Osteomyelitis after septic trochanteric bursitis - clinical case

We report the clinical case of a 76 years-old woman with a subacute trochanteric inflammatory pain with low-grade fever and laboratory markers of acute inflammation, associated with the ultrasonographic evidence of bursitis and radiologic evidence of femoral erosions, that resolved after intravenous antibiotherapy. Although rare, the infectious etiology should be considered in patients with clinical manifestations of bursitis and signs of systemic involvement.     

Robot-assisted laparoscopic prostatectomy: surgical technique

Prostate tumours are among the most frequently diagnosed solid tumours in males (a total of 192,280 new cases in the USA in 2009); since the approval of the PSA test by the Food and Drug Administration in 1986, incidence has risen significantly, particularly in the '90s; furthermore the spread of the PSA test has led to an increased frequency of cancer diagnosis at the localised stage. The standard treatment for tumour of the prostate is retropubic radical prostatectomy (RRP) which however is not morbidity-free, e.g. intraoperative bleeding, urinary incontinence and erectile dysfunction. This is why the interest of the scientific community has turned increasingly to mini-invasive surgical procedures able to achieve the same oncological results as the open procedure, but which also reduce the impact of the treatment on these patients' quality of life. The first step in this direction was laparoscopic prostatectomy described by Schuessler in 1992 and standardised by Gaston in 1997. However, the technical difficulty inherent in this procedure has limited its more widespread use. In May 2000 Binder and Kramer published a report on the first robot-assisted prostatectomy (RARP) using the Da Vinci system (da Vinci TM, Intuitive Surgical, Sunnyvale, CA, USA). From the original experience, RARP, which exploits the advantages of an enlarged, three-dimensional view and the ability of the instruments to move with 7 degrees of freedom, the technique has spread enormously all over the world. At the time of writing, in the USA, RARP is the most common therapeutic option for the treatment of prostate tumour at localised stage. In the present study we describe the RARP technique proposed by dr. Vipul Patel, head of the Global Robotic Institute (Orlando Fl).     

Reattachment of anterior fractured teeth: effect of materials and techniques on impact strength

Abstract – Background/Aim: The reattachment of dental fragments, as a conservative treatment, should be the first choice to restore fractured teeth. Therefore, the aim of this study was to evaluate the effect of different materials and reattachment techniques on impact strength of bovine incisors. Material and Methods: Standardized fragments were obtained when 80 crowns were sectioned 12 mm from the incisal edge. Teeth were mounted in PVC rings, embedded in acrylic resin and polyether to simulate bone support and periodontal ligament. Specimens were distributed in nine groups (n = 10), according to the reattachment technique (Direct bonding or Circumferential chamfer); the adhesive system (Single Bond or Clearfil SE Bond); and the intermediated material (Filtek Z350 Flow or Rely X CRA). Sound teeth composed the control group. Circumferential chamfer was prepared after the bonding of the fragment by means of a spherical point and filled with the composite Filtek Z250. The impact strength was evaluated in a universal testing machine Instron. A compressive load was applied at a crosshead speed of 500 mm min^?1 on the buccal surface, 2 mm from the incisal edge. Data were submitted to anova and Ryan–Einot–Gabriel–Welsch Multiple Range test (5%). Results: Mean value of impact strength for control group was 64.8 Kgf. The fragment reattachment using Circumferential chamfer was significantly superior to Direct Bonding. The use of Single Bond significantly increased the impact strength when compared to the use of Clearfil SE. There was no significant difference among Rely X and Filtek X350 Flow. Conclusion: No technique or material, when individually considered, was capable of achieving the mechanical strength of the sound teeth; however, the association of reattachment technique Circumferential chamfer with bonding system Single Bond could approximate the immediate impact strength of the restored teeth to that observed in the sound teeth.     

Early Bone Healing around Different Implant Bulk Designs and Surgical Techniques: A Study in Dogs

Purpose: To evaluate the bone healing response to different implant root shape designs in a dog model. Materials and Methods: Three by eight millimeter screw‐type short‐pitch (SP) and large‐pitch (LP) implants (Intra‐Lock International, Boca Raton, FL, USA), and 4.5 × 6 mm plateau (P) implants (Bicon LLC, Boston, MA, USA) were placed along the proximal tibia of six dogs for 2 and 4 weeks. The combination of implant design and final osteotomy drilling resulted in healing chambers for the LP and P implants. The implants were nondecalcified processed to plates of ～30‐µm thickness and were evaluated by optical microscopy for healing patterns and bone‐to‐implant contact (BIC). One‐way analysis of variance at 95% level of significance and Tukey's test were utilized for multiple comparisons among the groups' BIC. Results: Microscopy showed a ～150‐µm region of newly deposited bone along the whole perimeter of SP implants, near the edge of the LP implant threads, and plateau tips for P implants. Rapid woven bone formation and filling was observed in regions where surgery and implant design resulted in healing chambers. No significant differences in BIC were observed (p > .75). Conclusions: Different implant design/surgical protocol resulted in varied bone healing patterns. However, the BIC and bone morphology evolution between implant designs were comparable. Regardless of the combination between implant design and final osteotomy drilling, bone morphology evolution from 2 to 4 weeks was comparable.     

