Incorporation strategy for organic dyes into gold nanoparticle supercrystals.

Ordered arrays of plasmonic nanoparticles, supercrystals can lead to the formation of plasmon-polaritons. Coupling light emitters with plasmon polaritons might allow the formation of exciton-plasmon polaritons with properties tuneable by the supercrystal design. To construct such optically active materials, the inclusion of emitters is imperative. The addition of organic dyes without affecting the periodic order of the nanocrystals is difficult, as post-formation protocols might dissolve the supercrystals, and pre-formation addition might affect the self-assembly process. Here, we present an exemplary strategy to functionalize gold nanoparticles prior to self-assembly with a cyanine isothiocyanate dye that was obtained by a straightforward reaction of the amine functionalized dye with carbon disulfide. In the second step, the nanoparticles are functionalized with a thiol-terminated polystyrene, which stabilizes the nanoparticles and governs the self-assembly process. The dye can be integrated in a quantitative fashion, and the nanoparticles can be self-assembled into supercrystals. The strategy should be applicable in general for amine functionalized dyes, which is a common modification.

Tooth discoloration induced by apical plugs with hydraulic calcium silicate-based cements in teeth with open apices-a 2-year in vitro study.

OBJECTIVES: To assess tooth discoloration induced by different hydraulic calcium silicate-based cements (HCSCs), including effects of blood and placement method. MATERIALS AND METHODS: Eighty bovine teeth cut to a length of 18 mm (crown 8 mm, root 10 mm) were randomly assigned to 10 groups (n = 8), receiving orthograde apical plug treatment (APT). Apical plugs were 4 mm in length and made of ProRoot MTA (Dentsply), Medcem MTA (Medcem), TotalFill BC RRM Fast Set Putty (Brasseler), or Medcem Medical Portland Cement (Medcem) plus bismuth oxide (Bi2O3) with and without bovine blood. Further, orthograde (with or without preoperative adhesive coronal dentin sealing) and retrograde APT were compared. Teeth were obturated with gutta-percha and sealer, sealed with composite and stored in distilled water. Tooth color was measured on apical plug, gutta-percha/sealer, and crown surface before treatment versus 24 h, 1, 3, 6, 12, and 24 months after treatment by spectrophotometry. Color difference (ΔE) values were calculated and analyzed by Shapiro-Wilk test, ANOVA with post hoc tests, Friedman test, t test, and post hoc tests with Bonferroni correction (α = .05). RESULTS: Tooth discoloration occurred in all groups with no significant differences between HCSCs (p > .05). After 24 months, color changes were prominent on roots but insignificant on crowns. Blood contamination induced a significantly decreased luminescence (p < .05). Blood had a stronger impact on tooth color than Bi2O3. No relevant effects of retrograde placement (p > .05) or preoperative dentin sealing (p > .05) were detected. CONCLUSIONS: Apical plugs of the tested HCSCs cause discoloration of bovine roots, but not discoloration of bovine tooth crowns within a 24-month period. CLINICAL RELEVANCE: APT should be performed carefully while avoiding direct contact with the coronal dentin, and in that case no aesthetic impairments occur.

Tooth-colored CAD/CAM monolithic restorations.

A monolithic restoration (also known as a full contour restoration) is one that is manufactured from a single material for the fully anatomic replacement of lost tooth structure. Additional staining (followed by glaze firing if ceramic materials are used) may be performed to enhance the appearance of the restoration. For decades, monolithic restoration has been the standard for inlay and partial crown restorations manufactured by both pressing and computer-aided design and manufacturing (CAD/CAM) techniques. A limited selection of monolithic materials is now available for dental crown and bridge restorations. The IDS (2015) provided an opportunity to learn about and evaluate current trends in this field. In addition to new developments, established materials are also mentioned in this article to complete the picture. In line with the strategic focus of the IJCD, the focus here is naturally on CAD/CAM materials.

Intraoral scanning systems - a current overview.

