Abstract

The aim of this study was to compare the 5-year outcome of full-arch mandibular fixed prosthetic rehabilitation using the All-on-4 concept in smoking and nonsmoking patients. This retrospective cohort study included 200 patients (n = 100 smokers, n = 100 nonsmokers), 119 women and 81 men, with an average age of 53.7 years, rehabilitated in immediate function with 800 implants. Implant cumulative survival rate estimation (Kaplan-Meier with log-rank test) and marginal bone resorption (MBR) at 5 years (Mann-Whitney test) were compared between both groups. Multivariable analysis was used to investigate potential risk indicators for MBR ≥ 2.8 mm at 5 years. Nine patients (4.5%) were lost to follow-up. Four patients lost eight implants, specifically one nonsmoking patient (n = 1 implant) and three smoking patients (n = 7 implants), resulting in a cumulative survival rate estimation of 99.0% and 96.9% for nonsmokers and smokers, respectively (P = 0.296). The average (standard deviation) MBR at 5 years was 1.68 mm (0.76 mm) and 1.98 mm (1.02 mm) for nonsmokers and smokers, respectively (P = 0.045). Smoking (odds ratio = 2.92) was the only risk indicator significantly associated with MBR ≥ 2.8 mm in multivariable analysis. Smoking should not be an absolute contraindication for rehabilitation of the edentulous mandible through the All-on-4 concept; however, smoking habits were significantly associated with MBR ≥ 2.8 mm.

Introduction

Smoking has long been causally associated with several cancers, heart disease, and chronic obstructive pulmonary disease and represents the leading cause of premature death and morbidity in the Western world (U.S. Department of Health and Human Services. The health consequences of smoking: a report of the surgeon general. 2004; 1). Cigarette smoking was previously reported to have a detrimental effect on early bone tissue response around dental implants, with marginal bone loss, gaps, and fibrous tissue surrounding the implants retrieved from smokers, together with a significant decrease in bone to implant contact percentage compared to nonsmokers (2).

Objective. To determine the translucency acceptability and perceptibility thresholds for dental resin composites using CIEDE2000 and CIELAB color difference formulas. Methods. A 30-observer panel performed perceptibility and acceptability judgments on 50 pairs of resin composites discs (diameter: 10mm; thickness: 1mm). Disc pair differences for the Translucency Parameter (TP) were calculated using both color difference formulas (TP00 ranged from 0.11 to 7.98, and TPab ranged from 0.01 to 12.79). A Takagi–Sugeno–Kang (TSK) Fuzzy Approximation was used as fitting procedure. From the resultant fitting curves, the 95% confidence intervals were estimated and the 50:50% translucency perceptibility and acceptability thresholds (TPT and TAT) were calculated. Differences between thresholds were statistically analyzed using Student t tests (˛ = 0.05). Results. CIEDE2000 50:50% TPT was 0.62 and TAT was 2.62. Corresponding CIELAB values were 1.33 and 4.43, respectively. Translucency perceptibility and acceptability thresholds were significantly different using both color difference formulas (p = 0.01 for TPT and p = 0.005 for TAT). CIEDE2000 color difference formula provided a better data fit than CIELAB formula. Significance. The visual translucency difference thresholds determined with CIEDE2000 color difference formula can serve as reference values in the selection of resin composites and evaluation of its clinical performance.

Introduction

The increased demand of patients for highly esthetic restorations has driven the development of dental materials with suitable optical properties. Translucency is an important property of dental tissues and materials. Thus, an appropri- ate determination and communication of optical properties should include translucency, in addition to more popular parameters such as: lightness (L*), a* and b* (CIELAB coordinates), hue angle (h◦) and chroma (C*). Translucency describes the ability of a material to transmit light [1]. The translucency parameter [2] (TP) has been used to assess the translucency of dental materials [3–7]. TP is defined as the CIELAB color difference (E*ab) for a material, at a particular thickness, on optical contact with ideal black and white backings [2]. Aiming to improve correction between perceived and computed color differences of CIELAB formula, the Commission Internationale de l’Éclairage (CIE) [8] recommended the use of CIEDE2000 color difference formula. However, at the moment in the majority of translucency studies in dental literature, the TP is still quantified using the CIELAB color space and its associated color formula (E*ab). Thus, determination of TP has shown differences in translucency of different composite resins depending of its shade [9],thickness [10]; matrix composition [11]; filler particle size and content [12,13] and type and amount of the opacifiers used [14]. Perceptibility difference threshold represents the lower perceptual limit, and it is widely applicable, mainly, to develop new color notation systems and their color difference metrics, to study discernible colors by the human visual system [15] and to understand the mechanisms of color vision [16]. However, in many practical situations, differences above the threshold (supra-threshold) are used, passing from perceptibility thresholds or “just noticeable differences” to higher differences, named “acceptable differences” or “tolerances.” The industrial interest on these differences is justified, on one hand, by the high cost required to maintain the industrial production below the limits of the visual threshold (perceptible threshold) and, on the other hand, by the need of maintaining the differences under an admissible limit. The complete absence of control (monitoring) should involves a lack of similarity in the production outcome, with negative implications on the overall quality of the product.

