Chloroplast C-to-U RNA editing in vascular plants is adaptive due to its restorative effect: testing the restorative hypothesis.

The adaptiveness of nonsynonymous RNA editing (recoding) could be conferred by the flexibility of the temporal-spatially controllable proteomic diversity, or by its restorative effect which fixes unfavorable genomic mutations at the RNA level. These two complementary hypotheses, namely, the diversifying hypothesis and the restorative hypothesis, have distinct predictions on the landscape of RNA editing sites. We collected the chloroplast C-to-U RNA editomes of 21 vascular plants (11 angiosperms, four gymnosperms, and six ferns) from a previous study, aiming to testify whether the plant editomes typically conform to the restorative hypothesis. All predictions made by the restorative hypothesis are verified: (i) nonsynonymous editing sites are more frequent and have higher editing levels than synonymous sites; (ii) nonsynonymous editing levels are extremely high and show weak tissue-specificity in plants; (iii) on the inferred genomic sites with recent T-to-C mutations, nonsynonymous sites but not synonymous sites are compensated by C-to-U RNA editing. In conclusion, nonsynonymous C-to-U RNA editing in plants is adaptive due to its restorative effects. The recoding levels are high and are constantly required across the whole plant so that the recoding events could perfectly mimic DNA mutations. The evolutionary significance of plant RNA editing is systematically demonstrated at the genome-wide level.

Learning from the Codon Table: Convergent Recoding Provides Novel Understanding on the Evolution of A-to-I RNA Editing.

Adenosine-to-inosine (A-to-I) RNA editing recodes the genetic information. Apart from diversifying the proteome, another tempting advantage of RNA recoding is to correct deleterious DNA mutation and restore ancestral allele. Solid evidences for beneficial restorative editing are very rare in animals. By searching for "convergent recoding" under a phylogenetic context, we proposed this term for judging the potential restorative functions of particular editing site. For the well-known mammalian Gln>Arg (Q>R) recoding site, its ancestral state in vertebrate genomes was the pre-editing Gln, and all 470 available mammalian genomes strictly avoid other three equivalent ways to achieve Arg in protein. The absence of convergent recoding from His>Arg, or synonymous mutations on Gln codons, could be attributed to the strong maintenance on editing motif and structure, but the absence of direct A-to-G mutation is extremely unexpected. With similar ideas, we found cases of convergent recoding in Drosophila genus, reducing the possibility of their restorative function. In summary, we defined an interesting scenario of convergent recoding, the occurrence of which could be used as preliminary judgements for whether a recoding site has a sole restorative role. Our work provides novel insights to the natural selection and evolution of RNA editing.

Achieving conservation and restoration outcomes through ecologically beneficial aquaculture.

A range of conservation and restoration tools are needed to safeguard the structure and function of aquatic ecosystems. Aquaculture, the culturing of aquatic organisms, often contributes to the numerous stressors that aquatic ecosystems face, yet some aquaculture activities can also deliver ecological benefits. We reviewed the literature on aquaculture activities that may contribute to conservation and restoration outcomes, either by enhancing the persistence or recovery of one or more target species or by moving aquatic ecosystems toward a target state. We identified 12 ecologically beneficial outcomes achievable via aquaculture: species recovery, habitat restoration, habitat rehabilitation, habitat protection, bioremediation, assisted evolution, climate change mitigation, wild harvest replacement, coastal defense, removal of overabundant species, biological control, and ex situ conservation. This list may be expanded as new applications are discovered. Positive intentions do not guarantee positive ecological outcomes, so it is critical that potentially ecologically beneficial aquaculture activities be evaluated via clear and measurable indicators of success to reduce potential abuse by greenwashing. Unanimity on outcomes, indicators, and related terminology will bring the field of aquaculture-environment interactions into line with consensus standards in conservation and restoration ecology. Broad consensus will also aid the development of future certification schemes for ecologically beneficial aquaculture.

