Removal of fractured cylindrical implants

The implant fracture is a rare but significative complication which requires a specific treatment for the surgical removal of the fractured fixture and the modification of the initial prosthetic plan. On the basis of the most recent studies and of a case personally observed in which both the osteointegrated supporting implants of a maxillary overdenture were fracturated, epidemiological, etiopathogenic, diagnostic and therapeutical aspects of this complication are analyzed. Clinical situations most at risk are emphasized, including implant-supported maxillary overdenture, and the major etiologic factors, represented by defects in implant design or material and physiologic or biomechanical overload. The diagnostic criteria are described along with the three therapeutical possible options: 1) removal of the fractured implant, replacement of the implant and refabrication of the prosthesis; 2) modification of the existing prosthesis leaving the fractured portion of the implant in place; 3) modification of the fractured implant and refabrication of a portion of the prosthesis. Three surgical removal technics are then illustrated (block-section, vestibular approach, occlusal approach), with the emphasis on the one choosed in the case examined, in which the ostectomy around the remaining fixture has been carried out with a trephine drill in order to contain the bone loss.     

Shear strength of resin developed by four bonding agents used with cast metal restorations.

The evolution of the acid etch technique has made possible a more conservative approach to the fabrication of cast metal restorations. The resin bonding technique, however, places a greater burden for success on the selection of a bonding agent. This study examined the shear bond strength durability of cast metal restorations bonded to tooth structure with one of four metal adhesive bonding agents. Results indicated stronger bonds for restorations cemented with Panavia EX bonding agent than with any of the other bonding agents tested, both with and without exposure to thermal stress. Although it was one of the easier materials with which to work, Panavia EX bonding agent requires the additional step of applying an agent to prevent oxygen contact in the setting process.     

The influence of morphological variation on Candida albicans adhesion to denture acrylic in vitro.

Using denture acrylic pieces coated with either whole human stimulated saliva or oral streptococci, the binding ability of three different Candida albicans strains was investigated. The C. albicans strains include a clinical isolate with the commonly observed, smooth, round colonial morphology (strain 613p), a morphological variant spontaneously derived from the clinical isolate strain 613p (strain 613m1BK) and a clinical isolate from an oral lesion that was also a morphological variant upon primary isolation (strain 228). Levels of adhesion to the acrylic pieces were determined radiometrically using C. albicans cells metabolically labelled with [35S]-methionine. Whole stimulated saliva significantly increased the binding of all strains compared to uncoated acrylic. However, the level of binding of strain 613p to saliva-coated acrylic was significantly greater than the levels observed for the morphological variant strain 613m1BK. Coating acrylic pieces with either Streptococcus sanguis NCTC 10904, Strep. mutans GS-5 or Strep. sobrinus ATCC 27352 instead of saliva resulted in significantly greater binding by strain 613p compared to uncoated acrylic. Pre-coating the acrylic with the oral streptococci did not significantly increase the binding of morphological variant strains 613m1BK and 228 compared to uncoated acrylic. In general, preincubation of adherent streptococci with sucrose to induce the synthesis of extracellular carbohydrate polymers did not significantly increase the binding levels of the C. albicans strains above those observed using streptococci in buffer alone. Compared to its parental strain 613p, morphological variant strain 613m1BK adhered poorly to denture acrylic coated with either salivary constituents or oral streptococci, while strain 228 adhered to the same substrates at an intermediate level. Furthermore, physical disaggregation of clusters of the morphological variant strain 613m1BK did not appear to increase its binding capacity to saliva-coated denture acrylic. The effect of whole stimulated saliva on the adherence of C. albicans 613p to a variety of plastic substrates in addition to denture acrylic was examined. Overall, saliva pre-coating of the various plastics promoted C. albicans 613p adhesion. The adhesion of strain 613p to denture acrylic coated with whole stimulated saliva from each of five different donors or with parotid and submandibular/sublingual saliva from each of two donors was also examined. Regardless of donor, a coating of whole stimulated saliva significantly increased the binding of strain 613p to denture acrylic compared to uncoated acrylic. In addition, a coating of parotid saliva significantly increased the binding of strain 613p to denture acrylic compared to submandibular/sublingual saliva.     

Comparison of Nasometer and listener judgments of nasality in the assessment of velopharyngeal function after pharyngeal flap surgery.

This study examined the relationship between nasalance scores as derived from the Model 6200 Nasometer and listener judgments of perceived nasality for individuals with pharyngeal flaps. Sixteen individuals with pharyngeal flaps read a speech sample consisting of seven sentences for which associated nasalance scores were obtained. In addition, 10 trained listeners were asked to judge the subjects' audiorecorded speech samples for the degree of both hypernasality and hyponasality using two 6-point scales. The mean judges' ratings of hypernasality did not increase systematically with increasing nasalance scores or with decreasing hyponasality ratings. However, as the nasalance scores associated with nasal loaded sentences increased, a systematic decrease in listener perception of hyponasality occurred.     

Risk indicators for periodontitis in a military treatment population.

The association between the periodontal diagnosis and a variety of subject characteristics was studied in a group of 1,783 patients examined at a large military dental clinic. In order of importance, age greater than 30, smoking, male sex, and Filipino racial background were all found to be statistically significant risk indicators for the presence of moderate or advanced periodontitis. A logistic regression equation serving as a predictive model employing these four variables was presented. The strong association found between smoking and advanced periodontitis is consistent with the hypothesis that smoking has cumulative detrimental effects on periodontal health. While these and other risk indicators are neither causative, diagnostic, nor prognostic, they may be helpful in alerting the clinician to more carefully evaluate other clinical signs or laboratory findings of disease.     

