The Causes of Dental Implant Migration into the Maxillary Sinus: A Case Series Study from 25 Years of Experience.

The use of dental implants to restore edentulous jaws has become commonplace. Usually, in the maxilla, following a tooth extraction, the height of alveolar bone decreases. This alteration in bone increases the risk of implants migrating into the sinus. In general, Caldwell-Luc and endoscopic surgery are performed to retrieve dental implants. In this case series, we collected data from 39 patients who had the complication of implant displacement within the maxillary sinus for 25 years. All the implants were removed using the Caldwell-Luc technique. Implant migration happened following functional loading, during the prosthetic procedure, due to lack of osseointegration in 3 patients, and during implant placement into the fresh socket in 3 patients. In the remaining cases, migration occurred preoperatively or postoperatively and prior to implant loading. Insufficient bone quantity is sometimes causing the implant to migrate to the maxillary sinus. In case of minimal bone height, a sinus lift before implant placement should be conducted. Retrieval of an implant pushed inside the maxillary antrum using the Caldwell Luc approach proved to be a reliable technique.

Re-Examination of the N2O + O Reaction.

The reaction of N2O with O is a key step in consumption of nitrous oxide in thermal processes. It has two product channels, NO + NO (R2) and N2 + O2 (R3). The rate constant for R2 has been measured both in the forward and the reverse direction at elevated temperature and is well established. However, the rate constant for the N2 + O2 channel (R3) has been difficult to quantify and has significant error limits. The direct reaction on the triplet surface has a barrier of around 40 kcal mol-1, and it is too slow for the N2 + O2 channel to have any practical significance. Recently, Pham and Lin (2022) suggested an alternative low activation energy reaction path that involves intersystem crossing and reaction on the singlet surface. In the present work, we re-examined a wide range of experiments relevant for the N2O + O reaction through kinetic modeling, paying attention to the impact of artifacts such as impurities and surface reactions. Experimental results from shock tubes and batch reactors on the final NO yield in N2O decomposition, covering temperatures of 973-2200 K and pressures of 0.013-11.5 atm, support k3 ∼ 0, consistent with the high activation energy for reaction on the triplet surface and a low probability of ISC.

Evaluation of the bacterial contamination of face masks worn by personnel in a center of COVID 19 hospitalized patients: A cross-sectional study.

Background: During the Coronavirus Pandemic, the use of masks has increased significantly. The lack of control on hygiene protocols and the need to use PPE properly increases the spread of bacterial infection. The purpose of this study was to investigate the degree of contamination and frequency of bacterial species isolated from surgical and N95 masks used by hospital personnel. Methods: A total number of 175 masks were collected from staff working in Sina hospital (Hamadan province, Iran) during the first six months of 2022. The bacterial contamination of masks were evaluated and identified using biochemical kits. Antimicrobial susceptibility testing of the isolates were done using Kirby-Bauer methods and MIC were assessed for each isolate against different disinfectants (Sodium hypochlorite 5%, Hydrogen Peroxide 3%, Ethanol 70% and Deconex). Results: Of 175 masks, 471 bacterial isolates were detected including 9 species. The most prevalent strain were Coagulase negative Staphylococcus (28%) followed by Acinetobacter (20.8%) and Pseudomonas (13.8%), while, Klebsiealla and Enterococcus were the least frequent species with the rate of 3.8% and 1.2%, respectively. The results of MIC methods indicated that all 471 strains were resistant to ehtanol70% and sensitive to hydrogen peroxide 3%. Furthermore, the mean average of Deconex inhibitory effect is lower than Sodium hypochlorite 5%. Conclusions: According to the results of this study, there was a high prevalence of CoNS, Acinetobacter and Pseudomonas in hospital with a high resistance pattern against antibiotics especially Ampicillin and disinfectants.

Can electrocautery of the mandibular condyle effectively treat condylar hyperplasia?