Se necesita una gama de herramientas de conservación y restauración para salvaguardar la estructura y función de los ecosistemas acuáticos. La acuacultura (el cultivo de organismos acuáticos) generalmente contribuye a los numerosos estresantes que soportan los ecosistemas acuáticos, aunque algunas actividades de la acuacultura también pueden proporcionar beneficios ecológicos. Revisamos la literatura sobre las actividades de acuacultura que pueden contribuir a los resultados de conservación y restauración, ya sea al incrementar la persistencia o recuperación de una o más especies objetivo o al llevar a los ecosistemas acuáticos hacia un estado objetivo. Identificamos doce resultados con beneficios ecológicos que pueden lograrse con la acuacultura: recuperación de la especie, recuperación del hábitat, restauración del hábitat, rehabilitación del hábitat, protección del hábitat, bioreparación, evolución asistida, mitigación del cambio climático, sustitución de la captura silvestre, defensa costera, eliminación de las especies sobreabundantes, control biológico y conservación ex situ. Esta lista puede expandirse conforme se descubren nuevas aplicaciones. Las intenciones positivas no garantizan resultados ecológicos positivos, así que es importante que se evalúen las actividades de acuacultura con un posible beneficio ecológico por medio de indicadores del éxito claros y medibles para reducir el abuso potencial por ecoblanqueo o greenwashing. La unanimidad en los resultados, indicadores y terminología relacionada armonizará las interacciones entre la acuacultura y el ambiente con los estándares de la conservación y la ecología de la restauración. Un consenso generalizado también ayudará con el desarrollo de futuros esquemas de certificación para la acuacultura con beneficios ecológicos. Obtención de resultados de conservación y restauración a través de la acuacultura con beneficios ecológicos.

National trends and outcomes of total proctocolectomy and completion proctectomy ileal pouch-anal anastomosis procedures for ulcerative colitis.

AIM: The purpose of this study is to assess US operative trends and outcomes of ulcerative colitis (UC) patients undergoing total proctocolectomy with ileal pouch-anal anastomosis (TPC-IPAA) or completion proctectomy with IPAA (CP-IPAA). METHODS: Adult UC patients who underwent TPC-IPAA or CP-IPAA were analysed retrospectively using the 2016-2020 American College of Surgeons National Surgical Quality Improvement Program database. Factors associated with 30-day overall and serious morbidity were identified using multivariable logistic regression. RESULTS: A total of 1696 patients were identified, with 958 patients (56.5%) undergoing TPC-IPAA and 738 (43.5%) undergoing CP-IPAA. A greater proportion of TPC-IPAAs were performed each year (except in 2019) compared to CP-IPAAs over the study period (P trend <0.001). Unadjusted analysis showed comparable rates of overall (20.8% vs. 24.4%, P = 0.076) and serious morbidity (14.3% vs. 12.7%, P = 0.352) between TPC-IPAA and CP-IPAA patients. Robotic TPC-IPAA had no differences in complications compared to laparoscopic and open approaches. Robotic CP-IPAA had higher anastomotic leak rates and longer hospital length of stay compared to laparoscopic and open approaches. Obesity was associated with increased odds of overall and serious morbidity for patients who underwent TPC-IPAA. Steroid/immunosuppressive therapy was associated with increased odds of overall and serious morbidity for patients who underwent CP-IPAA. CONCLUSIONS: Obese patients should be informed of their increased morbidity risk and offered counselling on weight loss prior to surgery when feasible. Patients on steroid/immunosuppressive therapy within 30 days preoperatively should not undergo CP-IPAA or should delay surgery until they can be safely off those medications.

Childhood sound disturbance and sleep problems in Alpine valleys with high levels of traffic exposures and greenspace.

Sound disturbance and sleep problems are regarded as the most common adverse effects of environmental noise but evidence of the role of air pollution and greenspace is scant. This is especially true for children who find themselves in a sensitive developmental period and experience their environment differently than adults. This study examined the joint effects of traffic exposures and residential greenspace on child sound disturbance and sleep problems via perceptions of neighborhood quality. We used cross-sectional data for 1251 schoolchildren (8-12 years) in the Tyrol region of Austria/Italy. Questionnaires provided information on sociodemographic and housing factors, perceived neighborhood quality, sound disturbance in different situations, and sleep problems. Modelled acoustic indicators included day-evening-night sound levels and the highest percentile level, and night-time sound level and a bespoke sleep disturbance index. Nitrogen dioxide served as a proxy for traffic-related air pollution. The normalized difference vegetation index was calculated as a measure of residential greenspace, and presence of a domestic garden was self-reported. Results showed that higher level of traffic-related exposures was positively associated with sound disturbance and sleep problems, while living in a greener area, especially in a house with a garden, was associated with lower sound disturbance and less sleep problems even in the presence of traffic. Traffic exposures contributed to more unfavorable, and greenspace to more positive perceptions in terms of traffic-related stressors, opportunities for outdoor recreation, and general satisfaction with the neighborhood. This indirect path seemed more important for greenspace than for traffic exposures. In conclusion, it seems advantageous to combine traffic-related mitigation with improving access to greenspace in interventions for supporting the acoustic comfort of children during day and nighttime. Even highly nature-dominated environments could still benefit from proximal green infrastructure, especially from domestic gardens.