Factors to achieve aesthetics in all-ceramic restorations

The demand for aesthetic restorations has increased during the last years. Dental ceramics are a successful alternative for some cases because of aesthetics and biocompatibility. Therefore, the aim of this literature review was to present the factors necessary to fabricate all-ceramic restorations with aesthetics similar to natural dentition. A search of English-language peer-review literature was completed using MEDLINE database from 1975 to 2009 including the keywords "aesthetic," "metal-free crown," "all-ceramic," and "color." It was observed that several factors influence aesthetics of all-ceramic restorations. Color scale, light source during color evaluation, characteristic of core material, color of supporting tooth, presence of root post, and type of cement are clinical factors that may influence color of the restorations. Laboratorial factors as technique for ceramic condensation, thickness, temperature, and number of firing cycles also influence the result of these crowns. Although several clinical and laboratorial factors influence aesthetics of all-ceramic restorations, the aesthetic success and longevity of these restorations depend on the integration with surrounding periodontal tissue.     

Hardness evaluation of prosthetic silicones containing opacifiers following chemical disinfection and accelerated aging

We evaluated the effects of disinfection and aging on the hardness of silicones containing opacifiers and intended for use in facial prosthetics. A total of 90 samples were produced using a cylindrical metal mold 3 mm in height and 30 mm in diameter. The samples were fabricated from Silastic MDX 4-4210 silicone in three groups: GI contained no opacifier, GII contained barium sulfate (Ba), and GIII contained titanium dioxide (Ti). The samples were disinfected using effervescent tablets (Ef), neutral soap (Ns), or 4% chlorhexidine (Cl) 3 times a week for 60 days. After this period the samples underwent 1,008 hours of accelerated aging. The hardness was measured using a durometer immediately following the disinfection period and after 252, 504, and 1,008 hours of aging. The data were statistically analyzed using 3-way ANOVA and the Tukey test (p < .05). The GIII group exhibited the greatest variation in hardness regardless of elapsed time. All groups displayed greater hardness after 1,008 hours of accelerated aging independent of disinfectant type. All of the hardness values were within the clinically acceptable range.     

A human retrieval study of plasma-sprayed hydroxyapatite-coated plateau root form implants after 2 months to 13 years in function

Calcium phosphate-based bioactive ceramics in various physical and chemical formulations have been extensively utilized as biomaterials for bone regeneration/conduction. However, the determination of their in vivo temporal behavior from the short to long term in humans has been a challenge due to the lack of physical reference for morphologic and morphometric evaluation. The present study evaluated bone morphology and morphometry (bone-to-implant contact [BIC]) around plasma-sprayed hydroxyapatite (PSHA)-coated endosseous implants that were retrieved due to prosthetic reasons while successfully in function at the posterior region of the jaws from as early as 2 months to ～13 years after a 6-month healing period after placement. Bone morphology was evaluated by light microscopy, and BIC was determined using computer software. Irrespective of the time in vivo, lamellar bone was observed in close contact with the implant PSHA-coated surface and between plateaus. BIC ranged from ～35-95%, was highly directional, and Haversian-like osteonic morphology between plateaus was observed for most implants. The PSHA coating was present with little variation in thickness between the samples retrieved regardless of time in vivo.     

The Effect of Achievement Goals on Moral Attitudes in Young Athletes

The purpose of the study is to assess the hypothesis that achievement goal orientations will predict sportpersonship attitudes among young athletes, namely that task orientation will predict socially positive attitudes and ego orientation will predict socially negative attitudes. For hundred and eighty two athletes, aged 13 to 16 years completed the Portuguese versions of the Task and Ego Orientation in Sport Questionnaire (TEOSQp) and of the Sports Attitudes Questionnaire (SAQp). Bivariate correlations were used to examine the relationships between TEOSQp and SAQp. Afterwards, relationships between ego orientation and score agreement in cheating and gamesmanship as well as task orientation and score agreement in convention and commitment were examined through EQS (version 5.7). For the estimation of the model, the maximum likelihood method was used. A matrix correlation between the variables (task orientation, ego orientation, cheating, gamesmanship, convention and commitment) showed positive correlations between task orientation and convention (r = 0.29, p < 0.01) and commitment (r = 0. 40, p < 0.01). Ego orientation appeared to be positively correlated with cheating (r = 0.30, p < 0.01) and gamesmanship (r = 0.33, p < 0.01), and negatively with convention (r = -0.16, p < 0.01).The fit of the model was evaluated using the CFI (0.97) and SRMR (0.04). The hypothesized model was confirmed. Task and ego orientations produced a significant effect on prosocial attitudes and on antisocial attitudes, respectively. Task-oriented goals in youth sport programs can represent a relevant framework for promoting prosocial attitudes and consequentely increment the effectiveness of educational interventions.

Key points

• Sport seems to be an important component of daily physical activity in children and adolescents and its importance is often viewed as positive.
• Literature suggests that a high task orientation has a positive link with moral variables and a high ego orientation is likely to promote inappropriate behaviours.
• Task orientation will predict pro-social sport attitudes, and to assess the hypothesis that ego orientation will predict anti-social sport attitudes among young athletes.
• It is possible to suggest a pattern in which the self-referenced achievement goals can promote the expression of sportspersonship attitudes
• Environmental factors can be more influential than dispositional orientations when it comes to sportspersonship.

Key words: Youth sports, cheating, gamesmanship, convention, commitment.