Transcranial superior orbitotomy for the treatment of intraorbital intraconal tumors: surgical technique and long-term results in single institute

In this article, the authors are presenting their experience and the results with the surgical treatment of intraorbital intraconal tumors based on a review of 33 constitutive cases. Our data were evaluated in comparison to other major series, and possible factors that might influence surgical outcome and survival are discussed. Thirty-three patients diagnosed with intraorbital intraconal tumors between 1998 and 2009 were treated by transcranial approach. Of these patients, there were 14 males (42.4?%) and 19 females (57.8?%). The age ranged between 2 and 70?years (mean?=?36?±?16.6?years). The follow-up period ranged between 2 and 13?years (mean?=?7.3?±?3.2?years). The most common presenting symptoms were exophthalmus and decreased visual acuity, which was seen in 21 (63.6?%) and 19 patients (57.6?%), respectively. Total resection was achieved in 23 patients (69.7?%) while subtotal resection was done in ten patients (30.3?%). Cavernoma and optic nerve sheath meningioma were the most common histologic variants, which were found in 11 (33.3?%) and 10 (30.3?%) patients, respectively. In the long-term follow-up, 54.5?% of the patients showed total ophthalmologic improvement, 9.1?% showed partial improvement, 21.2?% demonstrated unchanged ophthalmologic status, and 15.2?% showed worse ophthalmologic outcome. Transcranial approach for the treatment of intraorbital intraconal tumors is an effective approach for the management of these pathologies. The effectiveness is clearly demonstrated by the clinical results and outcomes of these patients' groups.     

Conventional Multi‐Slice Computed Tomography (CT) and Cone‐Beam CT (CBCT) for Computer‐Aided Implant Placement. Part II: Reliability of Mucosa‐Supported Stereolithographic Guides

Purpose: Deviations of implants that were placed by conventional computed tomography (CT)‐ or cone beam CT (CBCT)‐derived mucosa‐supported stereolithographic (SLA) surgical guides were analyzed in this study. Materials and Methods: Eleven patients were randomly scanned by a multi‐slice CT (CT group) or a CBCT scanner (CBCT group). A total of 108 implants were planned on the software and placed using SLA guides. A new CT or CBCT scan was obtained and merged with the planning data to identify the deviations between the planned and placed implants. Results were analyzed by Mann‐Whitney U test and multiple regressions (p < .05). Results: Mean angular and linear deviations in the CT group were 3.30° (SD 0.36), and 0.75 (SD 0.32) and 0.80 mm (SD 0.35) at the implant shoulder and tip, respectively. In the CBCT group, mean angular and linear deviations were 3.47° (SD 0.37), and 0.81 (SD 0.32) and 0.87 mm (SD 0.32) at the implant shoulder and tip, respectively. No statistically significant differences were detected between the CT and CBCT groups (p = .169 and p = .551, p = .113 for angular and linear deviations, respectively). Conclusions: Implant placement via CT‐ or CBCT‐derived mucosa‐supported SLA guides yielded similar deviation values. Results should be confirmed on alternative CBCT scanners.     

Interstitial cystitis: a rare manifestation of primary Sjögren’s syndrome,successfully treated with low dose cyclosporine

Chronic interstitial cystitis (IC), mostly affecting middle-aged women, is a very rare manifestation of primary Sjögren’s syndrome (pSS). Hereby, we report a 42-year-old woman with pSS, presenting with dysuria, urinary frequency, and suprapubic pain. She was diagnosed to have chronic IC, based upon the cystoscopic biopsy finding of chronic inflammation in the bladder wall. Systemic corticosteroid and azathioprine treatments together with local intravesical therapies were not effective. Therefore, cyclosporine (CSA) therapy was initiated. Initial low dose of CSA (1.5 mg/kg/d) improved the symptoms of the patient, with no requirement for dose increment. After 4 months of therapy, control cystoscopic biopsy showed that bladder inflammation regressed and IC improved. This case suggests that even low doses of CSA may be beneficial for treating chronic IC associated with pSS syndrome.     