Objective: Maillard advanced glycation end products (AGEs) are connected with high dry temperature food processing, color and flavor modification of food products. Oral cavity pathology is strongly influenced by dietary intake. The aim of the present paper is to update current data regarding the sources and metabolism of AGEs, their impact on oral cavity tissues, to discuss and suggest new approaches for the early diagnosis and efficient treatment of AGEs-related oral pathology. Design: This paper is a narrative review of the studies discussing AGEs and mainly the dietary AGEs (dAGEs) sources, metabolism, linkage to general diseases, and specifically the oral cavity pathology. The authors used “PUBMED” and MeSH for the finding of English written and published articles concerning AGEs. There were used the next keywords association: “advanced glycation end products- AGEs” AND “Maillard products”, “AGEs” AND “diet-related disease, “AGEs” AND “salivary biosensor”, “AGEs” AND “metabolic syndrome AGEs”, “AGEs” AND “oral pathology”, “AGEs” AND “dentin AGEs” OR “periodontal AGEs”, “AGEs” AND “diagnosis and monitoring”. The authors used free full-text articles to determine the etiology and physiopathology of AGEs, their association with general diseases and oral cavity disease, assessment methods used in biofluids and tissues, AGEs prevention and treatment approaches. Articles concerning AGEs etiology, metabolism and effect in the human body and specific implication in oral pathology were selected. There were no exclusion criteria in what concerns the study design. Studies in other language than English and articles abstracts were excluded. Criteria of inclusion were free full-text articles written in English. Equally human and animal model studies were included. Regarding the date of publication, all subjects concerning glycation products after 1953 (first published article) were included. Results: Evidence show that AGEs are responsible for inducing low intensity chronic inflammation and thereby, for initiating and/or aggravating chronic diseases. Nowadays, research has demonstrated a significant association between AGEs and dental or periodontal pathology. Moreover, salivary AGEs are consistent with the levels of AGEs in other biological fluids and are correlated with the general and oral pathology. Conclusions: Assessment of salivary AGEs could be a reliable tool for early diagnosis and monitoring diet-related disease.

Introduction

Advanced glycation end products (AGEs) are final products of Maillard reaction. They were discovered by Louis-Camille Maillard in 1912, while he was trying to synthesize in vitro proteins by using a high temperature reaction between amino acids and sugars (Zhang, Ames, Smith, Baynes, & Metz, 2009). In 1953, John E. Hodge published an article in which he divided the reaction and in 1986, the formation of reducing sugar-derived carbonyl products was added to the Maillard chain reaction (Hodge, 1953). It was associated with the flavor and pleasant scent of food, but also with oxidative stress production, local and general inflammation, and last but not least, mutagenic dicarbonyl compounds (Nagao, Takahashi, Yamanaka, & Sugimura, 1979). In medical research, AGEs have been associated to ROS (reactive oxygen species) increase, with consequent generation of oxidative or carbonyl stress. Thus, ROS exert negative effects resulting in inflammatory, autoimmune, diet-related diseases. Comparing to the discovery of the Maillard reaction products, the hypothesis of the implication of AGEs in periodontitis and dental pathology was founded at a later time. Several studies have revealed a strong association between the accumulation of AGEs and the occurrence or worsening of metabolic diseases. However, the routine use of AGEs salivary levels for the diagnosis or monitoring the oral diseases has not been yet reported.