The varied restorative values of campus landscapes to students' well-being: evidence from a Chinese University.

BACKGROUND: The literature on therapeutic landscapes highlights that the university campus landscape has restorative effects on students. This deserves more scholarly attention since mental health has become an important issue among university students. However, existing empirical studies have revealed mixed evidence with little attention to the heterogeneity across the design and, therefore, the potential therapeutic effects across different landscapes. METHOD: This research examined how 13 landscape sites on a university campus might be differentially related to student well-being. These sites were identified from a variety of sources (campus design documents, photos used in the university's social media posts, and interviews with a small group of students) to represent a comprehensive list of places that students might visit. The data was collected in a large online survey of a Chinese university (n = 2,528). We asked about students' use of individual landscape sites and the associated motivations for visits, and measured well-being using a perceived stress scale and overall evaluation of the happiness level. Bivariate analysis was used to explore the zero-order associations between landscape use and well-being. OLS (for stress) and logistic regressions (for happiness) were conducted to further evaluate the associations after controlling the student background variables and potential correlations of uses across different landscapes. RESULTS: Among 13 landscape sites, four sites had significant positive associations with either or both measures of well-being after controlling for the student characteristics and use of the other landscape sites. There was also an additive benefit of visiting more landscapes. Compared to those who did not frequently visit any of the sites, well-being had a significant stepwise increase among those who frequently visited one or two and more sites. One site that was significantly related to both measures of well-being only offered distant views of landscapes, but it was right next to the study areas. CONCLUSIONS: This study demonstrates the heterogeneity of restorative effects across different landscapes on campus. The findings suggest that effective landscape design that aims to promote student well-being should be placed close to stressors (i.e., where they study), and between where they study and live to offer students opportunities to break from the common routines and to relax. The findings hold greater relevance for universities in China and institutions with similar student campus lifestyles, occupancies, and behavior patterns worldwide.

Inconvenient sampling: Community-engaged and restorative justice approaches to genetic counseling student research.

Genetic counseling research requires a comprehensive approach since it frequently serves as the foundation for clinical care practice. Genetic counseling students play a pivotal role in advancing the profession, as they contribute a significant proportion of the research conducted within the genetic counseling community. However, a prevailing trend of convenience sampling of genetic counselors has limited the diversity of perspectives in student research projects. This article promotes a strategy for greater inclusivity and equity in research by emphasizing community-engaged and empowered research through the perspective of restorative justice. Reflecting on the shadow of the harmful ideologies of eugenics in our profession underscores the need to amplify patients' voices and diverse experiences. Community-engaged research-in collaboration with individuals, families, and communities directly impacted by genetic counseling-transcends traditional research paradigms, empowering patients and addressing systemic inequities. Incorporating community-engaged research into genetic counseling student projects aims to empower future professionals to better understand patient perspectives and needs while working toward addressing historical injustices. This article explores the potential benefits and pathways of incorporating community-engaged research and restorative justice principles into genetic counseling scholarly work, promoting empathy, cultural responsiveness, and ultimately, a more patient-centered approach to research and clinical care. By embracing this collective journey toward authentic partnership in the production of high-quality evidence in genetic counseling student research and more broadly, genetic counseling can become a more just and inclusive practice.

A bibliometric and Altmetric analysis of the 100 top most cited articles on dentin adhesives.