There is no doubt today about the possibilities and potential of digital impression-taking with the aid of intraoral optical impression systems, and the past few years have seen a considerable increase in the range of optical intraoral scanners available on the market. On the strength of numerous innovations and a wider range of indications in orthodontics and implantology, intraoral scanning systems appear to be a highly promising development for the future. Digital impression-taking with intraoral scanners has already shown itself in some respects to be clearly superior to conventional impression- taking. Particularly worthy of mention is the versatile integration of digital impressions into diagnostic and treatment concepts to provide a customizable healthcare solution for the patient. It remains exciting to look forward to future developments that will allow us to observe digital impression-taking--as with other digital applications already established in everyday life--becoming firmly established in the routine of dentistry and dental technology. This article presents an overview of the benefits and limitations of digital impression-taking using intraoral scanning systems, and includes a summary of all the relevant intraoral scanners available on the market at present.

Adhesive luting of new CAD/CAM materials.

OBJECTIVE: To evaluate the adhesive bonding performance of recently introduced tooth-colored CAD/CAM materials after different pretreatment protocols and using different luting materials. MATERIALS AND METHODS: The CAD/CAM materials under investigation were e.max CAD (lithium disilicate glass ceramic; Ivoclar Vivadent, Schaan, Liechtenstein), Celtra Duo (zirconia-reinforced lithium disilicate ceramic; Dentsply DeTrey, Konstanz, Germany), Lava Ultimate (resin nano ceramic; 3M ESPE, Neuss, Germany), and Enamic (resin infiltrated ceramic; Vita, Bad Säckingen, Germany). A total of 240 blocks (n = 5) received various pretreatments (no pretreatment, silane, sandblasting, sandblasting + silane, hydrofluoric acid, hydrofluoric acid + silane), and then different classes of adhesive luting composites were applied (adhesive: Prime&Bond XP + SCA + Calibra; Dentsply DeTrey; self adhesive: RelyX Unicem; 3M ESPE). After 24 h water storage and 10,000 thermocycles (5°C/55°C), specimens were cut into beams and microtensile bond strengths were recorded. RESULTS: Bonding performance of recent CAD/CAM materials was clearly influenced by the pretreatment method (P < 0.05). In general, significantly higher µ-TBS values were recorded for the ceramic materials compared to the hybrid materials (P < 0.05). Among the hybrid materials, Enamic exhibited higher bond strengths than Lava Ultimate (P < 0.05). However, despite the differences found, all materials showed a high level of bonding performance, being sufficient to withstand intraoral chewing forces during mastication. CONCLUSION: When pretreated as recommended by the manufacturers, recent tooth-colored CAD/CAM materials show an encouraging bonding performance for adhesive luting.

Anatomical categorization of isolated non-focal dystonia: novel and existing patterns using a data-driven approach.

According to expert consensus, dystonia can be classified as focal, segmental, multifocal, and generalized, based on the affected body distribution. To provide an empirical and data-driven approach to categorizing these distributions, we used a data-driven clustering approach to compare frequency and co-occurrence rates of non-focal dystonia in pre-defined body regions using the Dystonia Coalition (DC) dataset. We analyzed 1,618 participants with isolated non-focal dystonia from the DC database. The analytic approach included construction of frequency tables, variable-wise analysis using hierarchical clustering and independent component analysis (ICA), and case-wise consensus hierarchical clustering to describe associations and clusters for dystonia affecting any combination of eighteen pre-defined body regions. Variable-wise hierarchical clustering demonstrated closest relationships between bilateral upper legs (distance = 0.40), upper and lower face (distance = 0.45), bilateral hands (distance = 0.53), and bilateral feet (distance = 0.53). ICA demonstrated clear grouping for the a) bilateral hands, b) neck, and c) upper and lower face. Case-wise consensus hierarchical clustering at k = 9 identified 3 major clusters. Major clusters consisted primarily of a) cervical dystonia with nearby regions, b) bilateral hand dystonia, and c) cranial dystonia. Our data-driven approach in a large dataset of isolated non-focal dystonia reinforces common segmental patterns in cranial and cervical regions. We observed unexpectedly strong associations between bilateral upper or lower limbs, which suggests that symmetric multifocal patterns may represent a previously underrecognized dystonia subtype.

InLab and Cerec Connect: virtual contacts in maximum intercuspation compared with original contacts--an in vitro study.