Dye leakage in retrofilled dog teeth and its correlation with radiographic healing.

In a previous study in beagle dogs, statistically significant differences in healing were observed radiographically 6 months after apicoectomy and retrofilling with amalgam and varnish, glass ionomer cement, or a composite resin. The purpose of this study was to compare the leakage of these retrofilling materials and to correlate leakage data with healing. After the dogs were sacrificed, 48 roots were extracted. Half of the roots had been irradiated with a CO2 laser on the bevelled root surface after retrofilling. The roots were coated with nail polish, except for their bevelled surface, and were suspended together with positive and negative controls in 2% methylene blue for 8 h. After the specimens were longitudinally split, they were ranked according to the severity of dye penetration, as observed with a dissecting microscope. The differences in dye leakage among the three retrofilling materials were not statistically significant. Consequently, dye leakage did not correlate with the previously assessed healing. Dye penetrated into the root through the bevelled root surface, regardless of CO2 laser exposure of that surface.     

Interactions of sanguinarine and zinc on oral streptococci and Actinomyces species

Sanguinaria extract, which contains benzophenanthridine alkaloids, has been used as a folk medicine for many years. Minimum inhibitory and minimum bactericidal concentrations (MIC and MBC values) for sanguinarine were determined for common and etiologically important plaque bacteria. Because the efficacy of sanguinarine is believed to be enhanced by zinc, isobolograms were assessed to determine their mode(s) of interaction. Hydrogen ion concentration influenced the inhibitory activity of both sanguinarine and zinc. For sanguinarine, at the optimum pH (6.5), MIC values were 4 or 8 micrograms/ml for Streptococcus mutans, Streptococcus sobrinus, Streptococcus sanguis, Actinomyces viscosus and Actinomyces naeslundii. MIC values were 0.125-0.50 mmol Zn/ml. MBC values ranged from 1 to 8 mmol Zn/ml at pH 5.5. Isobologram data revealed that sanguinarine and zinc interacted synergistically. Viadent oral rinse, which contained 300 micrograms sanguinaria extract/ml and 0.2% zinc chloride (14.9 mmol Zn/l), was inhibitory to all strains tested. MIC values were 1 or 2% (ml Viadent oral rinse/100 ml aqueous solution) for all strains except A. viscosus for which the MIC value was 12% (vol/vol).     

The normal and diseased periodontium and periodontal disease activity

Scientific knowledge regarding the cellular and molecular biology of the periodontium in health is fundamental to the determination of how periodontal diseases begin and progress. Advances in diagnosis and treatment are in turn becoming increasingly dependent upon advances in the molecular biology of inflammation-induced changes in the periodontal tissues, and the regenerative capacity of the periodontal cells. New in vitro cell culture models, a broadening array of monoclonal antibody reagents, and general advances in scientific methodology have presented the field of periodontal research with excellent opportunities to explore the mechanisms of tissue destruction, as well as test innovative means to induce tissue regeneration. Laboratory and clinical findings in the past year have led to major expansions in how we perceive the pathogenesis of periodontal diseases, and also have altered our long-held beliefs about periodontal disease activity.     

Antimicrobial effect of chlorhexidine in a controlled release delivery system

Chlorhexidine is widely used as a mouth rinse in the prevention and treatment of periodontal diseases and dental caries. The purpose of the present study was to evaluate the in vitro antimicrobial effect of chlorhexidine in a controlled release delivery system. The controlled release dispenser comprised a polymeric inner core matrix containing the medicament with an outer vinyl membrane controlling the drug release. The effect on the following bacteria was studied: Actinobacillus actinomycetemcomitans, Actinomyces viscosus, Streptococcus mutans, Wolinella recta, Bacteroides gingivalis, Bacteroides intermedius, Eikenella corrodens, Pseudomonas aeruginosa, Enterobacter aerogenes, and Enterobacter cloacae. Chlorhexidine-containing vinyl patches with a diameter of 5.5 mm were placed on blood agar plates containing the various bacteria. The plates were incubated aerobically or anaerobically at 37 degrees C for 24 h or longer, when appropriate, and examined for inhibition of bacterial growth. Distinct zones of inhibition were seen surrounding all vinyl patches on all plates with all bacteria. Thus, the vinyl dispenser appeared to be an effective vehicle for releasing chlorhexidine to a localized area such as the surface of a tooth, a periodontal pocket, or a root canal.     

免疫化疗与TIUL得率及其杀瘤活性测定

Tumor-infiltrating lymphocyte (TIL) in the primary site of oral SCC treated with S-PVP of PVP therapy was collected respectively and its yield,that is calculating the amount of TIL per tumor tissue.The cytotoxicity of TIL against the target,Tca8113 was detected.The results showed that the yield of TIL in S-PVP group was three times over that in PVP group.At the ratio of 5 to 1 (effector to target) the cytotoxicity was 38% in S-PVP group and 32% in PVP group.There was no significant difference in its cytotoxicity between two groups.The results revealed that immunochemotherapy of S-PVP regimen for treating oral SCC had neither direct damage to tumor cell from the agents nor antitumor immune reactivity with BRM stimulating an increasing in numbers of TIL.