RESUMO
OBJECTIVES: This prospective randomized clinical trial aimed to evaluate the long-term behavior of metal-free double crown retained dentures with secondary crowns and dental frameworks made of the fiber-reinforced composite Vectris(©) on all-ceramic primary crowns (IPS Empress 2(©)) over a period of up to 14 years and to subsequently evaluate patient satisfaction. For the control group, electroplated gold copings and metal frameworks were used. MATERIALS AND METHODS: A total of 29 patients were treated with a total of 37 prostheses on 165 primary crowns. Of these 37 prostheses, 27 were allotted to the control group and 10 to the test group. The mean observation time was 91 ± 57 months; patient satisfaction surveys were conducted over 77 ± 59 months. RESULTS: Success rates in both groups were compared using Kaplan-Meier survival curves and log-rank test. Up to about 3 years, both types of prostheses exhibited similar success rates. Afterwards, a massive decrease in the Vectris(©) curve could be noted, whereas the metal curve dropped only slightly. This difference was also statistically significant (p = 0.032361). There was a comparable susceptibility to damages in both groups: 88.9 % (control) and 90 % (test), respectively, of the prostheses had to be repaired within the period of investigation (p = 0,121). Damages of the Vectris(©) secondary crowns could be detected significantly more often compared to the electroformed gold copings (p < 0.00005). Patient satisfaction with the restorations was comparably high in both groups. CONCLUSION: Metal-free secondary crowns and denture frameworks made with the glass fiber-reinforced composite material Vectris(©) showed a lower survival rate than the electroplated gold copings and metal frameworks. Primary crowns made of IPS Empress 2(©) had insufficient stability. Exclusively high-strength zirconia ceramics should be recommended for this indication. CLINICAL RELEVANCE: Both clinical and statistical data indicated the superiority of the restorations made with electroplated secondary crowns and metal framework. Therefore, the use of Vectris(©) cannot be recommended for the fabrication of double crown retained removable dentures as permanent restorations.
Assuntos
Cerâmica , Coroas , Dentaduras , Vidro , Silicatos de Alumínio , Porcelana Dentária , Falha de Restauração Dentária , Planejamento de Dentadura , Retenção de Dentadura , Feminino , Ouro , Humanos , Masculino , Metais , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos ProspectivosRESUMO
INTRODUCTION: Groin and lower trunk defects are common problems, especially for elderly patients. While groin defects are often due to prior vascular interventions, trochanteric defects are mainly caused by pressure sores. Plastic reconstructive methods are manifold; however, the pedicled anterolateral thigh (ALT) flap is supposed to be reliable with sustainable results. OBJECTIVE: We present our experiences using the pedicled ALT flap for soft tissue reconstruction in patients with large wounds of the medial and lateral proximal thigh. MATERIALS AND METHODS: A total of 16 patients with groin and lower trunk defects due to prior vascular surgery or pressure sores received locoregional soft tissue reconstruction using a proximal pedicled ALT flap. Patient characteristics, defect size, surgery time, clinical outcome and complication rate were assessed. RESULTS: With the exception of two cases, sufficient soft tissue reconstruction was achieved. In all, 81,3% of patients were categorized as ASA (American Society of Anesthesiologists) 3. The average duration of surgery was 149â¯min. Length of stay was 18,3 days. A total of 31% needed revision surgery due to limited wound healing problems. Two patients died. All patients showed healed wound conditions when they were discharged. CONCLUSION: The proximal pedicled ALT-flap is a reliable method for soft tissue reconstruction in groin and lower trunk defects. This reconstructive procedure enables reliable wound closure, especially in elderly patients with substantially reduced general health condition.
