Fracture toughness measurements of some dental core ceramics: a methodologic study.

Fracture toughness is regarded as an important property of dental ceramics. The most widely used methods for fracture toughness (KIc) determination are based on assessment of cracks created by hardness indentations. Different formulas have been developed for KIc calculations and all these methods and formulas include empirical factors based on pure ceramics, i.e. non-composite ceramics. These factors may, however, vary for a specified method for materials with different and complex structure. An important question is whether the various proposed methods and formulas lead to approximately the same numerical KIc values or at least to the same ranking of materials. The aim of this work was to compare two indentation methods and various formulas for calculation of KIc values when used on four commercial composite dental ceramics. The two applied methods and the different formulas showed substantial differences in the obtained values for one and the same material and a different ranking of various materials. It is unknown which method gives the most correct KIc values for these ceramic materials.     

Pediatric patients with achondroplasia: CT evaluation of the craniocervical junction

Twenty-six patients (4 months to 6 years old) with achondroplasia complicated by sleep apnea and/or other neurologic manifestations underwent plain computed tomography (CT) of the craniocervical junction; six also underwent CT myelography. For objectification, multiplanar reconstruction was used to complement axial plane measurements by providing coronal and sagittal measurements; multiplanar reconstruction also improved perception of the longitudinal relationships between the brain stem and subarachnoid space. A narrow subarachnoid space was found in all 26 patients; marked cord compression was present in nine, six of whom underwent CT myelography. These six had marked focal obliteration of the subarachnoid space on both plain CT and CT myelography. Since the subarachnoid space immediately above and below the craniocervical junction is normally capacious, when marked constriction was present, no additional information could have been gained from CT myelography. Thus, plain CT was shown to be sufficient for surgical planning (suboccipital decompression) in nine patients with cord compression due to achondroplasia.     

Thrombosis at venous insertion sites after inferior vena caval filter placement

Color Doppler flow imaging or compression ultrasound (US) was used to prospectively determine frequency of thrombosis at 54 venous insertion sites (47 in common femoral veins, seven in right internal jugular veins) after percutaneous placement of Greenfield filters for interruption of the inferior vena cava. Fifty-one filters were successfully placed in 51 patients with a dilator set or a balloon angioplasty catheter. Nine focal thrombi were detected in the common femoral vein (19%) and one in the right internal jugular vein (14%). Use of dilators induced eight thrombi (24%), compared with two (10%) from balloon catheters. The left common femoral vein had a high frequency of thrombosis, regardless of dilation technique (five of nine). Of nine patients with acute common femoral vein thrombosis, four became symptomatic within 10 days after the procedure. Patients may remain asymptomatic or have delayed symptoms; thus, US is valuable for determining patients at risk of thrombosis of the common femoral vein.