OBJECTIVE: This study aimed to identify the 100 top-cited articles on dentin adhesives utilizing comprehensive bibliometric and altmetric analyses. MATERIALS AND METHODS: The Institute of Scientific Information Web of Knowledge database was used to compile the top-cited articles published from 1945 through February 12, 2023. Citation counts were manually retrieved for each article from Scopus, Google Scholar, Dimensions, and Altmetric. The articles were analyzed in terms of their number of citations, year, journal name, author (name, institution, and country), and type and specific field of study. We used descriptive statistics to summarize the results. RESULTS: The analysis revealed that the top 100 cited articles originated from 18 English-language journals and collectively accumulated a remarkable 34526 citations. The article with the highest number of citations garnered 1288 references. Among authors, Van Meerbeek B. stood out with nine articles and 4650 citations, followed by Pashley D.H. with six articles and 2769 citations. Japan was the leading contributor by country, while the Catholic University of Leuven led in terms of institutions with 20 articles. CONCLUSION: According to this study, basic research and review articles garnered the most citations, respectively. The citation analysis revealed different trends for researchers, the first being that researchers have focused on basic fields such as the ultramorphology of dentin and adhesive interfaces, followed by bond strength to dentin. Two studies on clinical experiences suggested that studies with high-level evidence, such as systematic reviews, meta-analyses, or randomized controlled clinical trials, are required. CLINICAL RELEVANCE: It is identified that more studies with high-level evidence-based research are needed in the field of dental adhesives.

Cost-effectiveness of restorative treatments for permanent molars with severe molar incisor hypomineralization: perspectives for the Brazilian public health system.

OBJECTIVES: To undertake a cost-effectiveness analysis of restorative treatments for a first permanent molar with severe molar incisor hypomineralization from the perspective of the Brazilian public system. MATERIALS AND METHODS: Two models were constructed: a one-year decision tree and a ten-year Markov model, each based on a hypothetical cohort of one thousand individuals through Monte Carlo simulation. Eight restorative strategies were evaluated: high viscosity glass ionomer cement (HVGIC); encapsulated GIC; etch and rinse adhesive + composite; self-etch adhesive + composite; preformed stainless steel crown; HVGIC + etch and rinse adhesive + composite; HVGIC + self-etch adhesive + composite, and encapsulated GIC + etch and rinse adhesive + composite. Effectiveness data were sourced from the literature. Micro-costing was applied using 2022 USD market averages with a 5% variation. Incremental cost-effectiveness ratio (ICER), net monetary benefit (%NMB), and the budgetary impact were obtained. RESULTS: Cost-effective treatments included HVGIC (%NMB = 0%/ 0%), encapsulated GIC (%NMB = 19.4%/ 19.7%), and encapsulated GIC + etch and rinse adhesive + composite (%NMB = 23.4%/ 24.5%) at 1 year and 10 years, respectively. The benefit gain of encapsulated GIC + etch and rinse adhesive + composite in relation to encapsulated GIC was small when compared to the cost increase at 1 year (gain of 3.28% and increase of USD 24.26) and 10 years (gain of 4% and increase of USD 15.54). CONCLUSION: Within the horizon and perspective analyzed, the most cost-effective treatment was encapsulated GIC restoration. CLINICAL RELEVANCE: This study can provide information for decision-making.

Sixty-month comperative evaluation of a glass hybrid restorative and a composite resin in non-carious cervical lesions of bruxist individuals.

OBJECTIVE: To compare the clinical performance of a glass hybrid (GH) restorative and a nano-ceramic composite resin (CR) in the restoration of non-carious cervical lesions (NCCLs) of bruxist individuals in a 60-month randomized clinical trial. MATERIALS AND METHODS: Twenty-five bruxist candidates having NCCLs were recruited in this clinical study. The depth, height (cervico-incisal), width (mesio-distal), internal angles of the NCCLs, degree of tooth wear (TWI) and gingival index (GI) were measured. One hundred-and-forty-eight NCCLs were restored either with a GH restorative (Equia Forte Fil) or a CR (Ceram.X One Universal). Modified USPHS criteria was used to evaluate restorations after 1 week and 12, 24, 36 and 60 months. Pearson's Chi-Square, Fisher's Exact and Cochran Q tests were run for analysis. Survival rates of the restorations were compared with Kaplan-Meier analysis (p < 0.05). RESULTS: After 60 months, 97 restorations in 15 patients were examined. The recall rate was 60.0%. Retention rates were 73.5% for CR and 66.7% for GH. A total of 29 restorations were lost (13CR (26.5%), 16GH (33.3%)). There was not a significant difference between tested restoratives in retention (p = 0.464), marginal adaptation (p = 0.856) and marginal discoloration (p = 0.273). There was no relationship between internal angle, depth, height or width and retention of the GH or CR restorations (p > 0.05). The increase in retention loss and marginal discoloration of both restorations over time were significant (p < 0.001). Sensitivity or secondary caries were not detected after 60 months. CONCLUSION: GH and nano-ceramic CR showed similar clinical performances in NCCLs after 60 months in patients with bruxism. CLINICAL SIGNIFICANCE: After 60 months, CR and GH materials showed clinically acceptable performances in restoration of NCCLs in patients with bruxism.