Assuntos
Procedimentos de Cirurgia Plástica , Coxa da Perna , Idoso , Virilha/cirurgia , Humanos , Pelve/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos/irrigação sanguínea , Retalhos Cirúrgicos/cirurgia , Coxa da Perna/cirurgia , Resultado do TratamentoRESUMO
OBJECTIVE: Despite dramatic improvements in burn care, the major part of the therapy of thermal injuries remains symptomatical in nature. A targeted approach to accelerate angiogenesis and woundhealing and reduce edema formation remains to be found. We therefore aimed to investigate the impact of anti-inflammatory, anti-coagulative and thrombolytic agents on microcirculation after thermal injuries on the mentioned parameters. METHODS: Full thickness burns were inflicted on the ears of hairless mice (n=48). The effects of five intraperitoneal injections of either recombinant tissue plasminogen activator (rtPA), selenium, prednisolone or sodium chloride on microcirculation, edema formation, leukocytes and angiogenesis were investigated over a 13 day period using intravital fluorescent microscopy. RESULTS: Prednisolone slightly improved angiogenesis (100.0% day 0 vs. 91.4% non-perfused area on day 1 post burn, p<0.05) and reduced edema formation (93.3% vs. 123.1% control on day 3, p<0.05). The rtPA-group showed the highest number of sticking leukocytes up to day 7 post burn (233%, 265%, 254% on days 1, 3, and 7, p<0.05 compared to baseline). A post-traumatic expansion of the non perfused area could only be observed in the selenium group (100.0% day 0, 103.1% day 1 post burn). In addition, selenium caused an increase of rolling leukocytes over the complete observation time. CONCLUSION: The often described positive influences of selenium for the treatment of burn patients could not be confirmed, on the contrary we found a post-traumatic expansion of the non perfused area and an increase of leukocytes in this group. The expectations to rtPA did not fulfill. Prednisolone improved angiogenesis and reduced the edema formation, both Parameters are essential for wound healing and survival of burned patients.
Assuntos
Antioxidantes/farmacologia , Queimaduras/patologia , Fibrinolíticos/farmacologia , Glucocorticoides/farmacologia , Neovascularização Fisiológica/efeitos dos fármacos , Prednisolona/farmacologia , Selênio/farmacologia , Ativador de Plasminogênio Tecidual/farmacologia , Animais , Queimaduras/diagnóstico por imagem , Orelha , Edema/diagnóstico por imagem , Edema/patologia , Microscopia Intravital , Leucócitos/efeitos dos fármacos , Masculino , Camundongos , Camundongos Pelados , Microcirculação/efeitos dos fármacos , Microscopia de Fluorescência , Proteínas Recombinantes , Pele/diagnóstico por imagem , Pele/patologiaRESUMO
BACKGROUND: The body of knowledge regarding the different facets of frostbite injury continues to expand. However, beside the administration of physiological saline, local rewarming, local disinfection and symptomatic medications, today no causal therapy is known which would accelerate angiogenesis and wound healing. The aim of this study was to investigate the influences of dilative acting drugs on microcirculation, angiogenesis and leukocyte behavior. MATERIALS AND METHODS: Ears of male hairless mice (n=40) were inflicted with full thickness frostbites using a cold air jet. Then the affects of four intraperitoneal injections of isosorbitdinitrate (ISDN, n=10), l-nitroarginine-methyl-ester (l-NAME, n=10), selenium (n=10) or sodium chloride (n=10; each administered to one of four corresponding study groups), on microcirculation, leukocyte-endothelial interaction and angiogenesis were investigated over a 12-day period using intravital fluorescent microscopy. RESULTS: Angiogenesis was most improved by ISDN (36.8 vs. 54.5% non-perfused area on day 3, 3.9 vs. 17.0% on day 7 compared to selenium, p<0.006). Venular diameter was most significantly dilated in the ISDN-group, l-NAME showed significantly decreased diameter over the complete time of 12 days. ISDN had positive influences on edema formation, which was significantly reduced compared to control (27% lower values compared to control; p=0.007 on day 3). The l-NAME-group showed the significant highest leukocyte-adhesion compared to control on days 7 and 12 (53% resp. 58% higher, p<0.006). CONCLUSION: Overall, out of all the drugs tested, ISDN improved angiogenesis, dilated venules and decreased edema formation and therefore seems to have the greatest positive impact on these crucial parameters after frostbite injury.
