Split-mouth evaluation of connective tissue graft with or without enamel matrix derivative for the treatment of isolated gingival recession defects in dogs

Abstract

Objectives

The potential additive effect of an enamel matrix derivative (EMD) to a subepithelial connective tissue graft (CTG) for recession coverage is still controversially discussed. Therefore, the aim of this study was to histologically evaluate the healing of gingival recessions treated with coronally advanced flap (CAF) and CTG with or without EMD in dogs.

Materials and methods

Gingival recession defects (5 mm wide and 7 mm deep) were surgically created on the labial side of bilateral maxillary canines in 7 dogs. After 8 weeks of plaque accumulation and subsequent 2 weeks of chemical plaque control, the 14 chronic defects were randomized to receive either CAF with CTG (CAF/CTG) or CAF with CTG and EMD (CAF/CTG/EMD). The animals were sacrificed 10 weeks after reconstructive surgery for histologic evaluation.

Results

Treatment with CAF/CTG/EMD demonstrated statistically significantly better results in terms of probing pocket depth reduction (P < 0.05) and clinical attachment level gain (P < 0.001). The length of the epithelium was statistically significantly shorter in the CAF/CTG/EMD group than in the CAF/CTG group (1.00 ± 0.75 mm vs. 2.38 ± 1.48 mm, respectively, P < 0.01). Cementum formation was statistically significantly greater in the CAF/CTG/EMD group than following treatment with the CAF/CTG group (3.20 ± 0.89 mm vs. 1.88 ± 1.58 mm, respectively, P < 0.01). The CAF/CTG/EMD group showed statistically significantly greater complete periodontal regeneration (i.e., new cementum, new periodontal ligament, and new bone) than treatment with CAF/CTG (0.54 ± 0.73 mm vs. 0.07 ± 0.27 mm, respectively, P < 0.05).

Conclusion

Within their limits, the present findings indicate that the additional use of EMD in conjunction with CAF + CTG favors periodontal regeneration in gingival recession defects.

Clinical relevance

The present findings support the use of EMD combined with CTG and CAF for promoting periodontal regeneration in isolated gingival recession defects.

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4-D flow magnetic-resonance-imaging-derived energetic biomarkers are abnormal in children with repaired tetralogy of Fallot and associated with disease severity

Abstract

Background

Cardiac MRI plays a central role in monitoring children with repaired tetralogy of Fallot (TOF) for long-term complications. Current risk assessment is based on volumetric and functional parameters that measure late expression of underlying physiological changes. Emerging 4-D flow MRI techniques promise new insights.

Objective

To assess whether 4-D flow MRI-derived measures of blood kinetic energy (1) differentiate children and young adults with TOF from controls and (2) are associated with disease severity.

Materials and methods

Pediatric patients post TOF repair (n=21) and controls (n=24) underwent 4-D flow MRI for assessment of time-resolved 3-D blood flow. Data analysis included 3-D segmentation of the right ventricle (RV) and pulmonary artery (PA), with calculation of peak systolic and diastolic kinetic energy (KE) maps. Total KE_RV and KE_PA were determined from the sum of the KE of all voxels within the respective time-resolved segmentations.

Results

KE_PA was increased in children post TOF vs. controls across the cardiac cycle, with median 12.5 (interquartile range [IQR] 10.3) mJ/m² vs. 8.2 (4.3) mJ/m², P<0.01 in systole; and 2.3 (2.7) mJ/m² vs. 1.4 (0.9) mJ/m², P<0.01 in diastole. Diastolic KE_PA correlated with systolic KE_PA (R² 0.41, P<0.01) and with pulmonary regurgitation fraction (R² 0.65, P<0.01). Diastolic KE_RV showed similar relationships, denoting increasing KE with higher cardiac outputs and increased right heart volume loading. Diastolic KE_RV and KE_PA increased with RV end-diastolic volume in a non-linear relationship (R² 0.33, P<0.01 and R² 0.50, P<0.01 respectively), with an inflection point near 120 mL/m².

Conclusion

Four-dimensional flow-derived KE is abnormal in pediatric patients post TOF repair compared to controls and has a direct, non-linear relationship with traditional measures of disease progression. Future longitudinal studies are needed to evaluate utility for early outcome prediction in TOF.

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The South Asian Facial Anthropometric Profile: A Systematic Review

Craniofacial anatomy, as measured by facial anthropometric data, varies significantly between races. South Asia, comprised of eight countries, represents a large proportion of the global population and is the fastest-growing region of the world. This systematic review presents the facial anthropometric data collected for populations from this region.

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Semiautomatic device for in vitro/ experimental bone perforation in dental implant research

The present study presents a semiautomatic device developed to perform in vitro experiments using surgical drills for assisting dental implant research. It was built to perform tests independent of human direct contact, and contains an adjustable toolholder for engaging different types of implant contra angle hand pieces, in which different drills can be adapted. The researcher is able to make a range of adjustments on the machine, such as controlling the drilling force and depth.

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Distinct transcriptomic profiles of early-onset atopic dermatitis in blood and skin of pediatric patients

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. The pipeline of novel targeted treatments for AD is expanding, largely based on our growing knowledge of disease mechanisms, with new therapeutics particularly focused on immune modulation.1 Most of our understanding of AD is derived from profiling tissues and blood of longstanding AD in adults, due to the difficulty of obtaining samples from infants and young children. However, initiation of AD typically happens very early in life, and the disease is already chronically established in the majority of patients by 5yrs of age.