A comparison of four different microleakage tests for assessment of leakage of root canal fillings.

OBJECTIVE: The purpose of this study was to compare four different microleakage tests (dye leakage, electrochemical test, bacterial test and fluid filtration) for evaluation of the coronal seal of teeth obturated using Thermafil or lateral condensation techniques. STUDY DESIGN: One hundred forty-four extracted single-rooted teeth were selected and prepared. The specimens were divided into 8 experimental groups. In 4 groups the root canals were filled with Thermafil obturators and in the other 4 groups by the lateral condensation technique. Coronal microleakage was assessed after exposing one group of specimens (n = 15 teeth) from each of the obturation techniques to each of the four microleakage tests. RESULTS: In the fluid filtration test, lateral condensation showed statistically less leakage than the Thermafil technique (P < .05). Electrochemical and dye leakage test results showed no difference between the two obturation techniques (P < .05). However, in the bacterial leakage test, Thermafil showed less leakage than lateral condensation (P < .05). CONCLUSION: There is poor correlation between various methods to evaluate hydraulic leakage. The clinical significance of leakage tests in vitro is questionable.     

Restorative space management: treatment planning and clinical considerations for insufficient space.

In attempting to provide a restorative solution for cases that have been compromised by spatial considerations, clinicians have traditionally opted for an orthodontic approach that did not provide optimal aesthetics due to changes in tooth morphology, specifically tooth size and shape as a result of dental deterioration. With the advent of contemporary aesthetic materials and preparation techniques, clinicians and technicians are now empowered to deliver a penultimate result with minimal compromise to the surrounding dentition. This article presents the clinical and laboratory considerations that must be addressed when providing a prosthetic restoration for crowded teeth.     

A surgical conundrum: Tessier number 4 cleft.

OBJECTIVE: Among the rarest of the craniofacial clefts is the Tessier no. 4 cleft; and hence little has been published about its management and treatment. Complete forms of the cleft yield poor surgical results because of the shortened oculoalar and oculo-oral distance and inadequate soft and bony tissue. Multiple sequential corrective operations are required. A primary early concern is the protection of the eye, particularly in severe forms in which corneal exposure occurs. This article presents two cases of Tessier no. 4 clefts, one unilateral and the other bilateral, and discusses the problems encountered during their surgical and postoperative managements.     

Complete genome sequence analysis of the Malacosoma neustria nucleopolyhedrovirus from Turkey

The lackey moth, Malacosoma neustria (Linnaeus, 1758), a worldwide pest, causes extensive economic losses particularly on hazelnut, plum, oak, poplar, and willow trees. A baculovirus, Malacosoma neustria nucleopolyhedrovirus (ManeNPV-T2), has been isolated from the larvae collected in Turkey and appears to have a potential as a microbial control agent. In this study, we describe the complete genome sequence of ManeNPV-T2 and compare it to other sequenced baculovirus genomes. The ManeNPV-T2 genome is a circular double-stranded DNA molecule of 130,202 bp, has 38.2% G?+?C, and is predicted to contain 131 putative open reading frames (ORFs) each with a coding capacity of more then 50 amino acids. There are 27 ORFs with unknown function of which 6 are unique to ManeNPV-T2. Eleven homologous regions (hrs) and two bro genes (bro-a and bro-b) were identified in the genome. There are two homologues of chaB and nicotinamide riboside kinase-1 genes, separated from themselves with a few nucleotides. Additionally, ac145, thought to be per os infectivity factor (pif) gene, is also found as two homologues. All 38 core genes are found in the ManeNPV-T2 genome. The phylogenetic tree of ManeNPV-T2 in relation to 50 other baculoviruses whose genomes have been completely sequenced showed ManeNPV-T2 to be closely related to the group II NPVs. This study expands our knowledge on baculoviruses, describes the characterization ManeNPV, and ultimately contributes to the registration of this virus as a microbial pesticide.