Assuntos
Endotélio Vascular/efeitos dos fármacos , Congelamento das Extremidades , Dinitrato de Isossorbida/farmacologia , Leucócitos/efeitos dos fármacos , Microcirculação/efeitos dos fármacos , NG-Nitroarginina Metil Éster/farmacologia , Selênio/farmacologia , Pele/efeitos dos fármacos , Vasodilatadores/farmacologia , Animais , Antioxidantes/farmacologia , Orelha , Inibidores Enzimáticos/farmacologia , Masculino , Camundongos , Camundongos Pelados , Microscopia de Fluorescência , Neovascularização Fisiológica/efeitos dos fármacos , Pele/irrigação sanguínea , Pele/patologiaRESUMO
The acceptance of the polymerase chain reaction (PCR) as an amplification method in molecular diagnostics and the rapid development of capillary electrophoresis (CE) as an analysis method of those PCR products was a reason for us to investigate further integration of those two techniques. Using a fused-silica capillary as a pipette we were able to compose a PCR mixture in the CE apparatus. Because a capillary can be thoroughly rinsed and the CE apparatus is a closed system, the risk of contamination and therefore the occurrence of false positive results is minimized. The fact that a CE system can be fully automated contributes to a more reproducible and standardized PCR composition protocol.
Assuntos
Autoanálise , Eletroforese Capilar/métodos , Ácidos Nucleicos/análise , Reação em Cadeia da Polimerase/métodos , DNA/análise , Contaminação de Medicamentos/prevenção & controle , Eletroforese em Gel de Ágar , Eletroforese Capilar/instrumentação , Etídio , Reações Falso-Positivas , Genes ras , Indicadores e Reagentes , Oligonucleotídeos/análiseRESUMO
Spectral and other physicochemical properties were determined for a suite of submicron powders of hematite (alpha-Fe2O3), maghemite (gamma-Fe2O3), magnetite (Fe3O4), goethite (alpha-FeOOH), and lepidocrocite (gamma-FeOOH). The spectral reflectivity measurements were made between 0.35 and 2.20 micrograms over the temperature interval between about -110 degrees and 20 degrees C. Other physicochemical properties determined were mean particle diameter, particle shape, chemical composition, crystallographic phase, magnetic properties, and Mossbauer properties. Only the magnetite powders have significant departures from the stoichiometric phase; they are actually cation-deficient magnetites having down to about 18.0 wt % FeO as compared with 31.0 wt % FeO for stoichiometric magnetite. A structured absorption edge due to crystal field transitions and extending from weak absorption in the near-IR to intense absorption in the near-UV is characteristic of the ferric oxides and oxyhydroxides and is responsible for their intense color. Particularly for hematite, the number and position of the spectral features are consistent with significant splitting of the degenerate cubic levels by noncubic components of the crystal field. The position of the crystal-field band at lowest energy, assigned to the envelope of the components of the split cubic 4T1 level, is near 0.86, 0.91, 0.92, and 0.98 microgram at room temperature for hematite, goethite, maghemite, and lepidocrocite, respectively. Comparison with Mossbauer data suggests covalent character increases sequentially through the aforementioned series. The positions of the spectra features are relatively independent of temperature down to about -110 degrees C. The maximum shifts observed were on the order of about 0.02 microgram shortward for the ferric oxyhydroxides. Variations in the magnitude of the reflectivity of the hematite powders as a function of mean particle diameter are consistent with scattering theory. The absorption strength of the crystal-field bands increases with increasing mean particle diameter over the range 0.1-0.8 micrometer; visually this corresponds to a change in color from orange to deep purple. The position of the split cubic 4T1 band shifts longward by about 0.02 micrometer with decreasing mean particle diameter over the same range; this trend is consistent with wavelength-dependent scattering. The cation-deficient magnetite powders are very strong absorbers throughout the near-UV, visible and near-IR; their spectral properties are independent of temperature between about -110 and 20 degrees C.