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Neutrophil to lymphocyte ratio is a novel independent predictor of severe exacerbation in asthma patients

Severe exacerbations are well-known complications of asthma, which increase the total and asthma-related health care costs1 and decrease the quality of life of patients2. Although some exacerbation predictors have been reported3,4, it is difficult to predict and prevent severe exacerbations in a large percentage of patients affected by asthma.

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SERPING1 mutation in a rare hereditary angioedema with skin blisters

Hereditary Angioedema (HAE) is a rare, autosomal dominant disease characterized clinically by recurrent episodes of edema that may affect the skin and internal organs. The pathophysiological background of HAE is primarily an increased vascular permeability reaction to a local overproduction of bradykinin1. The most frequent dermatological manifestation is angioedema, which may occur on any part of the body and erythema marginatum is sometimes seen as symptomatic of the onset of an attack. The formation of blisters, described by some authors2-5, is an infrequent cutaneous manifestation of HAE.

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IFAR 2018 Reviewers

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Changes in the clinical and histological characteristics of Chinese chronic rhinosinusitis with nasal polyps over 11 years

Background

Traditionally, it was believed that chronic rhinosinusitis with nasal polyps (CRSwNP) demonstrated less eosinophilic and more neutrophilic inflammation in China compared to North America and Europe. However, inflammatory patterns may change over time. The study aimed to analyze the changing trends in the clinical and histological characteristics of CRSwNP over time in China.

Methods

A total of 115 consecutive CRSwNP patients from 2003 to 2005 and 114 consecutive CRSwNP patients from 2014 to 2016 were enrolled in this retrospective study. The clinical and histological data were compared between patients from the 2 time periods.

Results

The percentage of eosinophils in nasal polyp tissue increased, and the percentage of neutrophils and total inflammatory cell count decreased, over 11 years. The proportion of eosinophilic CRSwNP significantly increased from 59.1% to 73.7% over 11 years. The proportion of neutrophils and the total inflammatory cell count in nasal polyps decreased, and the proportion of eosinophilic CRSwNP patients using intranasal corticosteroids 1 month before surgery increased remarkably over 11 years. Moreover, eosinophilic CRSwNP patients had better compliance with intranasal corticosteroid use than non‐eosinophilic CRSwNP patients, and patients with comorbid allergic rhinitis and asthma had better compliance with intranasal corticosteroid use than patients without those conditions.

Conclusion

Eosinophilic CRSwNP, which was previously a minor subtype in East Asians, has increased remarkably in incidence to become the predominant CRSwNP subtype in Beijing, China, indicating that rhinologists should place greater emphasis on its diagnosis and treatment.

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Contact of the incisive canal and upper central incisors causing root resorption after retraction with orthodontic mini-implants: A CBCT study.

Related Articles

Contact of the incisive canal and upper central incisors causing root resorption after retraction with orthodontic mini-implants: A CBCT study.

Angle Orthod. 2018 Nov 28;:

Authors: Pan Y, Chen S

Abstract
OBJECTIVES:: To explore risk factors for contact between the incisive canal (IC) and upper central incisors (U1) and to evaluate the relationship between contact and root resorption using cone-beam computer tomography (CBCT).
MATERIALS AND METHODS:: This retrospective study used CBCT data of 33 patients treated by a senior orthodontist. Anterior teeth were retracted with mini-implants, and CBCT scans were taken before and after retraction. IC height and width, U1 lingual movement, and U1-IC distance and root length decrease were compared between contact and noncontact groups.
RESULTS:: Sixteen U1 roots in 11 patients touched the IC. The contact group had lower positioned ICs (2.86 ± 1.10 mm) than the noncontact group (4.07 ± 1.72 mm). The middle of the U1 roots showed more lingual movement to ICs in the contact group (2.30 ± 1.20 mm) than in the noncontact group (1.07 ± 1.16 mm). Right central incisors were closer to the IC than were the left. Root length decreased significantly more in the contact group (2.63 ± 0.93 mm) than in the noncontact group (1.14 ± 0.83 mm).
CONCLUSIONS:: There is a risk for the U1 root to contact the IC during anterior retraction when the IC is lower positioned. This contact might cause external apical root resorption.

PMID: 30484326 [PubMed - as supplied by publisher]

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Long-term stability of maxillary protraction therapy in Class III patients with complete unilateral cleft lip and palate.

Related Articles

Long-term stability of maxillary protraction therapy in Class III patients with complete unilateral cleft lip and palate.

Angle Orthod. 2018 Nov 28;:

Authors: Zhang Y, Fu Z, Jia H, Huang Y, Li X, Liu H, Li W

Abstract
OBJECTIVES:: This study evaluated the long-term stability of maxillary protraction (MP) in patients with complete unilateral cleft lip and palate (UCLP) and identified factors influencing relapse and long-term outcomes.
MATERIALS AND METHODS:: Twenty-three adolescents with UCLP who underwent MP therapy were recalled when craniofacial growth was close to completion. Subjects exhibiting reverse/positive overjets were assigned to unstable/stable groups. Lateral cephalometric measurements were made before treatment (T0), after active treatment (T1), and at the end of the growth spurt (T2).
RESULTS:: About 63% of the subjects exhibited positive overjets during follow-up. The unstable group demonstrated higher B-x and Co-Gn distances than the stable group (both P < .05) at T0. More short-term (T0-T1) sagittal advancement of point A (A-y) was evident in the unstable group than in the stable group ( P < .05), but no long-term difference was apparent between the two groups ( P = .481). During the posttreatment period (T1-T2), the SNA angle and maxillary incisor protrusion (U1-SN angle) were considerably lower in the unstable group than in the stable group (both P < .05). Overall, the unstable group exhibited a lower increase in the vertical extent of point A (A-x) than the stable group from T0 to T2 ( P < .05).
CONCLUSIONS:: In the long term, MP affords favorable maxillary advancement in patients with UCLP. A mandibular excess at T0 and vertical maxillary hypoplasia may contribute to the long-term relapse of a reverse overjet.