PURPOSE: The aim of this in-vitro study was to evaluate the accuracy of inLab and Cerec Connect software in simulating the maximum intercuspal contacts in comparison to the real situation on the respective gypsum casts. MATERIALS AND METHODS: Ten pairs of maxillary and mandibular casts were mounted in articulators in maximum intercuspal position. The contacts of the gypsum casts were marked and digital photographs of the mandibular casts were taken. Digital impressions of arches were made using two different software packages; inLab (Version 3.83) and Cerec Connect (Version 3.83) using the Cerec Acquisition Center. The intercuspal position of the teeth was captured by buccal images. Screenshots of the virtual casts showing the occlusal contacts were saved. The digital photographs of the contacts of the cast and the screenshots of the occlusal contacts were superimposed using an image processing program. The number of contacts of the virtual mandibular models that were identical with the contacts of the gypsum casts were determined and calculated as percentages in relation to the gypsum cast contacts, which were set as 100%. The null hypothesis tested was that the Cerec connect software delivers contacts that are closer to the real situation than contacts created with the inLab software. RESULTS: Cerec Connect showed a median percentage of 41.6% and Inlab a median percentage of 31.9%. The Wilcoxon test revealed statistically significant differences between the inLab software and Cerec Connect. Especially at the contra-lateral side of that side where the virtual buccal registration was done, the contacts showed the greatest deviations from the original. CONCLUSION: Cerec Connect more precisely virtually simulated the real contacts than did inLab when scanning full-arch dentitions.

Examples of model-free implant restorations using Cerec inLab 4.0 software.

This case report demonstrates two ways to fabricate model-free implant restorations with the Cerec inLab 4.0 software. Because the patient, a woman with a history of periodontal disease, did not wish to have a removable partial denture, implant therapy was planned for the restoration of her edentulous areas 14/15 and 24/25. In addition, the restoration was to provide functional relief of the natural maxillary anterior teeth. The two implants for the first quadrant were planned as single-tooth restorations. Each was designed as a full contour implant supra-structure using the Cerec Biogeneric abutment design technique. After completing the design phase, each restoration proposal was split into two parts: a zirconia abutment and a lithium disilicate crown. For the restoration of the second quadrant, custom 20-degree-angled abutments were individualized and acquired with the Cerec camera. A block crown was then designed, milled in burn-out acrylic resin, and fabricated from a lithium disilicate glass-ceramic ingot according to the press ceramic technique. Additionally methods of provisional restorations are discussed.

Microscopic model of the optical absorption of carbon nanotubes functionalized with molecular spiropyran photoswitches.

The adsorption of molecules to the surface of carbon nanostructures opens a new field of hybrid systems with distinct and controllable properties. We present a microscopic study of the optical absorption in carbon nanotubes functionalized with molecular spiropyran photoswitches. The switching process induces a change in the dipole moment leading to a significant coupling to the charge carriers in the nanotube. As a result, the absorption spectra of functionalized tubes reveal a considerable redshift of transition energies depending on the switching state of the spiropyran molecule. Our results suggest that carbon nanotubes are excellent substrates for the optical readout of spiropyran-based molecular switches. The gained insights can be applied to other noncovalently functionalized one-dimensional nanostructures in an externally induced dipole field.

Performance of cardiac output measurement derived from arterial pressure waveform analysis in patients requiring high-dose vasopressor therapy.

BACKGROUND: Arterial pressure waveform analysis of cardiac output (APCO) without external calibration (FloTrac/Vigileo™) is critically dependent upon computation of vascular tone that has necessitated several refinements of the underlying software algorithms. We hypothesized that changes in vascular tone induced by high-dose vasopressor therapy affect the accuracy of APCO measurements independently of the FloTrac software version. METHODS: In this prospective observational study, we assessed the validity of uncalibrated APCO measurements compared with transpulmonary thermodilution cardiac output (TPCO) measurements in 24 patients undergoing vasopressor therapy for the treatment of cerebral vasospasm after subarachnoid haemorrhage. RESULTS: Patients received vasoactive support with [mean (sd)] 0.53 (0.46) µg kg(-1) min(-1) norepinephrine resulting in mean arterial pressure of 104 (14) mm Hg and mean systemic vascular resistance of 943 (248) dyn s(-1) cm(-5). Cardiac output (CO) data pairs (158) were obtained simultaneously by APCO and TPCO measurements. TPCO ranged from 5.2 to 14.3 litre min(-1), and APCO from 4.1 to 13.7 litre min(-1). Bias and limits of agreement were 0.9 and 2.5 litre min(-1), resulting in an overall percentage error of 29.6% for 68 data pairs analysed with the second-generation FloTrac(®) software and 27.9% for 90 data pairs analysed with the third-generation software. Precision of the reference technique was 2.6%, while APCO measurements yielded a precision of 29.5% and 27.9% for the second- and the third-generation software, respectively. For both software versions, bias (TPCO-APCO) correlated inversely with systemic vascular resistance. CONCLUSIONS: In neurosurgical patients requiring high-dose vasopressor support, precision of uncalibrated CO measurements depended on systemic vascular resistance. Introduction of the third software algorithm did not improve the insufficient precision (>20%) for APCO measurements observed with the second software version.