Assuntos
Compostos Férricos/análise , Compostos de Ferro/análise , Ferro/análise , Óxidos/análise , Planeta Terra , Compostos Férricos/química , Óxido Ferroso-Férrico , Ferro/química , Compostos de Ferro/química , Magnetismo , Marte , Minerais , Óptica e Fotônica , Óxidos/química , Tamanho da Partícula , Pós/análise , Espectroscopia de Mossbauer , Análise Espectral , Temperatura , TermodinâmicaRESUMO
Surgical simulation has many applications in medical education, surgical training, surgical planning and intra-operative assistance. However, extending current surface-based computer graphics methods to model phenomena such as the deformation, cutting, tearing or repairing of soft tissues poses significant challenges for real-time interactions. This paper discusses the use of volumetric methods for modeling complex anatomy and tissue interactions. New techniques are introduced that use volumetric methods for modeling soft-tissue deformation and tissue cutting at interactive rates. An initial prototype for simulating arthroscopic knee surgery is described which uses volumetric models of the knee derived from 3-D magnetic resonance imaging, visual feedback via real-time volume and polygon rendering, and haptic feedback provided by a force-feedback device.
Assuntos
Simulação por Computador , Modelos Anatômicos , Procedimentos Cirúrgicos Operatórios , Artroscopia , Humanos , Articulação do Joelho/anatomia & histologia , Articulação do Joelho/cirurgia , Interface Usuário-Computador , Gravação em VídeoRESUMO
The effect of storage media, which are routinely used in replantation, upon the proliferative capacity of periodontal ligament fibroblasts, was compared with the effect of a tissue culture medium. The periodontal tissue was obtained from mandibular central incisors of White New Zealand rabbits. The experiments were performed in fibroblasts derived during second subculture. The storage media were physiologic salt solution, Ringer's solution and Rivanol; the tissue culture medium was alpha-minimum essential medium without nucleosides. The incubation period was 1 hour. [3H]-thymidine incorporation and cell counts were taken to indicate changes in the proliferative capacity of the fibroblasts. The tissue culture experiments showed that the proliferative ability of the periodontal ligament fibroblasts was dependent upon the composition of the storage medium. Physiologic salt solution, Ringer's solution and Rivanol were unable to maintain the metabolism of the fibroblasts. alpha-MEM medium, however, was capable of stimulating proliferation of the periodontal ligament fibroblasts.
Assuntos
Meios de Cultura/farmacologia , Ligamento Periodontal/citologia , Animais , Contagem de Células , Divisão Celular/efeitos dos fármacos , Fibroblastos/efeitos dos fármacos , Fibroblastos/metabolismo , Ligamento Periodontal/metabolismo , Coelhos , Timidina/metabolismo , TrítioRESUMO
Monolayers of the thiolipopeptide NH(2)-Cys-Ala-Ser-Ala-Ala-Ser-Ser-Ala-Pro-Ser-Ser-(Myr)Lys(Myr)-OH (III) were formed on gold surfaces by self-assembly, mixed with a lateral spacer of the same peptide composition, NH(2)-Cys-Ala-Ser-Ala-Ala-Ser-Ser-Ala-Pro-Ser-Ser-Lys-OH (I). Different mixing ratios were employed ranging from 0.1 to 1, corresponding to 10-100% thiolipopeptide. These self-assembled monolayers (SAMs) were then exposed to a suspension of liposomes with the aim of forming lipid bilayers as a function of the mixing ratio. A clear optimum with respect to homogeneity and electrical properties of the membranes was obtained in the middle region (0.5) of mixing ratio, as revealed by surface plasmon resonance spectroscopy, impedance spectroscopy, and fluorescence microscopy. The combination of these methods was shown to be a powerful tool, although a true lipid bilayer was not obtained. Instead, vesicle adsorption was shown to be the predominant process, and FRAP (fluorescence recovery after photobleaching) measurements showed that the films were not fluid on the micrometer length scale.