PMID: 30484325 [PubMed - as supplied by publisher]

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Atomic layout of an orthodontic titanium mini-implant in human tissue: Insights into the possible mechanisms during osseointegration.

Related Articles

Atomic layout of an orthodontic titanium mini-implant in human tissue: Insights into the possible mechanisms during osseointegration.

Angle Orthod. 2018 Nov 28;:

Authors: Kim JS, Ahn JP, Kim YH, Seo KW, Zadeh H, Kim SH

Abstract
OBJECTIVES:: To evaluate nanoscale molecular interactions in the interface between human bone and orthodontic titanium implants.
MATERIALS AND METHODS:: An orthodontic implant (sandblasted with large grit and with an acid-etched surface treated with Ti6A14V alloy) retrieved from the mandible of human after 2 months of healing was used to analyze the molecular interactive mechanism between the implant and the surrounding bone tissue. To preserve the natural state of the sample as much as possible, cryofixation and scanning electron microscope/focused ion beam milling without any chemical treatment were used during sample preparation. Atom probe tomography was used to investigate the chemical composition and structure at the interface between the implant and human bone tissue.
RESULTS:: Three-dimensional (3D) reconstruction of the whole sample revealed a 20 × 50-nm2 plate-like bony element diffusion layer in the sample. The iso concentration analysis of the diffusion layer indicated that the bony element, calcium, and the implant element, titanium oxide, were interspersed with each other. Detailed ionic distribution was illustrated by 3D reconstruction with partial region of interest and one-dimensional concentration profiles of the implant-bone interface.
CONCLUSIONS:: The study results advance nanoscale understanding of osseointegration and suggest a potential nanostructure for increasing bond strength of biomaterials to bone.

PMID: 30484324 [PubMed - as supplied by publisher]

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Calendar

Publication date: January 2019

Source: Ultrasound in Medicine & Biology, Volume 45, Issue 1

Author(s):

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Contents

Publication date: January 2019

Source: Ultrasound in Medicine & Biology, Volume 45, Issue 1

Author(s):

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Editorial Advisory Board

Publication date: January 2019

Source: Ultrasound in Medicine & Biology, Volume 45, Issue 1

Author(s):

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Masthead

Publication date: January 2019

Source: Ultrasound in Medicine & Biology, Volume 45, Issue 1

Author(s):

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Exceptional contact elasticity of human enamel in nanoindentation test

Publication date: Available online 30 November 2018

Source: Dental Materials

Author(s): Naofumi Shimomura, Reina Tanaka, Yo Shibata, Zhongpu Zhang, Qing Li, Jun Zhou, Wurihan, Takuma Tobe, Sachiko Ikeda, Kazuko Yoshikawa, Yukie Shimada, Takashi Miyazaki

Abstract

Objective

Tooth enamel has unsurpassed hardness and stiffness among mammalian tissue structures. Such stiff materials are usually brittle, yet mature enamel can survive for a lifetime. Understanding the nanoscale origin of enamel durability is important for developing advanced load-bearing biomaterials. Here, nanoscale exceptional contact elasticity of the human tooth enamel, based on nanoindentation tests, is reported.

Methods

Spherical indenter tips with radii of 243 and 1041 nm were used to determine stress–strain curves of enamel. Force–displacement curves were recorded using quasi-static loading strain rates of 0.031, 0.041, and 0.061 s⁻¹. The storage moduli from a superimposed signal amplitude (dynamic strain at 220 Hz) embedded during primary quasi-static loading and from quasi-static elastic theory were simultaneously measured. Modulus mapping was considered to be an extremely low quasi-static loading strain rate indentation test.

Results

The elastic limits were 7–9 GPa and 5–6 GPa for the small and large indenters, respectively. The elastic–plastic transition point and elastic modulus value increased with substantially increased quasi-static loading strain rate. The results suggested that the increase of the elastic limit during high-loading strain was associated with exceptional contact elasticity at the nanoscale of the enamel structure and the consequent extension of the contact area (i.e., a temporary pile-up response, dependent on the enamel nanocrystals and protein glue).

Significance

Structural modification at this scale effectively prevents the initiation of cracking from localized strain, thus reinforcing the bulk structure. These results may provide valuable insight for conceptualizing bio-inspired nanocomposites.

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Residual strain mapping through pair distribution function analysis of the porcelain veneer within a yttria partially stabilised zirconia dental prosthesis

Publication date: Available online 30 November 2018

Source: Dental Materials

Author(s): Alexander J.G. Lunt, Philip Chater, Annette Kleppe, Nikolaos Baimpas, Tee K. Neo, Alexander M. Korsunsky

Abstract

Objective

Residually strained porcelain is influential in the early onset of failure in Yttria Partially Stabilised Zirconia (YPSZ) – porcelain dental prosthesis. In order to improve current understanding it is necessary to increase the spatial resolution of residual strain analysis in these veneers.

Methods

Few techniques exist which can resolve residual stress in amorphous materials at the microscale resolution required. For this reason, recent developments in Pair Distribution Function (PDF) analysis of X-ray diffraction data of dental porcelain have been exploited. This approach has facilitated high-resolution (70 μm) quantification of residual strain in a YPSZ-porcelain dental prosthesis.