Gastrointestinal stromal tumour presenting acutely as gastroduodenal intussusception.

INTRODUCTION: Gastrointestinal stromal tumours (GISTs) are uncommon tumours of the gastrointestinal (GI) tract. We report a case of a gastric GIST that presented acutely as a gastroduodenal intussusception. CASE PRESENTATION: A 59-year-old woman presented with a week's history of vomiting anything she swallowed. Physical examination revealed a mildly tender abdomen without guarding or rebound tenderness. An epigastric mass was, however, palpated. Abdominal ultrasonography suggested an intussusception. At laparotomy, a tumour on the anterior wall of the stomach causing intussusception of the stomach into the duodenum was found. After reducing the intussusception, a wedge resection of the tumour was performed, which proved to be a GIST. DISCUSSION: GISTs represent a rare group of neoplasms of the GI tract. Gastric intussusception is a rarely documented condition. Symptoms range from intermittent epigastric pain to sudden onsets of severe pain with vomiting and shock. Pre-operative diagnosis can be difficult and diagnosis cannot be confirmed until surgery. The treatment of choice for localised gastric GIST is surgical resection. CONCLUSION: Although gastroduodenal intussusception, particularly secondary to a GIST, is uncommon, clinicians need to have a high index of suspicion in acutely vomiting patients, especially if they have experienced similar symptoms intermittently in the immediate past.

The inconsistency and instability of Parkinson's disease motor subtypes.

INTRODUCTION: Tremor-dominant (TD), indeterminate/mixed (ID/M) and postural instability gait difficulty/akinetic-rigid (PIGD/AR) are commonly used subtypes to categorize Parkinson's disease (PD) patients based on their most prominent motor signs. Three different algorithms to determine these motor subtypes are used. Here, we examined if PD subtypes are consistent among algorithms and if subtype stability over time depends on the applied algorithm. METHODS: Using a large longitudinal PD database, we applied 3 published algorithms of PD motor subtype classification in two sets of analyses: 1) cross-sectional analysis in 1185 patients, determining the prevalence of subtypes in 5-year intervals of disease duration; 2) longitudinal analysis of 178 patients, comparing subtypes of individual patients at baseline (within 5 years of diagnosis) and at follow-up ≥ 5 years after baseline. RESULTS: Cross-sectionally, prevalence of subtypes varied widely among the 3 algorithms: 5-32% TD, 9-31% ID/M, and 59-75% PIGD/AR. For all 3 algorithms, cross-sectional analysis showed a marked decline of TD prevalence with disease duration and a corresponding increase in PIGD/AR prevalence, driven by increasing gait/balance scores over time. Longitudinally, only 15-36% of baseline TD patients were still categorized as TD at 6.2 ± 1.0 years of follow-up. In 15-39% of baseline TD patients, the subtype changed to ID/M, and 46-50% changed to PIGD/AR. This shift was observed using all 3 algorithms. CONCLUSION: PD motor subtypes determined by different established algorithms are inconsistent and unstable over time. Lack of subtype fidelity should be considered when interpreting biomarker-subtype correlation and highlights the need for better definition of PD subtypes.

Ultrafine particles in scanning sprays: a standardized examination of five powders used for dental reconstruction.