Assuntos
Lipossomos/química , Fusão de Membrana , Lipoproteínas , Microscopia de Força Atômica , Microscopia de Fluorescência , Peptídeos , Compostos de Sulfidrila , Ressonância de Plasmônio de SuperfícieRESUMO
The Procera AllCeram system is indicated for manufacturing all-ceramic crowns for single-tooth restorations in the anterior and posterior regions. In addition, it is possible to create metal-free superstructures on CeraOne abutments from the Brånemark implant system or crowns on individually prepared aluminum oxide abutments (CerAdapt). The Procera copings, which are manufactured using computer-aided design/manufacturing technology, are characterized by very good mechanical properties. Ceramic veneers tailored to the copings offer excellent esthetics, favorable abrasion behavior, and an ideal surface structure for non-inflammatory apposition of the periodontal or periimplant tissues. The present article offers an overview of previous scientific studies, describes clinical and laboratory procedures, and presents case reports.
Assuntos
Óxido de Alumínio , Coroas , Dente Suporte , Porcelana Dentária , Desenho Assistido por Computador , Planejamento de Prótese Dentária , Facetas Dentárias , Humanos , Teste de Materiais , MaleabilidadeRESUMO
OBJECTIVE: Burn wounds remain a challenge due to subsequent wound infection and septicemia, which can be prevented by acceleration of wound healing. The aim of the study was to analyze microcirculation and leukocyte endothelium interaction with particular focus on angiogenesis after full-thickness burn using three different repetitions of low energy shock waves. METHODS: Full-thickness burns were inflicted to the ears of hairless mice (n=44; area: 1.6±0.05 mm2 (mean±SEM)). Mice were randomized into four groups: the control group received a burn injury but no shock waves; group A received ESWA (0.03 mJ/mm2) on day one after burn injury; group B received shock waves on day one and day three after burn injury; group C ESWA on day one, three and seven after burn injury. Intravital fluorescent microscopy was used to assess microcirculatory parameters, angiogenesis and leukocyte interaction. Values were obtained before burn (baseline value) immediately after and on days 1, 3, 7 and 12 after burn. RESULTS: Shock-wave treated groups showed significantly accelerated angiogenesis compared to the control group. The non-perfused area (NPA) is regarded as a parameter for angiogenesis and showed the following data on day 12 2.7±0.4% (group A, p=0.001), 1.4±0.5% (group B, p<0.001), 1.0±0.3% (group C, p<0.001), 6.1±0.9% (control group). Edema formation is positively correlated with the number of shock wave applications: day 12: group A: 173.2±9.8%, group B: 184.2±6.6%, group C: 201.1±6.9%, p=0.009 vs. control: 162.3±8.7% (all data: mean±SEM). CONCLUSION: According to our data shock waves positively impact the wound healing process following burn injury. Angiogenesis showed significantly improved activity after shock wave application. In all three treatment groups angiogenesis was higher compared to the control group. Within the ESWA groups, double applications showed better results than single application and three applications showed better results than single or double applications.