Five-Year Longitudinal Follow-Up of Restorative Neurostimulation Shows Durability of Effectiveness in Patients With Refractory Chronic Low Back Pain Associated With Multifidus Muscle Dysfunction.

BACKGROUND: Adults with refractory, mechanical chronic low back pain associated with impaired neuromuscular control of the lumbar multifidus muscle have few treatment options that provide long-term clinical benefit. This study hypothesized that restorative neurostimulation, a rehabilitative treatment that activates the lumbar multifidus muscles to overcome underlying dysfunction, is safe and provides relevant and durable clinical benefit to patients with this specific etiology. MATERIALS AND METHODS: In this prospective five-year longitudinal follow-up of the ReActiv8-B pivotal trial, participants (N = 204) had activity-limiting, moderate-to-severe, refractory, mechanical chronic low back pain, a positive prone instability test result indicating impaired multifidus muscle control, and no indications for spine surgery. Low back pain intensity (10-cm visual analog scale [VAS]), disability (Oswestry Disability Index), and quality of life (EuroQol's "EQ-5D-5L" index) were compared with baseline and following the intent-to-treat principle, with a supporting mixed-effects model for repeated measures that accounted for missing data. RESULTS: At five years (n = 126), low back pain VAS had improved from 7.3 to 2.4 cm (-4.9; 95% CI, -5.3 to -4.5 cm; p < 0.0001), and 71.8% of participants had a reduction of ≥50%. The Oswestry Disability Index improved from 39.1 to 16.5 (-22.7; 95% CI, -25.4 to -20.8; p < 0.0001), and 61.1% of participants had reduction of ≥20 points. The EQ-5D-5L index improved from 0.585 to 0.807 (0.231; 95% CI, 0.195-0.267; p < 0.0001). Although the mixed-effects model attenuated completed-case results, conclusions and statistical significance were maintained. Of 52 subjects who were on opioids at baseline and had a five-year visit, 46% discontinued, and 23% decreased intake. The safety profile compared favorably with neurostimulator treatments for other types of back pain. No lead migrations were observed. CONCLUSION: Over a five-year period, restorative neurostimulation provided clinically substantial and durable benefits with a favorable safety profile in patients with refractory chronic low back pain associated with multifidus muscle dysfunction. CLINICAL TRIAL REGISTRATION: The Clinicaltrials.gov registration number for the study is NCT02577354; registration date: October 15, 2016; principal investigator: Christopher Gilligan, MD, Brigham and Women's Hospital, Boston, MA, USA. The study was conducted in Australia (Broadmeadow, New South Wales; Noosa Heads, Queensland; Welland, South Australia; Clayton, Victoria), Belgium (Sint-Niklaas; Wilrijk), The Netherlands (Rotterdam), UK (Leeds, London, Middlesbrough), and USA (La Jolla, CA; Santa Monica, CA; Aurora, CO; Carmel, IN; Indianapolis, IN; Kansas City, KS; Boston, MA; Royal Oak, MI; Durham, NC; Winston-Salem, NC; Cleveland, OH; Providence, RI; Spartanburg, SC; Spokane, WA; Charleston, WV).

Chewing performance of patients with worn dentition before and after restorations: A scoping review.