In order to cross-validate this technique, the sequential ring-core focused ion beam and digital image correlation approach was implemented at a step size of 50 μm. This semi-destructive technique exploits microscale strain relief to provide quantitative estimates of the near-surface residual strain.

Results

The two techniques were found to show highly comparable results. The residual strain within the veneer was found to be primarily tensile, with the highest magnitude stresses located at the YPSZ-porcelain interface where failure is known to originate. Oscillatory tensile and compressive stresses were also found in a direction parallel to the interface, likely to be induced by the multiple layering used during fabrication.

Significance

This study provides the insights required to improve prosthesis modelling, to develop new processing routes that minimise residual stress and ultimately to reduce prosthesis failure rates. The PDF approach also offers a powerful new technique for microscale strain quantification in amorphous materials.

Graphical abstract

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Influence of placement instruments on handling of dental composite materials

Publication date: Available online 30 November 2018

Source: Dental Materials

Author(s): Martin Rosentritt, Jana Hartung, Verena Preis, Stephanie Krifka

Abstract

Objective

Applicability and stickiness of dental composites are influential factors for the properties of those materials and so indirectly affect function, longevity and esthetics of composite restorations in the clinic. Thus, this in vitro study aimed for the influence of different placement instruments' diameter, geometries and coatings on the handling of uncured resin composite materials.

Methods

A survey about application technique of resin composites, placement instrument diameter, geometry and coating, and application temperature was answered by 55 German dentists in private practice. Due to these data diverse composite placement instruments were used to perform tensile tests on PMMA plates with application forces of 1 N and 2 N (v = 35 mm/min) at 25 and 37 °C. Following the dosing of a certain amount of the composite (nanohybrid, microhybrid) to the tip of the composite placement instrument, unplugging forces were determined after application and unplugging was performed.

Results

Unplugging forces were statistically significant different and varied between 0.27 N and 1.14 N. Stickiness of dental composites was dependent on the composite material itself as well as diameter, geometry and coating of the placement instruments.

Significance

Pre-clinical testing of composite materials' stickiness by unplugging forces facilitates the assessment of its handling properties.

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Antibacterial effects of polymeric PolymP-n Active nanoparticles. An in vitro biofilm study

Publication date: Available online 29 November 2018

Source: Dental Materials

Author(s): M.C. Sánchez, M. Toledano-Osorio, J. Bueno, E. Figuero, M. Toledano, A.L. Medina-Castillo, R. Osorio, D. Herrera, M. Sanz

Abstract

Objective

to study the antibacterial effect of polymeric PolymP-n Active nanoparticles using an in vitro subgingival biofilm model.

Methods

Hydroxyapatite discs coated with five modalities of nanoparticles (NPs): NPs, NPs doped with zinc, calcium, silver and doxycycline, PBS as control, and Streptococcus oralis, Actinomyces naeslundii, Veillonella parvula, Fusobacterium nucleatum, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were studied in a static in vitro biofilm model (12, 24, 48, and 72 h). Nano-roughness of the different disc surfaces (SRa, in nm) and morphological characteristic of the biofilms (thickness (μm) and bacterial viability) were studied by different microscopy modalities. Quantitative Polymerase Chain Reaction was used to assess the effect of the nanoparticles on the bacterial load (colony forming unit per milliliter) (CFU mL⁻¹). Analysis of variance and post-hoc testing with T3 Dunnett́s, and Student Newman Keuls correction was used. Results were considered statistically significant at p < 0.05.

Results

Surfaces containing the different nanoparticles showed significant increments in roughness when compared to controls (p < 0.05). A similar biofilm formation and dynamics was observed, although reductions in bacterial viability were detected in biofilms in contact with the different nanoparticles, more pronounced with silver and doxycycline NPs. Doxycycline-NPs biofilms resulted in unstructured biofilm formation and significantly lower number of the six species when compared with the other nanoparticles specimens and controls (p < 0.001 in all cases).

Significance

Polymeric PolymP-n Active nanoparticles when combined with silver and doxycycline showed a significant antibacterial effect when tested in an in vitro subgingival biofilm model.

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Physical properties and cytotoxicity of antimicrobial dental resin adhesives containing dimethacrylate oligomers of Ciprofloxacin and Metronidazole

Publication date: Available online 29 November 2018

Source: Dental Materials

Author(s): Yasaman Delaviz, Timothy W. Liu, Ashley R. Deonarain, Yoav Finer, Babak Shokati, J. Paul Santerre

Abstract

Objective

Antimicrobial oligomers synthesized from ciprofloxacin (CF) and metronidazole (MN) were investigated for their potential use in dental adhesives.

Methods

Susceptibility of the cariogenic bacterium Streptococcus mutans UA159 to CF, MN, and CF/MN combination was evaluated. Hydrolytic stability and drug release from the oligomers was studied in buffer and simulated human salivary esterase conditions. Cytotoxicity of films with 15 wt% drug oligomers co-polymerized with commercial monomers were assessed using human gingival fibroblasts (HGFs). In-house adhesives were prepared and characterized for viscosity. Polymerized films were analysed for gel content and water swelling. Interfacial fracture toughness (K_IC) of composites bonded to dentin by either a 2 or 3-step etch-and-rinse approach using the in-house formulated adhesives was measured.