This study aims to introduce and evaluate a novel technique to treat unilateral condylar hyperplasia (UCH) by electrocauterization of the mandibular condyle via an intraoral approach. Patients suffering from unilateral condylar hyperplasia (UCH) were included in this study. All patients underwent electrocauterization of the affected condyle. An intraoral incision on the anterior border of the mandibular ramus was made to expose the external surface of the ramus and access the anterior border of the condylar head. A hole was then drilled into the condyle and cauterization was performed; six patients also received orthognathic surgery during the procedure. Patients underwent careful clinical assessment and radiological evaluation including panoramic view, lateral and posteroanterior cephalometry, cone-beam computed tomography (CBCT) and scintigraphy to assess condylar growth for a period of 12-24 months. Ten patients (5 male and 5 female) with active UCH type 1B or 2A were included in this study with a mean age of 20.7 years (range, 18-21.7 years). At the 12-month postoperative assessment, clinical evaluation showed stable dental occlusion with no midline shift; scintigraphy showed persistently reduced cellular activity, and computed tomography scans revealed no degeneration in either of the condyles with complete healing of the drilled holes. Within the limitations of this study it seems that the proposed treatment approach might be an alternative to previously established protocols.

Fully Digital versus Conventional Workflows for Fabricating Posterior Three-Unit Implant-Supported Reconstructions: A Prospective Crossover Clinical Trial.

This study assessed the clinical variables influencing the success of three-unit implant-supported fixed dental prostheses (ISFDPs) fabricated using either fully digital or conventional workflows. The clinical trial evaluated 10 patients requiring three-unit ISFDPs in the posterior mandible. Maxillomandibular relation records, and digital and conventional impressions were obtained from each patient using an intraoral scanner (IoS) and polyvinylsiloxane (PVS), and the frameworks were fabricated using zirconia and cobalt-chromium, respectively. A 2 µm accuracy scanner scanned the conventional master casts and standard reference models. The stereolithography (STL) files of the digital and conventional impressions were superimposed on the standard model file, and the accuracy was calculated with the best-fit algorithm. The framework adaptation and passivity were assessed using the one-screw and screw resistance tests. The time required for occlusal adjustment of both types of reconstructions, including the duration of the whole treatment, was recorded. The aesthetic appearance of ISFDPs was rated by each patient and clinician using a self-administered visual analogue scale questionnaire and the FDI World Dental Federation aesthetic parameters, respectively. The sample size was based on the power calculation, and alpha was set at 0.05 for the statistical analyses. The impression accuracy, framework adaptation and passivity, and reconstructions aesthetics did not significantly differ between the digital and conventional approaches. The total fabrication time was significantly shorter using the digital workflow. Within the limitations of this clinical study, the fully digital workflow can be used for the fabrication of ISFDPs with a clinical outcome comparable to that of the conventional workflow.

On the Rate Constant for NH2+HO2 and Third-Body Collision Efficiencies for NH2+H(+M) and NH2+NH2(+M).

In low-temperature flash photolysis of NH3/O2/N2 mixtures, the NH2 consumption rate and the product distribution is controlled by the reactions NH2 + HO2 → products (R1), NH2 + H (+M) → NH3 (+M) (R2), and NH2 + NH2 (+M) → N2H4 (+M) (R3). In the present work, published flash photolysis experiments by, among others, Cheskis and co-workers, are re-interpreted using recent direct measurements of NH2 + H (+N2) and NH2 + NH2 (+N2) from Altinay and Macdonald. To facilitate analysis of the FP data, relative third-body collision efficiencies compared to N2 for R2 and R3 were calculated for O2 and NH3 as well as for other selected molecules. Results were in good agreement with the limited experimental data. Based on reported NH2 decay rates in flash photolysis of NH3/O2/N2, a rate constant for NH2 + HO2 → NH3 + O2 (R1a) of k1a = 1.5(±0.5) × 1014 cm3 mol-1 s-1 at 295 K was derived. This value is higher than earlier determinations based on the FP results but in good agreement with recent theoretical work. Kinetic modeling of reported N2O yields indicates that NH2 + HO2 → H2NO + O (R1c) is competing with R1a, but perturbation experiments with addition of CH4 indicate that it is not a dominating channel. Measured HNO profiles indicate that this component is formed directly by NH2 + HO2 → HNO + H2O (R1b), but theoretical work indicates that R1b is only a minor channel. Based on this analysis, we estimate k1c = 2.5 × 1013 cm3 mol-1 s-1 and k1b = 2.5 × 1012 cm3 mol-1 s-1 at 295 K, with significant uncertainty margins.