BACKGROUND: Tooth wear is a multifactorial complex process related to the loss of dental tissue, due to chemical or mechanical processes, by abrasion, attrition, erosion. Restorative treatment represents an attempt to rebuild and recreate the lost structure. OBJECTIVE: This scoping review aims to investigate whether restorative treatment of worn dentition (either with direct or indirect adhesive composite adhesive procedures or with prosthetic techniques) can have an impact on the masticatory performance parameters. METHODS: A scoping review was conducted on multiple databases (Pubmed, Medline CENTRAL, ICTRP), following the PRISMA guidelines. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who satisfied the inclusion and exclusion criteria. RESULTS: Only one article meet the inclusion criteria of the review. Restorative treatment of worn dentition although have a positive impact on the self-report ability to chew, has no effect on the masticatory performance test. CONCLUSION: At the moment, not enough evidence to comment on the actual therapeutic role of restorative treatment on tooth wear is available. Clinicians, before taking any clinical decision, should carefully discuss with patients the needs and expectations of the treatment plan.

Contact point marking with the OccluSense system-an in vitro study on reliability and validity.

BACKGROUND: Occlusal contacts can be stained and thereby visualised employing occlusal indicators. Qualitative and quantitative indicators are differentiated. The hybrid system OccluSense supposedly combines analogue contact marking and digital registration of contacts. The reliability and validity of its contact marking have not yet been validated. OBJECTIVES: The aim of this controlled randomised in-vitro study was to examine the reliability and validity of analogue contact staining with OccluSense compared to Arti-Fol and the reference standard Gnatho-Film. MATERIALS AND METHODS: An experimental apparatus was designed to simulate static occlusion. The occlusal contacts were stained 50 times with Gnatho-Film to determine the average number and location of contacts registered. For comparison, the contacts were pre-stained with Gnatho-Film and then registered with Arti-Fol or OccluSense 50 times each. Every staining was statistically evaluated and compared to Gnatho-Film alone, regarding the number and location of contacts. Based on the observed characteristic staining behaviour of OccluSense, a modified evaluation strategy was developed for its colour markings (OccluSense (mod.)). RESULTS: Both evaluations of OccluSense determine that the same number of contacts was registered in over 94% of all cases. Neither OccluSense nor Arti-Fol stain the exact same number of contacts as Gnatho-Film, but the modified evaluation OccluSense (mod.) did improve the results for validity. CONCLUSION: When employing the modified evaluation strategy, OccluSense staining achieves similar reliability and validity as the reference standard. Pre-colouring of occlusal contacts with Gnatho-Film and the modified evaluation strategy, might become standard for analysing occlusal contacts stained by OccluSense in the future.

A systematic and comprehensive protocol for rapid orthodontic extrusion.

OBJECTIVE: The aim of the present paper is to describe a systematic and detailed protocol for rapid orthodontic extrusion, and to summarize the main results of this protocol in terms of migration of dental, hard and soft tissues, for 10 cases. CLINICAL CONSIDERATIONS: The working design was to apply a protocol lasting 4 weeks of active phase with intense forces (greater than 300 g), perform weekly the circumferential supra-crestal fiberotomy procedure associated with root-planning, follow up with a passive stabilization phase of another 4 weeks and evaluate the results. CONCLUSIONS: We believe that despite the partial migration of periodontal tissue, the defined protocol we used is, for simplicity of application, brevity of treatment and results, a viable alternative to the surgical technique of clinical crown lengthening in those cases where it is necessary to have more dental tissue exposed for restorative and prosthetic purposes.

Zirconia restoration types, properties, tooth preparation design, and bonding. A narrative review.

OBJECTIVE: The purpose of this review was to provide dental professionals with information regarding the various types of zirconia restorations, their mechanical and optical properties, tooth preparation design, and bonding protocol in an effort to enhance the longevity and durability of zirconia restorations. OVERVIEW: The yttria content of zirconia ceramics determines their classification. The mechanical and optical properties of each type are discussed, with an emphasis on the effect of yttria concentration on the properties of zirconia. The processing and sintering methods are also discussed as they have a direct impact on the properties of zirconia. The design of tooth preparation, specifically occlusal reduction, varies depending on the type of zirconia used in each case. Finally, a protocol for zirconia restoration bonding is described to ensure optimal bonding to the tooth structure. CONCLUSION: Not all zirconia restorations are the same. The selection of zirconia type based on yttria concentration, processing and sintering methods, tooth preparation design, and adherence to the bonding protocol are all critical to the success and longevity of zirconia restorations. CLINICAL SIGNIFICANCE: Zirconia restorations are the most commonly used indirect restorative material. The selection of the most appropriate zirconia type based on its yttria content, which determines its strength and translucency, is critical to the success and the longevity of the restoration. Tooth preparation design also influences the strength and translucency of the zirconia. Air-borne particle abrasion, followed by a ceramic primer and resin cement, can ensure a durable bond to the tooth structure.