Results

The respective minimum inhibitory concentration for CF and MN against S. mutans was 0.7 and 2400 μg/mL, with the combination having an additive effect (0.35 μg/mL CF with 1200 μg/mL MN). Antibiotics were released upon hydrolysis of the oligomers. Films containing the drug oligomers were not cytotoxic against HGFs. Replacing 2-hydroxyethyl methacrylate with the drug oligomers increased the viscosity of the experimental adhesives, reduced gel content, and decreased swelling of films in water. Antimicrobial adhesives demonstrated bonding to dentin with interfacial K_IC values comparable to the in-house control in the 2-step application, and with slightly lower K_IC values in the 3-step approach.

Significance

The antimicrobial oligomers can be incorporated into dental adhesive systems using formulations that show comparable fracture toughness to commercial materials, and may provide a means to deliver local antimicrobial drug release at the marginal interface.

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Positive correlation between fluoride release and acid erosion of restorative glass-ionomer cements

Publication date: Available online 29 November 2018

Source: Dental Materials

Author(s): Lígia S. Bueno, Rafael S. Menezes, Ana Paula R. Magalhães, Maria Fidela L. Navarro, Renata C. Pascotto, Marília A.R. Buzalaf, Sharanbir K. Sidhu, John W. Nicholson, Ana Flávia S. Borges

Abstract

Objective

The aim of this study was to determine whether there is a correlation between acid erosion and fluoride release of conventional glass ionomer cements.

Methods

Ten specimens for each material were prepared for fluoride release tests and five for acid erosion tests separately. After placed in pH cycling solution, concentration of fluoride was measured by a fluoride-ion selective electrode each day for 15 days. For the acid erosion test, specimens were immersed in a lactic acid solution and their depth measured with a spring-loaded dial gauge. The data were submitted to 3-way ANOVA, followed by Tukey's test (p < 0.05)

Results

All materials showed ability to elute fluoride in the 15 day period of the test, with the same pattern of high fluoride release at the first 24 h. Despite this, the amount of fluoride released was statistically different among the 18 groups, with the highest for Maxxion R and the lowest for Chemfil Rock (p > 0.05). The highest acid erosion values were registered for Magic Glass, Ion Z, VitroFil and Maxxion R, which exceeded the maximum stipulated by the relevant ISO test (ISO 9917-1). A positive linear correlation (r² = 0.4886) was found for both properties, i.e., higher fluoride release is related to higher acid erosion.

Significance

Acid erosion and fluoride release are related properties of GICs, though factors such as pH and P/L ratio lead to differences between actual values for individual brands of these materials.

Graphical abstract

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PET/TC con 18F-FDG «superscan» en paciente con linfoma inmunoblástico

Publication date: Available online 30 November 2018

Source: Revista Española de Medicina Nuclear e Imagen Molecular

Author(s): I. Acevedo-Báñez, Á. De-Bonilla-Damiá, R. Fernández-López

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Treatment of Patients with Vocal Fold Atrophy and Comorbid Essential Voice Tremor: Long-Term Injection Augmentation Outcomes After Successful Diagnostic Vocal Fold Injection Augmentation

Publication date: Available online 30 November 2018

Source: Journal of Voice

Author(s): Maxine Van Doren, Elizabeth Faudoa, Thomas L. Carroll

Abstract

Objective

Vocal fold injection augmentation (VFIA) is employed diagnostically for patients with subtle glottic insufficiency. Its use in patients with both vocal fold atrophy and benign essential voice tremor (EVT) has been reported but not after durable augmentation. This study intends to evaluate the success of durable VFIA using either autologous fat or calcium hydroxylapatite in patients with both vocal fold atrophy and comorbid EVT.

Methods/Design

Retrospective review. Subjects included demonstrated subtle glottic insufficiency from true vocal fold atrophy and comorbid EVT with no other vocal fold pathology. Voice Handicap Index (VHI-10), aerodynamic data including subglottic pressure and airflow, and the tremor scoring scale were evaluated before diagnostic VFIA with carboxymethylcellulose and after durable VFIA with calcium hydroxylapatite or autologous fat.

Results

Seven patients met inclusion criteria. Six subjects went on to durable VFIA. Three of six demonstrated meaningful improvement in the VHI-10 score. Subglottic pressure improved significantly in those subjects with meaningful VHI-10 improvement compared to those that did not. The tremor did not resolve completely in any subject, but patient satisfaction and function was improved in four of the six.

Conclusions

VFIA for EVT in the setting of true vocal fold atrophy appears to offer benefit and may be an alternative treatment pathway for EVT patients. More than half of the subjects who underwent durable VFIA after successful diagnostic VFIA reported improvement in their communication despite inconsistent objective outcomes. Subglottic pressure improved significantly in half of the subjects who also reported a substantive improvement in their VHI-10.

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Biobehavioral Measures of Presbylaryngeus

Publication date: Available online 30 November 2018

Source: Journal of Voice

Author(s): Vrushali Angadi, Colleen McMullen, Richard Andreatta, Maria Dietrich, Tim Uhl, Joseph Stemple

Abstract

Objective

The objective of this observational study was to assess the relationship between established aging biobehavioral measures and voice decline in normally aging adults.

Study design

Cross-sectional study.

Methods

Participants 60–85 years of age were divided into two age and sex-matched groups, based on the presence or absence of presbylaryngeus. Both groups underwent a battery of tests measuring anthropometric variables, inflammatory markers, general health measures, and vocal function parameters. Differences from the norm were calculated for all variables. Parametric and nonparametric tests were performed to assess group differences. In addition, variable selection analysis was performed to determine variables that were most influential in predicting the occurrence of presbylaryngeus in our current sample.

