophic activity and denitrification in two long-term chronosequences of maritime Antarctica.

The main goals of this study were to identify whether key processes involved in microbial soil nitrogen transformations, such as diazotrophic activity and denitrification, the chemical properties of limiting elements in the soil, and microbial community structure, differ in the different successional stages of two long term chronosequences in maritime Antarctica. Moreover, we expect the rates of diazotrophic activity and denitrification to be stimulated by increases in air temperature and moisture. To answer these questions, we selected three stages in the succession (early, mid and late) in each of two well established chronosequences: three raised beaches in Ardley Island; and the Barton Peninsula, which includes two cosmogenically dated sites and the forefield of the Fourcade glacier. In the Ardley chronosequence, higher diazotrophic activity was found in the older successional stages, concomitant with an increase in the abundance of Cyanobacteria. In the Barton chronosequence, Cyanobacteria were only present and abundant (Microcoleus) in the early successional stage, coinciding with the highest diazotrophic activity. Denitrification in the Barton chronosequence tended to be highest at the mid successional sites, associated with the highest abundance of Rhodanobacter. In the Ardley chronosequence, the lowest abundance of Rhodanobacter was linked to lower denitrification rates in the mid successional stage. In the Ardley chronosequence, significant positive effects of passive warming and water addition on diazotrophic activity were detected in the first and the second years of the study respectively. In the Barton chronosequence on the other hand, there was no response to either passive warming or water addition, probably a manifestation of the higher nutrient limitation in this site. Denitrification showed no response to either warming or water addition. Thus, the response of microbial nitrogen transformations to global change is highly dependent on the environmental setting, such as soil origin, age and climate regime.

Six hundred years of South American tree rings reveal an increase in severe hydroclimatic events since mid-20th century.

South American (SA) societies are highly vulnerable to droughts and pluvials, but lack of long-term climate observations severely limits our understanding of the global processes driving climatic variability in the region. The number and quality of SA climate-sensitive tree ring chronologies have significantly increased in recent decades, now providing a robust network of 286 records for characterizing hydroclimate variability since 1400 CE. We combine this network with a self-calibrated Palmer Drought Severity Index (scPDSI) dataset to derive the South American Drought Atlas (SADA) over the continent south of 12°S. The gridded annual reconstruction of austral summer scPDSI is the most spatially complete estimate of SA hydroclimate to date, and well matches past historical dry/wet events. Relating the SADA to the Australia-New Zealand Drought Atlas, sea surface temperatures and atmospheric pressure fields, we determine that the El Niño-Southern Oscillation (ENSO) and the Southern Annular Mode (SAM) are strongly associated with spatially extended droughts and pluvials over the SADA domain during the past several centuries. SADA also exhibits more extended severe droughts and extreme pluvials since the mid-20th century. Extensive droughts are consistent with the observed 20th-century trend toward positive SAM anomalies concomitant with the weakening of midlatitude Westerlies, while low-level moisture transport intensified by global warming has favored extreme rainfall across the subtropics. The SADA thus provides a long-term context for observed hydroclimatic changes and for 21st-century Intergovernmental Panel on Climate Change (IPCC) projections that suggest SA will experience more frequent/severe droughts and rainfall events as a consequence of increasing greenhouse gas emissions.

Evaluación del tratamiento endodóntico y su relación con el tipo y la calidad de la restauración definitiva / Evaluation of edodontic treatment and its relationship with the type and quality of the definitive restoration