Surface roughness and optical characteristics evaluations after chairside adjustment of different zirconia types.

STATEMENT OF PROBLEM: Limited evidence is available for the effect of chairside adjustment using rotary cutting instruments on the surface roughness and optical properties of different zirconia types. PURPOSE: To evaluate the effect of simulated adjustments on surface roughness and optical properties of different zirconia types. MATERIALS AND METHODS: Three Partially Stabilized Zirconia (PSZ) types based on mole percent yttria (Y) concentration from the same manufacturer (Katana; Kuraray) were used: 3Y-PSZ, 4Y-PSZ, and 5Y-PSZ. Thirty disk-shaped specimens (Ø14 × 1.2 mm) from different zirconia types (N = 90) were prepared. Specimens were either left without adjustment (NA), adjusted with Dialite ZR finishing and polishing system (Brasseler) (APol), or adjusted with course diamond instruments only (ADia). The specimens were distributed into 9 groups (n = 10): Group 3Y-PSZ/NA, Group 3Y-PSZ/APol, Group 3Y-PSZ/ADia, Group 4Y-PSZ/NA, Group 4Y-PSZ/APol, Group 4Y-PSZ/ADia, Group 5Y-PSZ/NA, Group 5Y-PSZ/APol, and Group 5Y-PSZ/ADia. The surface roughness of specimen was analyzed using an Atomic Force Microscope (AFM) (Bruker's Dimension Icon, Bruker) and Root Means Square (RMS) were recorded (nm). Surface Gloss (SG), Translucency Parameter (TP), and Contrast Ratio (CR) values of all groups were recorded using an integrating sphere spectrophotometer. Statistical analysis was performed using analysis of variance (ANOVA) and Tukey's multiple comparison tests for pairwise comparisons at p < 0.05 and 95% confidence interval. RESULTS: APol had no effect on the surface roughness (p = 0.88) while ADia had a significant negative effect (p < 0.05) despite the type of zirconia. Out of the three testes optical properties, only SG was negatively affected by ADia for all types of zirconia (p < 0.05). The two adjustment types did not affect the TP of all the tested zirconia (p = 0.91). The CR was not affected by the tested adjustments for all zirconia types (p = 0.726). CONCLUSION: Proper zirconia adjustment following a sequence of burs and polishers can maintain acceptable roughness and optical properties. Adjustment of zirconia with rough diamond can lead to deleterious effects and should be avoided. CLINICAL SIGNIFICANCE: Chairside adjustment of zirconia could lead to rougher surface and unpredictable changes of surface gloss. Therefore, zirconia adjustment should be minimized to the greatest extent possible and a proper protocol should be followed if had to be done.

Agenesis of the maxillary permanent lateral incisors with the deciduous retained: Conservative and biomimetic approach using the BAIR technique.

OBJECTIVE: Agenesis of the maxillary permanent lateral incisors is a condition that requires treatment aimed at improving the esthetics, even at an early age. However, traditional therapeutic protocols are long, invasive and have limitations and contraindications imposed by the age of the patient. CLINICAL CONSIDERATIONS: Recent developments in restorative dentistry have provided a new approach to this clinical situation, in particular when the deciduous laterals are retained. We report two cases regarding the management of missing lateral incisors using Biologically Active Intrasulcular Restoration (BAIR) technique. The BAIR technique allows us to transform the shape of the deciduous lateral incisor into the permanent, acting both on the dental morphology and proportions, and on the appearance of the soft tissues and the gingival parables. CONCLUSIONS: The BAIR technique is a valid approach to cases of agenesis of the maxillary permanent lateral incisors, when the deciduous are retained. It does not require any preparation of the dental tissues, is reversible and minimally invasive. It is applicable to patients of all ages, and results are obtained in a single appointment. CLINICAL SIGNIFICANCE: The BAIR technique allows a biomimetic conservative approach for the rehabilitation of congenitally missing permanent lateral incisors, when the deciduous are retained. It is a non-invasive protocol and effective in successfully restoring esthetics.