Assuntos
Queimaduras/terapia , Orelha/irrigação sanguínea , Ondas de Choque de Alta Energia/uso terapêutico , Microcirculação , Neovascularização Fisiológica , Pele/irrigação sanguínea , Cicatrização , Animais , Modelos Animais de Doenças , Orelha/lesões , Leucócitos , Camundongos , Microscopia de Fluorescência , Pele/lesõesRESUMO
OBJECTIVE: Extensive wounds of burn patients remain a challenge due to wound infection and subsequent septicemia. We wondered whether extracorporeal shock wave application (ESWA) accelerates the healing process. The aim of the study was to analyze microcirculation, angiogenesis and leukocyte endothelium interaction after burns by using ESWA with two types of low intensity. METHODS: Full-thickness burns were inflicted to the ears of hairless mice (n=51; area: 1.3 mm(2)). The mice were randomized into five groups: (A) low-energy shock waves after burn injury (0.04 mJ/mm(2)); (B) very low-energy shock waves after burn injury (0.015 mJ/mm(2)); (C) mice received burns but no ESWA (control group); (D) mice without burn were exposed to low-energy shock waves; (E) mice without burns and with no shock wave application. Intravital fluorescent microscopy was used to assess microcirculatory parameters, angiogenesis and leukocyte behavior. ESWA was performed on day 1, 3 and 7 (500 shoots, 1 Hz). Values were obtained straight after and on days 1, 3, 7 and 12 post burn. RESULTS: Group A showed accelerated angiogenesis (non-perfused area at day 12: 5.3% vs. 9.1% (group B) and 12.6% (group C), p=0.005). Both shock wave groups showed improved blood flow after burn compared to group C. Shock waves significantly increased the number of rolling leukocytes compared to the non-ESWA-treated animals (group D: 210.8% vs. group E: 83.3%, p=0.017 on day 7 and 172.3 vs. 90.9%, p=0.01 on day 12). CONCLUSION: Shock waves have a positive effect on several parameters of wound healing after burns, especially with regard to angiogenesis and leukocyte behaviour. In both ESWA groups, angiogenesis and blood flow outmatched the control group. Within the ESWA groups the higher intensity (0.04 mJ/mm(2)) showed better results than the lower intensity group. Moreover, shock waves increased the number of rolling and sticking leukocytes as a part of an improved metabolism.
Assuntos
Queimaduras/terapia , Leucócitos , Pele/irrigação sanguínea , Som , Cicatrização , Animais , Adesão Celular , Movimento Celular , Endotélio , Camundongos , Camundongos Pelados , Microcirculação , Neovascularização FisiológicaRESUMO
The aims of the guidelines are to help assess the evidence for palliation surgery in patients with cholangiocarcinoma (CCA). The guidelines are classified in accordance with the location of the primary lesion, i.e. intrahepatic, hilar, and distal. They are based on comprehensive literature surveys, including results from randomized controlled trials, systematic reviews and meta-analysis, and cohort, prospective, and retrospective studies. Intrahepatic CCA, i.e. resection of lymph-node-positive tumors and R1/R2 resections have not been shown to provide survival benefit: Evidence levels: 2b, 4; Recommendation grade C. Hilar CCA: R1 resection is justified as a very efficient palliation. Non-surgical biliary stenting is the first choice of palliative biliary drainage. Distal CCA: Resection of lymph-node-positive tumours and R1/R2 resections should be performed. Non-surgical stenting is regarded as the first choice of palliation for patients with short life expectancy. For patients with longer projected survival, surgical bypass should be considered. Palliative resections have a relevant beneficial impact on the outcome of patients with distal and hilar CCA. Non-surgical stenting is the first choice of palliative biliary drainage for patients with hilar CCA and for those with distal CCA and short life expectancy. For patients with distal CCA and longer projected survival, surgical bypass should be considered.
RESUMO
Ischemia and reperfusion injury remains a relevant problem in clinical pancreas transplantation. We investigated the effect of sirolimus (SRL) in a rodent model of 90-min warm pancreatic ischemia. Four groups were studied: (1) sham surgery and vehicle; (2) sham surgery and SRL; (3) warm ischemia and vehicle; (4) warm ischemia and SRL. SRL (1.5 mg/kg/day) and vehicle were administered intraperitoneally for 3 days prior to surgery until the animals were killed. Microcirculation was assessed immediately after reperfusion by means of intravital fluorescence microscopy. Histopathological injury, apoptosis, proliferation and biochemical parameters were analyzed at 2 h, 1 day and 5 days after surgery. Ninety minutes after ischemia, intravital microscopy revealed an improved functional capillary density (p < 0.05) and reduction of adherent leucocytes (p < 0.01) and platelets (p < 0.05) in the SRL-treated group compared to the vehicle-treated controls. In contrast, on day 5 after ischemia, the pancreatic tissue of SRL-treated animals showed a higher grade of histological injury (p < 0.05) and higher rate of apoptotic cells (p < 0.05) than the vehicle controls. In summary, our data indicate that administration of SRL improves microcirculation at a very early stage, but results in an impairment of the recovery phase after pancreatic ischemia-reperfusion injury.