Acknowledgments

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Introduction

The classical roles of respiratory mucus are to maintain the hydration of the respiratory tract and to act as a protective barrier against the external environment by trapping particulate matter, including pathogens. Trapped matter can then be expelled from the airways by mucociliary clearance, the rhythmic beating of cilia bundles on the airway epithelium. It is now clear that this classical model is not complete and that mucus is a complicated, multicomponent secretion with numerous functions. The functions of respiratory mucus now include immune response regulation, the presentation of molecules that are inhibitory to pathogens, the regulation of cell differentiation and proliferation, and the maintenance of the barrier function of the epithelium.

Respiratory tract mucus is the first interaction that inhaled agents have with a potential new host. Accordingly, this mucus layer can determine the infectivity, and potentially the transmissibility, of respiratory pathogens including influenza viruses, respiratory syncytial virus (RSV) and rhinoviruses as well as pathogenic lung colonization by the opportunistic bacterial pathogen Pseudomonas aeruginosa (PA), particularly in patients with cystic fibrosis (CF). Here, we review the current understanding of respiratory tract mucus and its interactions with respiratory pathogens. We pay particular attention to studies investigating the interactions between influenza viruses and mucus and their importance in understanding influenza virus pathogenesis and host-range restriction.

Abstract

Introduction: This study aimed to report a possible effect of the presence of an adjacent implant on the development of a vertical root fracture (VRF) in endodontically treated teeth. Methods: A series of 8 cases in 7 patients with teeth diagnosed with VRF after the placement of implants in the adjacent area is described and analyzed. In addition, a comprehensive literature search with strict inclusion and exclusion criteria was undertaken to identify additional clinical studies that assessed this clinical scenario. Results: The case series analysis revealed that the time from implant placement to the diagnosis of VRF was between 5 and 28 months (average = 11 months). The majority of cases occurred in female patients who received 2 or more implants. Six of the 7 patients were older than 40 years, with an average age of 54 years. The majority of teeth with VRF were premolar or mandibular molar teeth (6/8 teeth). All fractured teeth had been restored with a crown and had a post present, and the quality of the root canal filling was determined to be adequate. The systematic review revealed that implant-associated VRF has not been investigated or reported in the literature yet. Conclusions: Based on a systematic review of the literature, this case series, although limited in its extent, is the first clinical report of a possible serious adverse event of implantassociated VRF in adjacent endodontically treated teeth. Additional clinical studies are indicated to shed light on this potential phenomenon. (J Endod 2016;42:948–952)

Tooth replacement with an oral implant may be indicated because of tooth loss as a result of trauma, dental caries, periodontal disease, and in case of a congenitally missing tooth. The missing tooth space may be restored with an implant when it is surrounded with healthy teeth or with intact prosthetic reconstruction of the neighboring teeth (1).

Abstract

Many different types of scaffold materials have been used for tissue engineering applications, and hydrogels form one group of materials that have been used in a wide variety of applications.

Hydrogels are hydrophilic polymer networks and they represent an important class of biomaterials in biotechnology and medicine because many hydrogels exhibit excellent biocompatibility with minimal inflammatory responses and tissue damage. Many studies have demonstrated the use of hydrogels in bone-tissue engineering applications. In this report, the summary was conducted on various kinds of polymers and different modification methods of hydrogels to enhance bone formation. The results revealed that hydrogels are applied for bone regeneration and that the modification of hydrogels with bioactive molecules or cell-based approaches resulted in significant increases in new bone formation. This suggests that the use of hydrogels with modification may offer an option for bone-tissue engineering, and further research is needed to identify the biological and physical properties of hydrogels.

Introduction

Many different types of scaffold materials have been used for tissue engineering applications, and hydrogels form one group of materials that have been used in a wide variety of applications (1). A gel is defined as a three-dimensional network swollen by a solvent, and hydrogels are hydrophilic polymer networks that may absorb from 10-20%, up to thousands of times their dry weight in water, and this property allows the cells to adhere, proliferate, and differentiate onto the hydrogels (2).

Hydrogels represent an important class of biomaterials in biotechnology and medicine because many of them exhibit excellent biocompatibility with minimal inflammatory responses and tissue damage, and thus many studies on bone-tissue engineering applications have been undertaken (3-6). In this report, the summary was conducted on various kinds of polymers and different modification methods of hydrogels in bone regeneration applications.