Staged esthetic crown lengthening: Classification and guidelines for periodontal-restorative therapy.

OBJECTIVE: This article presents technical guidelines for perio-restorative esthetic crown lengthening, along with a discussion of the biologic rationale. A classification system is proposed to assist in treatment planning and sequencing the surgical and restorative phases. CLINICAL CONSIDERATIONS: When esthetic crown lengthening is performed as an adjunct to restorative therapy, the surgical approach must be determined by the anticipated position of the restorative margins. The removal of sufficient bone to achieve the desired clinical crown length and preserve the supracrestal gingival tissue dimensions is facilitated by the use of a surgical guide fabricated according to the design of the restorations. A staged approach allows sequencing the provisional restoration to minimize unesthetic sequelae during the healing period. Inadequate bone resection and/or alteration of the soft tissue dimensions results in delayed healing, leading to coronal gingival rebound and biologic width impingement. CONCLUSION: The identification and preservation of appropriate restorative and biologic landmarks is essential for success in pre-prosthetic esthetic crown lengthening treatment. A staged approach improves the esthetic management during the postsurgical healing and maturation period. CLINICAL SIGNIFICANCE: A restorative driven classification system for sequencing and staging adjunctive esthetic crown lengthening procedures is presented. Technical guidelines to enhance gingival margin predictability are suggested, accompanied by relevant evidence. In addition, wound healing timelines following gingival and osseous resection are provided.

Setting restorative goals with a regional outlook: Mine-rehabilitation outcomes influence landscape connectivity.

Mining is increasing worldwide and is typically associated with highly negative environmental impacts, such as habitat loss and fragmentation. To counteract these effects and improve restoration practices, decisions, such as setting mine rehabilitation goals, could incorporate the assessment and restoration of landscape connectivity into their regional and local-scale planning. The overarching goal of this work was to assess landscape connectivity for flora and fauna and explore mine-rehabilitation scenarios that can be used as a tool for prioritising biodiversity outcomes. Our study area comprised the Fitzroy Basin (Queensland, Australia), where the disturbance footprints from mining cover a cumulative area of 121,239 ha. We considered two scenarios: rehabilitation to agriculture and restoration to native ecosystems. To compare these scenarios, we created differential maps, which highlighted that restoring to native ecosystems represented connectivity gains over agricultural rehabilitation goals. These maps revealed three ways to prioritise rehabilitation outcomes, giving priority to mines that: 1) presented medium to high connectivity values, 2) covered a large area of influence (contributing to connectivity on a larger scale, regardless of current flow values), and 3) showed a gain of important paths/corridors. We explored four case studies and found that three benefited from restoration outcomes, while the fourth did not benefit by either scenario. Our methods can be used for decision-making in restoration ecology and conservation, including mine rehabilitation priorities and goals, as well as for evaluating connectivity gains or losses.

Are we practising what we preach and are we all singing from the same hymn sheet? An exploration of teaching in paediatric caries management across UK dental schools.

BACKGROUND: The evidence underpinning caries management for children has progressed dramatically over the past 20 years. Anecdotally, this is not reflected in the teaching provided to undergraduate dental students, with the ongoing teaching of outdated methods within some dental schools. AIM: To capture the current undergraduate teaching provision and clinical treatment experience requirement relative to caries management in paediatric dentistry in UK dental schools. DESIGN: Cross-sectional analysis of current teaching methods on paediatric caries management was obtained using a piloted online data collection form. Question content included current caries teaching methods, assessment of student exposure and competence. The results were analysed descriptively. RESULTS: Of the 16 UK dental schools, 14 participated. Discrepancy in teaching content was apparent. Many schools (n = 9) taught biological caries management through therapeutic fissure sealants, yet this was not reflected in assessment and clinical requirements. Some schools (n = 4) taught amalgam placement in children, and most (n = 12) operatively taught treatments that would no longer be routinely provided in general dental practice in the UK, including primary tooth pulpotomy. CONCLUSION: There is substantial variation in the paediatric caries management techniques that are taught across UK dental schools, demonstrating a need for a national consensus to address these disparities.