Introducción El éxito endodóntico está determinado por la calidad de los tratamientos de canales radiculares y restaurador, en conjunto con la ausencia de signos y síntomas. Objetivo Determinar el porcentaje de éxito de tratamientos de conductos y su relación con el tipo y la calidad de la restauración coronaria. Material y métodos Se realizó un estudio clínico retrospectivo en donde se evaluaron 227 dientes sometidos a tratamiento de canales radiculares con 4 años de evolución, por un dentista contralor, que realizó el examen clínico y radiográfico de estos dientes, evaluando los signos y síntomas que presentaron y el tipo y la calidad del tratamiento restaurador. Los datos se analizaron mediante el programa estadístico STATA 13. Resultados En los tratamientos evaluados existe un porcentaje de éxito del 93,8% y un 6,2% de fracaso, además de una asociación significativa en cuanto a que los dientes con una restauración coronaria adecuada, directa o indirecta, están relacionados con tratamientos considerados como exitosos, mediante test de Fisher (valor p < 0,01) con un nivel de confianza del 95%. Conclusiones Los resultados obtenidos en este estudio muestran un alto porcentaje de éxito de los dientes tratados endodónticamente (93,8%) y que existe una asociación estadísticamente significativa entre la calidad de la obturación y la sintomatología (p < 0,01) con un nivel de confianza del 95%.

Introduction Success in endodontic treatment is determined by the quality of the root canal treatment and definitive coronal restoration, with the absence of signs and symptoms. Objective The aim of this study was to determine the success rate of root canal treatment and its relationship with the type and quality of the coronary restoration. Material and methods A retrospective clinical study was conducted on 227 endodontically treated teeth over a period of 4 years. The analysis was performed by a comptroller dentist, who carried out the clinical and radiographical examination, evaluating signs and symptoms and the type and quality of the coronary restoration. The data analysis was performed using the STATA 13 statistics program. Results The results obtained show that there is a success rate of 93.8% and a 6.2% failure rate of the teeth evaluated. There was also significant evidence as regards teeth with proper restorations, whether direct or indirect, and root canal treatments considered as successful, according to Fisher's Test (P<.01), with a confidence level of 95%. Conclusions It can be concluded with the results obtained, that there is a high success rate (93.8%), and that there is a statistically significant association between the quality of the restoration and the presence of symptoms.

Successional changes in soil nitrogen availability, non-symbiotic nitrogen fixation and carbon/nitrogen ratios in southern Chilean forest ecosystems.

Vast areas of southern Chile are now covered by second-growth forests because of fire and logging. To study successional patterns after moderate-intensity, anthropogenic fire disturbance, we assessed differences in soil properties and N fluxes across a chronosequence of seven successional stands (2-130 years old). We examined current predictions of successional theory concerning changes in the N cycle in forest ecosystems. Seasonal fluctuations of net N mineralization (N(min)) in surface soil and N availability (N(a); N(a)=NH4+-N+NO3--N) in upper and deep soil horizons were positively correlated with monthly precipitation. In accordance with theoretical predictions, stand age was positively, but weakly related to both N(a) ( r(2)=0.282, P<0.001) and total N (N(tot); r(2)=0.192, P<0.01), and negatively related to soil C/N ratios ( r(2)=0.187, P<0.01) in surface soils. A weak linear increase in soil N(min) (upper plus deep soil horizons) was found across the chronosequence ( r(2)=0.124, P<0.022). N(min) occurred at modest rates in early successional stands, suggesting that soil disturbance did not impair microbial processes. The relationship between N fixation (N(fix)) in the litter layer and stand age best fitted a quadratic model ( r(2)=0.228, P<0.01). In contrast to documented successional trends for most temperate, tropical and Mediterranean forests, non-symbiotic N(fix) in the litter layer is a steady N input to unpolluted southern temperate forests during mid and late succession, which may compensate for hydrological losses of organic N from old-growth ecosystems.

Nutrition in the treatment of attention-deficit hyperactivity disorder: a neglected but important aspect.

Attention-deficit hyperactivity disorder (ADHD) is multidetermined and complex, requiring a multifaceted treatment approach. Nutritional management is one aspect that has been relatively neglected to date. Nutritional factors such as food additives, refined sugars, food sensitivities/allergies, and fatty acid deficiencies have all been linked to ADHD. There is increasing evidence that many children with behavioral problems are sensitive to one or more food components that can negatively impact their behavior. Individual response is an important factor for determining the proper approach in treating children with ADHD. In general, diet modification plays a major role in the management of ADHD and should be considered as part of the treatment protocol.