Bending behavior of biomimetic scale covered beam with tunable stiffness scales.

Biomimetic scales provide a convenient template to tailor the bending stiffness of the underlying slender substrate due to their mutual sliding after engagement. Scale stiffness can therefore directly impact the substrate behavior, opening a potential avenue for substrate stiffness tunability. Here, we have developed a biomimetic beam, which is covered by tunable stiffness scales. Scale tunability is achieved by specially designed plate like scales consisting of layers of low melting point alloy (LMPA) phase change materials fully enclosed inside a soft polymer. These composite scales can transition between stiff and soft states by straddling the temperatures across LMPA melting points thereby drastically altering stiffness. We experimentally analyze the bending behavior of biomimetic beams covered with tunable stiffness scales of two architectures-one with single enclosure of LMPA and one with two enclosures of different melting point LMPAs. These architectures provide a continuous stiffness change of the underlying substrate post engagement, controlled by the operating temperature. We characterize this response using three-point bending experiments at various temperature profiles. Our results demonstrate for the first time, the pronounced and reversible tunability in the bending behavior of biomimetic scale covered beam, which are strongly dependent on the scale material and architecture. Particularly, it is shown that the bending stiffness of the biomimetic scale covered beam can be actively and reversibly tuned by a factor of up to 7. The developed biomimetic beam has applications in soft robotic grippers, smart segmented armors, deployable structures and soft swimming robots.

Prevalence of Ocular Complications in Patients with Zygomatic Bone Fractures in an Iranian Population.

OBJECTIVES: Damages to the middle third of the facial bone generally involve the orbital skeleton and can lead to eye impairment. In this study, it is attempted to determine the incidence of ophthalmic injuries in maxillofacial trauma with zygomatic bone fractures. MATERIALS AND METHODS: One hundred and fifteen cases with ophthalmic (ocular) involvement after maxillofacial trauma were referred to the Shariati Hospital, Tehran, Iran, and were visited at the Ophthalmology Department between 2016 and 2018. Zygomatic fractures and resulting ocular complications were evaluated in 87 males and 28 females with the mean ages of 26 and 32 years, respectively. RESULTS: Subconjunctival ecchymosis was detected in 23.07% of men and 21.05% of women. Displacement of the palpebral fissure was detected in 26.5% of men and 27.6% of women. Furthermore, the unequal pupillary level was observed in 18.37% of men and 15.78% of women. Diplopia was detected in 8.9% of men and 10.5% of women. Additionally, enophthalmos was observed in 23.1% of men and 25% of women. CONCLUSION: The most common ocular presentations in midfacial trauma are diplopia and reduced visual acuity. Even after the operation, a significant number of patients experience poor vision and diplopia. Ophthalmology consultation is essential for these patients.

Comparing 4-mm dental implants to longer implants placed in augmented bones in the atrophic posterior mandibles: One-year results of a randomized controlled trial.

BACKGROUND: Short implants have been proposed as an alternative for the rehabilitation of atrophic edentulous areas. PURPOSE: To evaluate the efficacy of 4-mm implants vs longer implants in the atrophic posterior mandibles. MATERIALS AND METHODS: Eleven patients with bilateral atrophic mandibles were rehabilitated with two to four 4-mm implants and 10 or 8-mm long implants in augmented bone using Guided Bone Regeneration procedure. One side of the mandibles was randomly allocated to vertical augmentation with mixed autogenous bone and allograft. Implants were placed in both sides of the mandible after 6 months, and loaded after another 2 months. Subsequently, implant and prosthesis failures, marginal bone levels changes, and any complication were evaluated after 1-year follow-up. RESULTS: In this study, one patient dropped out and no failures occurred. However, 4-mm implants loss of 0.30 ± 0.34 mm peri-implant marginal bone and long implants loss of 0.47 ± 0.54 mm marginal bone were observed after 1-year of follow-up. The difference between the two groups was not statistically significant (difference = -0.16 ± 0.68 mm; P = 0.46). Eight complications occurred in five augmented sites of the patients, and no complication was found to occur in the short implants sites. CONCLUSIONS: One-year after loading, 4-mm implants had similar outcomes as long implants in augmented bone. Therefore, short implants might be a feasible treatment in atrophic mandibles.