BACKGROUND: Intraoral matting sprays for chairside systems can release fine or ultrafine particles or nanoparticles at dentists' workplaces and cause work-related health problems by inhalation exposure. Until now, little is known about the magnitude of the ultrafine fraction, when using these scanning sprays. Hence, more information is needed for workplace risk assessments in dental practices. METHODS: Five commonly used dental spray-powders were examined under standardized conditions. Ingredients were taken from the respective safety data sheet. Particle number-size distributions and total number concentrations were analyzed with a fast mobility particle sizer, and reported graphically as well as mean particle fractions smaller than 100 nm. Based on these measurements, risk assessments were conducted, and particle depositions in the lung were modelled. RESULTS: The mean fraction of particles smaller than 100 nm varied between 9 and 93% depending on the matting agent and mode of application of the intraoral scanning spray. Propellants can represent a large fraction of these particles. Titanium dioxide, pigment-suspensions, talcum and others particles, which can pose relevant health risks, were listed as ingredients of scanning sprays in safety data sheets. Nevertheless, the deposited fraction of hazardous particles in the lung of employees in dental practices seems to be small (15%) during this dental procedure. CONCLUSIONS: Our results suggest that dentists' personnel can be exposed to hazardous fine and ultrafine particles. Though extensive standardized measurements and systematic evaluation of safety data sheets were used for this study, they cannot sufficiently assess and categorize potential workplace-related health risks.

A comparison of the fabrication times of all-ceramic partial crowns: Cerec 3D vs IPS Empress.

UNLABELLED: Apart from precision, the time factor plays a decisive role in the fabrication of all-ceramic dental restorations. Therefore, the aim of this study was to compare two all-ceramic systems with regard to the time required for the fabrication of partial crowns [MODB]. The null hypothesis tested was that the fabrication times of CAD/CAM generated partial crowns are shorter than the fabrication times of partial crowns manufactured in the laboratory. MATERIALS AND METHODS: In sixteen model pairs mounted in the articulator, which corresponded to different clinical situations, tooth 36 was prepared for an all-ceramic partial crown [MODB]. With the Cerec3D method [CHAIR], the fabrication of the restoration was simulated directly on the "phantom patient". The IPS Empress system [LAB] was used forthe indirectfabrication method via an impression of the phantom patient. Both methods were used for each preparation. The adhesive luting procedure was not simulated and, therefore, not measured. RESULTS: The mean processing times [hh:mm:ss] were 00:35:05 (SD +/- 03:27 min) for the Cerec method and 04:17:54 (SD +/- 26:01 min) for the Empress method. The mean time on the phantom patient for process-induced activities was 11:47 minutes (SD +/- 02:08 min) for the Cerec method and 03:58 minutes (SD +/- 02:50 min) for the Empress method. DISCUSSION: Time expenditure for fabrication is only one aspect in order to assess the suitability of a restoration system. Both methods enable the dentist to provide high quality all ceramic restorations. Although the Empress method showed a time advantage of 65% during the fitting phase and occlusal grinding-in on the phantom patient in comparison to the Cerec method, the time spent during the laboratory phase has to be considered as well.

Reporting infections in clinical trials of patients with haematological malignancies.

BACKGROUND: Infections are common among patients treated for haematological malignancies and are associated with significant morbidity and mortality. The completeness of reporting infectious complications in randomized controlled trials (RCTs) assessing treatments for haematological malignancies is unknown. OBJECTIVES: We aimed to evaluate the completeness of reporting infectious complications in RCTs assessing treatments for haematological malignancies. DATA SOURCE: A systematic literature search was performed in PubMed database. STUDY ELIGIBILITY CRITERIA AND PARTICIPANTS: All primary published phase II/III RCTs between September 2016 and September 2018 evaluating treatments for haematological malignancies in adult patients were included. INTERVENTION: Reporting infectious complications. METHODS: A systematic review was conducted to evaluate the completeness of reporting. Study characteristics and data concerning reporting of infectious complications were collected by two independent reviewers. Quality of reporting was assessed using a modification of the CONSORT extension checklist for harms, including 15 items. RESULTS: One-hundred and seven RCTs were included. Most trials (97; 91%) provided some report on infections. Approximately half reported on each of pneumonia, sepsis and neutropenic fever; 12 trials (11%) reported on fungal infections. Only nine trials (8%) listed infections by type of pathogen (i.e. bacterial, fungal or viral) and 48 (45%) by source/type of infection (i.e. pneumonia, urinary tract infection, etc.). Most trials did not address infections in their title, abstract, introduction or discussion. Median number of items of the CONSORT modification reported was 7 points, (interquartile range (IQR) 6-9) for all included trials, with lower median for 34 acute leukaemia trials (median 6, IQR 5-8). CONCLUSIONS: Most trials evaluating treatment for haematological malignancies provide some data relating to infectious complications. The reports are mostly incomplete and rarely provided in a structured presentation.