Assuntos
Microcirculação/efeitos dos fármacos , Pâncreas , Regeneração/efeitos dos fármacos , Traumatismo por Reperfusão/tratamento farmacológico , Sirolimo/farmacologia , Animais , Apoptose , Plaquetas/citologia , Adesão Celular , Proliferação de Células , Temperatura Alta , Leucócitos/citologia , Masculino , Pâncreas/irrigação sanguínea , Pâncreas/patologia , Pâncreas/fisiologia , Transplante de Pâncreas/métodos , Ratos , Ratos Endogâmicos Lew , Sirolimo/uso terapêutico , Circulação Esplâncnica/efeitos dos fármacos , Fatores de TempoRESUMO
The purpose of this study was to optimize the cleaning for colonoscopy. We compared a combination of senna pods and Goleytely solution to the exclusive ingestion of 7 litres of Goleytely solution. Test parameters were the score of visual assessment in five regions of the large bowel, the distension of the abdomen, concentration of hydrogen and methane in intestinal gases and subjective informations about abdominal complaints. We concluded from 80 colonoscopies that the combined procedure was almost identical with the cleaning by voluminal ingestions of Goleytely solution. There were no differences in the scores of visual assessment or concerning the intestinal gases. The additional administration of simethicone resulted in a statistically significant decrease of foam production. Thus, the combination of senna pods, a reduced ingestion of Goleytely solution supplemented with simethicone can be recommended for colonoscopy.
Assuntos
Antraquinonas/administração & dosagem , Catárticos , Colonoscopia/métodos , Eletrólitos/administração & dosagem , Intestino Grosso/patologia , Polietilenoglicóis/administração & dosagem , Irrigação Terapêutica/métodos , Adulto , Idoso , Antraquinonas/efeitos adversos , Terapia Combinada , Eletrólitos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/efeitos adversos , Simeticone/administração & dosagem , Simeticone/efeitos adversosRESUMO
The objective of our follow-up study was to evaluate the success of two different types of partially prefabricated post-and-core systems following crown placement. Two hundred and thirty-seven Permador posts and 49 Radix posts were evaluated clinically. Radiological follow-up was performed for 230 Permador posts and 47 Radix posts. The restorations had been in situ for an average of 3.9 years (Permador posts) and 2.3 years (Radix posts), respectively. Root canal fillings were evaluated as to their length, their homogeneity and their flushness with the walls of the root canal. The post-and-cores were evaluated for their orientation in the root canal and for the length of the inserted post relative to the length of the root. The position of the post was classified as centric in 78.0% of the restorations followed, and eccentric in 19.5%, while 2.5% showed a root perforation. The minimal requirement that the length of the post-and-core should at least be equal to the length of the clinical crown was met in 85% of the cases. Eighteen (6.3%) of the 286 teeth examined had to be extracted. There were significant correlations between insertion periods, horizontal bone loss, length of the root canal filling, and position of the post on one hand and tooth loss on the other.