Activation Toll-Like Receptor7 (TLR7) Responsiveness Associated with Mitogen- Activated Protein Kinase (MAPK) Activation in HIOEC Cell Line of Oral Squamous Cell Carcinoma.

STATEMENT OF THE PROBLEM: Oral squamous cell carcinoma is the most common oral malignancy. Toll-like receptor (TLR) activation led to alterations in the levels of mRNA encoding the TLR accountable for recognizing the inducing agonist and cross-regulation of other TLR. PURPOSE: The purpose of this study is determination of mitogen-associated protein kinase (MAPK) activation in human immortalized oral epithelial cell (HIOEC) line via up regulating of TLR7. MATERIALS AND METHOD: expression of TLR7 was measured in HIOEC and normal cells by quantitative real-time polymerase chain reaction (qRT-PCR) and samples were calibrated by ß-actin. RESULTS: Western blot analysis discovered high expression of TLR7 and MAPK in HIOEC cell lines. TLR7 was over-expressed in HIOEC cell line. Imiquimod-induced expression of interleukin (IL)-6, IL-8, and vascular endothelial growth factor (VEGF) was inhibited by TLR7 siRNA in HIOEC cells as determined by reverse transcription polymerase chain reaction (RT-PCR). Mean fluorescence intensity of nuclear p38 expression was determined in HIOEC cell lines (p< 0.05). RT-PCR analysis of IL-6, IL-8, and VEGF mRNA expression in HIOEC cells stimulated with imiquimod (1 µg/ml) for indicated time points. CONCLUSION: TLR7 is functionally over-expressed in HIOEC cell line of oral squamous cell carcinoma and development of resistance to cisplatin in human oral squamous cell carcinoma might occur through the mechanism involving activation of TLR7 and its dependent signaling pathway.

Comparison of Short and Standard Implants in the Posterior Mandible: A 3D Analysis Using Finite Element Method.

OBJECTIVES: This study aimed to analyze functional stresses around short and long implant-supported prostheses with different crown heights. MATERIALS AND METHODS: Four three-dimensional (3D) models were designed with SolidWorks 2015. In models 1 (control) and 2, three dental implants (second premolar 4.1×8 mm, molars: 4.8×8 mm) were placed. In models 3 and 4, three dental implants (second premolar 4.1×4 mm, molars: 4.8×4) were placed. Residual bone height was 10 mm in groups 1 and 2 (grafted bone) models and 6 mm in groups 3 and 4. The crown heights were modeled at 11.5 mm for groups 1 to 3, and 15 mm for group 4. The applied oblique force was 220 N to simulate chewing movements. The maximum von Mises and principal stresses on the implants and the supporting tissues were compared using the 3D finite element method. RESULTS: In all models, the highest stress value was seen within the most coronal part of bone (crestal bone), which was cortical or grafted bone. The highest stress values in the bone supporting the implant neck were seen in the premolar region of each model, especially in model 4 (291.16 MPa). The lowest stress values were demonstrated in the molar region of model 3 (48.066 MPa). The model 2 implants showed the highest von Mises stress concentrated at their neck (424.44 MPa). CONCLUSIONS: In atrophic posterior mandible with increased crown height space, short implants with wider diameter seem to be a more feasible approach compared to grafting methods.

Ab initio calculations and kinetic modeling of thermal conversion of methyl chloride: implications for gasification of biomass.

Limitations in current hot gas cleaning methods for chlorine species from biomass gasification may be a challenge for end use such as gas turbines, engines, and fuel cells, all requiring very low levels of chlorine. During devolatilization of biomass, chlorine is released partly as methyl chloride. In the present work, the thermal conversion of CH3Cl under gasification conditions was investigated. A detailed chemical kinetic model for pyrolysis and oxidation of methyl chloride was developed and validated against selected experimental data from the literature. Key reactions of CH2Cl with O2 and C2H4 for which data are scarce were studied by ab initio methods. The model was used to analyze the fate of methyl chloride in gasification processes. The results indicate that CH3Cl emissions will be negligible for most gasification technologies, but could be a concern for fluidized bed gasifiers, in particular in low-temperature gasification. The present work illustrates how ab initio theory and chemical kinetic modeling can help to resolve emission issues for thermal processes in industrial scale.

