Clinical and laboratory factors contributing to uninterpretable beryllium lymphocyte proliferation tests (BeLPT)

Background

The beryllium lymphocyte proliferation test (BeLPT), has become the principal clinical test for detecting beryllium sensitization and chronic beryllium disease. Uninterpretable BeLPT results can occur in a small but significant proportion of tests from poor lymphocyte growth (PG) or over proliferation of lymphocytes (OP). The clinical and laboratory causes of uninterpretable results are not known.

Methods

BeLPT data from the US Department of Energy‐supported Former Worker Screening Program were analyzed for a 10‐year period. Drivers of uninterpretable BeLPTs were investigated using multivariable models and classification techniques.

Results

Three participant attributes were significantly associated with PG, while OP showed no significant associations. Serum lot for the lymphocyte growth medium accounted for 21% of the variation in PG and 16% in OP.

Conclusion

Serum lots influence the likelihood of having uninterpretable BeLPT. To better understand uninterpretable results and possibly reduce their occurrence, additional laboratory‐related factors should be addressed.

     

Accuracy of Irreversible Hydrocolloid Impression Material Mixed With Disinfectant Solutions

Purpose Irreversible hydrocolloid is capable of resisting contamination by viruses and saliva when the disinfectant iodine or the disinfectant chlorhexidine is added to the water being used to mix the material. This study investigates the accuracy of alginate impressions made with water to which either of the two disinfectants has been added. Materials and Methods A total of 30 casts were made from an impression of a master cast. Ten impressions were made using water according to the manufacturer's instructions, ten were made using water to which iodine had been added, and ten were made using water to which chlorhexidine had been added. A measuring microscope was used to measure three different dimensions on each cast. Each measurement was repeated three times, and the average was used to compute the mean and standard deviation for each measured dimension. The data were statistically evaluated using a one-way analysis of variance. Results There was no statistical difference in the accuracy of irreversible hydrocolloid impressions mixed with water or with either of two disinfectant solutions. Conclusion Accurate casts can be obtained when either of the two disinfectants are incorporated into the alginate impression material.     

Fabricating Crowns to Fit Existing Removable Partial Dentures: An Illustration of Two Techniques

The prosthetic treatment of a structurally compromised abutment tooth supporting a removable partial denture may present a variety of restorative modalities. Ideally, a surveyed crown is made for the individual tooth, which is later followed by a new removable partial denture fit to the contours of the crown. Frequently, however, the removable partial denture is clinically acceptable, and remaking the prosthesis is not indicated. In these cases, the crown can be made to fit the existing removable partial denture. Fabricating crowns to fit existing removable partial dentures can be accomplished using a direct method, an indirect method, or combinations of these techniques. Direct techniques traditionally use acrylic resin and inlay wax intraorally to develop a custom pattern that captures the contours of the clasp assembly. Indirect techniques use a pick-up impression to allow the crown pattern to be waxed against the denture framework on a cast in the laboratory. Combination methods use either a direct-indirect or indirect-direct approach. The direct-indirect method develops the preliminary resin pattern directly on the tooth and finalizes the contours in wax on a master cast. The indirect-direct technique initiates a crown pattern on a die and completes it either intraorally or on the die after the intraoral refinements. This article reviews the literature for methods of fabricating surveyed crowns under existing removable partial dentures. Additionally, two cases are presented that illustrate an indirect and combination direct-indirect technique for making the restorations.     

Clinical evaluation of patients with temporomandibular joint implants

PURPOSE: An undetermined number of patients with temporomandibular joint (TMJ) symptoms have been treated with intra-articular disc implants composed of Teflon ethylene/propylene or Teflon polytetrafluoroethylene and aluminum oxide (Proplast-Teflon; Vitek, Houston, TX). These implants have shown the potential to fragment in situ resulting in nonbiodegradable particles that stimulate a giant cell reaction and lead to degeneration of local structures, pain, and limitation of mandibular opening. We examined the possible relationship between TMJ implants and persistent pain, responses to sensory stimuli, quality of life, and systemic immune dysfunction. PATIENTS AND METHODS: This case series (32 patients) were referred from university-based orofacial pain centers and private practices from across the United States. Laboratory and clinical assessments evaluated orofacial pain symptoms, neurologic function, clinical signs and symptoms of rheumatologic disease, physical function, systemic measures of immune function, and behavioral measures. RESULTS: We found that TMJ implant patients appeared to have altered sensitivity to sensory stimuli, a higher number of tender points with a diagnosis of fibromyalgia, increased self-report of chemical sensitivity, higher psychologic distress and significantly lower functional ability. Systemic illness or autoimmune disease was not evident in this series of TMJ implant patients. CONCLUSIONS: Significant problems were noted on clinical assessment of TMJ implant patients. This is a US government work. There are no restrictions on its use.     

The image intensifier in oral and maxillofacial surgery

The mobile image intensifier has been found useful in the removal of foreign bodies from both intraoral and extraoral sites. The safety of the machine has been verified, and a technique for its application is described. Additional uses for the machine are stated.