Assuntos
Planejamento de Prótese Dentária , Técnica para Retentor Intrarradicular , Adulto , Perda do Osso Alveolar/etiologia , Distribuição de Qui-Quadrado , Coroas , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/patologia , Falha de Restauração Dentária , Estudos de Avaliação como Assunto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Técnica para Retentor Intrarradicular/efeitos adversos , Radiografia , Materiais Restauradores do Canal Radicular/química , Tratamento do Canal Radicular , Extração Dentária , Perda de Dente/etiologia , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/lesões , Resultado do TratamentoRESUMO
STATEMENT OF PROBLEM: Ultrahigh-speed tooth preparation can traumatize the hard dental tissues and the dental pulp. PURPOSE: This in vitro study examined the relationship between different grits of diamond burs on the temperature response within a pulpal chamber during tooth preparation with a turbine. MATERIAL AND METHODS: Newly extracted, undamaged third molars were secured by a rapid-tensioning device mounted on an air-supported slide. NiCrNi thermocouples were inserted apically and used to determine the temperature within a pulpal chamber. The grinding tests used cylindrical fine, coarse, and ultracoarse diamond burs. RESULTS: The maximal temperature elevation within the pulp was 3.2 degrees C, and the most pronounced rise in temperature occurred with ultracoarse burs. Temperature increases in the pulpal chambers and grinding times or temperatures of the cooling water were approximately proportional. Residual dentinal thickness was inversely proportional to temperature elevation within the pulpal chamber. CONCLUSIONS: This study demonstrated that coarse diamond burs resulted in more pronounced temperature increases within the pulpal chamber during tooth preparation. In addition, the benefit of short intervals between grinding steps and a cooling water temperature between 30 degrees C and 32 degrees C was confirmed. A cooling temperature of 38 degrees C to 43 degrees C did not afford actual cooling.
Assuntos
Regulação da Temperatura Corporal , Equipamentos Odontológicos de Alta Rotação , Cavidade Pulpar/fisiologia , Preparo do Dente/instrumentação , Equipamentos Odontológicos de Alta Rotação/estatística & dados numéricos , Diamante , Humanos , Técnicas In Vitro , Dente Serotino , Projetos de Pesquisa , Estatísticas não Paramétricas , Temperatura , Preparo do Dente/estatística & dados numéricosRESUMO
Telescopic retainers with conical ceramic abutment crowns and electroplated gold copings define a new retainer for removable dentures exhibiting favorable tribological properties that could offer clinical advantages. The objective of this study was to evaluate the clinical effects of this retainer. To do so, a novel treatment modality was developed based on intraoral bonding of the copings to the framework in order to be able to realize, in a clinical setting, the retainer function based on a precision fit. A total of 32 patients wearing 33 dentures (16 mandibular, 17 maxillary; period of risk [months]: minimum = 3; maximum = 58; mean = 27.6), supported by 147 abutments (83 natural teeth, 64 implants) with ceramic abutment crowns (IPS Empress 1, IPS Empress 2, InCeram, Procera, CerAdapt; CeraBase) were followed at 6-month intervals. The ceramic abutment crowns showed low plaque accumulation (mean PI = 17.3%). The gingival tissues around natural abutments were generally free of inflammation; so was the mucosa around the implants (mean SBI = 4.9%). Denture adhesion and occlusion did not change, and there were no rocking movements. The mobility (as determined by Periotest) of 29 teeth was reduced in a highly significant manner within 6 months (t test, p < 0.001). Osseointegration was preserved for all implants. One abutment loosened. Six Empress 1 ceramic copings failed (94.6% Kaplan-Meier survival rate), and one abutment tooth was lost (99.2% survival rate). All patients reported problem-free handling, no rocking movements, and constant adhesion. The adhesive strength of one denture was too low at insertion. 94% of the patients experienced no problems with oral hygiene. The retainer examined has relevant clinical advantages and meets geriatric requirements for removable dentures.
Assuntos
Cerâmica , Materiais Dentários , Ouro , Contenções Ortodônticas , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The DNA of 60 adenovirus type 8 (AV8) isolates (collected during the period 1961 to 1982, mostly in Western Germany) was analysed by 6 endonucleases and revealed 6 different genome types, thus implying that the variability of AV8 is relatively low. It was found that 45 isolates belonged to the genome type D1. Restriction site maps of a prototype D1 and of all deviating restriction variants were elaborated for enzymes BamHI, BglII, Hind-III and SalI.