Optical accuracy assessment of robotically assisted dental implant surgery for partially edentulous patients: a single arm clinical trial.

PURPOSE: To quantify the clinical accuracy of a robotically assisted implant guidance system in partially edentulous patients without the use of postoperative cone-beam radiography. MATERIALS AND METHODS: A total of 10 implants (7 patients) were placed in partially edentulous patients utilizing robotically assisted implant guidance system. Following the implant placement a intraoral scan was performed to register the implant position after attaching a scan body. The virtual plan and the postoperative intraoral scan with the scan bodies were exported as STL files, superimposed and discrepancies were analyzed using Geomagic Control X software. Positional deviations were measured between the midpoint of the platform and apex of the planned and achieved implant positions. RESULTS: Seven of the 10 samples in this study were defined as fully robotically dynamically guided, while 3 were partially robotically guided. For the fully robotic dynamically guided group the mean deviation at the midpoint of the restorative platform of the implant, the apex of the implant, the top of the scanbody, and the mean angular deviation were 1.31mm (SD0.46mm), 1.58mm (SD0.61mm), 1.11mm (SD0.57mm), and 2.34 degrees (SD1.71°), respectively. While for the partially robotic dynamically guided cases it was 1.31mm (SD0.49mm), 1.45mm (SD0.3mm), 1.74mm (SD0.47mm), and 3.75 degrees (SD2.53°). Eight out of the 10 implants (irrespective of full or partial guidance) showed a buccal displacement. CONCLUSION: Robotic surgery offers a level of accuracy similar to fully guided implant placement, without the need for a physical template, and allowing for changes in the surgical plan at any time. The analytical method described in this study is an effective and radiation free quality control tool that can be used in implant dentistry as well as in other areas of dental research dentistry.

De novo bone formation after the sinus lift procedure.

BACKGROUND: The primary objective of this study is to use histomorphometric techniques to evaluate the concept that the new bone formed in the maxillary sinus lift procedure emanates from the endosteum of the sinus floor. In addition, the effect of the residual crest vertical dimension on the graft outcome and assessment of osteoclast numbers as an indirect measure of a connection between the crest and graft compartment are reported. METHODS: After grafting the maxillary sinus with irradiated allogenic bone, 37 intact, vertical bone cores with a 2.7 mm diameter were trephined at right angles to the alveolar crest. Quantitative measures were derived from a histomorphometric analysis of new bone and residual graft particles at contiguous zones along the long axis of the cores. Mean and median data were analyzed for associations with the distance from the sinus floor, dimensions of the residual crest, and other descriptive variables. A parallel series of tartrate resistant acid phosphatase-stained sections were evaluated for osteoclast counts. RESULTS: Mean new bone formation ranged from 24.3% to 30.2%. A statistically significant gradient of graft-particle area combined with this uniform distribution of new bone resulted in a false impression of less consolidation with the distance from the floor. There was no significant relationship between the distance from the sinus floor or dimension of the residual crest and the graft result. Mean osteoclast counts revealed a statistically significant difference (P <0.001) between the residual crest and the graft compartment with increased counts in the graft. CONCLUSIONS: Histologically, the process of new bone formation resembled a combination of de novo appositional and intramembraneous ossification. The findings suggested a passive role for the graft material and implicated the ingrowth of vascular and perivascular tissues as the most logical source of osteogenic capacity.

Efficacious recombinant influenza vaccines produced by high yield bacterial expression: a solution to global pandemic and seasonal needs.

It is known that physical linkage of TLR ligands and vaccine antigens significantly enhances the immunopotency of the linked antigens. We have used this approach to generate novel influenza vaccines that fuse the globular head domain of the protective hemagglutinin (HA) antigen with the potent TLR5 ligand, flagellin. These fusion proteins are efficiently expressed in standard E. coli fermentation systems and the HA moiety can be faithfully refolded to take on the native conformation of the globular head. In mouse models of influenza infection, the vaccines elicit robust antibody responses that mitigate disease and protect mice from lethal challenge. These immunologically potent vaccines can be efficiently manufactured to support pandemic response, pre-pandemic and seasonal vaccines.

TbG63, a golgin involved in Golgi architecture in Trypanosoma brucei.

Golgins are coiled-coil proteins that have been implicated in the structure and function of the Golgi complex. Here, we identify and characterize a trypanosomal golgin, TbG63, showing that it has a C-terminal membrane anchor and an N-terminus that projects into the cytoplasm. TbG63 in procyclic parasites is localized to the Golgi and interacts with the active, GTP-form of TbRab1A. Overexpression of TbG63 has dramatic effects on Golgi architecture -- effects that require the N-terminus -- whereas depletion has little, if any, effect on the growth rate. By contrast, in the bloodstream form of the parasite, depletion of TbG63 slows growth, although it has no obvious effect on the transport of a variant surface glycoprotein (VSG) or on Golgi structure. TbG63 might be a useful tool to study the structure and functioning of the Golgi complex.

A West Nile virus recombinant protein vaccine that coactivates innate and adaptive immunity.

A chimeric protein West Nile virus (WNV) vaccine capable of delivering both innate and adaptive immune signals was designed by fusing a modified version of bacterial flagellin (STF2 Delta ) to the EIII domain of the WNV envelope protein. This fusion protein stimulated interleukin-8 production in a Toll-like receptor (TLR)-5-dependent fashion, confirming appropriate in vitro TLR5 bioactivity, and also retained critical WNV-E-specific conformation-dependent neutralizing epitopes as measured by enzyme-linked immunosorbent assay. When administered without adjuvant to C3H/HeN mice, the fusion protein elicited a strong WNV-E-specific immunoglobulin G antibody response that neutralized viral infectivity and conferred protection against a lethal WNV challenge. This potent EIII-specific immune response requires a direct linkage of EIII to STF2 Delta , given that a simple mixture of the 2 components failed to induce an antibody response or to provide protection against virus challenge. The presence of a functional TLR5 gene in vivo is also required--TLR5-deficient mice elicited only a minimal antigen-specific response. These results confirm that vaccines designed to coordinately regulate the innate and adaptive immune responses can induce protective immune responses without the need for potentially toxic adjuvants. They also support the further development of an effective WNV vaccine and novel monovalent and multivalent vaccines for related flaviviruses.