Ameloblastoma is the common locally aggressive benign epithelial odontogenic tumour of the oral cavity. It was 0rst recognized by Cusack in 1827 and named in 1930 by Ivy and Churchill [1]. According to WHO classi0cation in 2005, there are 5 subtypes of benign ameloblastoma documented, and they are (1) solid/multicystic type, (2) desmoplastic type, (3) unicystic type, and (4) extraosseous/peripheral type [2]. Histopathologically, the 6 subtypes are follicular, plexiform, acanthomatous, basal, unicystic, and desmoplastic ameloblastoma. It can be managed either by the conservative method or radical approach depending on the type, location, and size and age of the patient. A systematic review by Almaida et al. described that the 50% of recurrence is seen in follicular subtype and the recurrence rate is signi0cantly low if a radical approach is used [3]. (is paper describes two cases of recurrence of ameloblastoma in patients who underwent segmental resection of the jaw. (ese case reports can be added to the list of reported cases of recurrent ameloblastomas.

2. Case 1

A 46-year-old male patient referred by a private practitioner complained of swelling in the previously operated area of the right lower jaw since one month. He had a history of surgery in the same region. While going through the records of the patient, he had undergone segmental resection and reconstruction of the defect with rib graft 15 years ago. Histopathology reports of the previous pathology were not available in the records. Panoramic radiograph and CT scan revealed multilocular radiolucent lesion in the previously operated site (Figure 1). (e clinical diagnosis at present was recurrent multicystic ameloblastoma involving the bone graft. (e excision of the lesion with 1 cm uninvolved soft tissue margin was performed through the previous scar (Figures 2 and 3). (e histopathology report of the specimen suggested follicular ameloblastoma with acanthomatous changes with tumourfree margins. A 1-year-follow-up showed no recurrence. He is planned for alloplastic reconstruction of the right hemimandible, considering the benign nature of the lesion.

A new idea was lately realized for nickel-titanium (NiTi) rotary instruments: it consists of using just one instrument with different working motions with the aim to prepare root canals.1e4 Diverse single-file systems have been promoted with the ability to prepare root canals with just one instrument. The recently introduced NiTi files Reciproc (VDW, Munich, Germany) and WaveOne (Dentsply Maillefer, Ballaigues, Switzerland) are made of a special NiTi-alloy called M-Wire which is created by an innovative thermaltreatment process. The benefits of this M-Wire NiTi are based on increased flexibility of the instruments and on improvement of resistance to cyclic fatigue.5 These files must be used in a reciprocal motion that requires special automated devices. Reciproc files are available in sizes 25e0.8, 40e0.6, and 50e0.5, and WaveOne are available in sizes 21e0.6, 25e0.8, and 40e0.8. The reciprocation working movement lies in a counterclockwise (cutting direction) and a clockwise movement (instrument release), whilst the counterclockwise cutting direction angle is greater than the instrument release one. Because the angle of counterclockwise is greater than the angle of clockwise, it is expressed that the instrument continually progress in the direction of the root canal apex. The One-Shape New Generation file by Micro-Mega (Besancon Cedex, France) is another single-file system, but used in continuous clockwise rotation; in addition to the size 25e0.6, there are Apical files in sizes 30e0.6 and 37e0.6. These instruments, having an innovative design, with three diverse cross-sectional areas above the entire length of the working part do not have a fixed pitch and a noncutting safety tip.6 The design features of Reciproc, WaveOne,3 and OneShape have been previously described in detail.6 Some data are present in literature on the shaping ability of these systems,2,6 but a comparative evaluation in canals with curvatures of over 35
is still missing. Therefore, the aim of the present study was to compare the shaping ability of WaveOne, Reciproc, and OneShape single-file systems in severely curved root canals of extracted human molar teeth. The null hypothesis tested was that there is no difference among different single-file systems regarding canal straightening, apical transportation, or preparation time when preparing severely curved root canals.

1. Introduction

The maxillary cysts lined by pseudostratified columnar epithelium (respiratory epithelium) can show different pathologic conditions and hinder the diagnosis, thus challenging the clinician and pathologist. These lesions include mucocele of the maxillary sinus and surgical ciliated cyst.The latter develops after a surgical procedure, such as maxillary sinus surgery (e.g., Caldwell-Luc), orthognathic surgery, and trauma caused by dental extraction [1–3]. In some cases, a radicular cyst can also be included in the differential diagnosis of these lesions. In fact, although its cavity is lined by a nonkeratinized stratified squamous epithelium, it can be partially or totally lined by a respiratory epithelium [4–7]. We report the case of an unusual cyst on the maxillary right first molar (tooth #16) region, in which the cavity was totally lined by respiratory epithelium. Interestingly, no previous history of surgical treatment of the sinus, trauma, or dental extraction was observed.