Results

Fifty-three participants were divided into age and sex-matched groups of "presbylaryngeus" (n = 26) and "non-presbylaryngeus" (n = 27). The two groups were statistically different in select measures of inflammatory markers, general health measures, and vocal function parameters. Anthropometric measures were not statistically different. Based on variable selection, the variables most predictive of the presence of presbylaryngeus were measures of the Physical Activity Scale of the Elderly, C-reactive protein, laryngeal airway resistance, and vocal roughness.

Conclusions

In addition to group differences in vocal function measures, results for the presbylaryngeus group consistently trended sub-optimally on anthropometric measures, two inflammatory markers, and general health measures. These results suggest that this sample of individuals with presbylaryngeus demonstrated greater biobehavioral deficits associated with aging as compared to age and sex-matched non-presbylaryngeus individuals.

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Challenges in allergy immunology practice: Solutions needed for persistent patient problems

Publication date: December 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6

Author(s): Gailen D. Marshall

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Author Index

Publication date: December 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6

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A new acronym for PPI-REE?

Publication date: December 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6

Author(s): Russell Hopp

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Editorial Board

Publication date: December 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6

Author(s):

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Information for Authors

Publication date: December 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6

Author(s):

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Table of Contents

Publication date: December 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6

Author(s):

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Information for Readers

Publication date: December 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6

Author(s):

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Erratum

Publication date: December 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6

Author(s):

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Anti-microbial Resistance In Atopic Dermatitis: Need for an Urgent Rethink

Publication date: Available online 29 November 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): C.P. Harkins, M.T.G. Holden, A.D. Irvine

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Individual 3-dimensional printed mold for treating hard palate carcinoma with brachytherapy: A clinical report

Publication date: Available online 30 November 2018

Source: The Journal of Prosthetic Dentistry

Author(s): Valentina Lancellotta, Stefano Pagano, Luca Tagliaferri, Marco Piergentini, Alessandro Ricci, Sandro Montecchiani, Simonetta Saldi, Sara Chierchini, Stefano Cianetti, Vincenzo Valentini, György Kovács, Cynthia Aristei

Abstract

This clinical report describes the use of a 3-dimensional (3D) printer to create an individual mold for delivering high-dose-rate interventional radiotherapy for hard palate cancer. The maxillary teeth and palate were scanned with an intraoral scanner (3Shape Trios 3). The scan was transformed into a mesh using the standard tessellation language (STL) format and aligned with Digital Imaging and Communications in Medicine (DICOM) computed tomography (CT) images using free Blue Sky Plan 4 planning software. A mold was generated by tracing a guideline around the gingival margins of the maxillary teeth and palate on the scan mesh in accordance with established parameters. All data were imported into computer-aided design (CAD) software. For this patient, 3 parallel 2.2-mm-diameter ducts were placed 10 mm from each other in the mold mesh. A CT scan of the patient's mouth with the mold in place was used for treatment planning. Treatment was delivered by means of microSelectron digital afterloading.

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Prosthodontic treatment of a patient with Ewing sarcoma of the left maxillary sinus: A clinical report

Publication date: Available online 30 November 2018

Source: The Journal of Prosthetic Dentistry

Author(s): Woo J. Chi, Matthew M. Hanasono, Theresa M. Hofstede, Ruth A. Aponte-Wesson

Abstract

This clinical report describes the prosthodontic rehabilitation of a 22-year-old woman with a substantial treatment history of Ewing sarcoma of the left maxillary sinus. The patient was diagnosed with Ewing sarcoma at the age of 7 years and went through chemotherapy, radiation, surgical resection, and free-flap reconstruction, initially without prosthodontic rehabilitation. The patient aged 22 years was referred to the oral oncology clinic at The University of Texas MD Anderson Cancer Center for prosthodontic treatment. The patient's prosthetic rehabilitation with dental implants and a definitive maxillary obturator prosthesis is presented in detail.

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Color stability of maxillofacial prosthetic silicone functionalized with oxide nanocoating

Publication date: Available online 30 November 2018

Source: The Journal of Prosthetic Dentistry

Author(s): Arghya Kamal Bishal, Alvin G. Wee, Valentim A.R. Barão, Judy Chia-Chun Yuan, Richard Landers, Cortino Sukotjo, Christos G. Takoudis

Abstract

Statement of problem

Maxillofacial prostheses made of silicone elastomers undergo undesirable color degradation over time. How this color change can be prevented is unclear.

Purpose

The purpose of this in vitro study was to evaluate the ability of an oxide nanocoating to prevent color degradation of maxillofacial silicone elastomers after artificial accelerated aging.

Material and methods

A silicone elastomer with functional intrinsic pigment was tested. Specimens (N=20) were fabricated, and half of them were coated with a nanolayer of titanium dioxide (TiO₂) using atomic layer deposition. Both coated and noncoated specimens (control) were exposed to artificial aging at 450 kJ/m² of total energy. Changes in the color of all the specimens with and without TiO₂ nanocoating were measured before and after the atomic layer deposition coating and before and after aging. The obtained color data were analyzed by using independent t tests and the 1-sample t test (α=.05).

Results

Color change (ΔE1=3.4 ±1.4) was observed for the silicone elastomers after the specimens were surface coated with TiO₂ nanofilm, although this change was not statistically significant (P=.369) compared with the acceptability threshold (ΔE=3.0). Upon exposure to artificial aging, the noncoated control specimens underwent color change (ΔE2=2.5 ±0.7, P=.083 compared with the acceptability threshold). The specimens with TiO₂ nanocoated surface experienced the least color change (ΔE3=1.4 ±0.6) when subjected to artificial aging, and this change was significantly lower (P<.001) than the established acceptability threshold of ΔE=3.0. In addition, the chemical analyses confirmed that the TiO₂ nanocoating remained on the surface after exposure to artificial aging.

