An In Vitro Evaluation of the Microleakage under Complete Metal Crowns Using Three Adhesive Luting Cements

Despite the material advancements and precise laboratory techniques, cement lines are inevitable in fixed prosthodontics which leads to increased dependence on the integrity of the cement to maintain the marginal seal. The material class of luting agent is known to influence microleakage. Studies of cement dissolution and disintegration have produced varying results. Hence, this study was done to evaluate marginal leakage under complete metal crowns using three adhesive cements, two resin cements (one self cure, one dual cure) and a glass ionomer cement. Metal crowns were prepared on sixty intact extracted premolars and were randomly divided into three groups of twenty each, with each group using a different cement for luting. All the samples were then subjected to thermocycling and were sectioned using a diamond saw. Reflected Binocular Stereomicroscope at 100× magnification was used to study the extent of microleakage at both metal cement (MC) and tooth cement (TC) interface, at two opposite margins of each sectioned specimen. Data was analyzed with a one way analysis of variance. For comparison among the groups multiple comparison Bonferroni test was done. Within group data was analysed with independent student t test. Between three groups, metal crowns cemented with multilink cement showed significantly less microleakage at both the interfaces. Glass ionomer cement recorded maximum combined microleakage amongst three cements irrespective of the interfaces. Within group, glass ionomer and multilink cement showed more microleakage at MC interfaces than at TC interface. A complex interaction between variables related to dental restoration, luting agent and tooth structure probably influence microleakage. In vitro studies must always be followed by in vivo studies before definite conclusion can be drawn.     

Surgical treatment of lower limb ischemia in diabetic patients – long-term results

Introduction

Lower limb ischemia may cause nonhealing ulcers, infection, amputation and even mortality in diabetic patients. In this study, we review our data of ischemic lower limb revascularization procedures in diabetic patients and present the early, mid- and long-term results.

Material and methods

From March 2004 to September 2008, 83 patients with lower limb ischemia in Fontaine class III and IV underwent distal arterial bypass procedures. Saphenous vein grafts were used for below-knee arterial bypasses in all patients. In 16 (19%) patients femoropopliteal bypasses were performed with PTFE grafts. Short-term and long-term surgical results were evaluated.

Results

Ulcer recovery was determined in 36% of patients. Graft patency was 95% and 1 death (1%) occurred in short-term follow-up. In long-term follow-up the total effectiveness rate was 74%. Graft patency was 79% and 6 deaths (7%) occurred during the follow-up.

Conclusions

Lower limb ischemia is a serious event in patients with diabetes mellitus. The consequences may include increased mortality and morbidity in this particular patient population. However, distal arterial revascularizations are considerably effective procedures to avoid amputation, to eliminate symptoms, to promote ulcer recovery and to help the patient participate in social life with acceptable short, mid- and long-term follow-up results.     

A Comparative Evaluation of the Linear Dimensional Accuracy of Four Impression Techniques using Polyether Impression Material

There is much discussion in the dental literature regarding the superiority of one impression technique over the other using addition silicone impression material. However, there is inadequate information available on the accuracy of different impression techniques using polyether. The purpose of this study was to assess the linear dimensional accuracy of four impression techniques using polyether on a laboratory model that simulates clinical practice. The impression material used was Impregum Soft?, 3 M ESPE and the four impression techniques used were (1) Monophase impression technique using medium body impression material. (2) One step double mix impression technique using heavy body and light body impression materials simultaneously. (3) Two step double mix impression technique using a cellophane spacer (heavy body material used as a preliminary impression to create a wash space with a cellophane spacer, followed by the use of light body material). (4) Matrix impression using a matrix of polyether occlusal registration material. The matrix is loaded with heavy body material followed by a pick-up impression in medium body material. For each technique, thirty impressions were made of a stainless steel master model that contained three complete crown abutment preparations, which were used as the positive control. Accuracy was assessed by measuring eight dimensions (mesiodistal, faciolingual and inter-abutment) on stone dies poured from impressions of the master model. A two-tailed t test was carried out to test the significance in difference of the distances between the master model and the stone models. One way analysis of variance (ANOVA) was used for multiple group comparison followed by the Bonferroni’s test for pair wise comparison. The accuracy was tested at α = 0.05. In general, polyether impression material produced stone dies that were smaller except for the dies produced from the one step double mix impression technique. The ANOVA revealed a highly significant difference for each dimension measured (except for the inter-abutment distance between the first and the second die) between any two groups of stone models obtained from the four impression techniques. Pair wise comparison for each measurement did not reveal any significant difference (except for the faciolingual distance of the third die) between the casts produced using the two step double mix impression technique and the matrix impression system. The two step double mix impression technique produced stone dies that showed the least dimensional variation. During fabrication of a cast restoration, laboratory procedures should not only compensate for the cement thickness, but also for the increase or decrease in die dimensions.     

