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.     

Multiple idiopathic cervical resorption: a diagnostic dilemma

Multiple idiopathic cervical resorption is an uncommon condition, the etiology of which remains unknown. The case of a 36-year-old woman with idiopathic resorption in the cervical areas of multiple teeth is presented. Her medical history was noncontributory, but her dental history was valuable in reaching a diagnosis. Hematologic and endocrinal investigations were unremarkable, but a computed tomography scan revealed relevant information. The progression of the lesion and involvement of multiple teeth without any pattern or chronology are challenges faced when diagnosing and treating this condition.     

Ewing's sarcoma of the lesser sac masquerading as a pancreatic tumor

Extraosseous Ewing's sarcoma/primitive neuroectodermal tumor (ES/PNET) is an uncommon, aggressive, and malignant tumor with a poor patient outcome. Its occurrence in the lesser sac is a rare event and to the best of our knowledge, has not been previously described. The present case was clinically and radiologically misdiagnosed as a pancreatic tumor/gastrointestinal stromal tumor. Histopathology revealed a tumor with "small round cells" that were positive for CD99, confirming the diagnosis of ES/PNET. This report highlights the importance of considering Ewing's sarcoma in the differential diagnosis of intraabdominal, extraintestinal masses.     

Volumetric and surface-based 3D MRI analyses of fetal isolated mild ventriculomegaly

Diagnosis of fetal isolated mild ventriculomegaly (IMVM) is the most common brain abnormality on prenatal ultrasound. We have set to identify potential alterations in brain development specific to IMVM in tissue volume and cortical and ventricular local surface curvature derived from in utero magnetic resonance imaging (MRI). Multislice 2D T2-weighted MRI were acquired from 32 fetuses (16 IMVM, 16 controls) between 22 and 25.5 gestational weeks. The images were motion-corrected and reconstructed into 3D volumes for volumetric and curvature analyses. The brain images were automatically segmented into cortical plate, cerebral mantle, deep gray nuclei, and ventricles. Volumes were compared between IMVM and control subjects. Surfaces were extracted from the segmentations for local mean surface curvature measurement on the inner cortical plate and the ventricles. Linear models were estimated for age-related and ventricular volume-associated changes in local curvature in both the inner cortical plate and ventricles. While ventricular volume was enlarged in IMVM, all other tissue volumes were not different from the control group. Ventricles increased in curvature with age along the atrium and anterior body. Increasing ventricular volume was associated with reduced curvature over most of the ventricular surface. The cortical plate changed in curvature with age at multiple sites of primary sulcal formation. Reduced cortical folding was detected near the parieto-occipital sulcus in IMVM subjects. While tissue volume appears to be preserved in brains with IMVM, cortical folding may be affected in regions where ventricles are dilated.     

Corticosteroids in Duchenne muscular dystrophy: Major variations in practice

Introduction: In 2004, a Cochrane Review and AAN practice parameter concluded that prednisone 0.75 mg/kg/day is of short‐term efficacy in Duchenne muscular dystrophy (DMD). Subsequent efforts to standardize care for DMD indicated wide variation in corticosteroid use. Methods: We surveyed physicians who follow patients with DMD, including: (1) clinics in the TREAT‐NMD (Translational Research in Europe—Assessment and Treatment of Neuromuscular Diseases) network (predominantly Europe) and (2) U.S. MDA clinic directors. We also documented the co‐administered corticosteroids in a trial of a putative treatment (ataluren) for DMD. Results: Of 105 Treat‐NMD clinicians, corticosteroids were not used in 10 clinics, and 29 different regimens were used—the most frequent 0.75 mg/kg/day prednisone (61 centers); 10 days on/10 days off (36 centers); 0.9 mg/kg/day deflazacort (32 centers); and 5 mg/kg/day on weekends (10 centers). Similar diversity was identified in MDA clinics and in the ataluren trial. Conclusions: Variability in corticosteroid use suggests uncertainty about risks/benefits of corticosteroid regimens for DMD. Muscle Nerve, 2013