Conclusions

TiO₂ nanocoating was shown to be effective in reducing color degradation of the silicone elastomer exposed to artificial aging for 120 hours with 450 kJ/m² of total energy.

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Clinical remounting of complete dentures: A systematic review

Publication date: Available online 30 November 2018

Source: The Journal of Prosthetic Dentistry

Author(s): Tyler V. Verhaeghe, Bernie A. Linke, Cheryl E. Cable, Nesrine Mostafa

Abstract

Statement of problem

A recent trend has been to reduce the procedural complexity of complete denture fabrication. Whether the clinical remount step is necessary is unclear.

Purpose

The purpose of this systematic review was to assess the relevance of the clinical remount procedure on complete denture outcomes.

Material and methods

Five electronic databases were searched through to May 2018. The terms "denture*", "dental prosthes*", "equilibrat*", and "remount*" were chosen. The titles and abstracts were screened, and those which met the inclusion criteria were selected for full-text assessment. Studies that only performed the laboratory remount or were not randomized controlled studies were excluded.

Results

After duplicate removal, the database search strategy resulted in a total of 226 potential studies. After the titles and abstracts had been screened and the inclusion and exclusion criteria applied, 10 studies were retrieved for full-text assessment. Four randomized controlled clinical studies were included in the systematic review. A meta-analysis could not be performed because of variation in outcome measures after the clinical remount.

Conclusions

A clinical remount for complete dentures is recommended on delivery to reduce clinically observed areas of discomfort and reduce the number of recall appointments. The development of a reliable and valid patient satisfaction questionnaire is necessary to determine conclusively whether the clinical remount also improves patient-perceived satisfaction and mastication.

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Is predicting masticatory function based on mandibular bone atrophy as defined by clinical and radiographic parameters possible? A clinical study

Publication date: Available online 30 November 2018

Source: The Journal of Prosthetic Dentistry

Author(s): Alessandra Julie Schuster, Raissa Micaella Marcello-Machado, Amália Machado Bielemann, Luciana de Rezende Pinto, Fernanda Faot

Abstract

Statement of problem

The degree of mandibular bone atrophy can guide and determine the choice of prosthetic treatment. Although several methodologies have been proposed for classifying atrophy, the clinical and radiographic parameters considered for the classification of mandibular bone atrophy should be standardized.

Purpose

The purpose of this clinical study was to evaluate the influence of methodologies of mandibular bone atrophy categorization on the masticatory function in complete denture (CD) wearers and to verify the relationship between these parameters according to the retention and stability of the mandibular CD.

Material and methods

CD wearers were radiographically and clinically evaluated to determine the mandibular bone atrophy levels. Three classifications were adopted: the Cawood and Howell criteria, the Wical and Swoope criteria, and the Kapur classification. CD retention and stability were scored based on the Sato et al method. The masticatory function was evaluated by the multiple sieve method using optical test food to determine the masticatory performance (MP) indexes (median particle size, MP X50; homogeneity index, MP B) and the masticatory efficiency (sieves 4 and 2.8).

Results

In this sample of 63 individuals (mean age of 67.4 years), atrophic participants presented significant differences in all radiographic parameters (Mann–Whitney test, P<.05) with both the Cawood and Howell and Wical and Swoope methodologies. No differences in masticatory function were found, except for atrophic participants classified by Wical and Swoope criteria, who had worse MP X50 (P=.047) than nonatrophic participants, with a medium effect size of 0.7. The retention of the mandibular CD significantly affected the masticatory outcomes, with higher values for MP X50 (P=.012) and MP B (P=.040) and lower values for masticatory efficiency, 2.8 (P=.008) for atrophic participants. The presence of mandibular bone atrophy showed an association with poor retention (P=.04) and poor stability (P=.002) when the Cawood and Howell criteria were adopted (Fisher exact test, P<.05).

Conclusions

The Kapur classification confirmed the clinical condition of the participants' atrophy, and the most clinically atrophic participants showed poor retention and stability of the mandibular CD. Only the poor retention directly affected the masticatory function. Radiographic evaluations alone did not provide sufficient data to determine the predictability of CD treatment regarding the participants' masticatory function. Radiographically, atrophic participants with poor retention had impaired mastication.

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Trephination-based, guided surgical implant placement: A clinical study

Publication date: Available online 30 November 2018

Source: The Journal of Prosthetic Dentistry

Author(s): Nawakamon Suriyan, Lertrit Sarinnaphakorn, George R. Deeb, Sompop Bencharit

Abstract

Statement of problem

Conventional guided implant surgery promises clinical success through implant placement accuracy; however, it requires multiple drills along with surgical sleeves and sleeve adapters for the horizontal and vertical control of osteotomy drills. This results in cumbersome surgery, problems with patients having limited mouth opening, and restriction to specific drill or implant manufacturers. A protocol for using trephination drills to simplify guided surgery and accommodate multiple implant systems is introduced.

Purpose

The purpose of this clinical study was to evaluate the accuracy of implant placement using this novel guided trephine drill protocol with and without a surgical sleeve.

Material and methods

Intraoral scanning and preoperative cone beam computed tomography (CBCT) scans were used for implant treatment planning. Surgical guides were fabricated using stereolithography. Implant surgery was performed using the guided trephination protocol with and without a surgical sleeve. Postoperative CBCT scans were used to measure the implant placement deviations rather than the implant planning position. Surgical placement time and patient satisfaction were also documented. One-tailed t test and F-test (P=.01) were used to determine statistical significance.