Telescopically retained removable partial dentures on CAD/CAM generated all-ceramic primary telescopes.

The provision of patients with removable partial dentures on all-ceramic primary crowns with electroplated gold secondary parts is described as an alternative worthy of consideration in dental journals, lectures and in further training courses. The mode of operation is based on a precise, frictionless, passive fit between female and male components. To guarantee this even over large spans, intraoral joining of the individual components is necessary. However, this requires a different sequence of the treatment steps. The different procedures (conventional, procedure by Weigl, modified concept) are described in the following article. Clinical considerations, design principles, and special characteristics involved in producing the partial denture are explained.

Arabinoxylan consumption decreases postprandial serum glucose, serum insulin and plasma total ghrelin response in subjects with impaired glucose tolerance.

OBJECTIVE: Arabinoxylan (AX) consumption is associated with metabolic improvement during diabetes and with modulation of ghrelin, an orexigenic gut hormone. The effect of AX consumption on ghrelin secretion in disturbed metabolic states is unknown. Therefore, we investigated the postprandial responses to AX consumption of serum glucose, insulin and triglycerides and plasma total and acylated ghrelin in subjects with impaired glucose tolerance (IGT). DESIGN: Randomized, single-blind, controlled, crossover intervention trial. SUBJECTS: Seven female and four male adults with IGT, aged 55.5 years, and body mass index (BMI) 30.1 kg/m(2). INTERVENTION: Subjects received either placebo or 15 g AX supplement for 6 weeks with a 6-week washout period in-between. MAIN OUTCOME MEASUREMENTS: Postprandial responses of serum glucose, insulin and triglycerides, and plasma total and acylated ghrelin after a liquid meal challenge test (LMCT) measured at the beginning and at the end of the dietary intervention at -20, -5, 0, 15, 30, 45, 60, 90, 120, 150, 180, 210 and 240 min. RESULTS: After LMCT, AX consumption resulted in lower postprandial responses in serum glucose, insulin and triglycerides (P<0.05). Compared to placebo, total plasma ghrelin was also reduced by 42+/-8 pg/ml (P<0.001) after AX consumption with no difference in plasma acylated ghrelin. CONCLUSION: AX consumption improved postprandial metabolic responses after an LMCT in subjects with IGT and reduced total ghrelin response. However, acylated ghrelin responses were unchanged, suggesting that the acylated ghrelin-mediated orexigenic regulation is not improved as only total plasma ghrelin decreased.

Fit of surgical guides--manufactured by InLab 3D.

Based on an exclusively virtual implant planning and positioning concept, the fit of surgical-guide-like workpieces was evaluated in an in-vitro pilot study, manufactured with the InLab 3D system. From 85 maxillary casts, 8 were randomly selected. The first right maxillary incisor was removed. After optical impression of the maxillary anterior teeth, a drilling template was designed by the use of the InLab software, version 3.0. The mode "bridge" "dental database" was applied. The guidance was milled from a methacrylate block and braced on the adjacent teeth. After milling, they were checked for proper seat (without rocking). The discrepancies between the inner surface of the template and the opposing tooth surface was shown with a silcone based material, which rested on the casts after removing the template. The difference between the thickness of the silicone layer and the subjacent tooth surface was measured with a high resolution scanner. In order to characterize the fit of the 8 workpieces the average mean, average maximum and average minimum values of the fit were calculated in the buccal, incisal and palatinal area using the program Match 3D (W. Gloger, LMU): average mean: buccal: 65 microm; incisal: 116 microm; palatinal: 94 microm; average maximum: buccal: 162 microm; incisal: 202 microm; palatinal:190 microm; average minimum: buccal: 5 microm; incisal: 14 microm; palatinal: 15 microm. In the present study it was possible to produce drilling templates with the already commercially available InLab system. The results were presented at the Annual Meeting of the German Society of Computerized Dentistry 2007 as a short presentation.