The effects of graft size and insertion site location during anterior cruciate ligament reconstruction on intercondylar notch impingement.

BACKGROUND: Intercondylar notch impingement is detrimental to the anterior cruciate ligament (ACL). Notchplasty is a preventative remodeling procedure performed on the intercondylar notch during ACL reconstruction (ACLR). This study investigates how ACL graft geometry and both tibial and femoral insertion site location may affect ACL-intercondylar notch interactions post ACLR. A range of ACL graft sizes are reported during ACLR, from six millimeters to 11mm in diameter. Variability of three millimeters in ACL insertion site location is reported during ACLR. This study aims to determine the post-operative effects of minor variations in graft size and insertion location on intercondylar notch impingement. METHODS: Several 3D finite element knee joint models were constructed using three ACL graft sizes and polar arrays of tibial and femoral insertion locations. Each model was subjected to flexion, tibial external rotation, and valgus motion. Impingement force and contact area between the ACL and intercondylar notch compared well with experimental cadaver data from literature. RESULTS: A three millimeter anterior-lateral tibial insertion site shift of the maximum size ACL increased impingement force by 242.9%. A three millimeter anterior-proximal femoral insertion site shift of the maximum size ACL increased impingement by 346.2%. Simulated notchplasty of five millimeters eliminated all impingement for the simulation with the greatest impingement. For the kinematics applied, small differences in graft size and insertion site location led to large increases in impingement force and contact area. CONCLUSIONS: Minor surgical variations may increase ACL impingement. The results indicate that notchplasty reduces impingement during ACLR. Notchplasty may help to improve ACLR success rates.

The effects of knee joint kinematics on anterior cruciate ligament injury and articular cartilage damage.

This study determined which knee joint motions lead to anterior cruciate ligament (ACL) rupture with the knee at 25° of flexion. The knee was subjected to internal and external rotations, as well as varus and valgus motions. A failure locus representing the relationship between these motions and ACL rupture was established using finite element simulations. This study also considered possible concomitant injuries to the tibial articular cartilage prior to ACL injury. The posterolateral bundle of the ACL demonstrated higher rupture susceptibility than the anteromedial bundle. The average varus angular displacement required for ACL failure was 46.6% lower compared to the average valgus angular displacement. Femoral external rotation decreased the frontal plane angle required for ACL failure by 27.5% compared to internal rotation. Tibial articular cartilage damage initiated prior to ACL failure in all valgus simulations. The results from this investigation agreed well with other experimental and analytical investigations. This study provides a greater understanding of the various knee joint motion combinations leading to ACL injury and articular cartilage damage.

Hierarchical analysis and multi-scale modelling of rat cortical and trabecular bone.

The aim of this study was to explore the hierarchical arrangement of structural properties in cortical and trabecular bone and to determine a mathematical model that accurately predicts the tissue's mechanical properties as a function of these indices. By using a variety of analytical techniques, we were able to characterize the structural and compositional properties of cortical and trabecular bones, as well as to determine the suitable mathematical model to predict the tissue's mechanical properties using a continuum micromechanics approach. Our hierarchical analysis demonstrated that the differences between cortical and trabecular bone reside mainly at the micro- and ultrastructural levels. By gaining a better appreciation of the similarities and differences between the two bone types, we would be able to provide a better assessment and understanding of their individual roles, as well as their contribution to bone health overall.

Effect of low-concentration povidone iodine on postoperative complications after third molar surgery: a pilot split-mouth study.

PURPOSE: Povidone iodine is used primarily as an antiseptic to decrease surgical site infection. Its hemostatic and antiedematous properties in oral surgery also have been investigated recently. PATIENTS AND METHODS: A randomized controlled clinical trial was performed in 30 patients undergoing mandibular third molar removal in a split-mouth design. In the study group, a povidone iodine solution with a concentration of 0.5 mg/mL was used as the coolant and irrigant solution, whereas normal saline was used in the control group. Swelling (orotragus and mentotragus distances), trismus (maximum interincisal opening), and pain (visual analog scale score) were evaluated on postoperative days 2 and 7. RESULTS: In the study group, a significant decrease in swelling and trismus was observed at the 2 postoperative visits (P = .00) compared with the control group. The decrease of pain in the study group was not statistically significant at either postoperative visit (P > .05). More patients (63%) were subjectively satisfied with the side treated with povidone iodine. CONCLUSION: Povidone iodine irrigation is an inexpensive and safe method to lessen the postoperative sequelae of third molar surgery.