Results

Thirty-five implants in 17 participants were included in this study. With a surgical sleeve, implant positional deviations were 0.51 ±0.13 mm vertically, 0.32 ±0.10 mm facially, 0.11 ±0.11 mm lingually, and 0.38 ±0.13 mm mesially. Without a surgical sleeve, implant positional deviations were 0.58 ±0.27 mm vertically, 0.3 ±0.14 mm facially, 0.39 ±0.16 mm lingually, and 0.41 ±0.12 mm mesially. No statistically significant difference was found between the 2 protocols (P>.01), except that the sleeve group had greater vertical control precision (F-test, P=.006), reduced placement time, and the time variation was reduced (t test, P=.003; F-test, P<.001).

Conclusions

This trephination-based, guided implant surgery protocol produces accurate surgical guides that permit guided surgery in limited vertical access and with the same guided surgery protocol for multiple implant systems. Guided sleeves, although not always necessary, improve depth control and reduce surgical time in implant placement.

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Satisfaction of patients with amyotrophic lateral sclerosis with an oral appliance for managing oral self-biting injuries and alterations in their masticatory system: A case-series study

Publication date: Available online 30 November 2018

Source: The Journal of Prosthetic Dentistry

Author(s): Nina Riera-Punet, Jordi Martinez-Gomis, Carla Zamora-Olave, Eva Willaert, Maria Peraire

Abstract

Statement of problem

About 10% of patients with amyotrophic lateral sclerosis (ALS) are candidates for oral treatment specifically because of traumatic injuries in the lips, cheeks, or tongue due to self-biting. However, patients with ALS have a prevalence of temporomandibular disorder (TMD) similar to that in the general population.

Purpose

The purpose of this case-series study was to determine the degree of satisfaction of patients with ALS with an oral appliance for managing oral self-biting lesions or symptoms related to TMDs. This study also assessed the degree of improvement of the chief complaint and the compliance with and adverse effects of this treatment.

Material and methods

Eleven patients with ALS who sought oral treatment because of oral self-biting or TMD-related symptoms were included. A custom complete-coverage acrylic resin device was fabricated and fitted to each participant. A follow-up visit was planned for 3 months after the placement of the oral appliance, at which point the patients would rate the degree of improvement or worsening of the chief complaint and their degree of satisfaction with the treatment. A 1-sample t test was used to assess whether the degree of improvement of the chief complaint was significant.

Results

Participants reported a mean of 61% (95% confidence interval [CI] 38% to 84%) improvement of the chief complaint and a mean of 84% (95% CI 72% to 97%) satisfaction with the treatment. The mean rate of compliance was 62% (95% CI 40% to 84%) of the recommended time, and only a few adverse effects were reported.

Conclusions

Participants with ALS were highly satisfied with the use of an oral appliance to manage oral self-biting or TMD-related symptoms. Adherence to this treatment was high, and no major adverse effects were observed.

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Fabricating a low-cost autoclavable throat screen from a steamer mat

Publication date: Available online 30 November 2018

Source: The Journal of Prosthetic Dentistry

Author(s): Ram Prakash, Krishna Prakash

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Quantitative Assessment of Bladder Cancer Reflects Grade and Recurrence: Comparing of Three Methods of Positioning Region of Interest for ADC Measurements at Diffusion-weighted MR Imaging

Publication date: Available online 30 November 2018

Source: Academic Radiology

Author(s): Hongyi Li, Lin Liu, Lei Ding, Zhenming Zhang, Mengchao Zhang

Purpose

To determine the impact of three different regions of interests (ROIs) positioning methods for apparent diffusion coefficient (ADC) measurements on the assessment of the grade and recurrence and to examine the correlation between ADC value and histopathological grade/ Ki-67 labeling index (LI) in patients with bladder cancer.

Materials and Methods

Sixty-one patients with bladder cancer were retrospectively evaluated. Two observers measured mean ADC values using whole-volume-ROIs, single-section-ROI and three-ROIs methods. Interclass correlation coefficient was analyzed to assess interobserver variability. The grade and recurrence in patients with bladder cancer were assessed by calculating the areas under the receiver operating characteristic curves with Az values. Spearman's correlation was used to analyze the correlations of ADC value with grade and Ki-67 LI.

Results

For the mean ADC value, the interclass correlation coefficient were excellent with the whole-volume and the single-section method (0.90 [95% CI: 0.84, 0.94] and 0.89 [95% CI: 0.81, 0.93]) and was good with the three-ROIs method (0.72 [95% CI: 0.53, 0.83]). The Az value for determining histological grade and recurrence of bladder cancer were not significantly different from each positioning method (all p > 0.05). There's significant correlation between histological grade and ADC measuring by whole-volume-ROIs and single-section-ROI methods (r = 0.31, p = 0.02; r = 0.37, p < 0.05). The ADC measured by whole-volume-ROIs, single-section-ROI, and three-ROIs methods were significantly and inversely correlated with the Ki-67 LI (r = −0.3; r = −0.49; r = −0.40, all p < 0.05).

Conclusion

There's no significant difference among any of the ROI positioning methods in evaluation of tumor grade and recurrence. There's significant correlation between histological grade and ADC measuring by whole-volume-ROIs and single-section-ROI methods. The ADC value obtained by either of three methods was significantly and inversely correlated with the Ki-67 LI.

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