Acute emergency tibialization of the fibula: reconstruction of a massive tibial defect in a type IIIC open fracture

Gustilo type IIIC open fractures of the tibia are high-energy injuries necessitating long treatment periods and usually multiple surgical procedures and eventually resulting in high morbidity rates and even amputations. We present here a case involving a type IIIC open tibial fracture with massive loss of the entire tibial diaphysis, which we treated by performing acute tibialization of the fibula after revascularization of the posterior tibial artery in a single-stage emergency operation.     

Chemosignals and hormones in the neural control of mammalian sexual behavior

Males and females of most mammalian species depend on chemosignals to find, attract and evaluate mates and, in most cases, these appetitive sexual behaviors are strongly modulated by activational and organizational effects of sex steroids. The neural circuit underlying chemosensory-mediated pre- and peri-copulatory behavior involves the medial amygdala (MA), the bed nucleus of the stria terminalis (BNST), medial preoptic area (MPOA) and ventromedial hypothalamus (VMH), each area being subdivided into interconnected chemoreceptive and hormone-sensitive zones. For males, MA–BNST connections mediate chemoinvestigation whereas the MA–MPOA pathway regulates copulatory initiation. For females, MA–MPOA/BNST connections also control aspects of precopulatory behavior whereas MA–VMH projections control both precopulatory and copulatory behavior. Significant gaps in understanding remain, including the role of VMH in male behavior and MPOA in female appetitive behavior, the function of cortical amygdala, the underlying chemical architecture of this circuit and sex differences in hormonal and neurochemical regulation of precopulatory behavior.     

Antagonist activity of the antipsychotic drug lithium chloride and the antileukemic drug imatinib mesylate during glioblastoma treatment in vitro

Objectives: Glioblastoma (GBM), the most common primary tumour of the central nervous system, is characterised by a high malignancy and poor prognosis. The aims of this study were to investigate whether the combination of imatinib mesylate (IM) and lithium chloride (LiCl) exhibited a synergistic effect in treatment and to determine whether midkine (MK) affected the fate of this treatment in vitro.

Methods: Monolayer and spheroid cultures of the T98G human GBM cell line were treated with an IM and LiCl combination for 72 h. The cell proliferation index, apoptotic index, cell cycle distribution, apoptotic and anti-apoptotic protein levels, and cAMP level as well as the cellular morphology and ultrastructure were evaluated.

Results: All applications inhibited cell proliferation and induced apoptosis. The most substantial decreases in cell proliferation and the caspase-3, epidermal growth factor receptor (EGFR), platelet derived growth factor receptor-alpha (PDGFR-α), multidrug resistance protein-1 (MRP-1), aquaporin-4 (AQP-4) and cAMP levels were induced by the LiCl treatment, which exhibited more pronounced effects compared with the combination treatment. LiCl was less effective in decreasing the MK and B cell lymphoma-2 (Bcl-2) levels compared with the combination treatment. The most substantial decrease in the p170 levels was identified following the combination treatment, whereas IM induced the second greatest decrease. LiCl alone had no effect on the p170 levels. IM induced the most substantial decrease in the phospho-glycogen synthase kinase 3-beta (p-GSK-3β)/glycogen synthase kinase 3-beta (GSK-3β) ratio, and LiCl induced the second most substantial decrease. Both LiCl and the combination treatment induced G2 + M arrest, whereas IM induced G0 + G1 arrest after 72 h of exposure. An apoptotic appearance and autophagic vacuoles were commonly identified in the LiCl, combination and IM groups, respectively.

Conclusions: The combination of IM and LiCl exhibited an antagonist effect, and MK had a role at this antagonism.     

Does combining magnetic-activated cell sorting with density gradient or swim-up improve sperm selection?

Purpose

The present study aimed to evaluate whether combining the magnetic-activated cell sorting (MACS) with density-gradient (DG) or swim-up (SU) sperm separation techniques can improve sperm selection to obtain higher quality spermatozoa.

Methods

Two commonly used sperm selection techniques, SU and DG, were compared to MACS combined with either SU or DG. Spermatozoa obtained from normozoospermic (n?=?10) and oligozoospermic (n?=?10) cases were grouped as SU, DG, SU+MACS, and DG+MACS followed by the analysis of sperm morphology, motility, DNA integrity, and the levels of Izumo-1 and PLCZ proteins.

Results

Although spermatozoa obtained by SU or DG when combined with MACS have improved aspects when compared to SU or DG alone, results did not reach a statistically significant level. Moreover, separation with MACS caused a significant loss in the numbers of total and rapid progressive spermatozoa.

Conclusions

Considering the cost/benefit ratio, MACS application together with traditional techniques may only be preferred in certain cases having higher concentrations of spermatozoa, but it does not seem to be an ideal and practical sperm selection technique for routine use.