Effects of different loading patterns on the trabecular bone morphology of the proximal femur using adaptive bone remodeling.

In this study, the changes in the bone density of human femur model as a result of different loadings were investigated. The model initially consisted of a solid shell representing cortical bone encompassing a cubical network of interconnected rods representing trabecular bone. A computationally efficient program was developed that iteratively changed the structure of trabecular bone by keeping the local stress in the structure within a defined stress range. The stress was controlled by either enhancing existing beam elements or removing beams from the initial trabecular frame structure. Analyses were performed for two cases of homogenous isotropic and transversely isotropic beams.Trabecular bone structure was obtained for three load cases: walking, stair climbing and stumbling without falling. The results indicate that trabecular bone tissue material properties do not have a significant effect on the converged structure of trabecular bone. In addition, as the magnitude of the loads increase, the internal structure becomes denser in critical zones. Loading associated with the stumbling results in the highest density;whereas walking, considered as a routine daily activity, results in the least internal density in different regions. Furthermore, bone volume fraction at the critical regions of the converged structure is in good agreement with previously measured data obtained from combinations of dual X-ray absorptiometry (DXA) and computed tomography (CT). The results indicate that the converged bone architecture consisting of rods and plates are consistent with the natural bone morphology of the femur. The proposed model shows a promising means to understand the effects of different individual loading patterns on the bone density.

Numerical simulation of load-induced bone structural remodelling using stress-limit criterion.

A simple and efficient numerical method for predicting the remodelling of adaptive materials and structures under applied loading was presented and implemented within a finite element framework. The model uses the trajectorial architecture theory of optimisation to predict the remodelling of material microstructure and structural organisation under mechanical loading. We used the proposed model to calculate the density distribution of proximal femur in the frontal plane. The loading considered was the hip joint contact forces and muscular forces at the attachment sites of the muscles to the bone. These forces were estimated from a separate finite element calculation using a heterogeneous three-dimensional model of the proximal femur. The density distributions obtained by this procedure has a qualitative similarity with in vivo observations. Solutions displayed the characteristic high-density channels that are evident in the Dual X-ray Absorptiometry scan. There is also evidence of the intramedullary canal, as well as low-density regions in the femoral neck. Several parametric studies were carried out to highlight the advantages of the proposed method, which includes fast convergence and low-computational cost. The potential applications of the proposed method in predicting bone structural remodelling in cancer are also briefly discussed.

Buckling of regular, chiral and hierarchical honeycombs under a general macroscopic stress state.

An approach to obtain analytical closed-form expressions for the macroscopic 'buckling strength' of various two-dimensional cellular structures is presented. The method is based on classical beam-column end-moment behaviour expressed in a matrix form. It is applied to sample honeycombs with square, triangular and hexagonal unit cells to determine their buckling strength under a general macroscopic in-plane stress state. The results were verified using finite-element Eigenvalue analysis.

In-vitro calcification study of polyurethane heart valves.

Tri-leaflet polyurethane heart valves have been considered as a potential candidate in heart valve replacement surgeries. In this study, polyurethane (Angioflex(®)) heart valve prostheses were fabricated using a solvent-casting method to evaluate their calcification resistance. These valves were subjected to accelerated life testing (continuous opening and closing of the leaflets) in a synthetic calcification solution. Results showed that Angioflex(®) could be considered as a potential material for fabricating prosthetic heart valves with possibly a higher calcification resistance compared to tissue valves. In addition, calcification resistance of bisphosphonate-modified Angioflex(®) valves was also evaluated. Bisphosphonates are considered to enhance the calcification resistance of polymers once covalently bonded to the bulk of the material. However, our in-vitro results showed that bisphosphonate-modified Angioflex(®) valves did not improve the calcification resistance of Angioflex(®) compared to its untreated counterparts. The results also showed that cyclic loading of the valves' leaflets resulted in formation of numerous cracks on the calcified surface, which were not present when calcification study did not involve mechanical loading. Further study of these cracks did not result in enough evidence to conclude whether these cracks have penetrated to the polymeric surface.