2. Case Presentation

We report the case of a 35-year-old healthy male who consulted our Oral Surgery, Implantology and Pathology Emergency Department with a chief complaint of pain in the posterior maxillary right region. He reported no history of trauma or surgery in the maxillofacial region and was not known for recurrent sinusitis. The clinical examination revealed a generalized periodontitis. Tooth #16 presented a periodontal pocket extending to the root apices with pus coming out from the gingival sulcus. The mobility of the teeth was grade 3, the vitality was negative, and the percussion was positive. The patient was not swollen and did not have any systemic symptomatology. A severe generalized horizontal bone loss associated with local vertical lesions and furcation involvement in the first quadrant was seen on the panoramic radiography. The diagnosis of a combined endodontic periodontal lesion was inferred.

Traumatic lingual hematoma (LH) is an uncommon condition that can rapidly progress to life-threatening upper-airway obstruction. The tongue is a richly vascular structure, mainly supplied by branches of the lingual artery. The majority of LHs are traumatic or spontaneous; the latter are often associated with the use of thrombolytics or other anticoagulants. To our knowledge, there are no reports documenting bilateral TMJ dislocation as a complication. We report a case of traumatic LH complicated by thrombocytopenia, which necessitated airway management with limited options. We will discuss airway stabilization in the setting of a large anterior airway obstruction, treatment of a traumatic LH, and a previously unreported complication of LH resulting in bilateral TMJ dislocations.

CASE REPORT

A 39-year-old man with a history of alcohol abuse was brought into the Emergency Department (ED) by ambulance due to an unwitnessed fall and suspected alcohol withdrawal seizure. Upon arrival the patient was alert and oriented with no evidence of acute respiratory compromise, despite a muffled voice and a large LH. He had no complaints and denied shortness of breath. Past medical history was significant only for alcohol abuse, but he had not imbibed for 24 h. He denied use of anticoagulants, angiotensin-converting enzyme (ACE) inhibitors, or history of allergic reaction. He also denied a prior history of tongue swelling or difficulty closing his mouth. He stated that both started while he was being transported to the hospital and were progressively getting worse. On arrival, the patient had a heart rate of 155 beats/min, temperature of 37.9
C, respiratory rate of 17 breaths/min, room air oxygen saturation of 100%, and a blood pressure of 191/121 mm Hg.

مقاله سال 2017

ماموریت رشته مراقبت پرستاری کوکران (CNCF)، توسعه نتایج سلامت از طریق افزایش استفاده از کتابخانه کوکران و حمایت از نقش کوکران با ارائه پایه شواهد و اسنادی برای پرستاران و متخصصینی که به نوعی با ارائه ، هدایت و یا تحقیق در مورد مراقبت های پرستاری ارتباط دارند، می باشد. CNCF ستونهای گوشه کوکران را فراهم می سازد که در جورنالهای مربوط به مراقبت پرستاری بطور منظم منتشر وچاپ می شوند.

1. سوال مرور
آیا دهانشوی های فلوراید جهت پیشگیری از پوسیدگی های دندانی در بچه ها و نوجوانان موثر و ایمن است؟
جمعیت : بچه ها و نوجوانان سنین 16 و یا کمتر
مداخله : دهانشوی های فلوراید
مقایسه: پلاسیبو یا عدم درمان
نتیجه: نتیجه اولیه رشد پوسیدگی است. پوسیدگی به عنوان تعداد دندانهای کرم خورده ، افتاده و یا پر شده و یا سطوح دندان ثبت می شود. رشد پوسیدگی تغییر در تعداد پوسیدگی را از مقیاسهای پایه اندازه گیری می کند. نتایج ثانویه شامل نسبت بچه هایی که پوسیدگی جدید داشتند و یا عاری از پوسیدگی نبودند ، نسبت بچه هایی که زنگ زدگی دندان ، سمیت حاد و سوزش مخاط تجربه کرده اند، می باشد.